 We're going to start right now and one first thank the Mead Public Library for having us today and obviously thank you for your interest in the town hall meeting we're having today. My name is Billy Feilinger and I'm the Executive Director of the Wisconsin Alliance for Tide Americans. Myself and Doug will be introducing ourselves in a minute but I first would like to introduce Patty Haferman who's the county's elder benefit specialist and when we have these town hall meetings around the state we always like to invite the elder benefit specialist and let them talk for a minute or two to introduce themselves if you don't know her. Doug and I always call the elder benefit specialist the angels of our state. We're really very fortunate to have at least one elder benefit specialist in every county in the state of Wisconsin so at this point Patty do you want to make some very brief comments and then hopefully that'll be fine. Thank you. Thank you for inviting me. I am the elderly benefit specialist so if you are somebody who is turning 60 thinking about retiring I would be the person you would call. I see some familiar faces in here it's kind of nice to see. I work with Medicare I work with Social Security all four parts of Medicare people say that to me all the time. You work with all four parts Pat and I go yes, yes I do, sad but I do. And we're located the plastic holder that you got is from the agency where I am located. I'm located in the ADRC here in Sheboygan County out actually in Sheboygan Falls ADRC stands for Aging and Disability Resource Center and like I said we're kind of a one-stop shop out there. You can come out and see me if you have people that you know that are disabled from the age of 18 up to 59 and a half there's a disability bend spec that works in this county now to help people get disability so there's a lot out there. There's a lot out there at the ADRC and you're always welcome just to stop by and see us. If you want to see me the people in here that know me would say call her and make an appointment. You all have my card in there. That's my direct number to my office okay. I tend to be in and out a lot sometimes but you'll always get a call back don't worry about that. Okay. Thanks. Thank you so much. Thanks for inviting me. Okay. And if anybody has any questions Patty will be here till around what time Patty? 10.30. 10.30 okay. Maybe afterwards but you already gave a card and everybody's is everyone get a packet? Great. And thanks again for coming Patty. As I said before my name is Billy Feilinger and I'm the executive director of the Wisconsin Alliance for retired Americans and Ron Miller is back there from community access from your area. Myself and Doug and Nate from Know Your Care have been going around the state of Wisconsin in all different parts of the state holding these kinds of town hall meetings. Our organization is a nonprofit organization. We provide public education and advocacy with people like yourselves and others around the state on state and federal programs that affect you, current or future retirees. And we do this on a regular basis Medicare, Social Security. One other quick thing from what Patty just said if you are on Medicare right now because she said 60 and over, if you're on Medicare right now there is a window of an opportunity every year if you're not interested in your current insurance plan you can change it during that window. I think in 2011 I think it was like from October 15th or 16th or November 15th to the middle of December. So October, it was October 15th okay. And so this next year if you have a plan and you're interested in thinking about changing it Patty's the best person to talk to. At this point I'm going to introduce Doug Hill from Know Your Care and then I will make some comments and then we'll open to questions and concerns that you might have. Doug Hill. Thanks Billy. I really appreciate it. I'm going to stand up. I have a raspy voice so sometimes people have a hard time hearing me but thank you for having us here today. We're happy to be here. Nate and I drove over from Wausau this morning so it was a little bit foggy but not me and spring is on the way so we feel good about that. As Billy said my name is Doug Hill. I am the state director of an organization called Know Your Care Wisconsin. And Know Your Care Wisconsin is also a non-profit, nonpartisan organization. And our organizational mission or task is to go around the state of Wisconsin to help educate and answer questions about the Affordable Care Act. The health care reform law that was passed almost two years ago now March 23rd will mark the two year anniversary of the health care reform law becoming law and being signed by President Obama. And if you're unfamiliar with the health care reform law or the Affordable Care Act it's more often referred to in the media as Obamacare. So when you talk about Obamacare it's kind of interchangeable with the health care reform law. One of the things I like to say right off the bat when we talk about you know the benefits of the Affordable Care Act and the Affordable Care Act itself is I understand and I acknowledge right away that when the health care law was passed that it was controversial, that many people were for it, many people were against it, there were people supporting it and people not supporting it. But our organization really doesn't take a position of being for or against it. Obviously I'm here to talk about it so I want to talk about the positive aspects of the law but our organization really believes that it's important that people understand the Affordable Care Act law, the benefits that are available to them just as we would any other law I think very often times as public policy is passed whether it be at the city level, the state level or the national level very often times people don't fully understand every single aspect of it