| 00:00:36 |
none, -
SYSTEM CRISES, HOW CAN WE PROCEED WITH REFORM. LAST NIGHT I WAS LOOKING AT THE TRUSTEE'S REPORT AGAIN. AND I'M STILL STRUCK BY THE WORDS THEY'RE USING...
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| 00:03:19 |
Unidentified Speaker, -
NOT REMEMBER WAS WHEN I WAS ON VACATION IN EUROPE DURING ONE OF THOSE YEARS, MY FAMILY AND I WERE GOING AROUND EUROPE INCOGNITO, I'D EVEN LET
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| 00:03:29 |
Unidentified Speaker, -
MY BEARD GROW A LITTLE BIT AND YOU WERE AT SOME CONFERENCE IN LUXEMBOURG, AND I ENDED UP GOING TO THE REST ROOM AND WHO WAS IN THE REST ROOM NEXT TO...
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| 00:04:10 |
Unidentified Speaker, -
LIKE TO DO, IF I CAN THIS MORNING IS TO TOUCH ON FOUR
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| 00:04:13 |
Unidentified Speaker, -
ISSUES AND LEAVE PLENTY OF TIME TO HEAR WHAT RUDIE HAS TO SAY, I VALUE HIS OPINION AND ALSO TO HAVE SOME DIALOG WITH EACH OF YOU ON THESE TOPICS. I BELIEVE...
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| 00:30:54 |
Unidentified Speaker, -
BIO WAS HE WAS AT AEI AS A RESIDENT SCHOLAR BETWEEN 77 AND 73 AND WE OVERLAPPED SO I'VE KNOWN HIM FOR A NUMBER OF YEARS. HE'S ALSO NOW A SENIOR FELLOW...
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| 00:31:44 |
Unidentified Speaker, -
BUT OTHER THAN THAT, I'M A PERFECT CHOICE FOR THE JOB. EVEN TO A NONEXPERT, THERE ARE CERTAIN THINGS THAT STAND OUT FROM DAVID'S PRESENTATION. FIRST,...
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| 00:42:08 |
Unidentified Speaker, -
MEDICARE TRUSTEES AND EMPLOYERS ASSUME, IN CALCULATING THE
|
| 00:42:13 |
Unidentified Speaker, -
ESTIMATED FUTURE COST OF HEALTHCARE FOR SENIOR CITIZENS THAT THE RATE OF INCREASE WILL ABATE AND EVENTUALLY LEVEL OUT. NOW, THE BASIS FOR THAT, ONE COULD...
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| 00:45:45 |
Unidentified Speaker, -
THE MICROPHONE AND LET US KNOW WHO YOU ARE AND YOUR QUESTION. LET'S START -- FIRST HAND I SEE RIGHT OVER HERE. >> I'M EDWARD SEIGEL, I WANT TO POSE...
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| 00:46:24 |
Unidentified Speaker, -
TO IMPROVED OUTCOMES AS A GENERAL PRINCIPLE. I THINK THE FALLACY IS THAT AS I SEE TODAY THE INCREASES IN WEIGHT AND BAD EATING ARE GOING TO OVERCOME...
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| 00:48:34 |
Unidentified Speaker, -
BUT I -- IT SEEMS
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| 00:48:36 |
Unidentified Speaker, -
TO ME PRETTY SELF-EVIDENT THAT TECHNOLOGY OVER TIME HAS INCREASED COSTS AND HAS RESULTED IN MAJOR BENEFITS OF INCREASED LIFE EXPECTANCY. >> MY PERSONAL...
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| 00:49:09 |
Unidentified Speaker, -
ONE WAY OR THE OTHER. AND I THINK THAT JUST LIKE IN THE PRESCRIPTION DRUG BILL, I MEAN, PEOPLE MADE THE ARGUMENT, WELL, WE'RE GOING TO SAVE A LOT OF...
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| 00:50:03 |
Unidentified Speaker, -
MY QUESTION IS HOW DO YOU DEVELOP A FRAMEWORK WHICH WE BOTH AGREE WE NEED
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| 00:50:07 |
Unidentified Speaker, -
WITHOUT REVEALING IT? BECAUSE WHAT I OBSERVED AT THE END
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| 00:50:11 |
Unidentified Speaker, -
OF THE CLINTON, SHALL WE SAY, SEMIDEBATE WHEN I, WITH BOB AND OTHERS, ATTENDED MEANT POSTMORTEMS, THE WISEST THING I HEARD, I'D LIKE TO KNOW WHAT YOU...
