{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://iastate.aviaryplatform.com/iiif/804xg9fv0q/manifest","type":"Manifest","label":{"en":["Shakeshaft, Alston J., Robert M. Sigmon, and Lee M. Couch, Current Programs, Problems and Prospects in Financing Health Care"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/004/original/ISULogo.png?1601681107","metadata":[{"label":{"en":["Preferred Citation"]},"value":{"en":["Current Programs, Problems and Prospects in Financing Health Care. Iowa State University Lecture Series (RS 8/6/53). Special Collections and University Archives, Iowa State University Library, Ames, Iowa."]}},{"label":{"en":["Publisher"]},"value":{"en":["Iowa State University. Special Collections and University Archives"]}},{"label":{"en":["Rights Statement"]},"value":{"en":["There are no restrictions on access. (access)","This item is protected by copyright and/or related rights. 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thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=8.63,10.543"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Good afternoon and thank you for coming.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=13.767,17.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd say in passing that there are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=17.293,18.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a lot of old familiar faces in the crowd","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=18.94,21.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and if the time permits I would introduce you all.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=21.27,25.437"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We do thank you especially those","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=26.31,28.084"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of you from the morning for coming up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=28.084,30.603"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm Jerry Shakeshaft in political science.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=31.45,33.733"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One of the directors of this project.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=34.59,36.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We have launched last night","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=38.22,41.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a moderately","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=41.48,42.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"ambitious experiment in public education.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=43.58,46.523"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And even though we have a long afternoon ahead of us,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=49.44,52.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd like to say a word or two about it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=52.05,55.432"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because the crowd here 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terms.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=82.61,83.683"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And none of us have been immune to those problems.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=85.51,88.467"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The galloping escalation of 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Heath","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=675.083,678.023"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/215","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Planning Council of HUW, I'll say no more.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=678.023,681.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/216","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Dan Slay.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=681.43,682.467"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/217","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e Dan:\u003c/strong\u003e Can I speak from here?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=684.754,685.587"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/218","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e Jerry:\u003c/strong\u003e You may speak from there Sir.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=685.587,687.285"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/219","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e Dan:\u003c/strong\u003e Okay, all right.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=687.285,690.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/220","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Jerry says there was a valid 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panel,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=818.34,820.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/267","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is really the Chief of Staff person","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=820.26,824.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/268","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in heading up the 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the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=854.578,858.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/277","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"proposal be available","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=858.73,861.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/278","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for submission to the Congress about March 15th.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=862.124,865.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/279","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And so there's a good deal of spending this activity","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=865.52,868.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/280","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"aimed at that goal.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=869.14,871.693"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/281","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As I say that there are essentially five major issues","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=873.07,877.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/282","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that have to be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=877.24,878.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/283","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"dealt with in some satisfactory fashion","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=879.44,882.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/284","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to get this issue moved ahead.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=883.55,887.047"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/285","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As I say put those issues on the table,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=887.047,889.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/286","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"outline them very, very briefly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=889.84,891.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/287","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and provide a basis for further discussion.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=891.94,894.633"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/288","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Those issues as I see 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package.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=901.47,904.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/291","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What are the services that are going to be paid for,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=904.06,907.023"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/292","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and covered under the National Health Insurance Program?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=908.16,911.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/293","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The second issue is the methods of financing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=911.66,915.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/294","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How is all this gonna be paid for?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=915.15,916.937"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/295","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The third issue are the methods of reimbursement.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=918.72,922.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/296","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How are we going to pay the providers a service","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=922.28,925.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/297","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who are gonna be participating in this benefit program?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=925.44,928.873"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/298","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The fourth issue,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=930.24,931.577"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/299","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and one of the more complex is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=931.577,933.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/300","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"how is all this gonna be administered?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=933.74,936.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/301","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What is the respective roles of the Federal Government","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=936.48,939.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/302","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the State Governments and private agencies","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=939.14,942.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/303","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and all the other various interested parties?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=942.44,945.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/304","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the fifth issue, one that is sometimes overlooked,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=945.9,948.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/305","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but not these days in Washington,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=948.62,951.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/306","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is the relationship between all of this","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=951.56,954.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/307","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"activity in the health financing area","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=954.62,957.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/308","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and its relationship to the health services delivery system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=957.33,960.403"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/309","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let me go back and talk about those five issues,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=961.48,964.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/310","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one by one over the next few minutes.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=964.81,966.863"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/311","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"With respect to the benefit package,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=968.43,971.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/312","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you'll find a pretty broad agreement, again,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=971.72,974.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/313","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on a set of words.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=974.4,976.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/314","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Almost everybody will agree that it ought to be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=976.49,979.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/315","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a comprehensive benefit package.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=979.22,981.093"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/316","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Difficulty is, again, that those words","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=982.82,984.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/317","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"have quite different meanings","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=984.86,986.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/318","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the participants in the 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services.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=993.29,998.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/321","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But once you move off that secure base,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=998.26,1001.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/322","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you've got lots of uncertainty.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1001.75,1004.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/323","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How much, for example, attention should be given to","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1004.64,1008.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/324","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a long-term care 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table,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1013.97,1015.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/327","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"including the Kennedy Coleman Bill,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1015.18,1017.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/328","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"deal very adequately with the long-term care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1017.42,1020.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/329","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Secondly, how much attention","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1021.94,1023.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/330","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"should be given to mental health 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elderly?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1066.36,1069.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/349","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Dental services for the working population?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1069.53,1071.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/350","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And finally the most difficult issue with prevention.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1072.79,1076.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/351","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Traditionally, we haven't done very well in this country","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1076.72,1079.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/352","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and most countries overseas,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1079.56,1081.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/353","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"have not done very well in covering preventative services","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1082.34,1086.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/354","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in a Health Insurance 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time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1613.187,1615.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/555","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but if the total financing of these systems","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1615.77,1618.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/556","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"was still a national health financing system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1618.42,1620.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/557","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we don't find a way to protect innovation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1620.91,1623.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/558","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then we have a great risk of freezing into the system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1623.85,1628.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/559","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"some of the undesirable practices of the present","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1628.18,1631.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/560","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and freezing out some of the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1631.65,1633.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/561","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"desirable changes of the future.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1633.17,1635.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/562","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So those are the five issues that I wanted","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1635.75,1637.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/563","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to call to your attention.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1637.74,1639.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/564","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The benefit system, the financing system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1639.25,1641.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/565","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the reimbursement system, the methods of administration,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1641.65,1645.399"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/566","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and its relationship to the services delivery system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1645.399,1648.049"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/567","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In closing, I would point out that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1649.4,1650.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/568","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the debate has got a good deal more complicated","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1650.8,1652.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/569","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in recent years.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1652.93,1653.763"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/570","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If you think things were tough before,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1653.763,1655.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/571","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you oughta see how it is now.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1655.9,1658.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/572","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Because it's gotten tough on two new issues,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1658.24,1661.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/573","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which have recently joined the discussion.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1661.04,1664.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/574","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One is the divided attention","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1664.17,1666.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/575","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"between the purpose of a National Health Insurance program.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1666.95,1670.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/576","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I can remember as I think many of you can,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1670.63,1672.732"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/577","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in which there was pretty clear agreement on the issue,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1672.732,1676.447"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/578","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but the major purpose of National Health Insurance","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1676.447,1678.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/579","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"was to improve equity within the society.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1678.37,1681.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/580","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That there were people within the country","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1681.4,1683.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/581","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who were not receiving equal services,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1683.15,1686.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/582","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we got to do something about that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1686.04,1688.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/583","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's only half the debate now though.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1688.1,1690.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/584","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There's another school of 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cost.