Association of the association of american medical colleges issued a report calling for much stronger conflict of interest standards, leaders standards, leaders with individual schools saying we just cannot keep going. All of all of those things came together, and the law passed in 2010. But the other piece of context that i think is not proximal to the laws passage but is important to understanding how it fits is this sort of much wider recognition that we really need to understand in this country that drivers of Health Care Costs and where the dollars go, and if you go back to 2,007 it would be close to unimaginable that cms would be publishing individual physician payment records. And so we now have the 1st report from the sunshine act 3. 7 Million Dollars in payments. Thats around nine billion a year, funds that that are either going to research and Product Development which is important and important for the public to understand are going to drive uptake of particular products whi
Dynamics between the region of government of baghdad as well as shifting relations between the groups including the syrian and iraqi satisfactions and implications. I am pleased to have with me an Extremist Group this morning. They include our own associates at the carnegie little east foundation. I cant see him from there. The Research Focused on the dynamics of the syrian conflict and the political role and Security Transformation in the arab world. We are also joined by our associate. He is formerly a researcher at the academy. His research has focused on iraq and authority in islam and middle eastern history and politics. Natalie is the senior fellow of the National University here in washington. Denise was formally a researcher working in the turkish regions of iraq. Turkey, iran, and syria. She specializes on the Regional Energy security and conflict state building. Finally to my immediate left is joseph who has just joined us here in d. C. As a visiting scholar at the carnegie e
Reserves so they can make a cash investment in a Capital Infrastructure to build a city hall or to do Something Like that and also to keep the bond rating agencies happy, to demonstrate that they are good stewards of the fiscal resources. So if you noticed the trend over time, it was much less than what we are now at about 22 of expenditures. Some 25 or 30 years ago it was much less. What cities have done over the last 25 and 30 years is theyve realized several things. One, that you cant predict the future as we all witnessed this last winter when salt reserves for at least the northern cities and some southern as well ran out very early and they had to dig into their reserves to buy more salt and snowplowing services. So preparing for these unexpected emergencies is one of the reasons that the reserves tend to grow over time. The other is that between the time that we started monitoring ending balances in the general fund to the present is that the federal government has become a much
Journal articles to providers out there and whether or not that should be reported. Its one that you and i spent time on and thats a challenging one absolutely but ultimately i am comfortable with sitting down with my provider and asking about a payment showing up in the database and having her tell me that this is related to learning more about this condition, which you dont have but another patient may have and that is why that was there. There are choices. Its to not take it, to take it and report it, or to purchase it on your own. Those are legitimate choices and providers have the opportunity to make those and then the reports go to the database and the patients can ask. We continue to believe thats totally legitimate and legal and attaching we are not rushing to attach judgment here and i hope i can continue to make that case successfully here. Can you wait for the mic please . The idea that a physician should never talk to a pharmaceutical rep or a device rep is like saying plea
Salmonthompson amendment. Daca protects a large number of unlawfully resident aliens from deportation. In addition to constitutional concerns and National Security implications madam chair, the action poses a range of unintended consequences. Case in point the president s policy creates a incentive to hire Illegal Immigrants over lawfully present workers. Illegal aliens who are granted deferred action are exempt from being counted under the 2010 Health Care Laws employer mandate. Which requires employers with 50 or more employees to offer Health Insurance or pay a penalty. Essentially the president s create add situation where employers face a penalty for hiring americans over illegal aliens. Madam chairman, the president s current deferred action expansion promotes the hiring of individuals who have broken the law. Over the men and women who have come through legal channels worked hard, and played by the rules. Congressman salmon and i are proud to offer this commonsense amendment. Th