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| 00:51:02 |
Unidentified Speaker, -
FUNDAMENTAL REFORM AND YET ALSO CONSIDERING THE PRACTICALITY OF WHETHER OR NOT THAT IS REALLY FEASIBLE IN OUR CURRENT SYSTEM. AND OUR SYSTEM HAS PLUSES...
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| 00:53:28 |
Unidentified Speaker, -
OUR VIEW OF HEALTHCARE HAS REALLY BEEN MORPHING OVER THE LAST 10 TO 20 YEARS, ACTUALLY, FROM ACUTE CARE TO KIND OF THESE --
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| 00:53:38 |
Unidentified Speaker, -
THE CHRONIC CONDITION MANAGEMENT. AND TRYING TO GRAPPLE WITH THE QUALITY OF LIFE WHICH DRIVES THE QUANTITY OF HEALTHCARE THAT WE SUPPLY. THE U.S. SEEMS...
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| 00:54:34 |
Unidentified Speaker, -
FROM OTHERS. SO WE CONSCIOUSLY ARE REACHING OUT TO TRY TO FIND OUT WHAT OTHER COUNTRIES HAVE DONE AND FRANKLY, WHAT STATES AND LOCALITIES HAVE DONE...
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| 00:56:13 |
Unidentified Speaker, -
DISTINGUISH BETWEEN THE NEEDS AND THE WANTS. AND I'D LIKE YOU TO EXPLAIN YOUR VIEW ABOUT HOW ONE DOES THAT AND WHO DOES THAT. AND IN PARTICULAR, WHAT...
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| 00:56:27 |
Unidentified Speaker, -
THE ROLE OF INDIVIDUAL CONSUMERS IN ALL OF THIS? SPEAKING FROM PERSONAL EXPERIENCE RECENTLY, I CAN TELL YOU THAT SOME PEOPLE MIGHT SAY THAT THAT MRI...
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| 00:57:07 |
Unidentified Speaker, -
DISTINGUISH BETWEEN WANTS AND NEEDS.
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| 00:57:10 |
Unidentified Speaker, -
I MEAN, YOU WANT WHATEVER IS AVAILABLE
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| 00:57:14 |
Unidentified Speaker, -
AS QUICKLY AS YOU CAN GET IT. BUT THERE ARE SOME THINGS THAT YOU HAVE TO LOOK AT FROM A BROADER SOCIETAL IMPACT. WHAT IS IN THE COLLECTIVE BEST INTEREST...
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| 00:58:47 |
Unidentified Speaker, -
AGE 80. IS THAT
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| 00:58:49 |
Unidentified Speaker, -
REAL BAD? IT SEEMS TO ME IT DOES RAISE A KIND OF MOST PROFOUND PHILOSOPHICAL DISPUTES THAT YOU COULD POSSIBLY HAVE. SOCIAL SECURITY IS A LOT EASIER....
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| 00:59:49 |
Unidentified Speaker, -
SURE THERE'S
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| 00:59:50 |
Unidentified Speaker, -
EQUITABLE DISTRIBUTION FOR THAT R AND D
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| 00:59:52 |
Unidentified Speaker, -
SO THE U.S. DOESN'T PAY A DISPROPORTIONATE SHARE OF IT. IF WE CAN NEGOTIATE BURDEN SHARING ON DEFENSE WHY CAN'T WE DO IT ON MEDICAL DEVELOPMENT? WE'VE...
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| 01:00:49 |
Unidentified Speaker, -
WANTS AND I'D LIKE -- I LIKE THAT YOU DEFINED CERTAIN -- YOU STARTED TO GET TO BASIC MINIMUM STANDARDS OF WHAT SOCIETY NEEDS AND WHAT DEFINES A BASIC...
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| 01:01:02 |
Unidentified Speaker, -
MINIMUM STANDARD SHOULD INCLUDE THAT EVERYONE HAS ACCESS TO HEALTHCARE, THAT IT'S NOT EVEN JUST THOSE WHO
|
| 01:01:08 |
Unidentified Speaker, -
ARE COMPLETELY UNINSURED, BUT THERE'S ACTUALLY A WHOLE RANGE OF PEOPLE WHO ARE INADEQUATELY INSURED. AND IN THAT, I WOULD THINK THAT PERHAPS IN YOUR...