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1693.16,1696.157"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/587","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that brings to the debate","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1696.157,1698.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/588","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"quite a different point of view.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1698.19,1700.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/589","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And while there can be a,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1700.14,1702.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/590","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there is a lot of agreement on the words,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1702.18,1704.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/591","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the relative emphasis given to equity and to cost control,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1704.71,1708.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/592","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is one of the more prevailing issues in the debate.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1708.65,1712.553"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/593","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"A second complication in the recent debate is the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1713.39,1717.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/594","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"attention given by the president to an incremental program,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1717.4,1721.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/595","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"phasing in the development of National Health Insurance.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1721.91,1726.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/596","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If we gotta phase-in National Health Insurance Program,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1726.33,1729.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/597","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we then have a second set of issue.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1729.08,1730.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/598","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Not only do we have to agree on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1730.96,1732.963"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/599","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what is the total program gonna look like","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1732.963,1735.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/600","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when we have a National Health Insurance Program,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1735.45,1737.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/601","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but we have to get some agreement on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1737.42,1739.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/602","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what will be the first step of that program,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1739.91,1743.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/603","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and you can get lots of disagreements on that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1743.06,1745.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/604","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Many people argue that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1745.93,1747.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/605","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the first step should be an extension of the agent program.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1747.18,1750.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/606","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Others feel that the first step","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1750.89,1752.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/607","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"should be a children's program,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1752.33,1753.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/608","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and others take a different points of view,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1753.79,1756.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/609","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"other points of view on that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1756.62,1758.859"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/610","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but even,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1758.859,1759.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/611","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't wanna end on such a sour note","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=1759.75,1762.147"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/612","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that may 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legislation.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2164.451,2166.683"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/746","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Provisions similar to those the HIAA proposed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2167.59,2172.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/747","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"are currently contained in the Health Professions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2172.63,2176.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/748","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Educational Assistance Act of 1976.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2176.05,2179.873"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/749","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we get to ambulatory care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2181.419,2183.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/750","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the 1970 version of the McEntire Burleson Bill","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2183.85,2187.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/751","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"stressed the need to expand ambulatory care 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involvement.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2208.98,2211.553"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/758","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"While it's true that McEntire Burleson has not passed,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2212.68,2216.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/759","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"many of its important original provisions have in 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people,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2277.46,2280.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/778","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that all Americans should have the very best","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2280.76,2284.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/779","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in medical 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time","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2305.22,2309.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/786","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"provide far less than the very best.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2309.55,2312.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/787","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is pretty well 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universal","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2319.81,2323.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/790","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and this is one of the real problems that must be solved.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2323.63,2326.633"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/791","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Consider these examples.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2327.54,2328.993"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/792","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How many of you will agree","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2330.22,2331.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/793","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that patients always need to be hospitalized","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2331.49,2334.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/794","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when outpatient or at-home treatment may suffice?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2334.16,2337.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/795","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But we all know many of our friends","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2338.39,2341.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/796","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that go to that hospital","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2341.61,2343.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/797","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because it's covered by their insurance.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2343.04,2346.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/798","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Do we all need to have hospitals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2346.11,2348.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/799","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the most expensive medical equipment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2348.87,2351.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/800","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"within five miles of our homes?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2351.05,2353.003"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/801","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Do we all need to have the physician personally see us,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2354.12,2357.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/802","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for the most minor of complaints?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2357.49,2359.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/803","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There are a lot of less costly alternatives","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2360.33,2363.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/804","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that are too often not used.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2363.52,2365.583"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/805","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Everyone knows that two aspirin and bedrest,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2366.88,2370.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/806","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"solves a high percentage of our complaints,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2370.67,2373.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/807","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but not many of them are solved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2373.74,2375.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/808","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when somebody else pays the bill with insurance.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2375.86,2378.533"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/809","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We do have a right to adequate health care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2379.86,2383.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/810","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I seriously question many of the extremes","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2383.36,2386.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/811","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to which our system has taken us.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2386.18,2388.113"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/812","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is not a popular stance,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2389.08,2391.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/813","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it is simply a practical reality.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2391.59,2394.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/814","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another real flaw in our system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2395.29,2397.733"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/815","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to which we have been partners is the rejection","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2398.84,2402.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/816","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of any type of cost benefit analysis.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2402.45,2406.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/817","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In simple terms, is the price we pay","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2406.06,2409.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/818","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for medical care worth the result?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2409.15,2411.143"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/819","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Where can we exercise constrain?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2412.17,2415.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/820","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"To illustrate, who should pay for facelifts,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2415.06,2418.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/821","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"nose jobs, breast augmentations and reductions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2418.6,2423.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/822","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"sex change operations and literally years of psychotherapy?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2423.01,2428.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/823","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"These questions are tough.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2428.1,2429.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/824","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They raise a lot of ethical, moral and legal problems.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2429.96,2433.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/825","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Problems that are not pleasant to face,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2433.46,2436.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/826","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but which ultimately must be confronted.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2436.16,2438.973"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/827","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It just may be that we can no longer","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2441.993,2444.893"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/828","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"afford the luxury of denying cost-benefit analysis","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2444.893,2449.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/829","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as an integral part of the practice of medicine.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2449.0,2451.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/830","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"At the very least,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2451.66,2452.603"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/831","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the public must know the cost of rejecting","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2453.71,2456.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/832","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a cost benefit analysis.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2456.82,2458.363"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/833","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The health insurance companies must be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2459.36,2462.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/834","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and are willing to be involved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2462.18,2463.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/835","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in facing up to these decisions.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2463.79,2466.387"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/836","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another soft spot in our insurance mechanism,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2467.38,2471.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/837","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is the lack of economic incentive for either the doctor","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2471.27,2475.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/838","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or patient to have efficient medicine practiced.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2475.19,2478.213"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/839","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We must continue to experiment to determine ways","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2479.29,2482.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/840","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to give monitory incentive to doctors.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2482.33,2486.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/841","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We already know how to give these incentives to patients.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2486.17,2489.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/842","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's called cost sharing,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2489.74,2491.823"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/843","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we do it with deductibles and co-insurance features.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2492.69,2497.424"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/844","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Unfortunately,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2497.424,2498.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/845","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we long ago answered the demand of the marketplace","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2498.76,2501.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/846","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and allowed too many of our policy holders","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2502.46,2504.982"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/847","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to become accustomed the full coverage.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2504.982,2507.693"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/848","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's high time we began the process of educating the public","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2509.702,2514.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/849","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that they cannot afford this illusory benefit","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2514.36,2517.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/850","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"called 100% coverage.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2517.6,2519.693"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/851","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Making this change is not going to be easy.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2520.84,2523.702"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/852","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's going to be a problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2523.702,2525.952"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/853","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Finally, one of the most blurring weaknesses,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2527.07,2529.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/854","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is that we do not provide affordable","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2529.91,2532.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/855","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"health insurance protection to all Americans.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2532.23,2535.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/856","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It doesn't matter that the vast majority are protected,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2535.93,2540.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/857","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"our job cannot be finished until every American","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2540.09,2543.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/858","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"has access to adequate, at least adequate healthcare.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2543.66,2547.383"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/859","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If we are going to do this,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2549.61,2551.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/860","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then we in the insurance business must find ways","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2551.19,2554.273"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/861","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to include more people into the group concept.