the problem is, the costs are skyrocketing with our health care system. every family, every business, every individual in this country is impacted by the cost of health care. and not just with what you're paying directly for your health care costs. what your co-payment, premium, deductible is. but the cost of everything you buy in this country is higher because of health care costs. we use the example of an american-made car. $1,500 of the price of every car made in this country goes to health care costs. the health care corses of the workers who are involved in putting that car together. but it's more than that. it's every level of the supply chain. every segment. if you think about the company that manufacturers the good, the people that ship the good, the people who receive it and stock the shelfs and the people who sell it at every level, there's a component of cost that is increased because of health care costs of the company involved in that. every level of the supply chain. . every segment of our lives health care is a part of that. what we are try

and the cost of the bill. oddly, that's the appropriate place where those conversations should be going on and i believe the committee established a feedbackroup now between us and the gao in terms of the cost of whatever title. however, let's talk about cost and what prevention and quality is. there are many things in here when you score the cost -- my father used to say, basrb, sometimes you have to spend money to make money. we have to save money to spend money. i didn't sit here while i was getting a manicure and wrote up five ideas on how to achieve quality. we had extensive hearings in terms of public experts in the area, number two the consensus in that area about what needed to be achieved, number three, estimated costs that it would be based on real life experiences. like the north carolina approach on medical homes. the management, the patient safety implementation, the checklist that was developed that saved michigan $200. we went and held extensive haegz and went to the public domain on the consens

so i think the cost number there is a myth. there are lots of arguments to support my position but one thing that always comes back to me is if you're going to say that in a situation where there's negligent or intentional conduct that leads to injury, serious injury, if you're going to say that you can have no, and i believe punitive damages help and i support them when a jury imposes them. but if you're going to say that you can only get, say, economic damages, you cannot get damages -- you cannot have punitive damages or damages for pain and suffering, what you're saying, for example, to -- let's say there's a woman who for a variety of reasons was not in the work force for a long time, didn't develop earning capacity because she was at home for many years and didn't work outside the home. what you're saying to her when you have these laws that are passed to limit her damages, because you don't have -- your earning capacity is limited, you're limited to what that capacity tells you. on top of that, you're not getting anythin

the goal is to lower your costs and the cost for all americans. host: linda debose is from the white house office for a care reform. there is a tweed saying, ms. douglas, why does this radical plan have to be implemented during a recession? it will only add to inflationary pressures. guest: i would certainly quibble with the word "radical," but one of the reasons that we're doing this is because we are struggling in our countries. this is -- in our country. this is squeezing our businesses and making it difficult for them to compete globally and to compete with businesses that do not provide health insurance because they cannot afford those costs. they cannot hire more workers. one of the reasons we're having a difficult time digging out of this economic trouble that we are in right now is because there is the way, the burden of these high health care costs on all businesses in this country. we pay twice as muc for health care as any other country in the world. we do not necessarily have better outcomes, but we are spending a lot of money on healt

between 1 trillion to $2 trillion in costs the next year. let me ask you this, if it does cost between one or $2 trillion depending upon whether it is the kennedy bill or the bill being considered by the finance committee, what new taxes or savings would the administration recommend to make sure we don't add to the deficit? >> well, senator, as you probably know in the 2010 budget the president recommended about $630 billion worth of both savings and revenue enhancements. we've also suggested after reviewing the overall medicare programs that within the medicare program we think another to to $250 billion is possible in terms of savings. there is no question that the additional and enhanced efforts on fraud and abuse will generate some additional savings, and he has had a lively discussions with members of house and senate about their ideas for funding the remainder of the program, but i think the good faith effort by the president and it's a demonstrated in this budget moving forward to come in with a substantial investment in reform moving

we with want the costs controlled. we want a viable health care industry that continues to produce 75% of the world's innovations in health care. now, i practiced medicine for almost 26 years. most of you don't know that prior to that i ran a business producing medical kwiesdevices. so i have the experience from being on the supplier side as well as the provider side. what is broken in this country is not health care. what is broken is the federal government thinking that we have answers and we provide solutions when there's very little information that goes into that process and it's limited information. it's circular knowledge. it lacks the test of what's happening in the real world. the problem in health care, a lot of it can be directed to medicare. we heard testimony about the lack of primary care physicians. why do we have a lack of primary care physicians? we have a lack of primary care physicians because medicare payment made it that way. a government program that we all think is necessary caused the shortage i