and it's important that that we do as citizens because it does affect us and so that's really the core mission of our organization is to try and go out around the state with organizations like Billy and other organizations to talk about the Affordable Care Act. Even if you were supportive or not supportive of the Affordable Care Act there are benefits of the law right now that are affecting you and members of your family and members of your community and before I talk about the specific ones that affect seniors and people in Medicare I'm just going to talk about a few aspects of the law that are currently in place affecting everybody. Two years ago when the law was signed on March 23rd two years ago a number of the provisions of the law came into effect right away and one of the core ones was the elimination of pre-existing conditions for children so previous to the law being signed if your child had a pre-existing condition they could by law be removed from your health insurance and so when the law was signed that's one of the first measures that took effect that no longer could children be kicked off of your health insurance because of pre-existing condition that part of the law will affect all Americans starting January 1, 2014 okay another provision of the law affected young adults age 26 and under so starting January 1 of this past year if you were a young adult age 26 or under you can now stay under your parents health insurance previous to that young adults didn't have access to the possibility of staying under their parents health insurance and as young adults graduate from college they move into the work world or go on to two-year college or four-year college having access to health care is one of those things that they didn't have in the past and that they now have access to over 23 million young adults since the law came into effect now have health insurance under their parents plan so that's another aspect one more is starting August 1st of this year preventive services for all women will be covered including mammography cervical cancer screening some assistance with things like nutrition and and breast feeding issues with domestic violence and things like that a lot of those measures will now be covered under the Affordable Care Act so women can go in for some of those preventive services that you know tend to be a cost a little bit more and they might not have access to so those are some of the things that are in place right now and when the law is fully in effect in January 1 of 2014 a lot of these measures will be fully in effect but what we want to talk about mainly here today is the preventive services to senior citizens and elder Americans who are on Medicare because the Affordable Care Act when we talk about preventive services one of the things that I think is most important to point out is that 75% of all the money that is spent on health insurance in this country goes to treat chronic disease things like diabetes high blood pressure hypertension 75% of all the money expended in this country goes to treat chronic disease and one of the main aspects of the Affordable Care Act whether it's for children for women for young adults and for elder Americans is to try and get after those preventive measures and preventive care so that we can hopefully by getting a handle on health care and disease and illness at the early part of onset we can try and keep those costs down and save money so you'll see as you look at various aspects of the Affordable Care Act that prevention is really a key part and you might say well why is you know you know why prevention for senior citizens or prevention for for young adults or for women just to give you one more statistic in Shiboyan Shiboyan County there are 19,296 people on Medicare that's 17% of the population and it's about one in every six people so you can see that you know it it does have a pretty big effect on a number of people here in Shiboyan County so talking really quickly about the Affordable Care Act measures for preventive care for Medicare for the next couple minutes. Billy and I like to use this really great handbook it's the Your Guide to Medicare Preventive Services it's a publication by the Centers for Medicare and Medicaid Services and it's a great booklet because it's user friendly does everybody have one if okay hey Nate could you bring up a couple more hold up your hand if you don't have one Nate will bring you a booklet these these are really great just because they're they're really user friendly and now under the Affordable Care Act law there are a number of preventive benefits that are available to people on on Medicare and this booklet is a great guide to help us walk through some of those preventive benefits and that's what I'll talk about now so if when you get your book if for those of you that don't have them Nate's coming up right now if you open up to the table of contents which is on page 3 I'll just really briefly go through this under the introduction the first section is what you can do to help preventive illness just kind of talks about some good tips that you should know in helping with preventive care the second part under section one is how to talk to your doctor health care provider just some tips that you should know when you're talking about preventive care and then some basic things you should know when you're reading about this booklet under section 2 talking about preventive care now because the Affordable Care Act you're once you become Medicare eligible so for me it'll be about 22 years I'll be Medicare eligible it's funny that I when my wife and I go on walks now instead of talking about kids and things like that we're starting to talk about retirement and things like that so it's it's pretty funny I do have a way to that's never to never too early to plan so now for me in 22 years once I become Medicare eligible I'm