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2554.273,2557.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/862","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It is clearly in the public interest","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2558.33,2560.013"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/863","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to make health insurance available,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2560.013,2562.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/864","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"whenever possible into the group type of contract.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2562.61,2566.333"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/865","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is the most economical way to offer good 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employers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2732.35,2734.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/916","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"are encouraging their management people","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2735.59,2738.328"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/917","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to become active in health planning 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administrate","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2942.012,2945.428"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/984","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"pragmatically and philosophically,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=2945.428,2948.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/985","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we think the answers are 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across.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3006.519,3009.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1006","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Not only as they apply to the private sector","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3009.32,3012.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1007","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but also in the Medicare and Medicaid 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sensitive,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3041.01,3045.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1018","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that we are capable of getting this job done","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3045.35,3049.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1019","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that we can and do act in the public 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program","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3064.433,3067.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1024","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that will be good for our country.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3067.23,3069.343"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1025","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that if a coordinated 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occur,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3075.817,3080.349"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1028","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we can perpetuate the best healthcare system in the world","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3080.349,3084.449"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1029","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at a price that we can all afford.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3084.449,3087.003"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1030","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's not going to be an easy assignment,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3088.666,3090.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1031","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it can be done.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3090.88,3092.173"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1032","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that's the way the Health Insurance Association","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3093.083,3095.807"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1033","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of America feels about things as they stand today","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3095.807,3099.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1034","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in health insurance business.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3099.34,3101.757"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1035","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e Jerry:\u003c/strong\u003e Thank you Mr. Couch.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3103.04,3105.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1036","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One thing that has been,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3106.45,3108.383"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1037","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then obvious, perhaps two things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3109.54,3111.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1038","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the presentation so far,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3111.09,3112.883"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1039","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is the enormous range of considerations","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3114.52,3117.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1040","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that will go into the financing program of the future.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3117.32,3122.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1041","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3122.48,3123.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1042","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the rather considerable glossary of terms","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3123.8,3127.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1043","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that has been thrown at you already.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3127.41,3129.743"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1044","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Couch, I thank you","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3133.55,3134.893"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1045","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for a beautiful layout of the position which","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3134.893,3138.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1046","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"has ended also 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said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3331.43,3333.657"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"Hey, I understand you married","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3333.657,3335.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1111","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one of two of those identical twins?\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3335.01,3337.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1112","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"He said, \"Yes, I did.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3337.84,3339.487"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1113","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"So I'll bet that's pretty fascinating.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3339.487,3340.633"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1114","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"You know, nobody's ever been able to tell them apart.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3340.633,3344.364"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1115","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"It's quite 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theirs.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3347.33,3349.724"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1118","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience giggles)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3349.724,3352.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1119","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Until we get confronted with illness","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3352.69,3354.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1120","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or having to pay for something,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3354.28,3355.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1121","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it's always somebody else's problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3355.45,3356.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1122","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"When the healthcare situations are as a fellow's","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3356.94,3359.432"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1123","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"released from the hospital,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3359.432,3361.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1124","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and finds his way to an office and says,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3361.87,3363.933"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1125","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"This the office for war on poverty?\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3363.933,3366.373"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1126","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You say, \"Yes it is.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3366.373,3367.206"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1127","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"He says, \"Fine, I surrender.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3367.206,3369.378"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1128","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience giggles)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3369.378,3371.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1129","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Cost, where are we today?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3371.65,3373.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1130","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Gross healthcare costs in this country in 1976,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3373.56,3376.457"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1131","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"$139 billion,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3376.457,3377.903"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1132","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"8.6 is a nice gross national product.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3379.69,3382.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1133","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"1965, by contrast, it was $39 billion and 5.9,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3383.278,3388.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1134","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the gross national product.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3388.04,3389.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1135","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"83% of our current population has some sort of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3390.9,3395.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1136","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"health insurance coverage.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3395.2,3396.981"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And two thirds of these have some sort of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3396.981,3398.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1138","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"catastrophic compound.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3398.78,3399.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1139","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'll pick 1965 because there was an ad that 1966,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3401.26,3404.913"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1140","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which we think is significant for consideration.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3406.19,3409.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1141","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In January, 1966, Medicaid was enacted.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3409.84,3413.063"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1142","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In July of 1966, Medicare was enacted.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3414.92,3418.373"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1143","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As far as health budgets, this is the two largest","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3419.817,3422.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1144","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"governmental absorbers by far of heath care dollars.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3422.16,3425.673"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1145","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Also in 1965,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3427.743,3428.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1146","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"34%","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3430.2,3432.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1147","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of hospital,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3432.6,3434.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1148","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"state represented the part of the healthcare dollar,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3434.65,3437.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1149","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"today it's 40%.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3437.04,3439.018"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1150","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're talking about much larger dollars.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3439.018,3440.933"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1151","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The average cost of a hospital stay in 1965,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3442.52,3446.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1152","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"$39.91.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3447.344,3448.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1153","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Today, last year in 1976,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3448.91,3451.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1154","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"$147.12.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3452.46,3453.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1155","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The average annual growth rate in this industry,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3456.094,3459.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1156","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"professions done 12.6%","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3459.01,3462.217"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1157","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"contrasted with consumer price index of 5.4%.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3462.217,3467.083"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1158","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I know this is heavy and I apologize.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3467.083,3469.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1159","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We give a point of view,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3469.44,3471.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1160","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where we've come and where we are.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3471.01,3473.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1161","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Want to speak to why.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3473.0,3474.617"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1162","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another sharp rate of growth","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3476.123,3478.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1163","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which is unprecedented in our history","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3478.36,3481.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1164","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"came about as a result,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3481.01,3482.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1165","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we think at least two medical programs,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3482.55,3485.153"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1166","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Medicare,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3486.232,3487.231"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1167","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and it speak specifically to the most expensive","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3487.231,3489.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1168","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"component of that cost which is in hospital stays","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3489.79,3492.629"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1169","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or short term care in hospitals.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3492.629,3495.296"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1170","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"With this two pieces of legislation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3496.329,3499.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1171","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"came two, possibly three 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troika,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3544.39,3546.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1188","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that has to be considered in all.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3546.56,3548.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1189","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that troika are three 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switch.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3599.72,3601.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1208","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who sees doctors in this 10 years?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3601.8,3604.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1209","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let me point that out to you what it is, today.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3604.04,3606.477"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1210","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Before,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3607.519,3608.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1211","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Medicaid recipients,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3608.72,3610.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1212","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on average see a doctor nine times a year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3610.52,3613.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1213","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The middle income bracket which is most of us,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3613.56,3616.239"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1214","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"see a doctor on average of five times a year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3616.239,3619.056"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1215","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The most affluent citizen,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3619.056,3621.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1216","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"sees a doctor on average three times a year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3621.04,3623.513"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1217","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What is the significance of that?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3625.34,3626.947"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1218","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, we increased access, then increased availability.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3626.947,3631.677"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1219","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And at the same time we have spoken time 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time","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3647.35,3648.836"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1226","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that this is gonna be quite expensive.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3648.836,3650.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1227","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's gonna be quite 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bulging,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3654.7,3655.793"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1230","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by a debate that has moved away,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3657.03,3659.