decision immediate the game. and zobrist has brought them right back. and there wasn't much question about that one. here is the 0-1 delivery on the way to pat burr r buehrle and he will take the pitch and it is a one wall, one strike count. zobrist now with 24 home runs and 75 rbi's on the season. will be inside out to right. not deep. markakis. two down. the non-save opportunities and that e.r.a. is way up. the save opportunities are still high. almost four. >> jim: he has just been out of sorts for about two and a half months because when jim johnson is relaxed and throwing the ball well, the ball sinks. the problem with zobrist is he just got behind it, so he saw actually six pitches. and russ springer is getting loose, the 40-year-old right- hander. we saw him on monday night. so you can take a good fastball hitter and throw him six straight fastballs and one is over the plate, he is probably going to have a good swing. >> gary: and he did and we're tied. the eighth home run surrendered by johnson on the season in 64 innings pitched. here is aybar. down to first. that will do it in the inning, but not before zobrist delivers the homer. we'll go to the bottom of the nine knot yeah. ( thud ) a 2-2 game. >> getting set for "o's xtra" post-game. the orioles were two outs away from a rain delay victory. now it is a tie game going to the bottom of the ninth. >> jim johnson who has struggled, the game right now is tied. not much offense for the orioles tonight. only four hits going into the bottom of the ninth inning. we're looking for a couple here and maybe a run. >> so a home run will win it positive tar birds. let's see what happens. back to the booth. >> gary: we go to the bottom of the ninth inning and the 40- year-old russ springer will come out of the bullpen and not only try to retire the side, try to get an out. >> jim: he came over from oakland and lately, the last three appearances, he hasn't retired a batter, all six batters have reached. izturis the other night in a line drive. he has been around 17 years in the big leagues. seven teams acouple of years in the postseason. he was throwing hard the other night. but he hit for a base hit. >> gary: 2-2 ballgame. the orioles here in the bottom of the ninth inning. scott wieters and wigginton will be due up. chris richard has come on to play at first base in place of aybar. we'll see what works here or not. springer had not worked for a long time. the appearance that he made yesterday was the first time on this long road trip that he had appeared in a ballgame because he had been so ineffective. the left-handers hitting .338 off of him and right-handers .271. he was simply sitting out there in the bullpen and watching games, and now with this rain delay ballgame going to the bottom of the ninth, he'll get a chance to try to regroup. luke scott will come up. scott has an rbi double. he is 1-3 in the ballgame. howell worked an inning and gave up a hit and one walk and got out of the eighth when the orioles left the couple on base. the orioles have stranded six. the jays have left four on. luke hitting at .258. the 22nd home run came in the ballgame last night. against the shift, he takes the pitch away for a ball. >> jim: well, off the lefty and he's done that quite a few times. brian shouse is looking at that ball with disdain. he didn't mean to give up the home run. luke is a very, very strong guy. they play him to pull again. the shift is own. >> jim: 1 -- >> gary: 1-0 is right there and a one ball and one strike count from springerment longoria stayed in in case there might be a bunt attempt and now moves way out. he had been playing almost on the grass at third. he now jogs it to the shift position. >> jim: they usually play shallow very deep. he is way out in left center. >> gary: 1-1. crawford is almost one of the few spectators left. if he took three more steps he would be out in the seats in left field. and just as far upton in center, barely visible. two ball one strike count on scott. the orioles need one to win it here in the bottom of the ninth inning. 2-1 pitch. a check swing. >> jim: that ball stays fair. look at what ortiz did when they're up in boston. a check swing single. if you hit a soft line drive and excuse me, just check swing down the third-base line you probably would get a double. >> gary: two ball, two strike count on him. scott, he'd like to end it right here with one swing of the bat. the 2-2 delivery on him, up high. >> jim: we told you about the strategy. a lot of teams like to pound him in. russ springer, he's always had had a pretty good breaking ball. he is trying to hit the outside corner. the bases empty and a 3-2. and walks him. so the orioles get the potential winning run on with a lead-off walk in the ninth inning. springer gives it up. only the fourth walk the orioles have picked up in the ball -- in the ballgame tonight. randy choate is already in the bullpen, a left-hander, will get a pinch runner. robert andino will run for scott. let's see how dave trembley plays this. matt wieters is coming up. sac fly. he has struck out and grounded out. longoria will play even with the bag at third against him. matt rarely, if will, called upon to bunt, but you want to stay out, of course, of the double play ball. >> jim: not in the big leagues to this point. >> gary: and not here either. in the air, left center field and that is near the wall and good-bye home run! a game-winning two-rbi homer by matt wieters! he has done it again! the second game in a row that wieters gets the game winner, and andino scores ahead of him. the players imitating his running style as he jumps on the plate! well, he's had a heck of a series against tampa bay. it is his seventh home run of the season. the rbi's, 33 and 34, and the orioles put anytime the books as a win 4-2. so that will take care of this one in the bottom of the ninth. the series finale tomorrow. mark hendrickson takes the mound against clay davis. our coverage will begin at 6:30 with "o's xtra" presented by at&t followed by game at 7:00. for jim palmer and amber theoharis, game gary thorne. thank you for joining us! it is worth the wait to see the finish. this has been a masn presentation. "o's xtra," jim and rick coming up. there is the game winner, the run, pie, and wieters! "o's xtra," right now! >> hi, again, everybody. matt wieters is coming in to celebrate his walk-off home run after losing the lead in the top the ninth get the lead off walk by luke scott and wieters jumped on the first pitch he saw aalready the opposite way. so another big flight for matt wieters and the orioles pull it out by a final of 4-2. hi, everybody. "o's xtra" presented by verizon fios. what an interesting night! this game was sailing along and then an hour and 40-minute rain delay. jim johnson allows the game- tying home run to zobrist in the top f the ninth, but the orioles come right back. very few fans left in the ballpark after the long rain delay, but the fans that stayed, they saw a treat as wieters hit it out. >> what can you say about matt wieters tonight? he did it on both sides of the line. a walk-off home run that makes seven rbis in the last two nights and throwing out crawford two times, the league's best base stealer. he has had a heck of a series. >> in a game like this, you really have to give the player as lot of credit for the concentration. whenever there is a rain delay, there is a thought maybe the umpires are going to call it. they didn't call it. the game played to conclusion and it was a thriller. >> let's get a look at the game summary. we're going to go back to the bottom of the fourth, 1-0, o's. luke scott nearly hit this one out, but it is high off the scoreboard for an rbi double. >> it bounces back in to play, but the orioles get on the board first with a big run right there. >> now, the top of the sixth, gregg zaun, a solo home run. there would cut the orioles' lead to 2-1. >> a pretty good swing here by my nephew. i have to claim this one here a pretty good swing. he gets tampa bay to within one run. the score is 2-1. the top of the ninth. one out and none on and zobrist worked it and hit it out to straight away center field. >> jim johnson continues to struggle with his command fastball right down the middle. it goes for a tying home run in the top of the ninth, but there it is. the orioles on their way back. >> and there is wieters against springer. he hits it out. that one fan was there there the entire rain delay. he goes home with the game- winning souvenir as matt wieters hits it out. the orioles win it by a final of 4-2. the birds had only five hits in this game and the game winner came in the bottom of the inning. 4-2. johnson gets the win after blowing the save. springer the also and the orioles have made it back-to- back wins against tampa bay. let's head back to the masn broadcast booth and welcome back jim palmer. what a real good win or the orioles because the concentration could have lapsed. it didn't and mat wieters continues to get better and better and he gives the orioles a walk-off win. >> the ball did not look like it was going to go out, but i think we get an idea of how strong he is, the swing getting better by the day. we saw the five rbi's. i'm sure he is just trying to drive a ball somewhere. it gets up in the air. i think early on that ball probably would have stayed in the ballpark, but with the front coming through and all of the rain, it just kept going going going. it was just like one f the bo jackson fly balls, and the next thing he is circling the bases. pretty timely, i would say. >> a pretty good outing by chris tillman. three up, three down. i saw a lot of progress in his game tonight. >> definitely. it was like i was pitching and you were catching. a lot of high fastballs. he got away with some stuff, i suppose, but, again, if they're swinging at your pitch, why not go after him. what i like is the fact, and i honestly believe that he is going to get a lot better. he is 21 years old. bartlett is one of the best fastball hitters around. he gets away with a hang they are to crawford. and a curve ball. he hits it right to markakis. so why change anything when you're having success? and, as you said, his only mistake tonight was a fastball. he got down a little bit and your nephew, the good hitter in the family, hit a home run to right field. so, again, here we go. their numbers are getting better. that back-to-back good start. should have got finance win tonight. i know jim johnson has got to be disappointed. he has a ball. sixth straight fastball to zobrist. but pretty timely hitting again by matt wieters and we get to go home a little earlier. >> and, jim, it is very encouraging when you look at the contributions of the young players that are a big part of the future next year because you mentioned that they're looking more and more comfortable. this is fast becoming their team and that is a good sign looking ahead. >> i think it would be easy. i don't know if dave trembley will be back or not, but the club, when they're undermanned. you lost supposedly your best home run hitter. he is in detroit a three-run pinch hit home run. you lost your closer. he is out with the dodgers. so this is -- you know, a club that is going to be undermanned. they play hard. they're playing well. markakis has been in a little bit of a rut but brian roberts is carrying. pie is getting a chance to play. ideally you would like to have adam jones out there having a great year maybe ending up with 25 home runs, but we know he'll be back. he is going to be 25 as he starts next season, 24. a lot of good signs. i think the one thing if you're going to have a guy, the number one draft choice for your ball club, it is wieters. you give him the money, let him get to the big leagues and feel his way through and he is doing a terrific job. >> from jim palmer we go to dave trembley presented by verizon wireless. >> and the pitch to zaun and, you know, that's -- that's a real plus outing and one that everybody has to be leased about. wieters did it behind the plate and did it with the bat. so he had -- he had a great game throughout crawford. the release was quick. good footwork right on the bag and he get as walk off. -- gets a walk-off. i was impressed with the at- bats we had after the long rain delay. roberts, markakis. you know, we tried to add on. it didn't lap. zobrist has had a very big year for them and guilty a very big hit. it forced us into having to get it done in the bottom of the ninth. albers came in, kid did his job and baez was good as well. but you've got to be real happy for how tillman pitched and, you know, his approach. it was pretty darn good. pretty darn good. >> and the pitching -- >> sonnanstine, you know, they were locked up in just a good, old-fashioned pitchers' duel. both guys kept their pitch count down. both guys were getting a lot of early swings and early outs and counts. there were not a whole lot of deep counts. you just got the sense that early in the game there weren't going to be a lot of runs and there wasn't going to be a lot of offense. so you were looking to break through one way or the other, and we got the big hit. it was fun that is fun. >> how long was the rain delay for you? >> well, we got a false alarm one time. we thought we were going to play, what did they say, 9:45? and i walked out there at 9:30 and i said i don't know how we're going to play unless something magical, unless we have a roof over it. and i thought, you know, before dale called it it was -- you know, pie's at-bat. i don't know how pie got through that at-bat. it was -- it was pouring. the field took a lot of water. the field was not in very good shape. they did a nice job of getting it back into playing shape. so we guilty a false alarm with the first one and then the second one, 10:45, they're ready to go at 10:45. >> do you think matt guilty that? >> no. >> no.