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Our constitution as opposed to the statute and he -- even go to -- -- -- -- somehow -- call -- a referendum to change the constitution when there's no provision in the constitution for caller referenda mean.
-- -- -- -- -- Five or three to want to say happened to see you -- Carl -- after the president's speech last night you know some -- sense of the strategy that President Obama Democrats are pursuing health care yeah.
Well I think are two ways of looking at it I personally walked away thinking he was signaling -- moment -- -- Democrats only.
Think when he was signaling was I'm -- -- a rhetorical flourishes to the Republicans but I'm really unity in this bill through I took that from his.
And there enough times gratuitous partisanship in his remarks.
That you don't go in there and in called people who you're trying to get their votes of this liars and you know deliberate deceiver who don't want to do anything which is really essentially didn't.
Two parts of the speechless.
Other people took a different view that they said that you know he has his outreach to Republicans was authentic -- that he was indicating a willingness to move on the public option I didn't I didn't take -- but I recognize it.
And I re read the speech again this morning a couple of times and you could conceivably walk away with I don't I think he's going with -- Democrat only strategy jam it through the vice president they said we have a bill by Thanksgiving and I think it was a my way or the highway.
I would give you a couple -- -- -- if you wanna come along fine but if you don't I'm Jim this thing through.
With a tuition one is whether Health Care Reform as they wanted to is a good idea that's one issue the second is sort of the political impact that if if they ram it through.
And I forget the weather to good -- that -- if they ram it through if it fails isn't.
Fatal to the minute we start having unbelievable problems with -- he's -- fatal to his party at least for a number of years to.
Well you know that's an argument I'm not sure I believe that that argument I mean -- two ways to look at this one ways to say look if they fail it's deadly and some Democrats are trying to suggest that this was what happened to the 1984 that they lost the congress.
Because they -- to pass health care I think they lost -- 94 because they tried to pass a bad bill.
I think guardian difficulty on this whether they pass it or not if he fails to pass it will undermine his presidency.
For some period of time doesn't Killen but it does it means he's got to come up with -- and become successful on.
Particularly things and have to do with the economy.
But I I frankly think the problems the Democrats got a RD green because they're pushing something that's not popular when you were taking something as big -- this.
You're in difficulty if you don't have a significant majority the American people in favor of it or if you've got to narrow majority.
You've got to have your people more enthusiastic about the change you want to the opponents are about a post and it.
In this camera will have that in this thing is upside down that is to say the -- the president's plan is less popular.
You know draws more opposition than it does support.
And then the people who feel strongly in opposition to -- are up here in the people who feel strongly in favor of the afternoon here particularly among the group.
That are going to be voting next -- in the elections in off year elections seniors who make up about one out of every six voters.
Eligible voters make up about close to almost one out of every three voters in an off year election.
The generic ballot before the election which Republicans picked a 54 seats in the house was.
45 Republican 43 Democrat in 2006 -- the Democrats took back the house he was fifty Democrats 43 Republicans.
Today -- is 51 Republicans 43 Democrats.
In the latest generic balance -- fed doesn't improve before the election it could mean.
A lot of bad things for -- But if it push it through nuclear option they push it through -- you on Democrats no Republicans going along -- -- picking off one or two but they push it through if it's safe return of BA great bill.
He and the Democrats are -- if it's a thought he and the Democrats.
Are villains for years to come out.
Well and remember.
In the -- it wouldn't we won't know the complete answer that for number of years but we do know the following.
The taxes and Medicare cuts begin immediately under HR 3200 -- begin in year one.
And in the year won in year two which of the two years before the election she's earning is that -- year 20102000.
Elevenths in the bill passes this year.
There won't be any new programs will be simply.
New revenue new tax increases.
And Medicare cuts we have ten point six million people on Medicare Advantage to be a 20% cut in the present in the in the government supported Medicare Advantage plans.
Every expert I've talked uses I mean Medicare Advantage programs are going away which means.