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1231","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as my colleagues here says,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3659.32,3661.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1232","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from equal distribution of healthcare,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3661.62,3664.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1233","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it's now a surging","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3664.52,3665.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1234","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and flowing around the debate about cost.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3666.898,3669.383"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1235","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I submit to you that we got there through,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3671.5,3673.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1236","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"points of view that everyone would support.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3675.7,3678.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1237","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we got there through the primary standings,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3678.7,3680.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1238","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of governmental programs,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3680.54,3683.015"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1239","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"governmental pushing to increase supply","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3683.015,3686.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1240","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and increase demand.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3686.88,3688.577"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1241","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's definitely true that the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3691.432,3692.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1242","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"more supply has not reduced the need,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3694.17,3697.251"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1243","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it's increased the demand.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3697.251,3699.418"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1244","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The bulk of resources that are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3701.06,3702.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1245","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"drawn into hospital care are interesting.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3702.54,3705.162"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1246","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Because it has not increased","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3705.162,3706.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1247","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the available days of care to people,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3706.58,3709.245"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1248","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it has increased the intensity of services.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3709.245,3712.145"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1249","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And this is a very important point.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3712.145,3714.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1250","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"On an average, hospital stays have actually","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3714.5,3717.407"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1251","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"decreased for individual illness.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3717.407,3719.843"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1252","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But the amount of things that happened to the patient","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3720.69,3722.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1253","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or the recipient, while he's in hospital,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3722.9,3726.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1254","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is much greater than it's ever been before","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3726.14,3729.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1255","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because of new procedures, new technology.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=3729.59,3732.153"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118","type":"AnnotationPage","label":{"en":["English [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30118/annotation/1256","type":"Annotation","motivation":"subtitling","body":{"type":"TextualBody","value":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/118/original/AV167975_Current_Programs_Problems_and_Prospects_in_Financing_Health_Care_a.vtt?1624899301","format":"text/vtt","language":"en"},"target":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/118/original/AV167975_Current_Programs_Problems_and_Prospects_in_Financing_Health_Care_a.vtt?1624899301"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30119","type":"AnnotationPage","label":{"en":["AV167975_Current_Programs_Problems_and_Prospects_in_Financing_Health_Care_a.txt [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632/transcript/30119/annotation/1257","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"- [Jerry] There's no around here, I don't really believe this thing. Good afternoon and thank you for coming. I'd say in passing that there are a lot of old familiar faces in the crowd and if the time permits I would introduce you all. We do thank you especially those of you from the morning for coming up. I'm Jerry Shakeshaft in political science. One of the directors of this project. We have launched last night a moderately ambitious experiment in public education. And even though we have a long afternoon ahead of us, I'd like to say a word or two about it, because the crowd here is relatively new this afternoon. I suppose that other than the energy crisis in Vietnam and Watergate, probably no set of problems have evoked so much public discussion and governmental attention in recent years as have what has been variously called the healthcare crisis, the great healthcare debate or some other terms. And none of us have been immune to those problems. The galloping escalation of costs, aging, chronic illness or really anything else. And the professionals, the providers, have been equally discerned with problems as the general public and legislators and courts, have taken an increasing interest in the manner in which the system is delivered, and the manner in which it is paid for. These concerns have been transmitted in odd ways to this campus, so that about 14 or 15 months ago, it appeared logical to try to put together three major educational outlets of the state, in a general program of public education on health matters. These were the campus lectures committee which conducts a vigorous program of lectures every year in assorted subjects individually and as assorted types of symposia, the cooperative extension service, which has received an increasing number of inquiries and requests for educational programs in health affairs. And the Iowa Board for Public Programs and Humanities based in Iowa city, which has also made similar expressions and requests for our program. The union of these three groups, in company with the faculty capable locally in one form or another of some assistance, has produced an educational effort which is somewhat new in the nation. Health meetings are legion in this country as every man at this table knows. But never to our knowledge quite like this. The effort is coming in two parts. The first of these is the symposium this week, which you are attending and which we have made available 18 national or local experts in some facets of the problem. And all of it is being filmed and over the course of the Winter will be edited and supplemented by literature by a committee within the extension service and taken on the road next Spring to a minimum of 24 Iowa communities. The sole purpose of this set of programs is the enhancement of the public's understanding of the problems. And within the time available to us, of course, it is impossible to present more than a moderately searching overview of the problems at hand. We all know that we deal with a set of problems that are economically huge, politically charged, scientifically very complex. And humanistically, really, as complicated as all of life itself. The point is that we can't hope to cover entirely the wide range of interests which impinge upon the subject. We have done our best with two purposes in mind, the broadest possible general public understanding and the highest degree of equity in the presentation of points of view that we could achieve. There is an addition to this, a subsidiary purpose of this problem. I am willing to even lay some money with my colleagues on this panel. That within the next 12 months, we will hear increase in talk even from the White House, about the degree to which the application of definitive medical care in many instances, this country is wasted. Not because the clinicians are no good, but because we are killing ourselves on the way to the clinicians and by the time we get there, we've already done the job. A look at the leading causes of death, for instance, in young to middle-aged adults in the United States now prove the point. It is the cigarettes we smoke, the liquor we drink, the cars we drive and the manner in which we worry and work. So, if it has any pitch, it is a subsidiary pitch to the educational purpose, which is the beginning of some awareness of the importance of prevention, if possible, through the modification of the manner of which we look at ourselves vis-a-vis the healing. And this accounts for the misprinted quotation on the face of the program. This afternoon, we have five experts on assorted facets of the problem and I am going to introduce them and then we will proceed through a rather loose discussion of problems and prospects in financing the health care system of the future. I owe an apology to professionals in the room. To a degree, the program is backwards and we know it. We really should have discussed the structure of the delivery system before going into financing, probably. The backwards arrangement arises from the commitments elsewhere of some of the people on the panel and we had no alternative when we finally got down to setting the schedule. On my right, in the extreme your left, is Bob Sigman of Philadelphia, Chicago and the airplanes in between, who has a long and truly distinguished career in these matters, as a facility planner on an area wide basis, as an executive vice president of Albert Einstein in Philadelphia and as a, at the moment as a consultant on hospital affairs to The Blue Cross Association of the United States. To Mr. Sigman's left, Julian Couch, who is Director of Healthcare Relations for The Bank of Life Company of Iowa, one of the largest underwriters of the people of Iowa along with Blue Cross. To my immediate right, a gentleman who learned everything he knows from the Political Science Department of Iowa State, Mr. Tom Higgins, who until a couple of weeks ago, was a State Representative from a district of the city of Davenport, Iowa and in the legislature he was chairman of the joint committee I believe it was at the time on human resources. And has been in the past two weeks, appointed by secretary Califano, as a Regional Director for the Department of Health Education and Welfare of this region in Kansas City. To Mr. Higgin's left, is Mr. Dan Schwick, Associate Administrator of the Health Resources Administration, in that vast empire in Rockville now HEW. No, pardon me. I knew I'd be up. Dr. Gardner, trustee of the American Medical Association, in Louisville, Kentucky, just inside Missouri Plain. We had even proceeded to something approaching a vote at lunch as to how we would proceed. And I urge you incidentally because he is being enormously restrained to him, and say's he isn't going to say anything assertive. To come here Mr. Sigman to hide, who is in my opinion certainly one of the 10 most articulate gentlemen in this program in this country. I don't believe that he's going to be quiet all afternoon. But out of difference probably, we elected Schwick. To lead off with an overview and portrayal of the alternative financing mechanisms at the problem, financing mechanism of the pros or the problems we face in financial system. I'm saying, any more or any further deduction, except that there are three men up here who were once young Turks together and now something much close to old turkeys. But Dan is leaving tonight to get back to set up the first meeting on the weekend of the National Heath Planning Council of HUW, I'll say no more. Mr. Dan Slay.\r\n\r\n- [Dan] Can I speak from here?\r\n\r\n- [Jerry] You may speak from there Sir.\r\n\r\n- [Dan] Okay, all right. Jerry says there was a valid and again, so often happens of the Fed Laws. But I was really asked to give you a report on what some of the people you pay in Washington a great expense, are doing in developing a National Health Insurance program at the present time to try to deal on more effectively with some of the health financing programs. What I'll try to do is to give you a brief report on some of the issues that folks in ATW and elsewhere in bureaucracy are thinking about and put those issues on the table for the further consideration of the panel and then of yourself during the discussion period. As was said at lunch, there's probably a universal agreement in this country that the time has come to develop a National Health Insurance Program in the United States. In fact, there's even some people who think that the time has passed which we should have developed a National Health Insurance Program. The only problem is of course is so many of us discover when there's universal agreement on something in this country, it's probably the different people are thinking of quite different things. So when the words of National Health Insurance are used, the various participants in the process, have quite different things in mind. And it's trying to sort out those differences and trying to find some common ground on which we can move forward perhaps incrementally, that much of the effort is underway. Secretary of Califano has appointed an advisory committee on National Health Insurance, shared by the other secretary Mr. Champion, Dr. Roy, who is a member of the advisory committee, and will be joining you tomorrow I understand and he should give you some further insights on the work of the Advisory Committee. Karen Davis, Whom I understand was to be invited to this panel, is really the Chief of Staff person in heading up the analysis. And I wouldn't pretend to be a substitute for Karen, she has a very able publication on National Health Insurance that you might wanna look at if you're not already familiar with. That she produced when she was at the Brookings Institute. And I as well as many other students on the campus, I'm sure will be cribbing from her report. The white House has requested, as I understand it that the proposal be available for submission to the Congress about March 15th. And so there's a good deal of spending this activity aimed at that goal. As I say that there are essentially five major issues that have to be dealt with in some satisfactory fashion to get this issue moved ahead. As I say put those issues on the table, outline them very, very briefly and provide a basis for further discussion. Those issues as I see them on the following subjects. First, is the nature of the benefit package. What are the services that are going to be paid for, and covered under the National Health Insurance Program? The second issue is the methods of financing. How is all this gonna be paid for? The third issue are the methods of reimbursement. How are we going to pay the providers a service who are gonna be participating in this benefit program? The fourth issue, and one of the more complex is how is all this gonna be administered? What is the respective roles of the Federal Government and the State Governments and private agencies and all the other various interested parties? And the fifth issue, one that is sometimes overlooked, but not these days in Washington, is the relationship between all of this activity in the health financing area and its relationship to the health services delivery system. Let me go back and talk about those five issues, one by one over the next few minutes. With respect to the benefit package, you'll find a pretty broad agreement, again, on a set of words. Almost everybody will agree that it ought to be a comprehensive benefit package. Difficulty is, again, that those words have quite different meanings to the participants in the process. Most everybody will agree the comprehensive probably covers hospital services and acute medical care services. But once you move off that secure base, you've got lots of uncertainty. How much, for example, attention should be given to a long-term care services? None of the major health insurance proposals commonly on the table, including the Kennedy Coleman Bill, deal very adequately with the long-term care. Secondly, how much attention should be given to mental health benefits? There was a good deal of attention given to him the last administration to that issue and a considerable disagreement remained at the end of that analysis. There are some people who think that can be extremely expensive, there were others who think that if we don't deal with mental health, that's gonna be a pretty incomplete program. Since Mrs. Cady is the honorary chairman of a Presidential Commission on Mental Health, obvious a pretty good assurance that that issue is not gonna be neglected. And there's the issue of dental health. How much benefits shall we provide to dental health in such a program? Should it be dental services for children or dental services for the elderly? Dental services for the working population? And finally the most difficult issue with prevention. Traditionally, we haven't done very well in this country and most countries overseas, have not done very well in covering preventative services in a Health Insurance Program. Should we stretch out the dimensions of other a Health Insurance Program to cover preventive services? And if so, what type of preventive services? Should they focused on children? Should they be focus again on the elderly or should we take a very modest approach to that as we have in Medicare and Medicaid? So there's still lots of disagreement over the scope and the extent of the benefit package, even though, as I say, most everybody's interested in a comprehensive benefit package. And that's the easiest issue I would say. The issues of financing, are certainly extremely complicated. Traditionally, we thought of a payroll tax as the way of going about an insurance program in this country. There was much agreement or disagreement over the years on whether a National Health Insurance Program should be added to the social security program. It's pretty broad the feeling in many quarters now that we've loaded above as much on the payroll taxes we'll likely to be able to do. Social security fund itself is inconsolable financial question. So therefore, how much of this program should be paid for through general revenue? How much of it should be paid for from the tax credits? Tax credits of course, is a program on strongly due West by one of the major interest groups. And then there's not a new idea. Many people forget that we can only have a tax credit program in effect in the United States. And we are commonly providing six to $8 billion of coverage a year for health insurance through a Tax Credit Program. Tax Credit Program, incidentally, that is highly biased these days, toward the middle class and the upper middle class. But the idea of the Tax Credit Program is certainly not a new idea in this country and one that has a lot of attractive features to it. One of the most ingenious focus to the problem was really identified and worked out rather well at during the previous administration. Bob Ball, the former head of the Social Security Administration, is referred to it as one of the more creative pieces of public administration in recent years, although he himself is personally strongly opposed to a program of mandatory coverage. But the approach of mandatory tabloids by which the federal government requires private employees to provide health insurance coverage, is really a very ingenious way of getting public programs extended without increasing anybody's taxes. And it's a very attractive program, even though particularly in a time in which people are trying to keep taxes from increasing. And finally, there's the relative role of the consumer in paying for health insurance. How much of the total program should be paid for through co-payment, sued by the actual payment, by the consumer at the time of the delivery of services? Many people have strongly supported that. Many economists are strongly supportive of it to ensure a continuing sense of cost consciousness among the consumers of service. So the methods of payment involved, no end of difficulties, but that's relatively mild also compared to the issues around methods of reimbursement. Once we have a health insurance program, how should the providers of here be paid? Up to now in the Medicare and Medicaid program, we actually adopted a policy which is really very traditional. We just adopted what was going on in the past, and paid positions on the basis of fees and paid hospitals on the basis of cost. And we've demonstrated how expensive that can be over the last 10 years. But our friends to the North, the Canadians, are following a very similar program and they've demonstrated that you can develop a National Health Insurance program based on cost reimbursement and fees for service, and not have it yet entirely out of hand. But in this country, there is considerable question whether there was a willingness to extend the methods of cost reimbursement and cheaper service payment to the total population. And so we see discussions of prospective reimbursement going on, of fee schedules, of pre-payment through capitation. That is perhaps the most controversial aspect of the total argument. And no doubt that there'll be further discussion of that during the remainder of the panel. The fourth issue that I put on this list of major issues concerning the administration of the program. There are some people, some major health insurance proposals that call for the federal government to entirely administer the program. That used to be considered the extreme position, but it was no longer an entirely strange idea. On the other hand, many people at the state level are strongly supportive of the continuing state role of the