that added to the cost. simultaneously, the overall economics began to fall out of the bottom as we saw new plants go by the wayside. it came to a point where it was not given that time, especially with the ridiculously high interest rates, it was not economical to build such a facility. it was a decision by the industry. from a public policy standpoint, president ford did it during the campaign. it was followed up on by president carter. he took it off officially. but president reagan came back three years later and said to have at it. but the economics have changed. >> by then, it was too late. >> it really comes down to price. >> i still blame jimmy carter. [laughter] thank you, senator. >> the other problem that seems to stand away is economics. what are we going to do to make sure that senator alexander's bill is actually implemented once enacted? how much is it going to cost? what will we have to do to the permitting and regulatory process? are we going to have to enact some litigation shortcuts so tha

a recent new yorker magazine article showcased the mayo clinic in the contests of health care's costs problem. according to an author, a physician, we're in a battle for the soul of american medicine. on one side is a fragmented volume-driven model that too often crosses into profiteering. there are good parts, believe me. i know this. i live in minnesota. we have to maintain those. but we have to fix this broken cost structure. on the other side, you see this model offered by mayo and other institutions across the country where doctors collaborate to provide the best, most efficient care for their parents. patient. on one side it is financially and morale unsustainable. on the other side is a new direction that promises to cub b costs and it is time to choose sides. for the sake of fiscal health and the sake of millions struggling to afford the care they need i urge my colleagues to choose the ladder. yesterday, i met with a bipartisan group of senators. i have to tell you i still have hope we're going to get this done. i have hope there will be bipartisan support for this. the thing

at some of the lowest costs in the nation. we should learn from their successes and promote the best practices, not the most expensive ones. this week, i conveyed to congress my believe that any healthcare. that means, if you like the plan you have, keep it. if you like the doctor you have, keep it too. i have made it clear, we must develop a plan that doesn't add to the bunlet deficit. we will work with congress tofully cover the costs through rig rouse spending redugs. we'll eliminate weavet fraud and abuse and take offer -- take on healthcare costs. >> in the "washington post" it is written. >> michigan on our line for independents. good morning, mike. >> good morning. let me say this to the democratic congress. if you believe we are going to spend our money to support insurance companies, you people have lost your mind. i think democrats want to loose in the midterm elections. go ahead and come up with a healthcare that is provided by these hacks insurance company. if you figure out that $100 million people paid $100 a hea

. -- 21 csi, we have seen as the nation the cost of a hot war, and the cost in terms of people, and blood and treasure. can you talk a little bit, is the key to it looking at the benefits of deterrence and how you put a price tag on that. >> absolutely. i think that there is no question that it is -- it is not -- and it's not just a cost issue, either. i mean, the need to do everything that we can to prevent war is more than a dollar value. it is this cost of human treasure. and so i believe you will see as an outcome of the qdr, the types of capabilities that will allow us to be more in the prevention regime, and that is why i feel quite good about the strategy that we have set, where we clearly articulated in our strategy, almost two years ago, that preventing wars is important as winning war. and why you you know -- the increased emphasis on things like maritime security regimes, where we can go in and work with friends and partners, to alleviate the type of activity, you know, transnational criminal activity that can produce those types of frictions that can then resulted in conflict.

he is well aware of what costs will be entailed in how the costs can be met. and american electric power has taken a real lead among utilities across this nation and in fact around the world in demonstrating the state of the art technology for carbon dioxide removal from the combustion process. in fact, on one of its facilities in west virginia, american electric power is on the verge of installing a new technology known as controlled ammonia. this application can remove the carbon dioxide and prepare it for storage underground. at that facility, they also have an underground storage cavity. at the same time that the co2 is removed, it will be permanently sequestered. this utility is leading the way, the largest coal user in the united states, showing that this can be done. it will be done in a way that is very affordable for the american public. let me stress again that the environmental protection agency says through its independent analysis that the cost of this measure, with all factors taken into account, will be somewhere between $77 and $111 for the typ

