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And its been a while since we didnt have any the irs is going to become increasingly dysfunctional in terms of its basic mission. And my concern is not what do we collect with our own efforts, my concern is at some point the voluntary Tax Compliance system begins to erode. And thats not an on off switch. And you cant wake up one day and say, wow, i didnt know that was going to happen, heres some more money. So part of the reason im so serious about this is that people need to understand the fiveyear implications and ramifications of where were headed. And as ive said in other contexts, i dont want anybody to say we didnt warn you. So you should treat this as your warning that this is a real problem, and its a serious problem, and were beyond the simplicity of saying well, well cut your budget and youll be more efficient. Or well make sure you know what youre doing, you know . Cut our budget again and i know what were going to do. ....
If i can have your attention. I am with the alliance for health reform. Thank you all for coming. Target lowincome population from the Affordable Care act and private insurance using federal medicaid dollars. To do that, they need federal approval in the form of a medicaid waiver. Three states already have their waivers in hand and are operating their new programs. Today we are going to take a look at the experiences of two of those states and a broader look at what some other states are proposing to do. We will also look at the balance between on the one hand exposing these same low income people to additional premiums are costsharing and on the other additional im sorry additional premiums in the condition of getting it and on the other hand not getting coverage at all. So we are pleased have as a partner today the Commonwealth Fund essentially philanthropy established ....
Sane up for the healthier michigan program, and im wondering if you cover cataract surgery. They said the reason ive been asking, ive been trying to get someone to pay for his cataract surgery, and the optometrist told hum if he had the surgery he have normal vision, and he has lost his job and has not been able to drive and this would enable this person to get back and about a contributing member of society and obviously improve their life. So i think as you hear those stories, there are compelling stories and our governor was really great about gets around the state and hearing the stories and its not true of the entire population but theres a segment of the population that has not been getting services, and their life will improve and they will be able to be more contributing members of society, and that, i think, is part of the argument as well. I would just add, if youre in a state that has already expanded above 138 , youre going to be bringing it down probably, and this doesnt o ....
Need 3. 6 trillion in investment and thats in all a number that includes things other than transportation but we need 3. 6 trillion in investment by the time the decade is through in order to raise it to appropriate levels. Now thats an all in number as i said. The thing is our infrastructure deficit is only going to get worse without action. We cannot meet the needs of growing country and a growing economy by simply maintaining our current level of effort. We must do more. Over the next generation this will become even more apparent because the country will demand more of this Transportation System than it ever has. By 2050 the system will need to move up to 100 million new people and 14 billion additional tons of freight almost twice what we currently do. Even if Congress Today funded our Transportation Syste ....
It is not realistically within the realm of possibility. This committee follow the murray ryan agreement and mark up at a trillion, 14 billion. That was the deal, and we will stick with the deal. The second issue that was raised is on the subject of entitlement reform. One of the reasons the mandatory programs are growing are because of the success of people who represent agencies at this table. Social security, people live longer. So we have more people than might have been anticipated by the actuaries in 1950 and 1960 when people died from heart attacks and so on instead of the challenges of chronic illness. One of the reasons that medicare is also an issue is because, again, people are living longer, and we need to manage the chronic illness. But there are paths forward to bend the curve, one of which is, again, from research. Much has been said about alzheimers. And, gosh, if we could crack that code, it would have a tremendous impact. So it all kind of goes hand in hand that, one, ....