administration of the National Health Insurance program, despite the somewhat unhappy experience with Medicaid. Similarly, the private health insurance groups, which we discussed here, have a very major role at the present time in administering health insurance in this country, and are not likely to be easily or readily set aside. And we have a strong basis of experience in using private health insurance in the administration of both Medicare and Medicaid. So if we are to have a National Health Insurance program, who is to run it? Who is to operate it to do the day-to-day work? And the final issue I have is a relatively new issue in the debate in this country, and around the world, around national health financing issue, and that is the relationship between the national health financing system and the services delivery system. We sponsored a study last year to take a look at what our friends in Western Europe had done on that issue, to see if we had something to learn in terms of how well they planned the development of their services delivery system, and their activities in developing national healthcare financing systems. And what we essentially learned from that is that at least we're no worse than they are. Almost all of those systems essentially began by paying the bill. And only recently have started to focus attention on the relationship between the organizational services and the financing services. So while we are slow in getting to this issue, we are not slower than a lot of other people around the world. But we have now I think an increasing sense in Washington, increasing acceptance of the idea both in Washington and around the country, that you really can't develop a healthcare system, healthcare financing system, without giving attention to its impact on the delivery system. That's a long way from 1965, and maybe the major lesson that we've learnt over the last 10 years, 'cause in the laws of 1965, there was specific prohibition against ATW interfering in the services delivery system as it administered Medicare and Medicaid. So we are now closely involved in the issues of the relationship of financing to planning, financing to resource development, and financing to manpower development. And that issue in itself includes again, another one of the more complex issues of this business, and that is the relationship of all of this to innovation in the system. One of the things we did learn in our studies of European systems and Canadian systems is that a national health financing system has a powerful tendency to freeze the system. It has a tendency at best to finance the best care that's going on at the time, at the enactment of the bill. The bills tend to be written by lawyers and administered by accountants, we sometimes say, and those professions, noble as they are, are not among the more flexible members of our society. So we tend to end up with very rigid systems and I've experienced in Medicare and Medicaid it is certainty supportive of the following experience. Essentially in Medicare and Medicaid, we are supporting the delivery system of 1965. Any innovation in American medical care since 1965, Medicare and Medicaid have a lot of trouble with. And at that, it's bad enough at the present time, but if the total financing of these systems was still a national health financing system, and we don't find a way to protect innovation, then we have a great risk of freezing into the system some of the undesirable practices of the present and freezing out some of the desirable changes of the future. So those are the five issues that I wanted to call to your attention. The benefit system, the financing system, the reimbursement system, the methods of administration, and its relationship to the services delivery system. In closing, I would point out that the debate has got a good deal more complicated in recent years. If you think things were tough before, you oughta see how it is now. Because it's gotten tough on two new issues, which have recently joined the discussion. One is the divided attention between the purpose of a National Health Insurance program. I can remember as I think many of you can, in which there was pretty clear agreement on the issue, but the major purpose of National Health Insurance was to improve equity within the society. That there were people within the country who were not receiving equal services, and we got to do something about that. That's only half the debate now though. There's another school of thought that really thinks that the purpose of National Health Insurance is to control cost. And that brings to the debate quite a different point of view. And while there can be a, there is a lot of agreement on the words, the relative emphasis given to equity and to cost control, is one of the more prevailing issues in the debate. A second complication in the recent debate is the attention given by the president to an incremental program, phasing in the development of National Health Insurance. If we gotta phase-in National Health Insurance Program, we then have a second set of issue. Not only do we have to agree on what is the total program gonna look like when we have a National Health Insurance Program, but we have to get some agreement on what will be the first step of that program, and you can get lots of disagreements on that. Many people argue that the first step should be an extension of the agent program. Others feel that the first step should be a children's program, and others take a different points of view, other points of view on that, but even, I don't wanna end on such a sour note that may have held on up to now, because I think we're quite capable of dealing with this issue. We do live in a society that has continuously learned how to deal with complex problems, and we have shown an ability in our own unique American way to solve those problems. And I'm quite confident that in our lifetime we will learn how to deal with this one.\r\n\r\n- [Jerry] Thank you Dan. If it is agreeable with this group, we will, I should have announced, we will have a brief presentation by another speaker, After which they will be asked to shoot at each other if they wish, and after which and they're all quite serious in wishing to leave as much time open for the floor as possible. It has been my privilege when I'm not in chains on the campus to have worked off and on in this business in assorted places in the state of Iowa. And, particularly with a body effort arising from the Federal Statute with some of my friends here, in comprehensive health planning over a period of several years. And in that period, one of the most co-operative and intelligent groups, I thought, in this day, with the Bankers Life company, and even if they were dumb and uncooperative, They'd be important here because they underwrite a great deal of people in this room. Mr. Lee Couch has been with Bankers Life since 1948, in the business of claims, in which he has been progressively an assistant supervisor and supervisor, in the 50. He's was an elected an officer of the company and the assistant secretary in 1967, and he has been it's Director of Healthcare Relations, I believe since 1974. Couch is a native of Iowa, a graduate of Valley High School in Des Moines and of Gate University, and is very well informed about the position of commercial health insurers in general relation with respective problem. And I now call on Mr. Lee Couch.\r\n\r\n- [Lee] Thank you professor Shakeshaft. I'm pleased to be a part of this event today, because I do speak or represent one of the so-called major interest groups. We do have a point of view and we liked the opportunity to present that point of view. The focus of my remarks is to identify for you this interest group called the Health Insurance Association of America, identify it's purposes, it's activities and its representation of the commercial health insurance industry. The Bankers Life is obviously a member of this association, and I serve as a local point of contact with the providers of healthcare throughout the state. The association was organized back in 1956 and it's currently consists of approximately 310 insurance companies. These companies are responsible for 85% of the current health insurance written by the carriers in the US today. Now this does not include that coverage written by Blue Cross Blue Shield. The general purpose of the association is to assist the member companies, in the promotion and development of voluntary health insurance, and the provision of sound protection against losses arising from sickness and injury. Its activities are typical of any association. It represents the member companies in dealing with state and federal legislative matters and another function unique to the insurance business is maintaining the liaison and furnishing information and technical assistance to national state and local organizations of healthcare providers. As well as to the consumer organizations involved in this kind of an activity. It also carries out the public relations and the information function for the health insurance business. I think it's obvious that the activities and services of the association are funded by the member companies. Policy of the association is determined by a senior company executive of the member companies, just in a way a background about the association. With that out of the way, I'd like to get on with specific comments regarding the private health insurance business and the things that we today claim as our strengths and those things we acknowledge as weaknesses in our financing of health care for our nation. National Health Insurance as we all know has been around on the horizon for quite a number of years now, and the health insurance industry has been deeply involved in every chapter of the book to date. We intend to stay there. First, McEntire Burleson or Burleson McEntire Bill for national health insurance is hopefully a widely recognized entry in the National Health Insurance race. It's been there since 1975. We think it's a great plus for our business. And we have been backing it since that time. The bill has already accomplished a lot in our country. Starting out with health planning. In the original bill, there was a provision calling for organized health planning. Today, you all know that Congress has enacted such legislation and that member company representatives set on many of these health planning boards and committees throughout Iowa and throughout the United States. Secondly, in the original act, there was also a provision calling for comprehensive health manpower legislation. Provisions similar to those the HIAA proposed are currently contained in the Health Professions Educational Assistance Act of 1976. And we get to ambulatory care, the 1970 version of the McEntire Burleson Bill stressed the need to expand ambulatory care facilities as an alternative to costly hospitalization. Three years later, Congress did in fact enact the HMO Act to accomplish exactly this. Again, many commercial carriers are involved in HMO activities today, and increasing the scope of their involvement. While it's true that McEntire Burleson has not passed, many of its important original provisions have in fact, been accomplished. So a lot of it we say, is already on the statute books in a very real sense. We also maintain that this bill has been effective in demonstrating that there are alternatives other than a monolithic government health care program, or programs. The HIAA supported Bill has represented in our judgment a positive rather than a negative approach, yet presents a positive program for solving the problems of providing healthcare to our citizens. But if it has been one of our strengths, and we claim that it has, there are also a number of acknowledged weaknesses and problems we have in providing healthcare to our system and changes that must take place. First off is the attitude shared by too many people in our judgment, including some insurance people, that all Americans should have the very best in medical care. In my opinion, our health care system is in no provision or no position to provide this much. We're having a tough enough time just affording and delivering adequate care to our population. Moreover, the highly touted programs around the world that we see written up from time to time provide far less than the very best. This is pretty well documented. In the US we already provide far better but our availability is not uniform and universal and this is one of the real problems that must be solved. Consider these examples. How many of you will agree that patients always need to be hospitalized when outpatient or at-home treatment may suffice? But we all know many of our friends that go to that hospital because it's covered by their insurance. Do we all need to have hospitals and the most expensive medical equipment within five miles of our homes? Do we all need to have the physician personally see us, for the most minor of complaints? There are a lot of less costly alternatives that are too often not used. Everyone knows that two aspirin and bedrest, solves a high percentage of our complaints, but not many of them are solved when somebody else pays the bill with insurance. We do have a right to adequate health care. But I seriously question many of the extremes to which our system has taken us. This is not a popular stance, it is simply a practical reality. Another real flaw in our system, to which we have been partners is the rejection of any type of cost benefit analysis. In simple terms, is the price we pay for medical care worth the result? Where can we exercise constrain? To illustrate, who should pay for facelifts, nose jobs, breast augmentations and reductions sex change operations and literally years of psychotherapy? These questions are tough. They raise a lot of ethical, moral and legal problems. Problems that are not pleasant to face, but which ultimately must be confronted. It just may be that we can no longer afford the luxury of denying cost-benefit analysis as an integral part of the practice of medicine. At the very least, the public must know the cost of rejecting a cost benefit analysis. The health insurance companies must be and are willing to be involved in facing up to these decisions. Another soft spot in our insurance mechanism, is the lack of economic incentive for either the doctor or patient to have efficient medicine practiced. We must continue to experiment to determine ways to give monitory incentive to doctors. We already know how to give these incentives to patients. It's called cost sharing, and we do it with deductibles and co-insurance features. Unfortunately, we long ago answered the demand of the marketplace and allowed too many of our policy holders to become accustomed the full coverage. It's high time we began the process of educating the public that they cannot afford this illusory benefit called 100% coverage. Making this change is not going to be easy. It's going to be a problem. Finally, one of the most blurring weaknesses, is that we do not provide affordable health insurance protection to all Americans. It doesn't matter that the vast majority are protected, our job cannot be finished until every American has access to adequate, at least adequate healthcare. If we are going to do this, then we in the insurance business must find ways to include more people into the group concept. It is clearly in the public interest to make health insurance available, whenever possible into the group type of contract. This is the most economical way to offer good coverage and carriers must aggressively innovate in the marketplace in order to provide the group coverage to more people. So these are the things that we identify as current weaknesses in health insurance business that we must work on correcting. Doesn't mean identifying villains or placing blame on others in the healthcare system. We don't maintain that anyone in the system is a villain. The hospitals aren't villains, the doctors aren't villains the government isn't a villain, neither are the health insurance carriers. All of us share major responsibilities for the problem but none of us fall into the villain category. A lot of people, including the groups that I've mentioned have studied the problem and realized there isn't any panacea. It's going to be a tough thing to solve. In health insurance industry, I mentioned that we have a point of view and I'd like to get on with mentioning some steps that we advance as things that perhaps will go towards successful solution of the weaknesses in our present system. These have been formally adopted by the Health Insurance Association as a program. Number one, the PSRO review activity required by that law, should be extended to all patient, not just those under Medicare and Medicaid. Every patient has the right to be sure they are getting equitable treatment for the doctor's fee, for the hospital charge that they pay, and for the type of care prescribed by their physician. We in the insurance industry have been working with the Iowa PSRO for several years to accomplish this step. And in other States, similar activity is currently underway. We think we may have a workable system in a very short period of time now. Secondly, we maintain that any new health facility should be certified as to the actual need in order to eliminate excess hospital beds and the wasteful use of services. This is not a new idea, you've heard it expressed by men. All of those who speak for the consumer, the business man, the labor official, insurance people, medical care providers, must involve themselves in this health planning process. Many insurance executives and employers are encouraging their management people to become active in health planning agencies. The system is beginning to work. And some of you are involved in this activity and can see that happening. Hopefully, this certificate will need legislation, to further solidify the process in Iowa, when it becomes operative on the 1st of July next year. Third, all hospitals should be required by law, federal or state, to have prospecting budget review and approval. However, and this is an important point, the process should apply uniformly through all sources of payment, not just those under government programs. There's a basic principle involved in this. We don't feel that we're ever going to get a real handle on cost if hospitals can make up for what they lose under government programs, by raising the prices for everyone else. Whenever government merely puts the cap on charges for their patients, it allows or forces the hospital to transfer the cost to the private patients. For alternative costly hospital care, the HMO and other types of outpatient care centers, must be given every encouragement and stimulus. One way to do this is to expand health insurance coverage through out-of-hospital services, and that's step number five. There is a lot of progress in this area but much needs to be done yet. Practically, all of the health insurance carriers now offer benefit packages which include, this coverages for preventive care services. Aiming for second and third opinions for elective surgery, payment for tests performed before going into the hospital, payment for home health care, and other extensions of coverage. Six, much greater emphasis must be placed on preventive care primarily through public health education. Somehow, we've got to get to the American public to place a greater value on their individual health, already been mentioned today. I'm encouraged to see a variety of these programs being undertaken by some of our employers, by some of the voluntary agencies, by some hospitals and by some health insurance companies. There is movement in this area, but not nearly enough. Now my own judgment is that it has to start earlier in the educational practice. Junior high is not too early to teach about drugs and smoking. It ought to be sooner than that. All of these initiatives, set the stage for a seventh and final step, a sound program of National Health Insurance. Yes, we in the HIAA and member companies, do want and do endorse the National Health Insurance program. Because this is where the question of private versus public accountability really comes together, because it involves these questions already mentioned: Who should pay for the program? How should it be financed? And very importantly, push and administrate pragmatically and philosophically, we think the answers are these: One, those who can afford to pay for health insurance, should pay for it, the way it works today. Those who cannot afford should be the responsibility of Government. Essentially, the same as today. Lastly, private business should insure and administer such a program, because we maintain it has been demonstrated adequately that it can do a far better and more efficient job than can Government. Eventually, Congress and the administration are going to face up these questions. However, we think it is a certainty that this is not going to happen until all of us together, the medical professions, the hospitals, the health insurers and the government agencies, coordinate all of our efforts to control current escalation of care across. Not only as they apply to the private sector but also in the Medicare and Medicaid program. So, I've attempted to outline some of the weaknesses that are hampering the health insurance industry effort to control health care cost. Obviously our first task is to shore up these these areas. We think we've done a good job but people simply expect more, and that's our challenge. We will continue to try to convince the public that we have been and will be socially sensitive, and that we are capable of getting this job done and that we can and do act in the public interest. That's our point of view. I think we can go a long way in winning public confidence based upon past performance, and for setting forth a type of national health insurance program that will be good for our country. I think that if a coordinated effort among those who finance and deliver, and use health care, can occur and it will occur, we can perpetuate the best healthcare system in the world at a price that we can all afford. It's not going to be an easy assignment, but it can be done. And that's the way the Health Insurance Association of America feels about things as they stand today in health insurance business.\r\n\r\n- [Jerry] Thank you Mr. Couch. One thing that has been, then obvious, perhaps two things in the presentation so far, is the enormous range of considerations that will go into the financing program of the future. And the rather considerable glossary of terms that has been thrown at you already. Mr. Couch, I thank you for a beautiful layout of the position which has ended also the, a good deal of education in directions beyond merely HIAA's point of view. No matter how you slice it, in the future, there is one particular group, somewhat aligned in recent years, who will be at the center of the delivery of care, perhaps not quite to the degree that we have associated them in the past, if delivery arrangements change, but who's interest nevertheless must be accommodated because, and given an enormous voice because they are after all the people who command the laying on of hands. We are really honored to have here today a trustee of the American Medical Association and Dr. White Gardener from Louisville, Kentucky who has a broad background as you can see in the printed program in Blue Shield, in the AMA board of trustees, and in the political action and points of view of the American Medical Association. Dr. Gardner, it is a pleasure to welcome you to Iowa, sir, and to thank you for coming. Dr. White Gardner.