(.ecl) that's what i asked him. i asked him after. i was watching crawford. i said when you hit it, did you think you got all of it? he said he wasn't sure. i was watching crawford. it looked like he was camped under it. we were yelling from the bench for andino to get back and tag. >> what was it -- did it remind you anything playing in important of 110 of your favorite friends and family? >> i think at some point in time this year i have signed an autograph for each and every one of them! [ laughter ] >> they all knew me by my name and i knew who they were! darn, no one offered to buy me anything, though. come on over. i got a soda or something ahot dog or something. darn! fame is gleeting around here. i know how it goes. you guys have been around for a while. but i saw a lot of people who were, you know, familiar faces and regulars on my e-mail list and regular on the video journal call-in and down the right-field line that i sign autographs with. so it was kind of like family at the end. >> you were talking about the progression of wieters and everything and tonight and the rbi's in two days, and you just can't say enough about what he has done here recently. >> well, he is going to do it here for a lock time. i don't think there is any question about that. this has been a tremendous season for him to learn, to go through some struggles. i think it is -- you know, we told the team the other day that one of the goals we had coming down here the last three weeks of the season is let's leave here and make a positive impression on your teammates, on your coaches, and people in the league. and, you know, we've got an awful lot of young guys whose eyes have been wide open. i think they have learned a great deal. i think they understand a lot more about themselves and how difficult success comes in this game. so the good ones, they're going to find a way to get it done. that's why you tip your cap to roberts and markakis and melvin there in that inning there in the bottom of the eighth after sitting in there for two hours and going up there and having to show that kind of mental fortitude, focus, you know. those are special players. those guys are the best of the best, and we think wieters is going to be a good one as well. tillman was -- you know, i got excited about tillman tonight because he just looked real relaxed, real comfortable. it was nice to see. >> for you to go back to johnson, he has warmed up before the delay? >> no, i don't think he was even warmed up. he is the ninth inning guy. she going to come in and get it done. that's how you feel. he is going to get it done. zobrist has broke my heart before this year and he'll probably do it again. he has had a heck of a year. for a guy who is 28 years old and under the radar, he is not under the radar anymore. he is a solid player, solid player. okay? >> manager dave trembley following the orioles' dramatic win after losing the lead in the top of the ninth, the two- run walk-off home run by matt wet neither the bottom of the ninth and the birds win it 4-2. the orioles in the finale tomorrow have a chance to get 3- 4 from tampa bay. at&t player oh the game as voted on by the fans an chris tillman with 91%. a tough luck no decision as he gets the at&t player vote by the fans. 91% as the orioles win it by the final of 4-2. well, the birds have won back- to-back games over in tampa bay. a dramatic walk-off for wieters and the birds take it by a couple. the new mcdonald's bacon and cheese angus third pounder. before taking it on, one must study it first. rushing in unprepared may prove overwhelming... with all that juicy, 100% angus beef. there! you found a point of entry! the bacon beckons like a springboard to paradise. one small bite for man... etcetera, etcetera. angus axiom number 11: bring on the bacon. the astonishing new angus third pounders. all angus. all mcdonald's. ♪ ba da ba ba ba >> back here on "o's xtra" there is one of the best oriole fans you're going to see. he was out here in left field in the stands the entire rain delay. he waited it out. he was one of only four fans by our account who waited it out and he caught the matt wieters' home run ball as the orioles win it 4-2. a dramatic win for the birds in walk-off fashion. thanks for hanging out with us and now we're going to go back inside and hear from the hero. amber is with matt wieters! >> getting on base, did you have in mind you were going to swing at the first pitch or did you see a good pitch? >> something gave me the confidence to swing away and i was going to look for a fastball and fortunately it carried it out. >> did you say dave said something to you? >> it is a situation where you might bunt in the ninth inning, but he was giving me free range to swing and try to drive something. >> for the night you've had last night and tonight, do you feel like you're locking -- it is tough to do that late in september, especially with a long season like this. >> it does feel good to play right now. it is something that comes and goes throughout the course of the year and hopefully we can keep it going for a built longer. >> dave talked about in the a.l. at least you need power to compete and with this team losing aubrey huff, there hasn't been a lot of power here. do you see that as a void that you can fill in the future, too, that you look forward to having more power and lifting this team up with that? >> i think the biggest thing is to be able to drive in runs and we lost a big rbi guy when we lost aubrey so a lot of different guys have to step up. >> we saw tillman. it is tough for him not to get the win after that long rain delay. what have you seen from him that made it so effective? >> his poise is outstanding. he went and did his business and nothing changed. he kept rolling on through the game. >> how fun is it now? it can be a tough, long september and you guys have the good series at yankee stadium. you win two against the rays and in pretty exciting fashion. are you having fun now? >> definitely. anytime you win games it is going to be fun and winning with this group, we had a bunch of young guys who are the first time through or the first couple of years in the big leagues, and definitely a lot of fun. >> thank you. >> amber, thank you very much. so matt wieters over the past two games, 4-#, a couple of home runs and eight rbi's. he had a three rbi night. he has seven home runs now and 35 rbi's ton year and he now has a three-game hitting streak. rick, what we're seeing is a player becoming more comfortable, not only at the plate, but behind the plate. >> it is all around that's what he is. he makes good solid contact again tonight. he had an opportunity early on in the billion game. this is actually last night when he hit his home run. that is a three-run shot. that capped off a five-rbi night and then tonight, again he had another opportunity with the base runners on defense now. that is crawford who is the base stealer in the american league. 57 stolen bases coming into this series and he threw him out not only once but twice on the night. sheer the second time. crawford get as pretty good jump. even a closer call. crawford didn't agree, but he did. he absolutely wedged that ball between the foot and the bag. another great night on defense. the last time up now, here it is, the fastball everybody was waiting for. matt wieters was the only person who knew that ball was out of the ballpark. he was jogging all the way to first base. the seventh home run of the season, the third rbi of the night. eight in the last two nights. matt wieters, the hero. >> to give you an idea of how just difficult it is to catch carl crawford anyway, but twice in a game, it is only the i second time in his career. gerald laird when he was still with the tigers, but in texas, april 10, 2007, gerald laird caught carl crawford twice in the same game. tonight matt wieters adds to that. so what a tremendous job by wieters. and on the first caught stealing, it was a tremendous an tall we had on the x-mo camera. you can see just how much that ball beat crawford ever crawford to the bag. >> no doubt in my mind he has some of the best velocity for a catcher in the american league. the only question i had earlier was the mechanics of throwing. he was always so uncomfortable. it seems like now he settled in nicely. he -- choice you woulders are square. he is coming out very balanced. you can see what it translates into. he is a very good throwing catcher. >> the orioles win it 4-2. a tough night for chris tillman the way it ended because this would have been his win, but instead it is a tough luck no decision. when we come back, we'll hear from the rocky right-hander. ♪ ♪ tell me who's watching. ♪ i always feel like somebody's watching me. ♪ (announcer) it's right here. it's easy. >> chris tillman, another strong outing. he allows only one run on five. tillman on his outing. >> matt wieters said you were about as poised as he has seen you do you feel very confident now? >> yeah, i feel like i have gotten that groove. i think i found my stuff in that yankee game. moeller got me settled dunn a little bit and got me working downhill. in my bullpen session between starts and i felt good tonight. i didn't feel like i had to throw too many off-speed pitches, well, minimal and the fastball for the most part. >> chris, you are almost equally as effective. do you feel like this is your best performance? >> i do. until i locate my fastball better, when i needed it, i had my off-speed stuff, too. my changeup is is a little better, but, i mean, i felt good after tonight. >> you sat down the first 10 you faced. are you saying you felt the stuff is good, this could be a good night for me? >> yes. after the fist one, i felt like i could be okay. i just wanted to work fast, get my team back in the dug-out, especially after scoring that run. i made one mistake in zauny, and he turned around that pitch pretty quick. >> were you surprised? >> no. i wasn't surprised because, i mean, the ball started rolling a little bit and you kind of want to shut that down the way the game is going 2-1. i think he made the right call doing the match-up that way. i definitely -- i felt like i could have gone the whole game really. [ inaudible ] >> absolutely that is huge for me. i wish i was out there and i was in here and working out and stuff, but i'm happy for him for him to get that win. >> so chris tillman did his main job. he gave his team a chance to win and the orioles did win on the two-run walk-off home run by matt wet neither the bottom of the ninth. >> fans, don't forget to ge line. log on to masnsports.com and play fantasy baseball for a chance at weekly prizes and an opportunity to have lunch with the skipper dave trembley. log on to masn sports.com and reg sphear for free and use a virtual $100 million salary cap to select your fantasy baseball rossster. fans can play on their own and invite their friends. play masn's maximum fantasy baseball today. prior proo to the game today, the orioles gave out their minor league awards. there is zach britton, the pitcher of the year and there is brian matusz, the pitcher of the year, the jim palmer award. joseph got the el rod hendrix award for the community service. jim howard, the scout of the year and mike griffin, the triple-a pitching coach. he got the cal ripken sr. award for player development. the orioles win it 4-2 in dramatic fashion. neither of us had matt wieters in our "o's xtra" challenge. i don't know what we were thinking. rick pulls it out! melvin mora, 2-4, with a single, a double and a run. luke scott adouble, a walk and an rbi. as we determined, two hits beats one rbi. so you pick up a win tnt and you're back up by four. let's take a look at tomorrow. the starting pitching match-up. wade davis against mark hendrickson. >> he has been doing a great job working out of the bullpen. they need him up on the mound as a starter. he'll be looking for his sixth win of the season in that respect. wade davis makes his third major league start, a rookie up from triple-a. 10-8 down in durham. the e.r.a. is not too good. it is going to be an interesting match-up, too. we'll see which one of them goes deeper in the game. >> the orioles looking to finish strong as they get this dramatic win in the bottom of the ninth after losing the lead trying to put together three consecutive wins and take the series from tampa bay a little momentum going down the stretch. >> we do. we got anytime our favor now. matt wieters is going to carry this ball club again. i might have to pick him tomorrow. >> i can guarantee you tomorrow, this guy is jumping ton wieters' band wagon and she going to pick wieters! thank you for staying up with us, everybody. it was minor league appreciation night. all of the affiliates honored tonight before and during the game. they liked the race with the mascots! and matt wieters wins it with the walk-off. tom and dave are still talking about it on the radio. we'll see you back here tomorrow night. have is a great rest of your night! xxúú who said there's no drama at the bottom of the baseball standings? arizona's mark reynolds who set a big league record with 204 strikeouts a year ago is only nine k's away from breaking his own standard. >> to be fair he does have 42 home runs but his team is in a battle to avoid last place in the national league west with san diego and they're playing them today and they were playing like last place teams. here's mark reynolds. stuart gave the numbers. he's got 196, 197, 198. 3-1, diamondback lead. top six, 1 9. >> let's do something positive. top seven, tied at 3-3. two on for justin upton, needs a home run to complete the cycle. doesn't get it. it's a career five-hit day. the end to his yang. back to reynolds. if he strikes out again it would be 200. and it is. he went 0-5, struck out four times. bottom nine, drama, one on for adrian gonzalez. big hitting for brother edgar off esmerling give me that. he sends it the other way, his 38th of the season. his first pinch-hit home run of his career. we're tied at 5-5-5. again, these are last place clubs or teams avoiding to play last place. here's your boy luis durango. his first start and steals second. scoring position. next pitch. evereth cabrera. we've got sunshine, shadows, sunshine. here comes durango. that's it and that's all. he had three hits, scoring the winning run in his first major league start. the pads are currently looking down in the basement at arizona. pads are two games out in front of the d'backs for fourth place in the national league west. pads are 8-5 going for their second straight winning month. san diego also has a scheduling advantage down the stretch. 