Ten point six million seniors are gonna lose their supplemental coverage that they now have under Medicare Advantage saying they'll be happy site.
Before the 2000.
Ten to congressional election that's about 24000.
Seniors on average per congressional district when -- 4300 seniors for congressional district.
That's like that's and -- bad number of people have irritated that they've now lost her coverage because in year one their program gets cut 20%.
And in the program begins to phase in in the future years and you know if -- if if if if what we think he is true.
That's got to run deficits.
You've known as a two year head start on collecting revenue by.
It runs through that surplus at first two years where the surplus pretty quickly and by the by you know by year ten the CBO number I think is somewhere like you know.
Several tens of billions of dollars a year in deficit by the tents here it gets worse and second decade trillion dollars worth of of deficits in the second decade.
Then you know you got real problems if you're the party that's pass this thing without the overwhelming support -- the American people.
Which seems to those who object to it and to everybody wants some sort of health care fix in in that -- -- goes -- -- But those who object to it some say that it's a bad plan to since -- that's now well -- Some say it's too costly some states to battle -- that it's really is sticking you know the -- -- stick its nose into personal decisions.
And I guess the best example -- -- I heard you talk about counseling.
Editorial having to do with every five years after we reviewed here on Medicare to -- for whether -- -- living will for instance which is not a bad idea but the idea of metal metal.
Yeah well -- -- who -- him and that particular instance we're gonna pay doctors.
To sit down with you in and talk you into him into his living will before we've left this decision would say very critical decision those of us who've had elderly parents -- had to go through this decision.
But it's a decision that -- was taking care of home with.
The doctor involved.
The parent the patient.
The face you know the face advisor -- religious person your pastor or your preacher.
In your family lawyer and now we're going to take doctors whose job it is to.
You know make you well and we're gonna add an additional responsibility of senior now supposed to become a legal expert with regard to living wills in the various kinds of of of directives and had many senior -- you know that any person -- have with regard that they ended in a life care decisions.
It's a little bit you know I think Charles -- had a good point which we we ought to be queasy about this we got enough the doctors have to do -- suddenly incentivizing them to go through this kind of thing in.
Give this kind legal.
Even in in there couldn't just be -- carved out because it's -- it's controversial because you know especially people who are elderly like -- you let them have these.
They're very fragile it's a very important time in in their lives for -- does that mean.
Why is that part of this.
I don't know and see if we have a little inside remember the veterans administration now has a -- out in which he counsels people on these kind of decisions.
Anybody you know who reads thank god would be very nervous I think most people would -- that -- would be very nervous about putting the government in charge of that kind of advice giving for all people.
And remember that the government here writes the advice and it's also supposed to give the doctors the list of approved.
Sources you know prove to be approved resource is that people can call upon.
If you look for example of VA got it doesn't have the Catholic Church the presbyterian church -- the Methodist Church it's got the Hemlock Society.
The people who -- and assisted suicide so there's a lot of it ought to be taken a minute there's an even bigger point you've touched on.
Why not take this staying a step at a time to -- says look I'm gonna pay for two thirds of the cost 622 billion dollars according to White House.
Of the 900 billion dollar cost is gonna.
My what he -- as relatively painless and easy money to get at a Medicare and Medicaid practically waste fraud.
And what he what he considers to be.
You know unfair subsidies for Medicare Advantage insurance plans.
Well if these are so easy to get particularly the waste and fraud.
Wouldn't the president be well advised to be demonstrating right now that that money can be recaptured that it really does exist and by doing so gain credibility.
Would -- be better if you took this highly contentious issue of the year but you know of the of the to look into life decision canceling -- -- -- what I understand a controversial that is it's not really.
-- let's pull that out of this if you were to do that that is to say approach this in an incremental fashion.
In the open and listening to people.
Then I suspect he get further last night by -- in essence.
They're not going to be death penalties in -- all stupid -- these were all lies in how dare you to bring this up.
He he really belittled in minimize the Austin concerns of people have I mean Charles -- that is not -- -- -- -- editorial page writer for a left of center newspaper the Washington Post.