\r\n\r\n- [Gardener] Thank you Mr. Chairman. Fellow panelists, ladies and gentlemen, first of all, may I congratulate you on being here. This is a heavy subject. It is complex and it's not conducive to coming in out of a bright, clear day in the middle of Iowa. Been listening to burdensome issues, bill of conflict, bill of a debate, and filled with uncertainty, and filled with lack of conclusion. So I congratulate you most of all for being here, we are here on assignment, you're here voluntarily. Anytime you mix dollars and compassion, regulation with individual selectivity, you have controversy. When you place a large cost factor into it, you have more controversy. Who's to pay and who's to receive, and who will share the intermediate burdens? All are serious confrontations. Okay, I'll very briefly, outline three points of discussion for my presentation. First of all, very briefly the cost today. Secondly, considerations of the people, the procedures, and the circumstances involved in this cost. And lastly, some overall considerations with recommendation from the American Medical Association that we thinks in behalf of all of us. Healthcare costs are somewhat like the man that married one of two identical twins. No one could ever tell the difference between them not even their parents. So after he got back from his honeymoon, not unexpectedly, he was confronted on the street by a colleague who said, \"Hey, I understand you married one of two of those identical twins?\" He said, \"Yes, I did.\" \"So I'll bet that's pretty fascinating. \"You know, nobody's ever been able to tell them apart.\" \"It's quite so.\" He said, \"Well, how do you tell him apart?\" He said, \"It's not my problem, it's theirs.\" Until we get confronted with illness or having to pay for something, it's always somebody else's problem. When the healthcare situations are as a fellow's released from the hospital, and finds his way to an office and says, \"This the office for war on poverty?\" You say, \"Yes it is.\" He says, \"Fine, I surrender.\" Cost, where are we today? Gross healthcare costs in this country in 1976, $139 billion, 8.6 is a nice gross national product. 1965, by contrast, it was $39 billion and 5.9, the gross national product. 83% of our current population has some sort of health insurance coverage. And two thirds of these have some sort of catastrophic compound. I'll pick 1965 because there was an ad that 1966, which we think is significant for consideration. In January, 1966, Medicaid was enacted. In July of 1966, Medicare was enacted. As far as health budgets, this is the two largest governmental absorbers by far of heath care dollars. Also in 1965, 34% of hospital, state represented the part of the healthcare dollar, today it's 40%. We're talking about much larger dollars. The average cost of a hospital stay in 1965, $39.91. Today, last year in 1976, $147.12. The average annual growth rate in this industry, professions done 12.6% contrasted with consumer price index of 5.4%. I know this is heavy and I apologize. We give a point of view, where we've come and where we are. Want to speak to why. Another sharp rate of growth which is unprecedented in our history came about as a result, we think at least two medical programs, Medicare, and it speak specifically to the most expensive component of that cost which is in hospital stays or short term care in hospitals. With this two pieces of legislation, came two, possibly three increasing, larger access by the poor, the elderly and the disabled all points of view with anyone would support that has compassion, of course. But increase the access. Some of them never had access before because all the dollar barrier. Now they did have access. To offset that, programs were instituted, they said we have to have more doctors because of poor distribution. We have to have more beds and facilities in order to be sure that everyone has a high level of care that's equal. And of course these are all worthy and certainly acceptable in any society of humanity. But with this, there's a troika, that has to be considered in all. And that troika are three things; access, cost and quality. You cannot influence any one of those three without having a direct influence on the other. The idea was, more beds, more facilities, more services, more doctors, will take up the lag in a reasonably short period of time, say 10 years. And then there will be a decline in the cost. So while an exploding cost offset, the extra access will then be diminished because many of the people, the rest are all of those that did not have care, be taken care of. It's not worthy to know that there's never been enough healthcare. Nobody has ever had all the healthcare they should have. There's been a great switch. Who sees doctors in this 10 years? Let me point that out to you what it is, today. Before, Medicaid recipients, on average see a doctor nine times a year. The middle income bracket which is most of us, see a doctor on average of five times a year. The most affluent citizen, sees a doctor on average three times a year. What is the significance of that? Well, we increased access, then increased availability. And at the same time we have spoken time again, the importance of public education. So if they're aware of what is available, how they can protect themselves, how they can respond to the opportunities of healthcare delivery. We did not say at that time that this is gonna be quite expensive. It's gonna be quite costly. So now we find ourselves, burdened and bulging, by a debate that has moved away, as my colleagues here says, from equal distribution of healthcare, it's now a surging and flowing around the debate about cost. But I submit to you that we got there through, points of view that everyone would support. And we got there through the primary standings, of governmental programs, governmental pushing to increase supply and increase demand. It's definitely true that the more supply has not reduced the need, it's increased the demand. The bulk of resources that are drawn into hospital care are interesting. Because it has not increased the available days of care to people, it has increased the intensity of services. And this is a very important point. On an average, hospital stays have actually decreased for individual illness. But the amount of things that happened to the patient or the recipient, while he's in hospital, is much greater than it's ever been before because of new procedures, new technology.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118632#t=0.0,3737.544"}]}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633","type":"Canvas","label":{"en":["Media File 2 of 2 - 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[Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e It 3 o'clock in the morning","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=5.765,6.653"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which is when (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=6.653,8.452"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when you're drunk and stayed on the doorstep","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=8.452,10.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for being man of the man of the cloth (indistinct) spirit","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=12.076,15.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but that was for months,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=16.78,17.947"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"finally said the Lord will forgive me for this transgression","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=17.947,21.128"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but I can't stand it anymore.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=21.128,22.578"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"3 o'clock door bang and he went near (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=23.45,27.125"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and he said (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=27.125,30.433"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I understand this discussion has gone on and on,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=30.433,33.167"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think it's wonderful","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=33.167,34.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that you have this concern","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=34.0,34.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about Northern Southern not Lutheran church,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=34.95,38.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I want to speak to you, that is not even my (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=40.071,43.117"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That it's three o'clock in the morning","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=45.36,48.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I do have other duties to take me to other places","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=48.29,50.781"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to other people (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=50.781,53.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Besides that you always attack me on this issue","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=53.6,55.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in a drunken state of affairs.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=55.96,58.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, what do you have to say about that?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=58.85,59.927"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And he says, doc, when I'm sober","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=59.927,61.832"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't give a about the United Luther Church.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=61.832,63.969"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughing)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=63.969,66.969"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The point I am making,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=70.187,72.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/25","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as long as people think it's not costing me","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=72.5,75.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/26","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"anything are we have been telling them you're entitled","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=75.28,79.154"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) they under the insurance program which we sell","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=79.154,83.114"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"under governmental programs with provided them","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=83.114,85.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/29","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but is there a writing expectancy.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=85.73,88.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/30","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They don't give a what it costs you see,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=88.26,90.263"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/31","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because they act as if it was a free commodity.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=90.263,92.743"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/32","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) the decision makers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=94.015,97.714"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/33","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and utilization of that care my profession in the hospitals.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=97.714,102.714"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/34","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Also have come to accepted it the same way,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=103.1,105.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/35","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because our incentives have been changed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=106.241,109.138"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/36","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as well-known fact, not only by research","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=109.138,111.963"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/37","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but practicality places as the doctor.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=113.02,116.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/38","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now doctor, I don't have any insurance.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=116.68,119.623"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/39","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Buy your judgments of what happens here","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=120.52,122.493"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/40","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is somewhat different than if he pulls out a full pay","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=122.493,125.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/41","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"insurance policy or flashes America","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=125.04,128.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/42","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Medicaid or Medicare card.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=128.41,130.573"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/43","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So that gives it to incentives provider and recipient.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=131.63,135.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/44","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now let me talk to you about and expand on those points.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=138.54,143.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/45","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=144.887,147.116"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/46","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the incentives and the price structure.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=147.116,149.833"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/47","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now this is a democracy, a compassionate society of people","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=151.95,156.223"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/48","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am most confident, feel not only deeply","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=156.223,159.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/49","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about our own people, body and soul.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=159.12,162.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/50","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But you know why we extend this to all people everywhere?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=162.0,164.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/51","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"None of those are circumstances","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=165.95,167.704"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/52","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we are reacting to the climate.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=167.704,170.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/53","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"A big feeling, about each individual person, the passion","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=170.22,174.633"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/54","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for his needs the most significant one,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=174.633,177.063"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/55","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is healthcare because without health","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=178.368,180.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/56","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you really have nothing wrong with problems result","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=180.98,185.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/57","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"revolve around this incentive, incentive","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=185.46,188.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/58","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"price structure (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=188.48,189.747"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/59","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Has to be looked up to,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=192.01,193.527"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/60","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"under the circumstances under the circumstances","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=193.527,194.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/61","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=194.99,196.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/62","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It has provided and accepted, then demanded","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=196.09,199.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/63","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that there'll be more doctor access.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=200.82,202.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/64","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This profession, people, society there is doctors.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=203.57,206.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/65","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As the Lord's doctor, ratio today there is no (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=208.17,211.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/66","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one doctor for every 551 people,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=211.71,214.003"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/67","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"surpassing what used to be the highest (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=215.04,219.516"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/68","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which now I have one for every 750.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=219.516,223.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/69","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's a whole nother debate (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=223.25,225.177"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/70","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There is a lot of doctors access","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=226.16,228.133"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/71","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it will be 25% greater in five years","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=228.133,231.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/72","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which means there's going to be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=233.57,235.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/73","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"an awful lot of doctors around.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=235.06,237.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/74","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We welcome that, here is the point I have to use","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=237.09,239.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/75","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there is an increase access","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=241.001,243.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/76","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it will not lower cost.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=243.32,244.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/77","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It will intensify competition,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=245.57,247.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/78","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which is always been in the profession anyway.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=247.26,249.917"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/79","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it will create more demand as well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=249.917,252.653"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/80","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Secondly, with that increase patient usage,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=254.92,259.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/81","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there's obviously going to be greater utilization;","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=259.45,262.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/82","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"hospitals, services, technology.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=262.55,265.173"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/83","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Technology's exploding in the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=267.7,269.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/84","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"extraordinary complex technology today.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=269.18,271.973"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/85","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think probably the most common one","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=273.129,274.947"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/86","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"everyone is familiar with so I will use it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=274.947,277.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/87","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Just one, but there are so many others","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=277.8,280.007"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/88","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) right behind it, calf scanners,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=280.007,283.443"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/89","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"start out with a million dollars to buy one,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=285.68,288.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/90","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"today it's $300,000.