entitled to what's called a welcome to Medicare prevention visit and what that is it's a really brief introductory visit for me to sit down with my health care provider so that I can start the dialogue with them about my health care and some things that my doctor may want me to know and so I'm still on page 3 and I'm talking about preventive services welcome to Medicare preventive visit and so what this is is it's not a full blown physical where they're gonna do diagnostic tests or things like that it's really meant to start the dialogue with your physician so we'll go in and I'll sit down they might do a blood pressure they might do a pulse and ask some medical history maybe I'm on some prescription drugs at that time and I'll say here's what I'm you know the prescription drugs I'm on and it's an opportunity for me to you know share my concerns and for the doctor to share their concerns with me as to some things that you know I might want to be concerned about so then after that one-time welcome visit each year every year you're entitled to a an annual wellness visit okay and this would be for free and at no cost okay and at this this one-time visit is very similar wellness visit is very similar to the welcome to a Medicare visit where again you're doing a brief health history you know the blood pressure or the pulse things like that it's kind of a review of the year saying hey here's here's where my health is right now here's some things that happen to me this year here are things I'm concerned about and it's an opportunity for you to talk to your doctor again about things that you're concerned about and it's an opportunity for him or her to share with them some things that they think that you should be thinking about and so again it's not a full-blown diagnostic you know visit with tasks but again it's it's trying to get that dialogue going one of the best questions we get when we're doing these preventive forms is as I go through these preventive benefits is well hey Doug I'm already a Medicare don't I already get these benefits in these treatments right now and my answer is yes you do what's different though because the Affordable Care Act is a lot of these services now are for free or at a reduced cost and a reduced co-pay so that's the big thing and we'll talk about some of those as we go through these so some of the other preventive services that are covered now because the other Affordable Care Act cardiovascular screening breast cancer screening including mammography cervical cancer screening colorectal cancer screening for men prostate cancer screening a number of immunizations including flu shots so now you should be able to go in and get a flu shot for free you shouldn't be paying for it at least once a year bone mass measurement diabetes screening with supplies and management training nutritional therapy like home attesting and a number of other preventive services all meant to help us get a handle on on our on our health I'm gonna ask you to turn a page 15 really quickly I'm just gonna highlight that section yeah no no this is sure some of them you might have to there might be a part be deductible for it but if you are on if you're on on Medicare you have access to all these preventive services and I might add at this point in time as well that the Affordable Care Act does not affect anybody on Medicare I know there's been a lot of I was called rumors or misinformation saying the Affordable Care Act you know makes people you know move off of the insurance that they already have that that's totally not true if you're on Medicare you stay on Medicare if you're on the VA health care system you stay on the VA health care system if you're on a private insurance plan that you still carry from your previous employer you stay on that the Affordable Care Act does nothing to move you off of that you still get to stay on on that if you if you want to okay okay so page 15 is a talks about colorectal cancer screening and why I like using this one is because it provides a number of different examples so in each section on each page it'll highlight a different preventive service and so in this one it highlights colorectal cancer screening and so at the very top it just talks about some basic facts about colorectal cancer usually found in people 50 or older talks about different screenings for polyps and things like that and then it jumps right into who is covered so in this instance all people Medicare age 15 older but there's no minimum age to have a screening colonoscopy okay and one of the questions we get as well how can someone age 50 or under you know be on Medicare sometimes in a disability situation people who become disabled are entitled to be under Medicare when you pay the FICA tax that you pay like I pay FICA you all paid FICA as we did through our jobs part of that that that tax that we pay is if in extreme circumstances we become disabled sometimes you are able to be on Medicare earlier and then you normally would be not at the same coverage rate but sometimes you're able to so that's why it says under age 50 then how often are these colorectal screening cancers covered so each one of these tests is is covered and each one is covered at a different rate so for instance like the feet fecal occult blood test you can you're entitled to that every 12 months and then the colonoscopy is every 120 months but if you're at high risk you can get it sooner I think here it says every 24 months and then it jumps into if you have original costs or original Medicare so for in this instance you pay nothing for the fecal occult blood test you pay nothing for the screening for the colonoscopy if your doctor accepts the Medicare assignment and then for instance it kind of gives some specifics for like the barium enemas you pay 20% of the Medicare approved amount for the doctor services and then in this instance the PARP deductible