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| 01:02:50 |
Unidentified Speaker, -
BE. BUT THE PRIVATE SECTOR HAS A DUTY OF LOYALTY TO ITS
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| 01:02:54 |
Unidentified Speaker, -
SHAREHOLDERS AND STAKEHOLDERS, NOT TO THE COLLECTIVE BEST INTEREST OF ALL AND NOT TO ANY PARTICULAR COUNTRY, BY THE WAY, TOO. AND SO I THINK THAT,...
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| 01:04:45 |
Unidentified Speaker, -
RECORDS, THE LACK OF STANDARDS, THE FACT THAT HOSPITAL SYSTEMS IN THE SAME REGION DON'T TALK TO EACH OTHER, RECORDS HAVE TO BE REINVENTED.
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| 01:04:52 |
Unidentified Speaker, -
WE DID A GREAT JOB ON THE CLAIMS SIDE IN TERMS OF USING IT. BUT COULD YOU COMMENT ON, YOU KNOW, HOW DO WE DEAL WITH THAT ISSUE? >> WANT TO COMMENT?...
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| 01:05:24 |
Unidentified Speaker, -
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| 01:05:25 |
Unidentified Speaker, -
THIS AREA. AND THAT'S A SUBSET
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| 01:05:27 |
Unidentified Speaker, -
OF THE BROADER CHALLENGE, I THINK. >> IT DOES HAVE A COST, OF COURSE. JUST THE GATHERING OF IT AND THE CREATION OF INFORMATION SYSTEMS. BUT THE OTHER...
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| 01:05:53 |
Unidentified Speaker, -
BEFORE, WE CAN'T AFFORD WHAT WE NEED. I DID A LITTLE BACK OF THE ENVELOPE CALCULATION MANY YEARS AGO THAT SHOWED THAT WHEN RONALD REAGAN HAD HIS COLON...
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| 01:06:05 |
Unidentified Speaker, -
COLONOSCOPY, THERE WERE 78,000
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| 01:06:08 |
Unidentified Speaker, -
ADDITIONAL MEDICARE COLONOSCOPIES IN THE NEXT THREE MONTHS. KATIE COURIC'S OPERATION APPARENTLY HAD THE SAME KIND OF EFFECT. BUT AT THE HEIGHT OF THAT,...
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| 01:07:50 |
Unidentified Speaker, -
OUGHT TO HAVE ACCESS, IT'S A MATTER OF WHO PAYS AND UNDER WHAT CIRCUMSTANCES, I THINK WE CAN DO IT. I ACTUALLY BELIEVE THAT WE CAN. >> I WANT TO BRING...
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| 01:08:21 |
Unidentified Speaker, -
WAS, THE RATIONAL FOR THAT WAS THERE WOULD BE A LIMIT WHAT YOU COULD TREAT AS TAX-FREE INCOME EMPLOYED BY YOUR EMPLOYER. JUST LIKE EMPLOYER PROVIDED...
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| 01:09:47 |
Unidentified Speaker, -
THE NUMBER ONE CHOICE BY EMPLOYEES WAS HEALTHCARE, THE NUMBER TWO WAS HEALTHCARE, THE NUMBER THREE WAS HEALTHCARE AND IT'S PROBABLY MORE THAT WAY NOW....
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| 01:11:07 |
Unidentified Speaker, -
WE'VE GOT A NUMBER OF
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| 01:11:08 |
Unidentified Speaker, -
OTHER QUESTIONS OR WE DID HAVE. WELL, YOU'VE GOT THE MICROPHONE RIGHT NEXT TO HIM SO THAT'S EASY. >> HELLO, I'M WITH E-BENEFITS MARKETPLACE. IN TALKING...
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| 01:11:28 |
Unidentified Speaker, -
ONLY COUNTRY OF THE INDUSTRIALIZED WORLD THAT DOESN'T HAVE NATIONAL HEALTHCARE. AND MAYBE THE AMERICAN ANSWER IS TO NOT TAX IT, THE BENEFIT,
|
| 01:11:39 |
Unidentified Speaker, -
HEALTH INSURANCE IN PARTICULAR, AS OPPOSED TO, YOU KNOW, GOING EVEN FURTHER AWAY. SO I WOULD IMAGINE THAT THERE'S GOING TO BE A HUGE SOCIAL AND POLITICAL...
|
| 01:13:55 |
Unidentified Speaker, -
BENEFIT, YOU'RE TREATING REGULAR WAGES IN A DIFFERENT WAY THAN YOU'RE TREATING THE BENEFIT THAT COMES FROM HEALTH INSURANCE. AND THE KEY PROBLEM WITH...