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=288.0,291.573"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/91","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Procedure used to cost four or $500 to do.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=291.573,294.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/92","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Today it cost in the range of $80 to $250,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=294.09,296.483"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/93","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"depending on where,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=297.79,299.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/94","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but they're proliferating all over the place.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=299.55,302.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/95","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Technology what does it do?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=302.37,304.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/96","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It gives us diagnostic opportunities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=304.23,307.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/97","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We didn't have before,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=308.49,309.323"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/98","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"painless ones I might say.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=309.323,311.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/99","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Except what grams which are almost gone because of this","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=311.68,314.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/100","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where it is available it was very expensive.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=314.97,317.653"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/101","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who do you want to deny to?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=319.04,320.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/102","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Where do you say your research stops here?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=321.75,324.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/103","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We don't expand the technology any further than this,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=324.33,326.871"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/104","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"calf scanners are the option","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=326.871,329.312"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/105","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=329.312,332.419"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/106","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I pass no judgment.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=332.419,333.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/107","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I only pass it on to you as part of the problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=333.94,336.563"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/108","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There's a gross inefficiency or the use of facilities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=336.563,340.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/109","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Why? Well, nursing home, for example,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=340.91,344.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"government regulation says","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=344.09,345.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/111","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you have to have a physical therapist there.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=345.31,347.373"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/112","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"An interesting question do you really?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=348.317,350.217"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/113","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The kinds of personnel have to be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=351.27,352.103"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/114","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the hospital frequently affected","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=352.103,354.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/115","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"today by governmental regulations.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=354.82,356.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/116","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They insist on it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=357.47,359.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/117","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Yep. Same time programmers,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=359.03,361.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/118","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"planners and regulators","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=361.37,362.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/119","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they (indistinct) cost on the very thing they insisted on.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=362.76,366.699"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/120","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So when it comes to the situation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=366.699,368.147"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/121","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or the barking dog that wags his tail,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=369.957,373.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/122","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which end do we believe?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=373.16,374.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/123","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I suggest to you, the services can be provided,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=377.666,380.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/124","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but they are very frequently","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=380.5,381.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/125","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they're inefficient, but no less costly.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=381.79,384.383"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/126","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They're going to be demanded and regulated","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=385.23,388.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/127","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which enhances not diminishes","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=388.1,391.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/128","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"supply for most (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=391.24,392.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/129","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"very frequently inefficient.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=392.73,393.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/130","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It is always costly, provisions are needed services.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=393.9,398.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/131","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"A common modality that happens today or insistence.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=400.614,404.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/132","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"For example, now you have another","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=404.7,406.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/133","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"comparative (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=406.97,408.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/134","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Every person in a nursing home","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=408.33,409.839"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/135","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"has to be seen at least once a month.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=409.839,411.954"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/136","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You know the doctor, if they're going to be accredited","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=411.954,415.405"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it is a very worthwhile in many instances,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=415.405,417.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/138","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in many instances, they share interface with other people.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=417.63,421.423"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/139","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It may sound uncompassionate to say that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=422.605,424.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/140","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but that's not true.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=424.56,425.613"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/141","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The catatonic that's lying motionless","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=427.52,429.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/142","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in bed sustained very expensive life support procedures.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=429.3,434.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/143","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It does not require a monthly visit by a physician.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=434.2,437.363"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/144","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We insist upon, it is costly, we've demanded it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=439.07,443.153"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/145","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And there was nothing wrong with it, but we must","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=444.295,446.401"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/146","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we talking about the dimension of our problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=446.401,449.848"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/147","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We have an additional thing, malpractice problem,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=449.848,452.333"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/148","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=453.579,455.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/149","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"my cost, the doctor is not great.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=455.76,457.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/150","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Relatively speaking. I think it's a, (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=457.8,462.323"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/151","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for instance, $3,100 a year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=462.323,464.163"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/152","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"My same colleague California is $40,000 a year","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=465.17,469.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/153","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because of the incidences,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=470.44,472.643"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/154","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was, a patient has less than a perfect result.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=472.643,475.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/155","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Takes (indistinct) and sues, now there is no way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=475.82,479.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/156","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) positions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=480.338,481.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/157","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"can recruit for (indistinct) $40,000 a year","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=481.55,485.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/158","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"without passing this on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=485.34,486.946"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/159","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"again (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=486.946,489.543"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/160","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"through one mechanism or another","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=489.543,491.731"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/161","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"through a third party.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=491.731,493.397"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/162","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The governmental (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=493.397,496.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/163","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they have another incident 1%,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=496.45,498.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/164","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so I hate it gets mostly headline","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=498.5,500.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/165","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it's 1% quality, (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=500.44,504.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/166","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when you're talking about billions.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=504.06,506.773"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/167","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"A billion dollars is a lot outright fraud.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=508.37,511.653"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/168","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now fraud does that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=513.13,514.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/169","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but the cost pass over a billion dollars a year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=514.27,517.553"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/170","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But let me talk about what really,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=519.217,521.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/171","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the, other than just plain access and use.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=521.56,524.893"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/172","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Some of the technology that is expanding and exploding,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=525.918,529.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/173","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we have just began to get the outer parameters on.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=529.04,532.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/174","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So you understand where we're heading in this situation.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=532.48,536.553"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/175","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Intensive coronary care units, in the hospitals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=539.963,542.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/176","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which represent 10% of all care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=542.6,544.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/177","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"very expensive, three times more usual daily rate.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=544.67,548.683"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/178","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Monitoring equipment, but who you say will be monitored,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=550.35,554.169"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/179","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and who do you say won't be monitored?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=554.169,556.108"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/180","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=556.108,558.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/181","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But one isn't no longer a fresh coronary,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=558.86,560.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/182","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but an old coronary.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=560.83,562.537"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/183","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"An acute respiratory distress,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=563.621,565.343"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/184","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where do you make the judgment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=566.4,567.233"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/185","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and turn it on and off.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=567.233,569.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/186","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Chronic pulmonary obstructive disease,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=569.35,572.153"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/187","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"how much analysis of these do they do?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=573.08,576.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/188","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"New life support equipment, like the new born,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=577.58,580.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/189","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"very expensive, kidneys dialysis machines,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=582.323,585.823"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/190","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where do you draw the line?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=587.92,589.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/191","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Is this affordable and possible","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=589.85,592.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/192","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it's extraordinarily expensive","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=592.69,594.727"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/193","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for a small number of people","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=594.727,596.882"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/194","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but who will be the executioner?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=596.882,599.493"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/195","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who will say no?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=601.57,602.403"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/196","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Are we doing on the basis of the dollar?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=603.303,606.055"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/197","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Or will we do it on a basis for regulation?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=606.055,608.193"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/198","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Are we doing it on the basis","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=609.03,610.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/199","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of saying no more technology.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=610.22,611.773"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/200","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"extraordinary sophisticated pediatric units,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=614.55,616.917"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/201","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am not talking about the new born,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=616.917,618.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/202","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am talking of those very involved problems,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=618.11,621.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/203","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"malformations of all sorts.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=621.27,623.003"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/204","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Burn units, treating of burns is exploding,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=624.38,627.