Yet his piece on this was I thought -- and in that it gave the voice to these concerns of the queasiness that people have about these.
If there's 600 plus billion in terms of waste that we can recover.
-- have -- deficiency.
I'm sort of curious as those -- don't have the numbers that if we take -- -- if we took that 600 billion typically behind insurance.
Anywhere out of the numbers work out wasn't enough a lot of money -- a lot but an awful lot people living.
-- hitter and the fact of the matter is -- if there was 622 billion dollars worth of savings it could be squeezed out a statement that 642 billion.
And there are less -- its presence -- thirty million uninsured -- has been using the number 46 but he's probably closer thirties probably not accurate.
It's probably a little -- at them but let's assume for minutes thirty million people into.
Billion dollars -- that we can pay for -- nice plan and that's assuming remember.
The 30000 lives -- the people who are uninsured to the census department says of the 46000.
Number which is what he's heretofore been used.
The census says nine point seven million -- illegal -- some over here on abuse and overstated some came here.
-- -- to begin with but they're nine point seven of those so there's roughly 36 -- -- for this these are not Democrats -- of Illinois are HR 3200 does have unit.
For provisions -- -- this morning by congressman Lamar Smith of Texas before provisions and HR 3200 they do allow.
They're they're they're back doors to do allow coverage for you legally -- but let's assume for a minute that that they close those loopholes which they haven't yet let's say that they closely.
Of the remaining population remember about fifteen million of them.
Make 300% or more the poverty level that is to say they make 50000 dollars more or more a year.
And they've made a decision I don't need health insurance I'm -- self insure.
Slow -- slightly smaller number that fourteen million and -- unchanged.
Are people who were RD and and available RD in -- eligible for Medicaid and asked you for government run health programs because they make too little money.
And they just haven't signed up it there's another example we've got fifteen million people who are -- covered by so government health program.
Why do we need to -- everything for the all the people who do have health insurance are covered with -- in order to cover fifteen -- people who are already eligible for government program.
For which they had not signed up.
This is fundamentally the problem the president faces.
Recent surveys have shown anywhere between.
You know eighty some odd percent in ninety some odd percent of Americans think they have health insurance they say they have the highest of -- in his 91%.
Most of those people generally in the eighty's.
Like the latest poll says 83% of Americans are comfortable to health coverage they have.
-- how can you say okay and 14% were not at 3% didn't know.
So why do you tell you how can you get from these sort of major changes in these big fundamental differences in these radical new things.
All out there when you've got you know better than.
Ratify an American say hey -- -- when I got.
What we hear these 600 billion saving of the not -- Billy is gonna cost to -- congress Republicans set.
Hossa missed again these numbers that's the other thing is it you know we hear Washington debating these bills and passing these bills whether Republicans or Democrats.
But then by the time we should have to pay the piper but is gone you know let's move got an awesome -- -- what you told us it was going to be 600 going to tell -- is -- -- 300 -- Let's not Wimbley pick up the for the American people pick up the pieces.
Well and look they've got a good reason to be concerned because in the history of government health programs and I mean all of -- Medicare Medicaid.
Asked ship VA care tri care champ as you name only government health programs.
In -- its -- its government begin paying for health but the health care.
There's been only one of the government program that has come in under the estimates which Medicare prescription drug -- the benefit passed in 2003.
It is 40%.
Under the estimated cost of the program Congressional Budget Office estimates.
It's 40% under even though more people signed up and they signed up faster.
Is there a higher what's called utilization to use the program more and why -- the cost 40% last.
You -- -- -- him here is 40% less because the program relies upon the private market to deliver the benefit it says okay.
Private companies get to compete for it you get -- you get support based upon income.
And you can pick a program that meets your needs in your family's budget in as a result.
Rather than having as -- racial fear was one or two or three or four people companies in each market.
There are dozens of companies in virtually every market in the country in very robust competition as result prices are down.