doesn't apply but if it's done in a hospital on outpatient setting then you'll pay the co-pay that would normally be covered under the Medicare PARP yep okay yeah when you when you're every once you're entitled here once every yep the 120 correct every 10 years exactly that would be starting there and it's the same thing you someone asked me is it on a calendar year or is it on when you have it and it's it's not on the calendar it's when you have it so if for instance I turn 65 I Medicare eligible I go in and say okay I want to get that that preventive screening for the colonoscopy and I do it in March then every it would it would start from that March date and that's true of any preventive service that you would have for instance the flu shot if you got that just happen to get it in June it would be on that June to June it wouldn't be on that on the calendar year that's a great question and then at the very end it just talks about if you're at risk for colorectal cancer and some some brief tips there so this is it follows pretty similar for the for the other screening and prevention benefits that are in here I'm going to pause at this time turn it over to Billy for his comments I'm going to be here for questions and answers and I'd be more than happy to help you out with questions and concerns and if I don't have the answer I'll make sure I get your name and number and and get back to you but I'm going to turn over to Billy great thanks Doug and then as Doug said once I get through and I'll probably talk to me like about 10 minutes and then open it up to concerns or questions you folks might have as I said my name is Billy Feilinger and I'm the executive director of the Wisconsin Alliance for retired Americans and as Doug as his part I'd like to talk about the impact potential impact that Congress and president can have on specifically as it relates to Social Security and Medicare so if you remember late in the summer of 2011 early in the fall the Congress created this committee called the super committee and the purpose of the super committee was to address the federal deficit what kind of cuts would be necessary to address the deficit as well as enhancing revenues for the Congress to take action to reduce that deficit and as you probably know or maybe don't know that they were supposed to make recommendations in December to the Congress and then the Congress supposed to take a vote on those issues well as it turned out to make a long story short they didn't have enough votes at the super committee level to bring anything to the Congress but I can guarantee you if you've been following that all those things that they were talking about are still on the table as possible cuts and revenue enhancements but we're feel very strongly that until the entire population of our country participates in sacrifice to deal with the deficit we will not support any of the things I'm about to tell you and most of these things that I'm about to tell you probably will not impact you but could impact your kids your grandkids I became a grandfather twice now and I want to make sure I'm sure you do too want to make sure that our kids and our grandkids have these great programs called Social Security and Medicare so there really are five reasons why we're in the financial predicament that we're in and this is not Billy Feilinger from the Wisconsin Alliance telling you this this is coming from the Correctional Budget Office which is a nonpartisan independent federal department within the federal government who has have reported in back in 2010 there are five basic reasons why we're in this financial predicament one we have two wars one is now going to an end the Iraqi war but neither one of those wars were ever paid for until President Obama came on board secondly there's a program called Medicare Part D that's not the exact language but back in 2000 and through three a law was passed to deal with Medicare beneficiaries having some of their costs through Medicare paying for your physician drugs it's a 500 billion dollar program that started in 2006 for 10 years it wasn't paid for the third we had two of the largest tax cuts in the history of America back in 2001 and 2003 where overalls over half of it went to the wealthiest 2% of Americans that wasn't paid for for we currently have double digit increases to health care costs now that is a problem and that does impact on medic the Medicare system which I'll talk about a minute double digit increase and the fifth reason we're in the predicament we're in is that we've had the worst economic downturn since the Great Depression that started back in 2007 those are the five reasons we're in this predicament did anybody hear me saying about Social Security Social Security hasn't contributed one penny to the federal deficit not one penny in fact your trust fund the Social Security trust fund has a surplus of 2.7 trillion dollars in your trust fund 2.7 trillion dollar surplus I know some of you are smiling I'll tell you why that some people say it's just nanogens it's Ponzi scheme it's a bunch of IOU papers I'll talk about that in a minute but if the federal government did nothing and we're not recommending they do that your trust fund would be able to pay a hundred percent benefits until the year 2037 and remember we want our kids and our grandkids have this great program called Social Security so some things are going to have to change back in 1982 then President Reagan Republican Speaker of the House Democrat Tip O'Neill came together and were able to come up with a compromise on Social Security because of what they were able to do people like myself a baby boomer will now have Social Security when I decide to retire have a hundred percent benefits because what those men in the Congress did back in 1982 we believe that the adults in the Congress today and the president need to come up with a compromise