lowering the cost of health insurance. also, they say the number one priority is to expand health care coverage so that americans who do not have health insurance can get it. those two goals are very important, but the most important goal is to determine whether you live or die, to make sure that especially if you are facing health care challenges of the most severe degree, you have the greatest chance for you or a member of your family to survive. this is most clear in the case of cancer. when a patient, when you or i or a member of our family gets that terrible diagnose from a doctor that you will be fighting cancer, the question asked, how much time do i have? will i be able to able to survive. "the "lancet" did a cancer survival study of cancer rates and found you are more likely to survive in the united states than you are in european countries. they looked at a number of different cancers. prostate cancer, 78% survival rate in europe, which is fairly good, but a 99% survafle rate if found in the united states. bladde

including with the associated transmission costs. the alternative view is that they should plan and cite transmission that would connect areas with strong renewable resources to areas of high electric demand via some green transmission super highway paid for by taxpayers. under this model, thinkment would pick technologies and locations and build transmissions to facilitate them. i have strong views about this approach. first, it can lead to expensive outcomes. all business owners know that if they establish the fact to keep production costs down they have to weigh that against shipping costs, but if we socialize shipping costs of renewable generation, we skewed decisions away from locally based options that may have a lower total cost. that is why a bipartisan coalition of ten northeastern governments wrote to congress warning that this policy would undermine their efforts to grow renewable industries. moreover, building thousands of miles of transmission lines in anticipation of the arrival of renewable generation may lead to an ex

>> the reality is the cost about the same enemy look at the cost of transmission to move power from west to east there is significant cost involved however if that coast is ignored in everybody pays the same price regardless of how offered myths the changes the economics and yes decota wind would then be more economic on that basis once the cost of transmission is ignored, then michigan or the east coast. we don't think that is the right way to look at it. >> one of the things that we are trying to accomplish obviously in the waxman-markey bill is to generate renewable electricity and renewable energy jobs generally in all 50 states. so mr. izzo had the plan. along with many other people in new jersey, to generate new renewable energy jobs that help with the employment in his company but in the state of new jersey as well. and, we don't want to invoke the law of unintended consequences and have the standard imposed upon the jersey and not have the jobs created in new jersey especially if they have the richest renewable energy resources to write off their shore. mr. anguish. >> mr. chairm

we know the cost of doing nothing. without reform small businesses will pay $2.4 trillion in health care for their employers over the next decade. reforming the system and controlling costs could save those small businesses $800 billion by 2018, and save $168,000 jobs unless we do nothing. currently 46 million americans lack health insurance. we know the economic costs of that. in 2008 federal, state, and local governments paid $42.9 billion to reimburse the uncompensated cost for visits to health clinics and hospitals. by the uninsured. that place as tax burden on every american of $627 a year, madam speaker. if we continue doing nothing, the tax burden in inflation adjusted dollars will nearly triple by 2030. a health insurance cost continue to rise, and they l. and as more americans find themselves unable to afford insurance, and they will, those reimbursement cost also skyrocket. we know the cost of doing nothing and we cannot afford that cost. americans have the most expensive health care system in the world. true

the only reason doctors aren't delivering babies in those regions is because of the cost of the errors and omissions policies. believe me, the harm that's caused as a result of not having a doctor within a reasonable distance is -- far exceeds, i think, the anecdotal statements from the senator from rhode island. in addition, this doesn't cut off recovery. if it cut off recovery, the people of texas would have rejected it. the people of california would have rejected it. two of the largest states in this country are under this regime already. this simply creates an opportunity for the baby doctor to practice in a rural area. how many programs have we talked about today, 20 or 30 or 40 or 50? that have been directed at getting doctors, primary care doctors, into rural america or out of the cities where they're concentrated. probably couldn't do anything more constructive in that area than to allow doctors in those areas to be able to deliver babies. they're still going to have to pay an errors and omissions policy. they're still going to be subject to liability. liability's still there.