8-15 games are against teams above .500. back to the nfl. what's worse than throwing a career high four interceptions in your first game as q.b. of a team you were supposed to be the savior for? how about getting blasted by former coaches turned tv analyst. said jim mora sr. of jay cutler's most game interview after the bears were smacked by the packers, quote, i thought he looked completely immature and acted like he didn't care, closed quote. added, mike ditka, quote, somebody needs to talk to him. cutler's response, i can't worry about it, which might sound cavalier but he does have the defending world champs coming to town. george smith has more. continuation for as much as you could? >> yes. i appreciate you qualify that one of the most frustrating things to do for the reliability failures and i separate that but 90% that causes the design flaw and with that caveat, it is our belief were nast should do the real qualification steps we could continue with reasonable safety rebates that partly one of our members dr. sally ride was a member of the columbia also of the challenger failure and devaluations. but it is our belief that that could be done. >> on the issue of the commercial development, i have been certainly a supporter of the commercial arch coal transportation system. that is a verifiable area for private investment and also the investment of a fallback position where we needed to but i do want to ask you if we do have that capability but not the or write an order ares 1 ready to go and we still have the gap in the nests the capabilities you think exclusive reliance on the commercial development is justifiable in the face of the need to utilize the space station and or does that concern you? >> the reason we offered options that depend heavily on commercial development is we try to free nasa money and talent to tackle the tough problems rather than running and other service. when the government stepped in and awarded contracts to carry the mail, that was the thing that made the airlines viable and nasa has and pursuing this opportunity and it bears the risk. many firms involved without major launch systems in our evaluation we are particularly conservative with their capabilities some claim they can have vehicles ready within three years. we think it is more like six years. but certainly there is no reason these companies can produce viable capability given the support of the nasa. >> will you be comfortable they could provide that service if there is a gap. >> i think the answer is yes but fortunately we do not have to answer that at this moment. there are other alternatives available including launch vehicles, we could use a russian launch vehicle but none of which are attractive as an american all the way believed an international programs and if you have international programs that are meaningful, we have to get used to having other nations on the critical path but at the same time there is no more critical path and to carry astronauts to low-earth orbit a think that is one exception to have capability. my answer is risk, not trivial risk, but it is a risk worth taking. >> thank you, mr. chairman. >> following up with the question on the commercial, you're looking at the cargo capability on commercial because the next step of the question of safety for human capability capability, what did your committee come up with on that? >> it would be our recommendation that has nasa develops new launch vehicles, it would make arrangements so they could be him been at an appropriate time we think it is wise to address how would you rate those commercial vehicles? >> did your committee have a time in which you think they might be ready for human rated commercial vehicles? >> i think mr. chairman i better provide that for the record we did evaluate that but i cannot remember it is not within the next six years or so but i will provide that for the record. >> senator bitter? >> too directly follow-up is that to say he would agree with the 0h report that it is unlikely that cots would be done to minimize the gap? >> yes. >> okay. going back to the gap and extending the shadow, if you extend the shuttle at least slightly into 2011, as you talked about simply to insure there is no launch fever, but not beyond that and you except a gap verses extending the shuttle beyond that to close the gap, how much, may put it this way how much do sacrifice to extend -- beyond that to close the gap in terms of pushing for word next generation activity? i have been doing this calculation mentally but it would probably be about $18 billion to close the gap. by using the shuttle would be the incremental cost. >> what does that translate into times otherwise using it to pull next generation for word? >> so i guess so it i would characterize that if they let you do the $3 billion additional profile these are not precise numbers. i think the most important thing is not so much that time it pulls forward but when you reach these milestones with new launch vehicles you have money to develop things to put on top of them to go somewhere. >> would you develop a new launch vehicle somewhat sooner? >> if you use that money you could fix telerate some but i do not think, certainly a few spend the money on ares 5 you could pull it out but not a significant. >> how would you suggest we analyze that difference? how would we extend the shuttle or close the gap verses except the gaap and try to minimize it but trying to use that money to where we're ultimately going? >> we did do that analysis and we will provide it. it was our conclusion continuing this shuttle to close the gap is a viable option and one that we offered. i am trying very hard not to make a recommendation. but the more money that you spend in the near term the less you can do with the exploratory program. so the cost to operate the shuttle is quite high. >> that is rare was going that is a lot of money. to continue the shuttle. represent louisiana which includes and i am all for the external fuel tank but my concern is once you start putting off the next generation that much, he threatened ever getting there. are you threaten really building a consensus and a reality that people think we'll ever get there so we don't. do you have a reaction and? matured coming back to the fundamental problem of mass of that it does not have enough money to generate the next generation while it operates the current system so the consequence today is the gap of which we are not particularly happy and there will be another problem we can complete the ares 1 and what will we do with the ares 1 and ryan when we get them? and when we complete ares 5 it will be a little lunar lander or a surface system. this may be the first of three or four. >> just to be clear, this concern of mine is not solved by the extra $3 billion? that mitigates it but that trade-off is still there even with the higher funding levels you are talking about? >> the problems we have that add-on to the $3,000,000,000.1 of them includes a shuttle the other did not include the extension of the shuttle beyond mid 200011. >> okay. i want to ask a series of questions around the major themes of your report. the fact if we have a robust human space program, that it will have to commit the resources to specifically talk about 3 billion per year. your architecture is the various and engineers such as yourself and leadership have to determine fact architecture but the goal that the committee has said it is to go out beyond glo bourse order that nasa ought to explore the heavens with the human space program and in the meantime we have to worry about the work force. and i want to pick up on those three themes that i think will be the major themes the president will have to make his decision. you came up with this idea of 3 billion per year. if you had additional resources, what would you do? >> beyond the 3 billion? the primary things that we think need to be done in the near future are largely covered in the 3 billion figure. if you add additional funds funds, you would be able to move forward somewhat, some of the work that the area's one but it could be a modest amount that you could excel rate that. you could move ares 5 four word or an alternative which would be very important because that is the long pole in our space exploration tend. >> the ares 5? it is a heavy lift capability and a good example. >> you have come up with the idea or a consensus that you feel the 3 billion is enough in order to support a robust human space flight program in the near term without having to shortchange other missions and science and aeronautics? >> we believe that is true we assume good management for the additional money. and we have also proposed creating a fire wall between the human space flight funding and i emphasize finding or not technology and the science program because as we all know, the human space flight program is so large it tends to cannibalize the space program. do you feel that nasa, in order to maintain the most robust human space flight program, do you feel like the realities of this gap are unavoidab unavoidable, and the fact that we are going to have this gap with that $3 billion that you can keep things going by developing the new technologies on down the line? >> to eliminate the gap or significantly reduce it, would have a significant negative impact on the long-term exploration program. i think the gap is something that we're presented with, based on decisions that were made in the past, perhaps good decisions, i don't know. but i think that we're to a considerable degree stuck with a gap. >> did the committee look at taking the constellation program as it has been defined and see how much it would cost to execute the constellation program? >> we did. and this $3 billion profile that's added permits either the constellation or several other options to be carried out so the answer is we did, and it can be done. >> but according to one of your charts, which we can show up here, and what you call the -- the less constrained budget, the first one under the moon, first operations, right in the middle of the page, the less constrained, or, in other words, the $3 billion additional each year, with aries 5 is the heavy launch, and with aries 1 and or wry on and crude alio, under that funding scenario, lo and behold, the space station is going to go in the drink in 2015. so your committee also said that's unacceptable. i happen to agree with you. i mean, why would we spend $100 billion building a space station and then put it in the pacific? but that's what the funding profile is for that hong woo-hoo hawarden when will i can't see that chart but i refer to option three. >> and option three was intended to take the baseline program of record and apply less constrained budget just as we did at the other cases. the program of record as you say splashes the access and early 2016. it completes the flight of the u.s. in 2015. the >> how is it with what you call the constrained budget, which is the present [inaudible] [inaudible] -- i hope it from your lips to the president's years. option number one, constrained. no $3 billion extra iss in the ditch in 2015 and areas have five and one. so, what are you buying extra from option one option three? and option three you are getting an additional 3 billion. >> option is the program of record of course with the current funding, and with that, you basically get launch vehicles with nothing to put on top of them. i am oversimplifying, mr. chairman. with option three, i -- you are able to develop the area of life in an earlier time and peery -- [inaudible] [inaudible] -- rather substantial to be getting the program and one gets funding to carry out assignments on board, the science and technology on the board the iiss over that in your period. >> and i think that is the answer. it is the additional science and technology that the chart, and maybe the chart needs to be refined before the final report comes out. option one and option three or a difference of $3 billion, yet it looks like they present the same result because in option three you are putting the space station in the pacific in 2015 under this. the difference with option number four is you have replaced aires one and zero rollin and with a commission to get to earth orbit. >> you're point is a very good one. this chart is somewhat misleading. there is also the date the change when things -- when you can conduct human exploration missions. that is our view, not necessarily nasa's. whereas option three you could do a considerably earlier. >> since we have consensus of opinion that we need to get nasa out of l.e.o. -- i know you said you're not in the business of recommending a specific course, but do you have any personal feelings you want to share with the committee? >> mr. chairman, we have tried very hard to not put you or the president -- options and if you don't agree with afterward about that. so, the answer is that i feel i could speak for the committee on options one and two we deem to be modifiable. the remaining three primary options, each has some advantages and disadvantages. and the committee has never discussed with our personal preferences are. i have no idea what my colleagues believe. i would go so far as to say that these flexible path options are particularly interesting to me because i am concerned that if we committed to going to the moon, there is a reaction as a primary objective many people's reaction as we did that years ago, why do that again? if we take down the iiss so you don't have things happening between 2015, 2020, you have the problem and you just described, mr. chairman. and a few say we will go to mars after the moon there is such a long period of time how you cite young engineers who want to commit their career to that and cite tax payers to want to pay for that. and so to me there is great marriage to having interim milestones along the way to mars, still going to mars ultimately but where you can point to significant technical engineering, scientific if you will advantages and accomplishments. what i am saying to be more specific is that clearly option five carries that the opportunity. you could marry that opportunity with some of the other options as well, and indeed we have done that with option 58 which ties in to the ad versions of area five. >> at the end of october, this year, nasa is on the way to doing a full flight test of the ares 1 bickel licht x, it is rocket boosters with a segment on the top with a dummy zero wrong in it is its dynamics, the avionics, etc.. did your committee discuss any attitude about that particular test that's right down the pike less than six weeks away? >> the committee did not discuss that. i did discuss it myself with the administrator of nasa and of course it is his call to