Projections and also hear it from the private sector. The belief is, having come from the private sector and actually having come from a company that is known for its negotiating on price, walmart, the idea that we use Market Mechanisms to try and put downward pressure on price is something we think is important. Thats why weve asked for those authorities, so that we can try and work with the pharmaceuticals and negotiate to keep downward pressure on that price. Thats what we hope we can do. We see it as part of the overall issues that we are being asked about how we transform the system for the long term. We believe there are things we need to do and pressure we need to future. What do you see as some of the key problems that you are going to be having as you try and move forward with this . I think with regard to this particular issue its not one you know, it is a elect lative and a statutory issue. It will take a statutory change to grant the authorities to be able to negotiate. Tha
Thank you, mr. Chairman. Thank you madam secretary, for being here. There are some questions i want to bring up to begin with. Then we will get to the questions. These are things i want your shop to answer. One are the medicare wage indexes. If you look at those around the country, it was never intended to be like that. 20 of the highest are in california and massachusetts. 14 of the lowest are in alabama and tennessee. For instance, what you get paid in santa cruz, california is 1. 7 with a medicare wage index. And. 73 where i live. Its putting us out of business. That needs to desperately be looked at. The second thing, and i want to know your solution to that. Certainly were all against fraud and abuse. But in my state the medicare comes in, does these audits, withholds the payments. We win 72 of them. And we now, the backlog is so long, you cant get in front of anybody to get your money back that you have earned. And thats unfair. And i think you absolutely need to redo the audits.
Abide by the rigid man daytodays under the law. The Congressional Budget Office estimates the law results in 2. 5 million fewer fulltime jobs reflecting what we heard over and over again from employers who have no choice but to cut hours or delay hiring because of the laws burden mandates. Prices skyrocket. Health Insurance Companies are seeking rate increases of, quote, 20 to 40 or more. Markets are still adjusting to the quote, shock waves, set off by the Affordable Care act. After nearly 2 trillion in new government spending, its estimated more than 25 million individuals still lack basic Health Care Coverage. Yet, just last month, president obama said the law, quote, work the out better than some of us anticipated, close quote. Of course, for those who oppose this government takeover of health care, this is precisely what we anticipated and preciseprecise ly why the American People deserve a better approach. In closing, madam secretary, thank you for joining us this morning. It is
Information with regard to the question of premium cigars and how they are or are not sold to children. That was a part of what we are trying to do. And we are reviewing that. And we are in the middle of that process now. Having said that, as we are in that process, a part of your question was the recognition of small employers. And that is something that will be taken into consideration no matter where the rule ends, its something i think is very important that we do as we think about implementation. And so wherever the rule making comes out, as we are in a process. But i do want to recognize the point that youve made, which is making implementation for small employers and small institutions possible, whatever it is. Its something we consider a real priority and something we believe no matter where you are we can work on as part of the implementation. The proposed deeming rule has been under consideration for more than a year. Regulatory uncertainty is exceptionally challenging for Sm
Framework so it is a convert we made a hypothetical assumption youll be able to continue to do things it will only be harder calculations as a result you know exclude a number of things value of foregone trips for example, if muni was there people would have to travel less theres a value were not calculateing they include things for circling for parking and the costs they actually exclude the population employment growth this is a model based on the current circumstances now how much worse but the impacts will grow request population employment so were going to look at as it is today preliminary skaegz we we looked at travel time savings phone call for muni drivers but automobile drivers they save times because muni reduces congestion and looked at the improved safety and the air quality issues and safety ones we didnt anyomonetize this services with the accessibility issues we didnt look at the last one i want to mention worker productivity next slide, please. Obviously muni improves