the costs. the problem is they do not print money. they raise rates. the cost of electricity will go up dramatically. in my state of arizona, we got a letter from r utilities in response to a request, and they said that in the first year, the cost of electricity will go up at least 2% to 3%. the problem is that those costs going up are imposed upon you and i, and they damage the economy. as for whether carbon dioxide it is depleted? the john and said i in peach myself. i want to be reasonable about the issue, but the evidence seems to be -- in the rest of the world, skepticism about manmade carbon dioxide causing global warming is not just appearing in australia, where the article was written, but in japan, germany, and other places around the world. in the czech republic, only 11% of people believe carbon dioxide created by man is causing this problem. you heard a pretty good reputation of both sides of the debate. host: let's go to the democratic lonine. kay from minneapolis, minnesota. caller

customers of the lowest possible cost. and neither can the government. that is why i strongly support policies such as our es and carbon pricing the sampras signals to the market and on leash creativity and entrepreneurial spirit of the american people. thank you. >> thank you, mr. izzo. the next witness is joe nipper for governmental affairs of the american public power association representing the nation's more than 2,000 community owned electric utilities. thank you for being here and whenever you are ready please begin. >> thank you and members of the subcommittee i appreciate the opportunity to be here. we represent the interest of 2,000 publicly owned state and locally owned utilities across the country collectively serving 45 million americans. american utilities collectively own about 8% of the nation's transmission lines of 138 kilovolts or greater and the great majority is members of transparent that is dependent on facilities owned by oberst require of the electricity they need for their retail customers. our me

but premiums and co-payments under the public auction will cover the cost? >> that is my understanding. >> the public auction must adhere to the same rails and regulations as all other plants? >> that is correct. >> the public option will be administered by a separate agency from the one that runs the exchange? >> that is the way the draft is written. >> the public option will offer the same minimum benefit designed as all other plans in the exchange? >> yes, a level playing field. >> individuals and families will be permitted to apply subsidies toward both public and private plans in equal fashion? >> yes, sir. >> i apologize to you. we have a lot of business to do. madam secretary, there has been concern over the consolidation of the health insurance market and the impact it has on health insurance claims. according to the american medical association, 94% of the insurance market in the united states are now highly concentrated. this has decreased the amount of competition. this is a major problem of health concern. >> there is a monopoly and much -- in mu

pricing the cost of health insurance is going

i-2035 alone, the total cost is over $4,600. -- by 2035 alone, the total cost is over $4,600. we estimate of losses averaging 1.4 5 million from 2012 to 200035. these are net losses after the much-hyped green jobs are taken into effect. many jobs will be outsourced to nations like china and india who have repeatedly stated they will not help -- they will not hamper their own economic growth for the sake of energy policy. higher gasoline and diesel fuel costs, higher electricity costs, higher natural gas will erode profits which are expected to drop 28% in 2012. as with american manufacturers, it puts farmers and the global disadvantage. other food-according nations will have no comparable measures in place. overall, it reduces gross domestic product by an average three and $93 billion annually and cumulatively by 9.4 -- $9.4 trillion. these costs are not distributed evenly. low income households would be hit harder in average. of course, part of this is to give back some revenue to low- income households, but in my view, it will only restore part of what was taken off from hou

levels the cost is shifted to the private sector than congress comes in complaints about the cost of the private sector. yet they are responsible for its. we'll there be lower administrative costs in the public option? no. we have the actuarial firm to a study of two years ago medicare head and administrative costs when they talk about the 2% administrative costs that is simply what a cost to pay the bills. the rent on the building, salaries, management , insurance, all of that comes under other parts of the federal budget. that is what the study did go up during it in the of budget even the prod the office of inspector general comes under a different budget and the medicare administrative costs. those are actually very high they may not be quite as high as the private sector but very high and they will be higher in the public plan. then there's the startup cost of yugo start an insurance company you have to raise millions of dollars to have been reserved the federal government will not do that it will just hit the taxpayer for it and claim it as a savings. in addition what if the pr

interest of african americans, both legislatively and in the civil war, the extraordinary cost don't necessarily contribute to the better angels of our nature. i think we've got a long way to go to achieve that ideal of equality of opportunity in this country. but we've come a long way toward a more perfect une 81 and i think we always -- union. and i think we should acknowledge that. >> we'll be right back with our reporters. >> david, what political position are the republicans in right now? >> frustrated. they don't have the numbers. democrats in congress and for that matter the white house know they can get things done without them. there's very telling last week when senate majority leader harry reid was asked to in effect define bipartisanship on health care because for weeks we've heard that democrats want 70, 80 votes to pass health care because it's so broad and so all-encompassing. and senator reid said i'll consider it bipartisan if i can get three or four republicans. that's it. and after, democrats control 59 senate votes and i believe 258 house votes. touf check me on t