make. i have enormous respect for his ability and judgment. if it were my call, i would fly it, and the reason is negative we will learn important, technical -- we will gain technical knowledge we have paid a great deal to get and we should get a to and if we continue in the ares 1 it is an important piece of information but it relates to ares five and others. while it has technical problems some not significant, there is no reason to believe good engineering and sufficient funds won't make the ares 1 a good vehicle and a time. >> let's talk about my third major category that i think the president in making his decision is going to have to look to, and that is how is he going to keep this extraordinarily talented workforce operating. share with us what your committee deliberate about that. >> that is the key part of this whole question. needless to say this is rather esoteric business and it takes years i have observed to begin to understand some of the subtleties and gain the culture that goes with launching rockets. one of the reasons be that this is such an unforgiving business we generally don't get recalls in this business. nasa has without question the largest talent base in the world today to conduct space activities, both human and robotic. that is a national treasure to us. the options we have offered beyond the 2i have suggested are probably not liable for they all have or will have the same overall budget, and unless one makes a major shift to hell one conductus business the overall nasa and why mad should stay about the same. however the mix of that will certainly change. flake sample if we terminate the shuttle in 2010 or early 2011 the people who have been focus focusing on shuttles are different people probably than needed to build areas one and ares five or whatever shuttle vehicle so there will be changes at skill. we looked at me to kind of asset when it comes to human talent. one is the overall work force, namely jobs, not an an important subject. it is our view it will be tragic as the jobs program. nasa has more to offer than just creating jobs. the other we looked at our those critical skills only people at nasa or the industry are likely to have. those we think it is important to preserve and we need to consciously go out and do that. an example would be large segment of rocket motors it is an art as well as a science to build those things safely. if we lose that capability will be hard to get back. building of liquid oxygen we would like to see us learn how to do that in space as well as your honor of. we have to find a way to preserve and mr. chip and if i could exchange your question one last comment as i have said before has high-cost base and makes it extremely hard to create new opportunities and options when you have that cost base and part of that fixed cost base is the facilities and it would be -- [inaudible] great deal of latitude that he is responsible for. >> [inaudible] -- of mountain that's going to change some of the difference in terse according to the work force does -- [inaudible] >> we might be building the new rocket with the technologies and the new money that you have laid out. so i hope that the president and the administrator of just exactly what you said. the flexibility so that he could utilize that work force in different places with different missions so as to minimize the economic devastation and in this regard i will put on life provoke hanft because the center that is going to get hit the hardest is the kennedy space center, the cause of the listening launches of humans. now, if indeed for example the president were to pick that option of a commercial, that can come in and make some amelioration of that lay off, but it's not -- it's not going to stick and so we need to give the administrator of nasa and flexibility. thank you for that statement. i want to ask you what if you had more time, you had 90 days, you had more time. do you think the results would change? >> the first thing my wife would have divorced me. [laughter] >> i understand. >> all ten of us have regular jobs so to speak. and when we began i questioned whether 90 days was adequate to take on the task of this type. we could have done a more thorough analysis, given more time. but it is also my belief that if the differences are small between the new options and the current program we should stick with the program. and so i think we are not discussing the small differences. there need to be significant differences. and our conclusion is it would be easier and we would have been able to get the third significant figure much more accurately, but in terms of the basic thrust of the options we've offered in the assessment, i think we could stand behind them. >> you had testified earlier that your panel's recommendations are don't rush the shuttle flight out, keep safety. of which by the way parenthetically i assume will be a theme that will run throughout your report once it is produced publicly that all of these items that safety has to be paramount given the experience, the very tragic experience we have had. but you have indicated in your testimony that you thought that it's realistic to think that at least part if not all of fiscal year 2011 would be consumed by the flying out of the shuttle on the remaining missions to supply eddy equip the space station. did you attach a dollar figure to 2011 and that fly out since the president's budget right now, and i will refer to the omb budget, and i say that sarcastically. only provides for fiscal year ten on a flight out of the shuttle. did you attach cost to that? >> we did and we have spoken with a wendi in the order of the number. i can't speak for a way be obviously. my recollection is mr. chairman you should check that to be exact. it is our view that is very important to get that to the 2011 budget and as you say it is sent there today. the problem of not being there as it introduces pressure on getting the time i refer to that as large fever something we try to fight at the company i used to serve. it is a subtle pressure and by a challenger spoke to that pressure as one of the causes they thought and having said this i would hasten to add we spent quite a deal of time talking to people responsible for launching the remaining shuttles, and they are very conscious of this. they are taking an attitude they won't be worried. i think they are doing everything right. the problem is they are going to run off of a budget cliff 12 months from now, and we need to fix that for them, and i think if we do, they will manage things very properly. >> am i have been amazed as i've watched this entire space team knowing the space shuttle was likely to country and in the and they haven't missed a beat with a still negative morrell. to me i am just amazed and very appreciative. >> i never cease to be amazed when having to close a plant, terminate a program of the commitment of the people to doing just what you said and that is particularly true in the arena and the defense arena where what they are doing is more than building which it. >> that is correct and i might say thank you for putting that on the record. it's important the white house and a owen b. hear what you've said and its budget for the out year 2011 and additional budget authorization of $2.5 billion in order to fly out the space shuttle and year 2011. but that is in a budget planning document. it has to be put into reality and there is only the white house can do that with the congress come during. let me ask you as you look to the future, do you think, or let me ask you, what is your opinion about a constant source of funding and adherence to a defined plan once the option is chosen as a key success for nasa's teacher? >> that clearly would be a key factor if it accounts for the unforeseen reserved at the time and funds and technology. it is almost impossible to manage a program that goes out to the year 2030 when you don't know what the funding commitment is and you have to redesign the program each year. this is a program that probably involves tens of thousands of contracts and subcontractor agreements, and when you change the budget, you have to renegotiate those and rarely do they go down and you renegotiate so the total costs go up. stability of funding would have an enormous impact. having said that i recognize the difficulties you face in your chair when you don't know the economy is going to collapse a year ago. and that the government's receipts are going to drop. it's not clear to me how one can guarantee a program but for the kind of time period it takes to undertake these major pursuits. but anything that can be done by the congress and the white house to put stability in funding and let the nasa leadership know ahead of time but that funding is going to be so that they don't have to guess would be one of the greatest contributions you could make to the flight program. >> let's talk about these options, for a through the bottom where the am i crew to the low earth orbit despite the commercial provider instead of nasa vehicle you know the history of developing spacecraft you think that seven years that you could have one of these commercial operators be able to get a human crew out to the space station? >> i think if you were to have several paths with several operators, several firms not necessarily only the smaller firms that were put on their feet but also some of the larger and more experienced firms that are probably less quick but have more scar tissue i think if you could have several firms involved through a competition the chances would be very good that one but her success. the feedback to earlier in my career when we had icbm launch vehicles -- i speak to the atlas icbm's in those days i was involved were designed to real liabilities that don't even approach -- [inaudible] we talk about [inaudible] we called man reading in those days and correctly. we find a way to man great the vehicles in those days and then they perform very well. so there's no fundamental reason this shouldn't be possible. it isn't without risk. there are backups one can consider that is there are other launch vehicles including four of launch vehicles during the period of time. >> so when it comes to u.s. -- [inaudible] confident of that capability? >> i think that is true. it's provided technical oversight and help, which gives me greater assurance and these firms have some very talented people and i think there is every reason to believe they can be successful. >> you want to talk to us about the differences between the ares fight capability and your discussions as an alternative to ares five plight? >> i would be glad to do that. the ares fight is part of the current record of the one fortunately it has not been able to be funded because to keep the budget for the ares 1 and orion on change we have put a delay on starting the ares 5 and things that might go with it. the ares 5's light is very similar to the ares 5, but it has less capability and the basic figure as you know 150 metric tons, let's see in my getting mix, 140 metric tons for the ares 5, and 130 iowa -- there's about 820 metric ton difference in terms of payload. the ares 5 white basically has one of less engine and has half a segment less on the solids and could be designed to have more margin and that's important because the ares 5 even today many years from the first launch has very shallow margins and if there is one thing we have learned i think it is having margins is the blessing of the space program to be able to read things. the ares 5 would be used in companion with ares 1. it's referred to by nasa as one and a half warehouse busbee team white would be used with other ares 5 as its companion. that also has advantages of having a scarce and so on for launch vehicles of the type so through the ares 5 which gives -- my numbers are escaping me at the moment but let me just check -- its 160 -- >> metric tons for the ares 5 and for the light it is 143. >> thank you. to have 120 metric tons of wheat to ares 5 and you have come excuse me, you have a substantially less weight with ares 1 than glesby 18 combination so we think there's a good deal of merit to the ares 5 light approach. the disadvantage of course is that the ares 1 is partly developed and the ares 5 is not. >> according to the much more complicated chart, you could have the ares 5 light friday to go in the early 2020 s if you went the flexible path, if he went to the newland first -- to the moon first. of course the president said in the campaign he wanted to be on via moon by 2020 so that is pretty much out the window according to your panel, isn't it? >> that is true. >> since you are talking early 20s you could have ares 5 ready and have a scenario by which you could get ares 5 with a crew as also with a lunar vehicle or but vehicle? >> we are speaking to the larger budget level of course and the answer would be yes. >> do you want to for the record get any comments about the alternative e. -- eelv? expendable launch vehicle? >> yes, it is one that has been with us for many years and traces back to the icbm program in fact and it has been extended by the department of defense. visa vehicles have been he used in various forms. some not yet carrying the full weight that would be needed for this mission. and the vehicles are improving. they are not here rated and they would require additional development. they offer legitimate alternative. they also offer the advantage that the department of defense and the intelligence community might find useful. and we could have some savings that offer the disadvantage of having to coordinate vehicles coming down the line of fruit gets what and who gets first priority. but it would be the committee's view that the eelv family is a laudable option worthy of consideration, and we have not attempted to make specific choices here. in part because it would require a great deal more analysis not wanting to take a position. it is a joyous good engineering could make. >> i'm curious years of accomplishment is under using a eelv guinn the flexible pad and you're looking at the years 2015, 2016. can you comment on that? >> yes. the reason for that of course is the call has changed. the goal is much less demand and on the flexible path option. >> said that would still get you out on things like astrolabes or one of the martian moons utilizing a eelv? >> upgraded, yes. >> and you could do that within the span of 2015, 