it's not going to be an easy one because we want to make sure that our kids and our grandkids have Social Security so how does an elected official a congressman your congressman or US senator here in the state of Wisconsin tell you that your trust fund is a Ponzi Social Security is a Ponzi scheme and it's a bunch of IOUs there's only one way they could say that to you in all honesty and look you straight in the eye that they would have to default on your Treasury bonds both Democrats and Republicans have taken money from your trust fund to use for other federal programs our belief is it should be a lockbox remember back in 2000 then Vice President Gore ran and running for president said he thought that the Social Security trust fund should be a lockbox well it's not happening so the federal government is using your money but in response to that they have to have issued Treasury bonds guarantee Treasury bonds they're the same Treasury bonds that I bought for my grandkids when they were first were born in the last few years they're the exact same guaranteed Treasury bonds that we issue to China that we issued at Japan so only way that an elected official from our state or our country who could look you straight in the eye and say there are a bunch of pieces of paper IOUs don't that doesn't exist there's a Ponzi scheme the only way they can do that is they're gonna have to tell you they're gonna default on those Treasury bonds and I would like to see the day that anybody in our country or in our state who are elected officials your congressman and your US Centers wants to default they're gonna have to vote on that and I can guarantee you with you being the largest block of voters I don't care if you're a Republican or a Democrat you're gonna vote those people out of office because they haven't stuck to their commitments that they had made to people like yourselves and future generations with those Treasury bonds so one thing we think should happen before I talk about Medicare right now workers who contribute of their income is about a hundred up to 108 thousand dollars so any worker in our country that makes up to 108 thousand dollars they contribute a hundred percent anybody worker above that 108 to whatever it might be does not contribute on that part of their income now they don't get they don't get contributions for Social Security when they retire but they get it up to 108 thousand dollars so for example Billy Feilinger is a worker today making fifty thousand dollars a year I pay a hundred percent contributions people like Phil us let's say Bill Gates just joking around here makes three hundred thousand dollars he only pays one third contribution to your trust fund we believe if we start having them pay either a hundred percent no matter what their income is we will have this problem almost solved by the year two thousand and seventy five now we're not going to be living but again we want our kids and our grandkids have this great program so we believe that something that should happen right now it's something similar to what happened in 1982 the three things that Congress today are looking at are changing their retirement age right now it goes from around 65 upwards to 67 depending on when you were born but they want to go to almost 70 years old and I always like to give the example there in Appleton I met with about 25 steel worker retirees there was one woman who was getting a hundred percent benefits because she lasted as long as she did but I could tell that she was having problems had wristbands and other things around her wrist because she was a steelworker and had a very difficult job if she had a work till 70 years old there's no way that woman would have been able to work to 70 years old if that was the maximum that was what she had to do she would have seen significant cuts in her benefits if we increase it over the next 20 30 years upwards up to 70 years old the second is means testing now some people might say means texting is not a big deal that some people in Congress want to change that certain people would not get Social Security if you made $200,000 a year as a worker the reason why we're against that is because we believe we want the entire population who works to participate in Social Security one we think it's a smart thing politically that all Americans are participating in and secondly we don't want this to turn into something that's called a welfare program because people like yourselves have earned this income that you get when you retire so we don't like means testing the third one which could impact you is changing the formula for cost of living now the last couple years I think you got a rebate of $250 two years ago I don't know if you got one last year this year it's 3.6 percent cost of living increase well there's some people in Congress who want to change that formula that 3.6 percent by changing the form would be even less than 3.6 so we're opposed to all those things but that one could impact on your lives now Medicare the trust fund is in financial problems but thanks to the Affordable Health Care Act your trust fund will last minimally till the year 2024 and will still be able to make pay benefits after that but it would be a lot less so we do need to make some changes but because of the Affordable Health Care Act the trust fund is solvent until the year around 2024 the other reason we like we support the Affordable Health Care Act or the following reason as Doug said kids right now who have pre-existing conditions can no longer being thrown off of an insurance plan kids 26 and under will can still stay on their parents insurance plan today 26 and under that right now a small insurance company has to because the Affordable Health Care Act has to pay 80 percent of their premiums to directly pay for medical expenses larger insurance companies premiums have to pay 85 percent of all the