when it comes to the cost of our health care, the status quo is unsustainable. [applause] reform is not a luxury, it is a necessity. when i hear people say, well, why are you taking this on right now, you've got these other problems, i keep reminding people, i'd love to be able to defer these issues, but we can't. i know there's been much discussion about what reform would cost. rightly so. this is a test of whether we, democrats and republicans alike are serious about holding the line on new spending and restoring fiscal discipline. but let there be no doubt, the cost of inaction is greater. if we fail to act -- [applause] if we fail to act, and you know this because you see it in your own individual practice, if we fail to act, the roles of the uninsured will swell to include millions more americans, which will affect your practice. if we fail to act, one out of over $5 we earn will be spent on health care within a decade. in 30 years, it will be about one out of every $3, a trend that will mean lost jobs, lower take home pay, shuttered businesses and a lower

the cost of failure for the last three to four decades has cost this country. progress will be far less expensive than failure. my children, my grandchildren and the generations to come will be either the beneficiaries of our stewardship or the victims of our neglect. i urge my colleagues this day to reject this substitute not because it is bad for the words -- words that it incorporates, because its effect would be to stop action so desperately needed by this country and this globe. i urge my colleagues, defeat this substitute, pass this bill, take this historic opportunity for our children, our grandchildren and generations yet unborn. i so a lot of power without any congressional oversight. now i really hate to do this, but when you file a 3---- 300-page amendment at 3:09 a.m., the american people have a right to know what's in this bill. they have a right to know what we're voting on.

the cost of failure for the past decades have cost this country. progress will be far less expensive than failure. my children, my grandchildren, and the generations to come will be either the beneficiaries of our stewardship

over the cost of this same time, health care costs went up by 80% and the cost of higher education went up by 60%. these are not nice to have, these are essential things if our middle class is to remain intact and we're to preserve the american dream for the next generation of americans. our revenue as consumers have been far outstripped by costs of things that are essential to all of us. it is one of the reasons we find ourselves in the fiscal mess we're in. in order to finance that gap, we piled on credit card debt. we had home mortgage loans we couldn't afford, all to try to finance this gap. it's unsustainable. it's a house of cards and we're dealing with the consequence now already some coloradans are seeing cutbacks on the benefits of their coverages and some businesses are no longer able to afford coverage for their workers. faced with the unchecked increases, health coverage is a luxury some families an small businesses can afford. many people are cutting back on other essentials, visiting the doctor less frequently even when they know they need care. we must meet this economic

the cost of failure for the last three to four decades has cost this country. progress will be far less expensive than failure. my children, my grandchildren and the generations to come will be either the beneficiaries of our stewardship or the victims of our neglect. i urge my colleagues this day to reject this substitute not because it is bad for the words -- words that it incorporates, because its effect would be to stop action so desperately needed by this country and this globe. i urge my colleagues, defeat this substitute, pass this bill, take this historic opportunity for our children, our grandchildren and generations yet unborn. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from virginia. mr. forbes: madam speaker, could i request how much time is remaining? the speaker pro tempore: the gentleman from virginia has 3 1/2 minutes remaining. the gentleman from california has 10 minutes remaining. mr. forbes: madam speaker, i'd ke to yield myself 1 1/2 minutes, please. the spe

what accounts for the bulk of the costs is the nature of our health care delivery system itself. a system where we spend vast amounts of money on things that aren't necessarily making our people any healthier. a system that automatically equates more expensive care with better care. now a recent article in "the new yorker" for example, showed how mcallen, texas, is spending twice as much as el paso county, twice as much, not because people in mcallen, texases -- mcallen texas, are sicker than el paso, not because they're getting better care or outcomes, it's simply because they're using more treatments. treatments that in some cases they don't really need. treatments that in some cases can actually do people harm by raising the risk of infection or medical error. the problem is, this pattern is repeating itself across america. one dartmouth study shows you're less likely -- you're no less likely to die from a heart attack and other ailments in a higher spending area than in a lower spending area. there are two main reasons for this. the first is, a system of incentives where the