For the to the consumer in the benefits -- -- -- -- everybody's what you do.
If you could have fewer charges of reforming health care what would it first I'd start off by saying let's take some easy steps -- don't have a lot of costume.
There will allow greater access lower cost let's allow.
Small businesses to pool their -- -- joined together let all the people who burger joints don't joined together let all the people who live in a particular part of the country lit led all the left handed orthodontist.
Join together and pool the risk of their employees and get the discounts to big boys here.
Let's allow people to buy health insurance across state lines.
Like today you can buy auto insurance across state lines which you can't buy health insurance so there is kind I should.
Well it doesn't make any good tonight I would notice such -- insurance commissions the federal government gave it over except for very large enterprises the federal government said the it and said.
Regulating health insurance is a state full actuarial even in the hands of the states.
What happened is we built up these you'll sort of individual sets of regulatory patterns to which people became dominant players and as a result.
You know control the market and it also -- it.
The government steps -- -- regulates open it drives up prices.
Health insurance more expensive in New Jersey than it is Connecticut the two Dakotas -- it's more expensive one lesson another.
New York here in new York and Pennsylvania you're 25 years old living in north Eastern Pennsylvania your health and 25 year old male healthy doesn't smoke.
Your health insurance and roughly a third of the cost assuming you're between five Mosley in New York we -- -- have a national market in health insurance like we have an auto insurance in competition grow.
John and John Shattuck of Arizona has been pushing this for years we also want to make it truly transportable that is to say we ought to have the tax benefit go with the individual.
Not just the corporation.
Might -- given a healthy tax credit.
To poor people in a -- healthy tax deduction to war.
To to more well off people.
That what would happen is as it would be incentivize people to purchase health insurance using their own dollars because -- we get either deduction on their taxes actually get money back if they're poor.
In all the studies show this would dramatically increased purchases of health insurance and -- the private market do its own people would be out there compete in -- We also need to allow people to save more out of pocket for their out of -- more tax free for their out of pocket medical expenses.
I've got what's called an HSA -- health savings account.
I can save a certain amount of money each year in my health savings account for -- out of pocket medical expenses I could then buy a high deductible.
Catastrophic policy which covers everything beyond a certain -- -- that deductible.
Well I'm about ready to go to my agents say provider and say I'd like to raise my deductible because I've been careful about the pennies and I -- in my HSA.
So I'm building up my little war chest solidified -- -- and I've got it covered there.
And that allows me to get these same coverage I had before for the for catastrophic for everything above a certain level no limit you know whatever happens to be bad.
But I cover the first.
X number of dollars out of my tax free savings that we ought to allow that and we have to have tort reform I just I know this is at at complex issue and know what people feel it is.
Isn't just limited -- all you have to do is limit the fees that lawyers on both sides not just the plans lawyers but the defense lawyers because unless you do it put a lid on both one runs it up right.
And and had a contingency fee is a problem also I think we need to have limits on the so called non epic economic damages if somebody is hurt by -- her hospital.
They -- -- every penny do them from an economic perspective that these so called pain and suffering awards in some places.
They literally Alabama for example in Mississippi before they enacted tort reform it was routine to have.
You know who -- there was a famous case in Alabama involving a water heater.
That and this and -- and the general question for reform not just medical liability but.
Literally the people who had their small house burned out by a used water heater that they bought from a junk -- there and we get like a ten million dollar verdict.
For having bought and you know he used -- from the junk yard and installed it themselves and they got the big award.
For pain and suffering we got to live at the pain and suffering -- awards damage awards like we did in Texas in what happens is people get.
Made whole economically but by -- at pains suffered -- insurance cost goes down and as result cost of health care.
And somebody had to make them because it was this -- -- -- got a dangerous territory with a lawyer.
You know I got I got something to give you here before -- go Alexis there we go I had a -- it was gone -- and take off and like yeah so great pairing guys.
Think you've had -- -- -- I know I heard I heard so that's great.
Thank you how you -- thank you.
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