2016? >> would be well beyond that. i unfortunately don't have the numbers with me but it would be well beyond that. >> i was looking from this complicated chart. >> i don't have that chart. >> under that plan on the same chart you would be the late twenties doing a landing on some island. >> that sounds more correct. >> did your committee discuss an atlas wartell tuck on the eelv? >> we did and they are both certainly plausible candidates. i do have it, and thank you. >> how did your kennedy arrived at the cost estimates for the different options? >> the committee as i mentioned hired them what to assist on this regard and we had a good deal of help from nasa and we ought to and the nasa estimates they have and the probabilities of confidence levels that go with them. the corporation has some models based on a large number of prior programs i believe 77 prior programs, space programs. and the laws will also show correction factors account for the real world experience as compared with estimates made at various points in the programs. the took the work break a stricter line by line and considered what was be a majority of the work under that line item. is this a component that exists which case the fact they would add 1.0. if it was a component that was just beginning depending upon the component id used a factor of about 1.5. if you go through that whole set of items it is about 1.25. factors as i say we in the majority of the item in question so that tends to reduce the factor added somewhat more who. nasa has raised the point that they consider some of these factors were many of them were included in the original estimates and win aerospace stake in the steps we've double counted. the aerospace corporation believes that is not the case and even if it is the case, is unlikely we have been too conservative and i will give you one reason if you look at the set of programs the corporation uses a think it is 77 programs for the host of programs have given factory. if you take the human space flight programs from that sit you have a factor almost twice as great and so, even if we have double counted the chances are we've double counted in the order of 10% or so and experience would suggest that is probably not a bad thing to do. >> how do you answer this question that he spent $8 million thus far on the present architecture that includes ares 1, and now we are going to abandon that, having spent $8 billion? >> my answer is we offered a set of five options. we have not suggesting abandoning ares 1. some of the options to abandon. we could continue with ares 1, no question about it and we could continue with the space shuttle, it is a question of if you do all of those things you just don't get some of the things in the future like build ares 5 or heavy lift vehicle which we think is what this nation has badly needed since the first of the studies i was involved in and recommended at that time. so ares 1 in our mind we have not recommended it be discontinued or abandoned. if it were to be abandoned we think there ought to be compelling reasons to abandon. one of the strong sentiment five deride in my career is constantly changing programs is one of the worst things you should do and should only make changes for compelling reasons. we have offered the pros and cons and it's up to the reader to judge what the definition of compelling is in their mind. there are liabilities continuing with ares 1. one of the liabilities is under the current program plan as i mentioned at the outset, we won't even get it until two years after the iiss is by our estimate. if we extend the iiss we will be able to use ares 1 about three years to support then there won't be that much to do with it frankly until we get to ares 5 but we will get their leader because we spend the money on ares 1. on the other hand the ares 1 is designed to be the most reliable vehicle ever built and there is a chance that will be the case. as you say we've spent $8 billion that is a cost negative you nonetheless we have spent $8 million. there's a lot of people working on it and we are getting ready to conduct a test what one might call a prototype of that vehicle and it, too is a viable vehicle. sell i would like not to make a choice here but point out the pros and cons. >> if the president were to pick the option of the ares 5 heavy lift or flight you will be able to utilize the technology that you've developed for the ares 1 so you don't lose all the value of the $8 million that's already been spent read is that the committee concluded? >> that is absolutely true and similarly, if you pick another option you can always complete the ares 1 by adding whom money. again i don't have my data but i think it is 1.5 billion or so but pretty soon you add up these things. we tried very hard to scrap for money so our profile was $3 billion not six or five. >> what was the committee's thinking on promoting the development of orbit refueling? >> interesting question. as a matter of fact, some of the ridings you may be familiar with, pointed to the enormous the advantages of orbit and refueling and over the years we have had efforts begun to look up the subject but have never carried them to any great fruition principally for financial reasons, cost reasons. it is our belief that the on orbit refueling will be a factor in the space exploration one day we are not ready to undertake it today. it would be too dangerous. but there is reason we know of from an engineering standpoint that one cannot do it, and we would like to use some of the money that we propose spending under these options three, four, five, to run tests first on the ground, and then in the general vicinity of iiss on orbit, and once that's been done it could have a significant impact on some of the options for example the closely divided shuttle options benefit substantially from the orbit refueling, so we think it is something ready for a major technology effort today, but not anything further. >> did you have any in your discussions any idea of the time in mind as to why and we should try to target for on orbit refueling? >> i would like to provide that for the record if i could. >> okay. does any of the staff have additional questions or do you want to keep the record open? that we will do, keep the record open for members of the committee. i know senator pryor was trying to get here and was with his father, the former senator so i am sure he will have one. can you give an estimate how much it will cost to continue flying the shuttle until ares 1 or a commercial solution is available in that range of 2016, 2017? >> that was the -- >> let me complete the station because it is one of your options, and that would also support the iiss until 2020, and maintain the development of a heavy lift capability by the early 2020's. speed if you were going to continue the shuttle to support through 2020 -- >> that's right. >> he would probably have to add negative -- >> just until a new commercial human rated vehicle would be developed. >> him unrated, of course. >> that doesn't seem to be one of the -- [inaudible conversations] >> yeah, it would be the best of all worlds. [inaudible] the question is what is it going to cost? you had a human rated capability you keep the station up there until 2020 so that we have the value of that, and at the same time you do your technology development of a heavy lift capability by the early 2020's. >> my estimate is the additional cost 10 billion. >> over the whole time period? >> yes. >> that is above the 30 billion over the tin your period which was 3 billion per year. >> exactly. you have to add that or at least to get out of the -- [inaudible] -- options very operating and in production and for that period of time, then driving from the external tank becomes a possible option. the difficulty of course is we only have three shuttle's left. the loss rate will be very low. you go to the level of launch rates and start worrying about safety. >> that would be more like option five -- [inaudible] -- the space station on till a commercial human capability were ready. >> you describe it the derivative and he would continue the shuttle. >> any further questions from the stuff? okay, the record will stay open for a couple of days. and again, i want to thank you for what you've done. this was very unselfish work and i think the president has a major decision and there is nothing like a president making a bold decision to focus the nation where we ought to become technologically and he is at that point, and you have laid out a lot of parameters. and i think it is going to be up to the president. we will certainly advise him but it is his decision, and it is at a tough time because of what we are facing with a budget deficit. just look at these gyrations we are going through right now in the senate finance committee trying to come up with a consensus on trolleying to meet the health care problem street on. very difficult. but i believe the president is a visionary and the president is going to take a bold stroke not unlike president kennedy. and he set this nation on a course that was extraordinary, and it is my belief president obama will do that. with that optimistic note, thank you. the hearing is adjourned. >> thank you, mr. chairman. [inaudible conversations] next, a hearing on private health insurance. witnesses and put policyholders and insurance company executives. domestic policy subcommittee dennis kucinich chaired this to our and 50 minute hearing. [inaudible conversations] >> good morning. the domestic policy subcommittee of the oversight and government reform committee will now come to order. today's hearing will examine how the bureaucracy of the private health insurance industry influences the relationship during physicians and their patients. this hearing is divided into two parts. today the subcommittee will hear testimony from patients and health care providers with personal experiences. the subcommittee will also hear from a four or health insurance executive who will testify about internal practices of the industry. and to individuals whose focus is on health policy. tomorrow the subcommittee will hear testimony from top executives of the six largest health insurance companies in the united states. without objection, the chair and ranking minority member will have five minutes to make opening statements followed by opening statements not to exceed three minutes by any other member who seeks recognition. and without objection members and witnesses may have five legislative days to submit a written statement or extraneous materials for the record. an observer of the public debate on reform of the health insurance industry would draw three conclusions, all of which are false. the first is that government doesn't play a role in ensuring health care today in america. the truth is tens of millions of americans get their health insurance right now for a government-run insurance, medicare, medicaid, va and tricare. the third myth is it is wasteful. the truth is government-run health care has lower prices and much lower administrative cost than private insurance. government-run insurance negotiates hard bargains with pharmaceutical companies to get lower prices. it has no multimillion-dollar executives colin no corporate jets or dividends, no lobbying expenses or campaign contributions to pay for. and no television advertising. private insurers pay for all of these things out of the premium dollars they collected and these things have nothing to do to improve health care outcomes. the third myth is bureaucracy is solely a government problem. the truth is that for millions of americans there are layers of corporate bureaucrats standing between them and their doctors often on matters of life and death and those bureaucrats work for the private health insurance industry. the hearing we will hold today and tomorrow will examine the cost, techniques and consequences of the bureaucracy of the industry. wall street considers paying for your cancer treatment a loss and want to see health insurers keep those losses to a minimum. they have the statistics known as the medical loss ratio, or mlr that keeps track how effectively private health insurance bureaucrats achieve that financial objective of keeping losses at a minimum. to please wall street, private health insurers have to deny medical claims, a raise premiums or both. even as the rate of inflation of medical prices has increased, the share of premium dollars spent on medical care has come down to about 83%. from over 90% in the early 1990's. the state of ogletree record and pockets aren't replete with recent findings of wrongful denial of health care by private insurance bureaucrats. for instance, in 2008, pacificare paid $3.5 million fine, 25 million in premiums and reimbursement of medical expenses and restoration of health care to nearly 1,000 patients to result of violations of california law including ron kissell denial of 130,000 claims , incorrect payment of claims, failure to acknowledge receipt of claims in a timely manner and for imposing the hassle of multiple requests for documentation already provided. similar regulatory actions exist for nearly every private insurer. private health insurance bureaucrats plea with the lives of people. our constituents, and when they are at their most vulnerable, when they have a life-threatening injury or when their children develop severe diseases, when their parents are battling cancer, this is when the pressure that insurance companies can bring is the greatest. for managers perspective people who need their health insurance to cover life-saving medical treatment threaten the company's medical loss and investors want mccullough's to be minimize to maximize profits, pure and simple. the fact is that in america today you don't know if your health insurance will take care of your bills until you become seriously ill or injured. by then it is too late to shop around. you buy health insurance on blind faith coverage will be afforded when you need it. but you receive no guarantee from private health insurance especially if you get very sick. and that contradicts the purpose of health insurance in the first place. to spread the cost of illness especially serious illness requiring specific care. we will hear today how the private health insurance bureaucrats become more sophisticated that denying extensive treatment and more effective wearing down doctors and