and what is the cost? >> when i come up with legislation i usually have the cbo numbers before i introduce a bill. >> we're trying to get language appear that has the numbers we cannot run the numbers until we kraft the language. >> they run the numbers it is $1 trillion. >> weir unprecedented no question with health care a lot of things we're talking about cbo is under pressure from the house and finance committee to produce numbers on various ideas for commonality but it is the check-in and the eight numbers language without the numbers makes the question obvious that what does it cost? if i cannot answer the question then the indictment is you put up the language without the numbers so we try to accommodate both and is simultaneously recognizes by the rules of 24 hours which is a normal process that is difficult to do so i want to accommodate that senator burr has raised to give adequate time for people to respond so you can have amendments ready if you are not happy with the cbo numbers provided. >> mr

the cost shifting. i've heard it is about $100 per family that goes to paying for the cost of indigent care. is that about right? >> i would have to check the numbers. it is certainly substantial. >> thank you. >> can you say a word about the cost of covering prenatal care and early child comprehensive care? >> i think that certainly goes to mr. kaplan's point. in terms of preventive care that has a good pay off, i feel very strongly with the evidence suggesting prenatal and child care is crucial. >> the medicaid program has a program epsdt. are you familiar with that? it is a comprehensive set of benefits. it is -- is it essential that that same set of benefits, which includes preventive screening tests be available on all accounts? . . when we think about setting up a public auction, it will be able to put competitive pressure on private firms because there may be more administrative costs. >> is there much difference between the two? >> i believe it is substantial. >> the 25%-45%, is that the magnitu

for the government, the growing costs of medicare and medicaid is the biggest threat to our federal deficit. bigger than social security, bigger than all the investments we have made so far. if you are worried about spending and your word about deficits, you need to be worried about the cost of health care. we have the most expensive health-care system in the world, bar none. we spent almost 50% more per person on health care than the next most expensive nation. here is the thing, green bay. we are not any healthier for it. we do not necessarily have better outcomes. even within our own country, there are a lot of places where we spend less on health care but actually have higher quality than places where we spend more. it turns out green bay is a good example. right here in green bay, you get more quality out of fewer health care dollars and many other communities across this country. [applause] this is something to be proud of. i want to repeat that. you spend less, you have higher quality here in green bay and in many parts of the country. but across the country, spending on health care

the doctor-patient relationship because that is where the cost, the primary cost driver at the intersection of that relationship. there are secondary cost drivers in the insurance market. what i like about what we have done, we have taken a comprehensive look at this because my goal was to ensure that all americans have the highest quality access to a doct doctor. and our plan will do that. we also look at the insurance markets and make some substantive reforms in the insurance markets creating a wide range of choices that will open things up for americans and create different options for different families, small businesses and so forth. so, we have taken a comprehensive look at this. but i have to say once again, if you don't focus on the doctor-patient relationship, the behavior of the doctor and behavior of the patient and where that intersection occurs, or where it doesn't occur, that is where we are really driving the costs with utilization, care in the emergency rooms and so forth. so we focused on all those things i have just mentioned and i believe we have a very good plan that wil

the services costs in the hundreds of dollars. the surgery-related to diseases not caught early are in the continues of thousands of dollars. it makes sense economically and president obama's right to invest in health information technology that will save money and also manage individuals' care in a more effective way. so there are a lot of ways to bring down the cost of health care but let me talk about one issue that has a lot of attention on this floor by some of my colleagues that seem to be opposing health care reform before we have a bill before us. that is the conversation about a public insurance option. mr. president, i'm somewhat bewildered by the discussion because i don't hear to many of my colleagues suggesting the medicare system should be done away with. the last time i checked medicare was a public insurance program. but let me differentiate because this point has been misled on the floor that within you is a government or option it doesn't mean the government provides the health care. it means it pays for the heal

your cost could be cheaper, especially if the fuel costs go up more for the other sources. >> we have got to compare the theoretical and the real world. senator alexander pointed out some in his speech at oak ridge that the attorney general of connecticut was complaining at one point that the nuclear power guys were making so much profit that they ought to put an extra windfall tax on them. i am looking at finland. finland is complaining. i am reading the words of the finnish government. the lower price and the fact that the nuclear plants do not have to fool with the carbon trading costs, they do not have the uncertainties that other people have, all of this means they are making unfair and unearned income. it has become so profitable. the french presumably share that situation. it is becoming so profitable that they ought to turn it back to the government. sweden is doing a similar thing. norway is doing it. in belgium, the government is no carrierringconnect 1200 250 n >> it is not exactly a fair comparison. france was facing the same decisions we were. they decided they did not wa