premiums that they get revenue 85 percent has to go for medical expenses and last before I talked specifically about retirees is the fact that we they have put more money in the Affordable Health Care Act to look at fraud duplication of billing waste things of that sort many of health care providers do not mean to do anything fraudulent they make mistakes so we want to get a handle on those and then there is a percentage of health care providers who are doing fraud and we got to make sure we get every one of those pennies back so we can use every one of those pennies to help for direct certain medical services anybody on Medicare Part D anybody here on Medicare Part D okay back in 2003 that law that I talked about past called Medicare Part D and there were two specific three provisions that I want to mention today real quickly one is the donor hole because of the Affordable Health Care Act previously if you met the donor hole you had to pay a hundred percent of your out of your pocket to up to seventy hundred dollars in 2012 that would have been twenty nine hundred dollars up to seventy six hundred dollars in 2012 anybody who gotten to that donor hole before the law passed would have to be a hundred percent out of their pockets then after that ninety five percent of my catastrophic would be picked up by Medicare five percent by the consumer of Medicare beneficiary because of the law up to twenty nine hundred dollars they pay seventy five percent the Medicare that you pay twenty five percent after that if you're on a brand name prescription drug you will get a fifty percent discount if you're in the donor hole from twenty hundred dollars to seventy seven hundred dollars if you are on a generic prescription drug they will pay for there will be a fourteen percent discount in fact in this in the county of Sherboy County there's about thirteen hundred twenty five Medicare beneficiaries in 2011 who fell in the donut hole sorry about that who fell in the donut hole and they received these discounts up and the total was about eight hundred fifty thousand dollar savings for in Sherboy County people who met the donut hole do that eight hundred fifty thousand dollar savings because of the Affordable Health Care Act the second thing is Medicare advantage people know Medicare advantage anybody on Medicare advantage okay you might not be totally pleased what I'm about to say over and by the way before I forget Medicare parking will end in terms of the donut hole by the year two thousand and twenty there will no longer be a donut hole obviously we want it sooner than that but that's what will be totally closed Medicare van is someone just asking what is the Medicare advantage Medicare advantage is an alternative program that you can have with a private insurance company before the law changed the former health care law changed that the the federal government was subsidizing tax dollars our tax dollars to give two insurance companies somewhere in the neighborhood of 13 to 15 percent tax subsidies to private insurance companies compared to traditional Medicare Part D or Medicare in general now they do get more benefits if you're on Medicare advantage so I don't want to say they compare apples to apples but 13 to 15 percent tax subsidies those insurance companies for this program and sorry about that shut this off sorry about that I don't like seeing I love seeing my grandkids but I wish we just go off now oh there it goes so over the next several years there will be a reduction in that subsidy but the program will continue but at some point the insurance companies who have Medicare advantage are gonna have to figure out if they want to keep those customers are they gonna keep the level of cost the same or the premiums the same or the co-pays the same or the deductibles that's something that has to be worked out but because of there will be some reduction in those subsidies over the next ten years there will be a savings of about 1.6 billion dollars because of those reductions in the subsidies so at this point I think I'd like to open it up to Doug and myself to questions or concerns you have and again thanks so much for coming we have about 15 20 minutes yes one and then back to you back there Carol yes absolutely my understanding and I think this is true I wish Patty was here I'm pretty sure that the county's elder benefits specialist has that data I don't know if in Wisconsin if there's a website that you could go to and answer what your question but I'm pretty sure Patty the elder benefits specialist should have that information and if she doesn't she'll have a better idea where to get that information you know I don't know that's a great question I wrote it down because I'm gonna I'm gonna check to see if there's something specific that is best to point people to but I do know that on the back side on the back cover of this handout there's a website it's www.mymedicare.gov just before I can find an answer for that that's what I would recommend there might be something where people can go search out so if you give Doug your name and your phone number he'll give you a buzz back yeah but I think that's a great question because use I mean rather than hunting and pecking for everything to go to one spot that will list them would be great that's right it's a very narrow no the question is is starting in about two weeks the Supreme Court is going to hear a case where essentially the constitutionality of the individual mandate portion of the Affordable Care Act is being challenged and unconstitutional and essentially what that boils down to is the Affordable Care Act mandates that every citizen in the country if they don't already have some sort of unhealthcare like Medicare, like VA, like private insurance or retirement health insurance like in their previous employer be required to purchase at least a minimal coverage of health insurance