patients, conditioning them to choose to pay for the treatment themselves or to go without rather than insist their insurer pay. in the business of private health insurance, corporate bureaucrats may put profits before people thereby becoming as noxious as disease itself. such was the conclusion of the ohio supreme court when it upheld the largest jury award in ohio history against and and some for denying lifesaving treatment to esther gardinger. nmk!rus)s,!u)!,sa,h!a)emhd;@ @ s hearing and want to thank the witnesses for participating and look forward to hearing their unique perspectives on this important topic. i know many of them have tragic so stories to share and they certainly -- you certainly have our sympathy. the ongoing health care debate is extraordinary. americans bought previously engaged in politics are attending town halls, rallies, tea parties. in august and the september i had the opportunity with constituents in ohio. each and every person expressed grave concern about government-run health care system but no one denied the current system needs reform and that is what i hope we can gather from the next two days, the kind of reforms will make sense and help families, help small business owners and americans. health care spending is out of control and we are not covering the most vulnerable. medicare alone accounts for 3.5% of the product congressional budget office predicts by 2018. without intervention it will be as high as 13.5%. total health care spending in 2007 exceeded $2.2 trillion that represents over 16% of gdp. in the debate there are areas of agreement between republicans and the president back last week to the joint, christa president said, and i quote, let me set the record straight. my guiding principle is and always has been that consumers do better when there is twice and competition. that is how the market works. mr. chairman, on this point i agree with the president, that we have co-sponsored a piece of legislation, h.r. 4400, that relies on free-market approaches and tax credits to incentivize americans to buy their own plans instead of mandates and surtaxes which are part of the current house bill passed out of committee. our bill allows individuals and businesses to purchase insurance across states, increasing choices from a dozen carriers to over 1300. in contrast, the bill being discussed decreases competition by installing a government subsidized public option into the marketplace to crowd out private sector. the competition in the private market helps reduce prices. government-run monopolies will cost all of us especially children and grandchildren. rather than federal government serving as an intermediary my colleagues and i realize families are best served when there is a strong relationship between them as a patient, their primary and specialty health providers. our plan strengthens that relationship by reducing the practice of defensive medicine, brought about bye lawsuits and acting in medical liability reform will reduce the price of medical malpractice and defensive medicine both of which are passed on to consumers through increased cost and higher premiums. by establishing health course and crating best practice measures we will eliminate the lawsuits that harm positions while ensuring justice is done to the victims. mr. chairman, i hope that the comments are on the board. i hope the trust health care officials more than a government bureaucrats. they want to keep what they like best about their plan while addressing the problems with costs, excess and portability. mitra's trust all the ingenuity and compassion of the american people and professionalism and confidence of the health care professions. thank you, mr. chairman. >> i thank the gentleman. the chair recognizes the gentleman mr. cummings. >> i want to thank the chairman for convening this hearing. it is a very important hearing. one of the things i want us to keep in mind is that insurance companies are making life-and-death decisions every single day. folks talk about government, worrying about government coming in and making decisions. insurance companies are making life and death decisions every day. there is a gentleman in my neighborhood who had a swelling on his leg, and i guess maybe about two years -- i see him every day. i live in baltimore, 40 miles away from here, and he went in and he found out that it was cancerous. he had surgery, then he had radiation, and then he had chemo. then the cancer apparently spread to other parts of his body. and he had been a hard-working american, working for the city of baltimore, and he had moved into a disability status. and he used to tell me about his problems and that the copay for the chemo left him in the position he had to choose between eating and paying the co-pay. and i would see him almost every day. and i just think our society is better than that. this is the point in time where we must put -- we've politics at the door and address the problems of all americans. we need to keep in mind as the president said the other night, the last two years one out of every three americans have had a gap in their insurance coverage. and what does that say? what that says is if you have a gap in your insurance coverage that means you have to get more insurance at some point. this is a bullet in coming over the wire. the older we get, the more likely it is we are going to have a pre-existing condition. and if you haven't gotten there yet you just keep on living. and the fact is that we've got to deal with these pre-existing conditions. where a person gets sick they've been doing everything they are supposed to do, working hard, paying their premiums, and when it comes time for the insurance company to help them, suddenly they find they have no insurance. we've got to deal with the high cost insurance going up. the president said and we have said we want people to keep what they have. but guess what? if it is too expensive you won't be able to afford it any way. that is a major problem. and so, i am glad that -- and i had a town hall meeting and i went well. and i have listened to, what has happened across the country but i'd think we need to hear not only from the people who are opposed. we need to hear from everyday american citizens, who have been placed in the position where they cannot get the coverage they need. and so mr. chairman i applaud you for these hearings, and i look forward to the testimony. >> i thank the gentleman. the chair recognizes the gentleman from massachusetts, mr. tierney. >> thank you, mr. chairman and all the witnesses for being here today. this idea of competition is great and it's interesting to hear people say they want corporations to be able to go across states. i think many of them see that as an opportunity to avoid state regulation, and we have to make sure that if that happens and companies are about to go across the states they don't avoid regulation, just go to the lowest common denominator on this. dealers seeking to avoid competition with any plan that essentially would do things other than their way and that is one of the reasons they are avidly fighting this public option. they are happy to compete with any other plan or insurance company that does the things they do, paying excessive and exhort and salaries to executives, pay a lot of money to figure out ways not to cover people with health care and give dividends not reasonable that are excessive to shareholders will actually punish them when they spend too much of the dollar on the health care delivery. it is a little shocking to me as we watch what goes on in the country at town meetings that so many people that consider themselves out there fighting for the people, wittingly or unwittingly out there shilling for insurance corporation's the prescription drug companies. but they're looking for is the status quo that is a little bit amazing. if they were populace they would be out there saying there is right in time the government ought to step between corporations that go to the excess. between corporations that use power and bureaucracy to deprive us what we pay our premium for and to stand with a little regulation. and we are making sure the competition does work. that doesn't seem to be the message going on out there at all and it is surprising. when ratio the german mentioned before, companies get punished when they show the medical loss ratio is too high. it was common for the medical and ministration to be 95%, every hundred spent 95 would go to health care and life would go to salaries and overhead and profits and the companies are doing well, extremely well. the studies show in some instances the medical loss ratio is 57%. 57% of your premium dollar going to care and the rest of it going to them. i would be on the streets pounding away saying why isn't my government out there doing something to stop that? that's what a ridiculous. you want to go out and yell and scream at the town hall meetings, where the culprit is. they are taking our premium dollars and what do they get in return? rescission. you were in the middle of york. these eckert your records and figure this is the reason we don't you have a pre-existing condition, you don't get care at all or put a cap on it. 60% of bankruptcies in this country are directly or indirectly related to medical expenses families are experiencing, and 85% of those families have health insurance. that's what we should be on the streets protesting about, and that's why this bill should directly look in there and say look, we need to put in regulation. no more precision common gillmor caps, no high deductibles and co-payments and telling people pre-existing conditions are going to keep them off and no more getting away with spending less than a reasonable amount of premium dollars on actual health care services. you can have a decent profit, you could have a decent salary, but $80,000 a day as but some executives are getting and millions plus bonuses plus stock options isn't a good way and that is why this health care reform package all to be more about health insurance reform the anything else. we have to move in that direction and yes, there should be an option out there people say i don't want to go to that private company, that gives that kind of bad coverage. i will take another option, a public auction, and maybe these people will do the right thing. maybe when they see that there's somebody not playing their game and we are not going to let people in the game to do with the way they are doing they will have to behave better and that is this is about and hopefully with the american people will understand and move in that direction. thank you, mr. chairman. >> a thank the gentleman. we are now going to hear testimony from the witness is. and the first witnesses are sharing a personal merit with an congress tend to expound on these matters we are always much more informed when we hear what people have to say about their own experience. and so two of our witnesses will provide information about their personal experience. this is important pay careful attention. there are no additional opening statements, so we will receive testimony from our witnesses. i would like to introduce our first panel. mr. mark gendernalik. is that right? >> gendernalik. >> mr. gendernalik, is that right? okay. mr. gendernalik is a teacher from california where he lives with his wife and three children. his daughter suffers from a neurological disorder known as infantile spasms. ms. erinn ackley is a resident of montana where she lives with her husband and their daughter to read and 2006, ms. ackley assisted her daughter in a struggle to obtain approval from this private health insurer for prescribed medical treatment. dr. melvin stern has been a primary care pediatrician in highland maryland the last 28 years. in addition to the direct patient care, dr. stern has been continuously involved in teaching the medical students, pediatric residents, and physician extenders such as physician assistants. dr. stern has served on the medical faculty of the maryland chapter of the american academy of pediatrics and also previously served as the chairman of the maryland state medical society legislative committee. dr. linda@@@@@@@@@ "rr)rr companies. mr. potter was the chief corporate spokesman for cigna insurance company. i want to thank each and every one of the witness this for appearing before the subcommittee today. .. your complete written statement will be included in the hearing record so if you are worried about not giving in a certain word just know it is going to be in the record of the hearing and all members will have access to that. we are going to start with mr. gendernalik. you are going to be our first witness and we would like you to proceed at this time, and before you begin i would like to recognize and welcome the distinguished gentlelady from california, congressman watson. thank you for being here. you may proceed. >> mr. chairman, members of the committee and want to thank you for inviting me to share my daughter's story with the. i hope it will inform you about the human side of the business of health care in america. as americans it is an honor to be a part of this democratic process of such an important time. like many americans i'm unashamedly guilty of the sliger that comes with that heartfelt feeling i live in the best country on earth. i unfortunately bats swaggert where's then when we don't deliver when we come up short. and health care is one such area where we are not the best in the world. we are far too much for health care, and getting far less. far less than the american people deserve and far less than my daughter sydney desert. that has real consequences for people, especially my daughter, sydney. arleigh one afternoon when sidney was three months old as i walked down the steps of the living room of my home her arms suddenly struck out that an awkward angle, her eyes looked odd into the distance. she is three months old. i was concerned but not alarmed at that point. i thought well, that is odd and then we had a few more, and then we bought and sold the pediatrician. and we started what would be the beginning of what may be sidney's lifelong struggle. we are here today to not only help my little girl but the families of the fight beyond exhaustion just to receive the care that their hard-earned dollars were supposed to have provided them when they bought their insurance. soon sidney was sent