, the costs rose. but the ability of the taxpayers to meet the rising costs was limited. what does the government do? it restricts care. it denies treatments. it denies service. it rations care. that's sort of a microcome. that's what happens in massachusetts and perhaps other western european countries or canada. i'm not here to either praise or condemn those systems. in western europe, the united kingdom, or anywhere else. they're different systems. people need to understand that. what happens in those systems when the costs continue to rise for health care and there aren't the tax dollars to meet the costs they deny care. i think we all know that -- we know that people are concerned about cures, not treatments. they want to be treated like human beings, not numbers. unfortunately, that can happen in those systems when off single payer system, take a number, wait for dialysis, wait for hip replacement if you can wait that long. if you're canadian, if you have the money, come across the border and get

they use the term cost shifting. a budget cost shifting. as you move towards public health insurance, how are you going to pay for it? how are you going to avoid not having the ability to cost shift as you shrink that portion of privately funded health insurance? that is the direction it is going to go and here is how it works. the employee listed employees, he pays five vendor dollars a month for each employee to have healthcare. that is $60,000 a year. if you give give the alternative to push them into medicaid like we did with schip he is going to say i had a 60,000-dollar break here so he says to each one of these templates, you know we are going to change the benefit package. you do have access to it through medicaid, and he saved $60,000 a year and it comes to the taxpayers to pick up that cost, so how are you going to pay for the public health insurance program that your department is moving ford and the administration is moving forward? >> well, congressman i think that the president starts with a principle that he does not support

that increases the cost to everyone of their health insurance policy and increases the cost of the doctor bills that we get, the hospital bills we get and indigent taxes. so if your family has health care, you pay at least $1,000 more than you would if all other families had health care n that letter i expressed my sincere thoasincerehope that republicank with us. i asked for their hope. i knew we would disagree at tiessments i told them i looked forward to working with them to help struggling americans. in had letter i especially asked our republican colleagues to focus on the concrete and critical crisis that affects children, families, and small businesses every day. a parent who cannot take a child to the doctor because insurance doesn't exist or is prohibitively expense six a family lives one accident or illness away from financial ruin. a small business that lays off employees because they can't afford skyrocketing health care premiums. we hear those stories every time we time we go home. i ask that letter that we used short and valuable time we have to work together rather than aga

the reality, of course, is the costs are not the same. we look at the cost of transmission to move power from west to east. there's significant cost involved. however, if that cost is ignored and everybody pays the same price regardless of how far it moves it changes the economics and, yes, dakota wind would then be more economic on that basis once the cost of transmission is ignored, then michigan or the east coast. we don't think that's the right way to look at it. >> one of the things that we're really trying to accomplish, obviously, in the waxman-markey bill is to generate renewable electricity and renewable energy jobs generally in all 50 states. so, mr. izzo has a plan to, along with many other people in new jersey to generate, you know, new renewable energy jobs that help with the employment in his company but in the state of new jersey as well. and we don't want to invoke the law of unintended consequences here and have a great revolution, have a standard that's imposed on new jersey and then not have the jobs created in new jers

the cost of a hot war. the cost in terms of people and blood and treasure. can you talk -- is the qdr looking at the benefits of deterrence and how you put a price tag on that? >> absolutely. there is no question that it is not and it is not just the cost issue, either. the need to do everything we can to prevent more is more than a dollar value. it is the cost of human treasure. and so, i beliebveve you will see as an outcome the types of capabilities that will allow us to be more in the prevention regime. that is why i feel quite good about the strategy that we have sent where we clearly ar ticulated in our strategy that preventing war is as important as winning more and why the emphasis on some things like maritime security regimes were we can work with friends and partners to alleviate the type of activity, transnational criminal activity that can produce those types of corrections and that can result in conflict. theanand why we think there is value in the humanitarian assistance that we have been cond