and the premise behind that for the law is that it's been proven through actual health tables and through studies that the best way to lure the cost of health care is to basically put everybody in the pool because when you put everybody in the pool, healthy people are also put in the pool and you put healthy people in the pool who pay premiums and don't utilize services that cost them for everybody as opposed to just putting the sick people in the pool so that part of the law is going to be challenged and as the lady said that's just the one aspect of it so we'll vote that you'll hear the arguments that I'm getting sometime in the Supreme Court, we'll probably be going at the end of the time. And that if it's if it's not overturned that specific will happen in 2014. Just one quick more thing that Carol and one of the reasons we support it is because of the following. Billy Feilinger does not have a primary care doctor does not have insurance. My daughter gets hurt. I take her to the emergency room. Well, guess what? Who pays for that? All of us around this room here and others around the country and the cost is much more significant by taking my daughter into that nursing and to the emergency hospital than it would be if she had a primary care doctor. And so that's another reason why we were very supportive besides the cost effectiveness of including everybody in the population. Carol and then you. Because in the last two years they've cut over a billion in Medicare payouts primarily because they set up three sites in Arizona. I'm not sure what city of Los Angeles and Miami is. It's the portable air care act put together they enabled the task force of HHS officials and FBI investigators who investigate Medicare fraud. And that's how much they have pulled out of the system because and it's only the tip of the iceberg. They found that there is a Russian and I believe Albanian criminal gang that were operating out of post office boxes storefront. They were paying senior citizens for their Medicare numbers and they were also paying off doctors to submit fraudulent claims. In fact last two weeks ago a nightline session on I guess a doctor in Arizona that they were trying to interview. But this is an ongoing continuing thing and for the lady who is concerned about doctors not accepting consignment there is one insurance company in Wisconsin that will offer a Medicare supplemental plan that will pay the difference between what Medicare approves and what a doctor charges for non-assigned claims. I know because I have it and I have one thing that I have to use that the pharmacy will not accept assignment on and I get that paid 100%. In fact other than my insurance premium I paid nothing for any of my medical claim. Wisconsin also has a unique thing in their tax code that if you take the standard deduction they still allow you to write off cost of your health insurance. We have a presidential election coming up in a few months. If the party who becomes president doesn't support the Affordable Care Act and if the Senate and the House also no longer support it and any of what you've talked about the entire Affordable Care Act or other people that just be voted out. Absolutely. So depending on who gets into office starting in 2013 everything that we've talked about today if there was a majority in the Congress and the president to support the repeal they could do that and eliminate everything that Doug and I talked about today. Yes. I don't know the exact amount and I would assume it would depend on the service medical services but generally speaking it's significantly more obviously if you're taking your kid like my situation I would try to do that but I'm just saying if I would have done that. I don't know if it's $1100. It's pretty significant though. I'm not sure I'd use $1100. I've never heard that exact amount but I know it's significant. Yes and then back there. There's such a huge gap in the price charge for services. Party Express that's $5,000. You won't let it be refused suddenly. It's sad that it was such a big money insurance. Right. And I think the insurance companies are the ones that need to be closed. Yes back there. Yeah I just got on Medicare and I had this wellness visit. I called my doctor and he wants me to have a full physical right away so I called Medicare today and I talked to them and she says that's fine as long as they accept a salary. That's fine. So is that what long as the doctor accept what Medicare will pay? Yeah absolutely as long as the doctor is a Medicare accepting doctor they will do it but the one thing that we've gone through doing almost 50 of these forms is that often not often but at times someone will call for their wellness visit and they'll go in for the wellness visit and then during the wellness visit the doctor may say well hey you know based upon our conversation I think you should have this test and then that test gets in that envelope of being free. So there may be diagnostic tests that come about because of that wellness visit. He said I would be fine as long as he accepts. And I agree with that statement but I just want to be clear that if it gets in a situation where they start doing other diagnostics that it would go beyond that but absolutely if they accept the assignment and you do it annually you're ready to do that. People have that chance to talk first yes and then over there yes. That's not true. You go to the doctor. You wait for three months for your things to come back. They've got to send it to the insurance company. You get back a slip that says Medicare did the lollipsting either goes to the insurance and you pay the bill. What the lady is saying is at times. Does Medicare pay for diagnosis? No. As far as anything. Does it pay for diagnosis? The diagnosis test has always come back with a note from Medicare. Your lab is covered. There's so many not covered. They can't