to a pediatrician, from the pediatrician to a neurologist and that neurologist ordered in mri with contrast dyke and in e.g.. he conducted his own edu cheek and send out. insurance companies, medical groups denied medical with ucla children's hospital. she was then sent to an imaging center that just does x-rays, mri's, images. their staff were incapable of injecting mice small daughter with the die necessary to create the contrast to give my neurologist the images he needed. the end result was my neurologist did not get the images he needed to actively diagnose my daughter but the medical group got to say the little money. mineralogist rug but there and we made the best to cut out of that. we reached the point where he was coming before he understood her diagnosis. it is a syndrome diagnosed by symptoms. we send out for a second opinion just to be prudent. we ordered a second opinion and the insurance company authorized children's hospital to conduct the second opinion and then refuse to authorize the neurologist to any-- to any of the diagnostics to form a second opinion. my wife went to the neurologist and they waited. that neurologists ordered the panel of diagnostics and was denied. we were then sent to ucla where they didn't even have a room for as. we were sent by the telephone agents to say, go there, they are ready for you. my wife and my daughter spent the day without food other than hospitals that in the emergency room so i finally got of work and they were able to tell us that they weren't , and they were not able to service my daughter that they had the position to know where we were coming. or they could add it does today later they may delay did their pilot diagnostics that confirmed to the diagnosis have a sow with the first course of treatment the universally recommended course of treatment called act age it would not return a phone call they would give them answers like we will call back by 5:00. and is under review after six days of being impatient ucla my wife and i living with my daughter and a hospital room daughter said we have to discharge you we cannot get any response from your medical group. at the time i was angry i tried calling the insurance company myself i was hung up on twice. for only asking for a supervisor and a tone of voice like i am using today. finally i call the state regulatory agency and lire able to mysteriously get authorization over telephone to ucla no explanation written documentation or anything quote clearly the plan was to exhaust us or where us out. my time is coming to an end. my final statement we have spent so much time fighting to ensure proper care of all to often i feel like her medical manager instead of her daddy. consumer union is here today with their own ideas how we can put consumers back into this competition scheme we are just a franchise. i just want to go home and be a dad. thank you. >> thank you. >> mr. chairman and members of the committee thank you for inviting me to participate in today's hearing on health reform. i am honored to have the opportunity to convey my family struggles fifth administrative measures phalanx that we went to to obtain his doctor prescribed treatment in the form of a bone marrow transplant. what follows is an abbreviated journey when the insurance company set up one bureaucratic roadblocks after another. my father bill accolade dedicated 31 years of his life to the children of montana as a public school teacher and administrator and in 2003 he wrought days retire to florida trusting his group profit insurance a blue cross and blue shield of montana would continue to pay for medically necessary treatment of his chronic leukemia. in 2005 my dad's doctor determined he needed a bone marrow transplant because his can of beer at -- chemotherapy regimen as no longer accepting accepting -- running with this cancer in 2005 an unrelated donor match was found in 2005 a record january 2006 my dad began two rounds of leukemia to suppress the disease for the transplant four 1/2 months later we were euphoric april 14 when my dad's transplant doctor gave him the news his disease had responded well and he was ready to proceed with the transplant however this is the number one of unexpected and emotional struggle with blue cross blue shield shield -- the cross blue shield of montana because they pay for all other treatments leading up to the transplant including the donor surge you can imagine how shocked we were one week later when the insurance notified the hospital , now my parents that it was the ninth the transplant claiming the procedure as investigational. we continue to run around in circles never actually speaking to a human that could discuss my dad's case to obtain approval for my father's prescribe treatment while his body was still receptive to a transplant. on the surface and may not seem like a long time but when you go through a life for third death struggle you can hear the clock ticking every minute. my dad's dr. submitted for a full transplant but denied on the grounds of investigational both transplant protocols were approved treatments under medicare. neither of eighth time consuming appeals processes were completed in the promised timeframe. during that agonizing time we reach out to the montana insurance commissioners offers to insisted on keeping them in compliance realistic the help of countless friends and families to hold them accountable on my father's behalf and having consulted an attorney that had experience with litigating transplant denial cases per bereday number 48 my dad was readmitted for another round of intensive chemotherapy because his cancer was growing rapidly. we were emotionally exhausted, frustrated and devastated we had to continue focusing summertime and energy to hold this insurance company accountable instead of spending quality time with my father and concentrating on his care. due to his persistence and refusal to accept that denials are the deciding factor in his life and death struggle with the disease he lived with he was finally transplanted on august august 17, 126 days after the first transplant request. what would happen if the first transplant request would have been approved? we will never know. we do know he never returned home. we spent christmas with him in the hospital room he made it to the new year. he passed away january 3, 2007 at the age of 59. leaving behind a grieving widow and daughter and missing the chance to know why if with his only grandchild born 17 months later my written testimony includes a detailed timeline of our insurance company and i sincerely hope you will read it and consider the implications of how an agonizing and bureaucratic denial and appeal process change the course of my father's treatment and affected his chance for a successful life-saving transplant. thank you. >> thank you for your testimony. the chair recognizes dr. stern. >> they do chairman kucinich and members of the committee for this opportunity to before you today i'm here on behalf of the patients and families i take care of the american academy of pediatrics. as already noted i have ben and practice with primary-care pediatrics approximately 30 years and have spent a fair amount of that time advocating for my patients and families and the public policy arena. one of the templates i use for reviewing problem -- public policy if it makes sense for children it makes sense for the community if it does not then we should reexamine. based on that to go forward with the remainder of my evaluation we discuss the bureaucracy of both the private ensure it as well as not-for-profit in 2003 of serving 30% of the health-care budget, a 30% of the dollar is now spent on administration. that is in the private sector. has an example of what goes on and how that impacts and results in what happens with the private office, when i started private practice over 30 years ago, there were two full-time equivalence that were supporting me. one was a nurse fully involved with patient care did nothing in terms of the administration i have a receptionists that handle scheduling and the billing. today, i am still a solo practitioner, with four as a full-time equivalents and the only one exclusively involved with patient care the others are involved with chasing after insurance companies and doing referrals, prior authorizations and arguing for benefits for my family is professor may 8 dramatic increase -- a dramatic increase in office procedures for crow the bureaucracy that we see in the private sector the impact is you have already heard and i will give you a scenario in my office of a newborn with a tumor. the baby was born with a tumor as a world-class hospital in baltimore. and was insured by a for-profit ensure. from the time the baby was born, the insurer required referrals. recognizing i have never seen this baby and was not medically in charge of this baby for me to begin to refer this baby for additional services at an institution that has world authorities in regards to what should be done and have the tumor should be handled was sheer nonsense and obstruction to the care. obstructed it to the point* where there were therapies and devaluations messed and not obtained on a timely manner. but in the end those therapies 14 word initially the administrative burden was labored and people working in conjunction with my office to do the paperwork to gt the child to care that she needed. following the inpatient treatment which required surgery the child began outpatient chemotherapy at that point* insurance company became obstructionist and utilizing the melamed and robert set criteria for evaluation whether the service should be paid for the night inpatient chemotherapy services for understand there are no milliman-robertson criteria for an fluoridation fans a tumors but they proceeded to say there would not allow this baby to have been patient services. the only reason we can afford desai bluntly told them, look, either provide this infant with what are clearly standard treatments in the hospital, or we will have to go public. it is a beautiful baby and will attract a great deal of attention you can deal with this in the media or deal with it appropriately. and they chose at that point* to say we would get it organized. that does not the way to run the health-care system that is not the way i need to spend my time. this invasion and obstruction is not very productive. and finally i would like to leave you with the notion or the issue of two things. one, it is not really an issue of insurance coverage. this is an issue of access to quality healthcare. mr. cummings is painfully aware of a youngster in our community who had coverage but did not have care and died in this very city as a result of lack of care because providers run to available. the last thing come at the current rate we know they lie bill vase hour generating station that we are generating in the health-care area are left at the feet of our children that cents -- lettuce make sure the assets are in their hands. thank you very much. >> i want to a knowledge what you said about mentioning mr. driver we have had an ongoing conversation about that young man's death and i think by the end of the debris will have a chance to recount what had happened with him and this system. dr. peeno you may proceed. >> i appreciate the opportunity to be here. i am a former company doctor who made those life and death decisions mr. cummings referred to. one of my prior appearances was in 19962 talk of how company doctors cause harm and death to patients and the fact that little has happened is evidence that clip of the hearing has resurfaced and is still very time a. after 1996 i continued to work on health-care issues and more than 150 legal cases and have assisted in the appeals i have a wealth of acquired information about the inner workings of the health insurance company. the one thing i have detailed the written comments is this has never been a more deadly time for patients in terms of insurance practices they have been more expert in achieving the cost cutting and saving coal. of four areas are like to talk about specifically, the first half's to do with claims and i see a lot of insurance rhetoric that says they are kinder and chancellor and 89 fewer claims but a recent study in california shows as many as 40 percent were denied but the more interesting thing is what we don't know but the evolution of managed care is to shift the process of limitation to 90 and substitution prospectively so if you create conditions like we have already heard real obstruct and 11 and where people down then those are things that are never recorded there is no data or statistics to show the amount of care that have spend all tour through the process. the sac and saying it is a shift in health care is to move everything more technical so they go over the past decade has been to eliminate the independent medical judgment and the health care professionals to normalize through criteria and other scientific based ways to eliminate the patient particular spur crow coinciding with that is the attempt to make other agents the denial factor by one co-op position and altering the medical ethics to achieve the goals of the company but more disturbing making patients the agents other on denials through the economic changes. fourth, it has been touched on already buy several remarks fact is the expert use of terms like investigational, experimental and medical necessity also the case the mention mr. kucinich which was an interesting case because the definition of experimental changed as it went through layers of review an order to constantly shifting and justify the denial parker in fact, part of the e-mail communication the health plan employees were deliberately delaying because they knew she would die soon because there we're avoiding making a decision in order to avoid dealing with the issue of paying for it in hopes she would die before they would have to address the. the recent attention on and criteria with evidence based madison it sounds wonderful to talk about best practices. we should be focused on that but there is a low level of rhetoric that hides what goes on underneath. companies for example, the appropriateness of a hysterectomy should be the same weather and boston are los angeles this same whether he amana o.r. cigna be yet they are proprietary i company would never purchase criteria that would cause it to be more generous. they are used