i presume that the cost of building a text message is twice the cost of carrying it. that would make the cost of text messaging to be 0.3 cents. this portion of analysis makes a strong assumption about billing costs. to sum up the cost of a text message is smaller than 1 cent based on testimony from at&t and verizon. it is likely to be swallowed and 0.3 cents based on my analysis. -- is likely to be smaller than 0.3 cents based on my analysis. i believe the only possible reason to raise the price per message would be if the amount of radio spectrum used by the traffic was so great as to cost [unintelligible] in this case the price increases would dampen [unintelligible] but the total worldwide traffic of 3.5 trillion text messages carried in 2008 account for the radio spectrum available to just a few hundred cell phone towers. i have estimated [unintelligible] however, in 2008 alone 300,000 were sold. so is unlikely that text message traffic is congesting the network. therefore, the price increases cannot be cost-justified. i have tried to answer the questions to the

what accounts for the bulk of our costs is the nature of our health care delivery system itself. a system where we spend vast amount of moneys on things that do not make people more healthy. a system that automatically equate more expensive care with better care. a recent article showed how texas is spending twice as much as el paso county. not because this area of texas is sicker than in el paso. not because they are getting better care or better outcomes, it is simply because they are using more treatment. treatment that in some cases they do not really need. treatments that in some cases can actually do people harmed by raising the risk of infection or medical error. the problem is that this pattern is repeating itself across america. one part of the study shows you are no less likely to die from a heart attack and other elements then a higher spending area than in a lower spending area. there are two main reasons for this. the first is a system of incentives where more tests and services are provided and the more money we pay. a lot of people in this room know what i am talki

and get bigger because they needed to get big tore pay the cost of the -- bigger to pay the cost of the regulation. the small operators went out of business. they just could not endure what you were asking them to endure. and over time you ended up with exactly what we're trying to deal with here, is the big got bigger. >> right. i completely agree with that. we have to be sensitive to costs going forward. one of the segments of our financial services industry that tellly weathered the past year reasonably well were smaller and medium-sized financial institutions, and so i think it's -- and which shows to me that the diversity of financial institutions in this country is important to safety and soundness feature in and of itself, and i think it's going to be very important for the regular laters as we create a new regulatory structure of congress to be sensitive to cost particularly those borne by smaller and made yum sized businesses who are very important to access to financial services for americans who will not be going to the largest dealers. >> if i might, senator, i'm actuall

all the government plan does is shift the cost of every one who does not have that plan. doctors have seen that now read it these are not advocates for the insurance company but advocates for a competitive marketplace that works. one of the principles that we have is that we are not for a government takeover of health care because we think it drives people away from the coverage they have now. most americans really think the coverage they have now works pretty well for them. the have heard of reports, the discussions, they listened throughout the campaigns and they believe there is a problem, they just don't think the problem affects them. 82% of the american people think that their current health care coverage is either good or excellent. 83%. that is what you hear the president saying, as mrs. clinton started singing last year, if you like what you have, you can keep it because they know that people like what they have. it the truth is, under their plan will not be able to keep it because it will not be there anymore. the government will never compete fairly, so before

we are concerned about the costs. the office has yet to weigh in on the cost. early analysis by mr. stve and who testified yesterday, scores of legislation at a whopping $3.50 trillion. we need to come up with real solutions to improve healthcare that american families can afford. the promise of the obama administration and the leadership here on the hill has been that if you have -- if you like what you have then you can keep it. that is a play on words. it is drafted does what i think it will do, it will destroy that private health insurance market and will ultimately lead to what i consider a one size fits all government's plan. if we focus on reforming the health care delivery system with the benefit of the american people in mind, we should not focus our efforts on things that will destroy the private insurance market. i believe we should be encouraging physicians to enter into the field of medicine as the demand for health care related services will continue to grow. with the proposal before us today, which benchmarks' public plan reimbursements to medicare, on that in itself

a public option would help to cut down on the bureaucracy. and of the cost. i am all for host: it david is our next caller on the republican line from nashville. caller: 01 to every democrat, every liberal over 50 to remember this moment in our nation's history. we are in the process of destroying literally the best quality, best service, best health care service in the world. we are destroying it. we are taking it the way of canada and europe. just as they are running away from it because what it leads to inevitably is government deciding what is best for your health care. it destroys the quality. it winds up with fewer doctors and hospitals. a government takeover of 15% of the economy. this is worse than quadrupling the national debt that obama did in the first five months. host: let's take a look at some of the headlines from around the country in the world. in this paper one of the top stories is "obama talks tough about iran." they also talk about the passing of ed mcmahon. johnny carson's sidekick passed away today. the real-estate situation is the wors