go fishing for things to diagnosis conditions. If you have a history of cholesterol they can check your cholesterol. So in plain English first of all the doctor has to establish that you have diabetes before they'll pay for diabetes. Burn the test but you have to prove that you have diabetes before they have it. No. My daughter had a surgery for a gallbladder emergency. She had to go to a hospital. Okay. Nothing is covered by insurance. Insurance just takes your money and puts it into their funds and his benefits of people that she got by stock. That's what insurance is doing. If our plans to fight they should be fighting what's happening to these premiums. Because the insurance companies are making money off of it. Plenty of money. I'm not disagreeing with that. The thing I'm having a hard time figuring out is it would depend on specifically what diagnosis. And you're saying your daughter. I'm saying that no matter what with the insurance companies. The insurance company and Medicare work together. If Medicare doesn't allow it the insurance don't cover it. And you pay it. Young people are being self-insured. They put their self-suring accounts. They have no faith in your Medicare whatsoever. I have grandchildren that tell me. Forget it grandma. I'll just put my money away on my page. I don't pay my own bills. And that's, they're more than we. I mean there's more young people than old now. That are in the workforce. And that's where your money's going. But no. I just went to the eye doctor. They said I have to have cataract surgery. They told me I have to have it within three months. Or all this diagnostic testing. Will not be any good. And I have to pay it out of my own pocket. If I don't make up my mind within three months I'll have it done. And they also tell me. They're just going to put up. They're going to put up the lens in there. Taking the lens, all the brittle lens in there. Giving me a pair of glasses. Because if they put up extra lens in Medicare, don't pay it. I have to go to Dr. Larson. I have to pay $2,000 to reach out. To get a lens so I can see. Just to summarize. Because he just informed me now. Because that's caused cosmetic. This is what I've been told. To summarize basically. Why doesn't Medicare provide funding for more. Service that you're suggesting today. Is that pretty much. Ventures. You have to have dental insurance. That's a laugh at this thing. There are definitely. I mean the best of all worlds. Ideally. I'm agreeing with what you're saying. But right now there are not enough people. In Congress. Who would support. It being under one system. And really dealing with more than just. Like no words. You talked about dental. You talked about eyes. Those are the two essentials. I'm agreeing with you. I'm agreeing with you. Actually co-correct will let you down here. And all these others pre-ventive. That you're telling people to have. By the time you get to be 70 years old. I'm sorry. Your life is just about over. Count the years. Get up in the morning and say thank you. Carol, let me just. The person behind. You give a quick comment. Because I want to know the words behind you. She. The other people normally are not on Medicare. I am 70. I am not. No, you're talking about your granddaughter. I'm talking about. Everybody. Is. But that is an advocate. By the insurance. Different program. It's not funny. I'm not talking about Medicaid. My daughter paid her own bill. $20,000 all over savings accounts. I'm saying. That our government should be looking into. My insurance companies are doing with the money. Not what Medicare is. Well. I'm talking about the insurance companies. Was taking your premium and investing in the stock market. And this company back up in that company making money. It's a fact. You know. We're the wrong people to say this. We agree with you. We agree with you. We agree. We agree. We agree. The provider bills are wrong. We agree. We agree. We agree. We agree. We agree. We agree. We agree. We agree. We agree. We agree. We agree. We agree. I think this is a reasonable point. I did a not hearing member. And. The dust there. Well. Back there. You had a question. Or comment. Like. To the. Is. When. 8acer. And unfortunately it's not. That's like. That's a question. That's come up. And it's, you know, 200 or $400. And the reason why. Is. Really. Went into that purpose. Com potent of. Save. a doctor's group and a doctor's panel to put it together. And what they did is they started with the initial preventive services that they felt were best to start with. And that's not to say that the shingles vaccine is not an important vaccine or is it important to anybody. My father had shingles and was in the yard for 12 days because of it. So I get that. But I think what they wanted to do is start with initial preventive services. And there may be a possibility of that in the future. But unfortunately, now it's not. So one more question who hasn't had a chance to talk. Yes. If a person has Medicare supplement insurance, most of these policies also carry a preventive clause in there. Some are $150, some are $300. They will pay for shingles. Just end on this. Your frustration. We're on the same page. You've got to believe me. In the best of all worlds, you have a right to certain things. And when your daughter is paying ex-dollars out for insurance, that's wrong. That's why we don't go along. I could go along with you. I'm sorry. OK, one more quick comment. Go ahead. Just one comment. You may have known that in the papers that the state insurance commissioner requested a waiver on the 80% premiums to health care request to civilians. If you want to get health care with that too, if I start voting right, would God say? He said that. We're going to say have that conversation. Thank you so much. There's still some coffee left. And I hope this was helpful for you today. Thank you so much. You're welcome.