deliberately to justify denial and limit care and these tools are being developed using public research and should be transparent and publicly available. there are some things i could go into i have seen i went into detail with the written remarks but are like to some of the patients are not anecdotes' but that is the way the insurance company would like to dismiss any claims of adverse effects on health and last, they operate in a medical and ethical and legal void. there is no medical ethics when you work on behalf of stockholders and the legal situation is most americans have no legal recourse because of the release of and holding them accountable. i think we will have no health and form unless we reform the health insurance industry to a system that is of the call and patient centered. thank you very much. >> thank you dr.. you may proceed mr. potter. >> thank you chairmen kucinich and members of the subcommittee for this opportunity the title for today's hearing serves as an antidote as to who or what stands between a patient or his doctor there are many who fear the government bureaucrats but the alternative has proved much more fierce them the status quo for most americans is health-insurance bureaucrats stand between them and their doctors and maximizing profit is the mandate that is overtake and has members discuss the various compromises in the coming weeks i encourage you to look closely at the role of a for-profit insurance company in particular the role they play in making the health care system one of the most expensive and dysfunctional i know the serial have members of congress look beyond the destructive rhetoric of the headlines and help to provide a sense of what life will be like if the so-called reform is enacted. an estimated 25 million americans are under insured for two principal reasons in addition to 45 million who are uninsured a high deductible plans that many have been forced to except have been forced to pay more for her own care. second, the number of a underinsured have increased as they have fallen deceptive practices and bought fake insurance industry's insistence on retaining so-called the benefit design flexibility so they can continue to market these worth less policies. i have spent millions of dollars with companies that specialize in limited benefit plans but the one is marketed called star bridge select not only are benefits limited but the underwriting criteria established essentially guarantees big profits and pre-existing conditions are not covered under the first six months the employer must have an annual turnover rate at least 70% most workers are not on the payroll long enough to use the benefits of no more than 65% can be female. i'm sure you have heard insurance executives say they are bringing solutions to the table to address the problems of the under ensured a fair completely honest they would tell you the solutions they have in mind removing millions more into a high deductible limited benefit if congress goes along the bill may as well be called the insurance industry profit protection and enhancement act. they rarely use the term insurance the refer to their companies now as health benefit company are also wishing company because they have been moving rapidly away from the risks that insurers use to assume for customers and toward a business model that enables them to administer benefits for large self insured companies and also to shift the burden to individual workers if employers are not big enough to self insured performs a member of the subcommittee, asked about the trend and what has been happening to the fully insured books of business and if they're honest there telling you it has been shrinking and they have been taking deliberate actions to make it shrank. according to recent story the largest for-profit health insurance companies have seen a decline in 5 million members since 2007 hour task executives why this has happened and if they expect the trend to continue and ask them what kind of businesses are fully insured? affair on as they will tell you they are primarily small or midsize customers that are not large enough to self insure. that does not bode well for them future of the country as most job growth occurs in small or midsize businesses i would ask what benefits their marketing and those with a high rate of turnover if they're honest they will say their marketing limited benefit or high deductible plans. i would ask cigna in particular wire they are supporting limited benefits conference next month and what does voluntary main? of their honesty will tell you all workers enrolled in voluntary benefit plans pay the premium and high out-of-pocket expenses employers and have to pay a dime toward the employee health-care benefits and they prohibit employers from subsidizing the premiums. as organizers of the los angeles conference notes voluntary benefits are a multibillion-dollar industry and one of the fastest-growing segments of the health insurance industry. another question to ask how much insurance companies to they make from investments by dealing payments? doctors have staff members dedicated solely to get insurance companies to pay claims that have been denied the longer they can avoid paying its claim the more interested can flow mr. chairman, this is the current state of the inadequate it regulated free market system health-care companies want to preserve records have 25 million better underinsure duty insurance company-- industry gets what it once that number will grow people you know, your constituents may be your son's or daughter's will join the ranks of the under insured and will be forced by law to pay private insurance companies for the lousy coverage and you and i will have to subsidize the premiums for those who cannot afford them. i implore you not to let that happen and thank you for considering my views. >> thank you very much mr. potter for your testimony and also your expression of civic consciousness. before i begin my questions i just want to say how deeply moved if i was to hear the testimony of mr. gendernalik and ms. ackley pro how is your daughter? >> she is improving gradually. her condition has a seizure disorder she is now on a medical diet designed to alleviate seizures. we are having some success but she is way off of her benchmarks. we don't know if they will leave her severely mentally retarded. >> your family remains in our thoughts also, ms. ackley, i have the chance to read the exhibits but in particular the obituary of your dad who was obviously a wonderful person and i can imagine what it is like for you to testify. one nablus listening to both of your testimony, and was not just hearing the words i could feel it in my heart. this is the kind of testimony that i think can move the country. you can feel this. they he for being here and our condolences too you and your family from your experience perhaps congress can become better informed from the actions we need to take. if i want to thank dr. stern for sharing his testimony as well as dr. peeno with the workings of the industry. i want to be can questions with mr. potter who as i said earlier is the former head of corporate communications for cigna in philadelphia. first and went to ask mr. potter about the business model of the insurance company. how do they make money? >> they make money by avoiding as much risk as possible and by dumping people that are six they do this to delay or deny care, another is two resend policies that we have read about in the news and has been subject of committee hearings people who have been paying premiums when they get sick with high medical bills the insurance company will review the original application if they find any reason to cancel, they will. also purging small businesses. they deliberately looks to save small businesses whose medical claims are higher than the underwriters expected and they will jack those rates up. when those customers accounts come up for renewal and they will jack them of so high that the businesses have no alternative but to drop insurance coverage. that is why we have had such a drop in the number of small businesses decline from 67% in the '90s to about 38% now. >> we talked about the reduction of coverage will you explain the policy of recission and how widespread was sap practice? >> policy rescission, this is in the individual market but not so much in the market that people get their coverage through their employer. many people to not have the option to get coverage through the employer. you have to fill out an application 51 to get coverage and you have to include whether or not you have been sick or why you have gone to the doctor or have been hospitalized. what pre-existing conditions do you have that they should know about? and in many cases a pre-existing condition means you cannot get coverage at any cost and also children who are born with birth defects cannot get coverage in a system we have now it is a mean to avoid paying claims. if you fail to disclose and do get sick and there are high medical bills letter sent for payment, they will look at your application and look to see if you have in differ in they were purposely not disclosed something. >> one of the things we have been hearing in the past, it is out private insurance industry use special-interest groups to send a message they want to send. can you explain how this happens? can you comment how the industry wants us to believe but they are there to help us get healthier? what do they think they're doing? who are they talking to? >> the industry and i know this from working in trade association in committees committees, they plan and carry out a duplicitous pr campaign. wind is the charm effect they will come here and tell you they're in favor of reform and who work with you as a good faith partner had unable say the same thing they said in 1993 sliced 94 that they are in favor getting rid of the pre-existing condition clause and avoiding or the jury picking. >> they say one thing and doing another. do they do that consistently? >> they say what you want to hear that is the charm. they will talk about how they are in favor of bipartisan reform but behind the scenes they conduct a covert pr campaign that they work through big washington-based n.y.-based pr firms us the up front to groups for them like in the '90s one group called the health business coalition was set up presumably a business coalition but the funding came from health insurance companies and the sole purpose was to kill the patients bill of rights the. >> front groups that mobilized to try to present themselves as representatives of public opinion? >> that is right. they employ pr tactics and they work with the media and members of capitol hill but the pr people have connections will feed messaging to them and talking points and a lot of reporters and producers and pundits who are sympathetic to them. >> i am looking forward to asking mr. potter more questions from my time is expired and before recognize mr. jordan, i want to our knowledge the presence of the gentlelady from ohio ohio, ms. kaptur has joined us and mr. jordan you may proceed. >> i apologize to our committee i have to jump out i have another committee. >> we're always in of how you can be in two committees at one time. >> thank you for this important hearing and two mr. gendernalik and ms. ackley your stories, i think every single american what will agree what you went through was wrong we paid premiums and for honesty should not go through the harassment. this is coming from a conservative republican to say what happened is wrong. americans see this whole health care debate they hate being told what to do the idea somebody would get between them and their doctor whether the insurance company it or the doctor does not sit well. there are things we have to focus that empowers the family and does not take place. i like what dr. stern said earlier i am old enough to remember going into the family doctor there was one per cent out front typically a lady in those days taking care of things and maybe the individual has snores but now there are more people out front complying with the bureaucracy government or insurance more than in the back trying to get you well. but is a problem and what is so frustrating to sell many americans. some of the things that i outlined in my opening statement that i would go to dr. stern. do think we need some liability reform in the current health-care system? is the appropriate? >> the short answer is very definitely yes. >> do you think there is a need for more empowerment with health savings accounts, health association and health plans i was giving a speech before i gave the group's small-business owners are in the business and they said we would love the ability to pull together with other small-business owners and use the economy of scale. does the makes sense and the health savings accounts as part of a way to empower people and health -- help with cost and the system? >> there is a conflict. the issue of pulling together and generating much larger insurance pools makes an infinite amount of sense. in fact, and merrill lynch agreed to have a small business paul the issue of the health savings account and the notion the consumer can be empowered to spend a dollar more wisely flies in the face of what the actual market is. madison is not a free-market. >> i agree with that. >> a free market demands the free flow of information both ways. >> i was going to go there. how we get the transparency? had a we
Related Keywords
Louisiana , United States , Montana , Germany , Texas , Philadelphia , Pennsylvania , Florida , Boston , Massachusetts , Town Hall , California , San Diego , Russia , Washington , District Of Columbia , Jordan , Arizona , Sydney , New South Wales , Australia , Iowa , Maryland , Ohio , Capitol Hill , Baltimore , Americans , America , German , Russian , American , Pat Burr , Carl Crawford , Clay Davis , Bickel Licht , Jim Howard , Luis Durango , Russ Springer , Adam Jones , Gerald Laird , Justin Upton , Jim Palmer , Jay Cutler , Zach Britton , Randy Choate , Mike Ditka , Bo Jackson , Melvin Mora , Adrian Gonzalez , Los Angeles , Gary Thorne , Mike Griffin , Luke Scott , Amber Theoharis , Dennis Kucinich , Nba , Chris Tillman , George Smith , Eelv Guinn , Brian Roberts , Gregg Zaun , Brian Shouse , Wade Davis , Chris Richard , Robert Andino , Jim Johnson , Ron Kissell ,
comparemela.com © 2020. All Rights Reserved.