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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 ....
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, ....
Executive Infrastructure Club which brings together companies and key u. S. Decision makers at the federal and local levels who have informal roundtable discussions. It allows a dialogue in order for us to sort of share our best practice and Lessons Learned over time. And when i speak to my counter parts in the d. O. T. And those on the hill, its very clear that we have had the same challenges that were always very happy to share those experiences. So thank you very much for the opportunity to explain that. [applause] thank you so much. Nigel. Thank you very much. Good morning, ladies and gentlemen. And thank you very much to the organizers and sponsors of this weeks event for infrastructure week 2014. So im going to talk about p3. Im going to talk about p3 from a u. K. Perspective, from my involvement in the private sector so youve had heard from judith a lot of what i ....