|
| 01:15:25 |
Unidentified Speaker, -
GET
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| 01:15:26 |
Unidentified Speaker, -
THINGS DONE WHERE YOU CAN HAVE A BIG ENOUGH POOL TO SPREAD THAT RISK, OKAY? SECONDLY, ON ONE HAND, YOU CAN BET EMPLOYERS UNDERSTAND THAT IT'S TOTAL...
|
| 01:16:58 |
Unidentified Speaker, -
BE A WELFARE PROGRAM AND LIMIT ITS EXISTENCE. THE
|
| 01:17:03 |
Unidentified Speaker, -
SAME WAY WITH RESPECT TO THE HEALTHCARE PROGRAM. WHEN YOU TALK ABOUT, YOU KNOW, THE FACT THAT IT'S NOT WAGES, I THINK WHEN YOU GO BACK AND LOOK AT HISTORY...
|
| 01:18:25 |
Unidentified Speaker, -
OF THAT SORT. MAYBE NOT GENEROUS ENOUGH IN THE EYES OF SOME, BUT STILL SUBSTANTIAL SUPPORT. BUT WHETHER OR NOT THE ROOSEVELTIAN THEORY IS TRUE, IT IS...
|
| 01:19:34 |
Unidentified Speaker, -
THE 1960s. BASED UPON CONDITIONS THAT EXISTED AT THE TIME THAT THEY WERE PUT IN BASED UPON POLITICAL ENVIRONMENT, ECONOMIC ENVIRONMENT, SOCIAL ENVIRONMENT,...
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| 01:21:25 |
Unidentified Speaker, -
HEALTH SAVINGS ACCOUNT WHICH BELONGS
|
| 01:21:27 |
Unidentified Speaker, -
TO THE INDIVIDUAL AND MAKES THEM RESPONSIBLE FOR THE FIRST DOLLAR PART OF THE COVERAGE. I THINK THAT COULD BE A PART OF THE SOLUTION. AND I HAVEN'T...
|
| 01:21:57 |
Unidentified Speaker, -
POLICIES WITH HIGH DEDUCTIBLES AND COPAYMENTS WITH A HEALTH SAVINGS ACCOUNT IN A WAY THAT DOES LOOK VERY ATTRACTIVE TO ME. NOW, THERE'S SOME OTHER...
|
| 01:22:38 |
Unidentified Speaker, -
IT'S NOT A PANACEA. AND WE NEED TO ENGAGE IN MUCH MORE FUNDAMENTAL AND COMPREHENSIVE REFORM. SO I THINK THERE ARE SOME PLUSES BUT I THINK WE'VE GOT...
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| 01:23:12 |
Unidentified Speaker, -
POLITICAL ECON -- PLYING SCIENTIST THAT I KNOW SORT OF TELLS US HIS THEORY ABOUT THE INCENTIVE STRUCTURE FOR A TYPICAL MEMBER OF CONGRESS IS VERY SHORT-TERM....
|
| 01:24:08 |
Unidentified Speaker, -
NUMBERS WITH THEM, THEY'RE SURPRISED. AND IT'S NOT THEIR FAULT, IT'S BECAUSE THEY HAVEN'T BEEN GIVEN THE NUMBERS, AND BECAUSE THE WAY WE KEEP SCORE,...
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| 01:25:01 |
Unidentified Speaker, -
OF CURRENT COST.
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| 01:25:02 |
Unidentified Speaker, -
AND THEN WE NEED TO FIGURE OUT HOW CONGRESS, POTENTIALLY WITH COMMISSION OR COMMISSIONS CAN START LOOKING AT THE BASELINE OF GOVERNMENT. THE BASELINE...
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| 01:25:45 |
Unidentified Speaker, -
TROUBLE GETTING THAT ACROSS. THE OTHER MISUNDERSTANDING, I THINK, IS THAT IT SHOULDN'T BE THAT HARD TO DEAL WITH IT. AGAIN, GOING BACK TO MY PREPARED...
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| 01:28:21 |
Unidentified Speaker, -
DAVID AND RUDY BOTH VERY MUCH FOR SOME VERY THOUGHTFUL COMMENTS TODAY. THANK YOU. [APPLAUSE] ...
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NOTE: The transcript for this program was compiled from uncorrected Closed Captioning.