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/205","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"ordinary extraordinary prices.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=627.66,629.757"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/206","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Organ transplant units,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=631.62,632.953"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/207","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"here again who will say it? Who we will not do it?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=633.803,636.973"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/208","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now we develop a new modality,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=638.457,639.963"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/209","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"chemotherapy for malignancy.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=641.0,642.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/210","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Just again, this is a sophisticated piece of (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=642.33,647.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/211","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"just beginning to be developed with the annotating","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=647.97,651.276"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/212","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"radiology and surgery","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=651.276,653.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/213","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the doorsteps and another threshold of therapeutic trial,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=653.57,656.663"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/214","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"very costly, demanding special personnel, special units","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=658.46,663.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/215","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"special equipment,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=663.09,664.363"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/216","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"highly trained people.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=666.26,668.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/217","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Where do we stop?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=668.46,669.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/218","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"From these units alone,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=673.49,674.763"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/219","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the last five years has increased hospital cost by 10%","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=676.53,680.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/220","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In 1975 it is 12.5%,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=682.46,686.303"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/221","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"excuse me, $12.5 per day extra costs.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=686.303,689.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/222","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So now we come to the final consideration,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=692.173,693.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/223","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I told you I could speak to.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=693.67,695.843"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/224","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"These are the value judgements to which I 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question,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=703.627,706.743"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/227","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"man was shot to death in close range by his wife.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=709.0,713.317"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/228","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The coroner said, \"I suppose there is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=713.317,715.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/229","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"powder bone burns on the body.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=715.37,716.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/230","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The police man said, \"no way son,\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=716.95,718.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/231","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"pardon me, \"so I suppose there is powder marks on the body.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=718.43,723.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/232","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The policeman said, \"yes that's what caused the shooting.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=723.41,726.679"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/233","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laugh)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=726.679,729.429"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/234","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the value 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value?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=737.89,741.273"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/237","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"These are for each procedure, and each circumstance","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=744.27,748.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/238","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is the patient individually overall better off.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=748.24,752.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/239","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm gonna give you an overdrawn illustration","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=752.88,755.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/240","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but an example happens all the time.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=755.32,758.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/241","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Represents Oh 0.5 hospital bed occupancy","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=760.15,763.452"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/242","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in almost any major city, all the time","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=763.452,766.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/243","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from (indistinct) comatose patients","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=766.35,769.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/244","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but never regained consciousness","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=770.47,772.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/245","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"monitor; day week, month, year","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=773.09,777.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/246","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on and on last important mechanism,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=777.18,779.993"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/247","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"unconscious no quality of life,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=781.77,784.093"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/248","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"no value judgment haven't gotten","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=786.32,787.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/249","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to a point of pulling the plug.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=787.53,789.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/250","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But we are arguing about these costs,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=790.603,792.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/251","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"extremely high costs, expertise and personnel as well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=793.9,798.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/252","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now life expectancy, on average is increasing,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=800.72,804.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/253","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Why he would have died of that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=806.31,807.143"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/254","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And they all want to say, well","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=807.143,808.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/255","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where are all the people living be 200 years of age?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=808.57,810.937"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/256","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"No its not men, all kinds of reasons","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=810.937,813.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/257","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but your life expectancy is growing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=813.97,816.623"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/258","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"All kinds of arguments going on, how you get there?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=819.6,823.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/259","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But nevertheless, it is primarily a medical reason.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=823.13,826.417"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/260","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"At least the healthcare reasons, not a medical care reason","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=826.417,830.223"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/261","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but there's these kind of new care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=832.06,834.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/262","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"high risks associated, and high cost (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=834.5,839.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/263","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and given the resources that are currently available,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=839.71,841.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/264","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they are costly.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=841.14,842.483"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/265","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Whatever is used for the benefit of the patient.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=844.04,846.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/266","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) with cost, has to be analyzed on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=847.789,851.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/267","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what how much should be forbidden.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=852.49,855.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/268","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In what quantities? And for whom?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=855.26,858.073"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/269","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now there is a (indistinct) concern,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=859.44,861.886"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/270","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"how much at what cost (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=861.886,866.407"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/271","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it obviously can (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=867.327,869.796"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/272","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and produce new technology, greater expansions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=869.796,873.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/273","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it's going to cost more,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=873.23,874.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/274","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"quality care is never changing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=876.01,878.585"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/275","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But if we wish to draw a dollar cost,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=878.585,881.273"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/276","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then the value of judgements, the exercise","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=882.29,884.647"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/277","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the methods that are gonna do it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=884.647,886.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/278","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And what level? And in what restriction?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=886.57,889.233"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/279","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Responses and resources versus benefits.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=891.26,893.597"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/280","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So for our nation, its been the same","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=894.62,897.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/281","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"whatever that maybe helpful for all","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=898.8,900.857"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/282","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is what we want.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=904.398,905.231"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/283","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now that's what our value judgment at this time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=906.08,908.673"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/284","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all I can say if anyone want to argue with that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=908.673,911.321"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/285","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"may but you are gonna be stalling in the street.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=911.321,915.073"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/286","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But this compassionate (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=915.073,917.264"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/287","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that said, \"whatever is necessary","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=917.264,920.821"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/288","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for all, is what value judgment is,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=920.821,923.847"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/289","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we try to find ways to afford it.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=923.847,926.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/290","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Medicare today (indistinct) on my way","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=928.015,932.761"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/291","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) governmental people.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=932.761,935.653"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/292","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The cause of propaganda issue that time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=936.93,939.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/293","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about what the cost is gonna be.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=940.242,942.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/294","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The expectancy, reductions, demand,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=942.25,945.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/295","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"increase in competition are all gonna bring in","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=947.613,948.446"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/296","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"loyal order of cheap care, quality (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=949.72,953.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/297","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by a lot of people (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=953.31,954.607"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/298","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now nobody really believed that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=957.0,958.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/299","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at the time, it is a great fairly tale","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=958.81,960.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/300","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it is nice to read about","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=960.57,962.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/301","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it's not transported into this real world.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=962.01,964.473"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/302","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're hearing none of the same arguments again today,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=965.41,968.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/303","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"except we kind of slid away to a different situation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=968.82,972.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/304","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but yes we still want the poor, disabled","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=972.51,975.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/305","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"those that can't or those that won't care for themselves","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=975.74,978.278"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/306","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=978.278,979.518"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/307","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we said that mutuality of concern","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=979.518,982.228"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/308","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"through program only government can do","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=982.228,985.083"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/309","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but do we impose on 90% of the people, all the other funds.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=986.047,991.047"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/310","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now we have given these procedures for the most part","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=992.29,995.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/311","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"giving of course to the fact that there still","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=995.87,998.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/312","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"mal distribution and there is still","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=998.39,1001.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/313","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"some people disenfranchised","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1001.07,1002.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/314","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but there is been a great change","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1002.53,1004.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/315","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so today we're saying,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1005.64,1007.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/316","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we must have a governmental situation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1007.39,1009.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/317","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because it's proven costly.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1011.57,1012.973"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/318","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I point back to you how we got there?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1016.28,1018.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/319","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And who provoked it? And how was this started?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1019.126,1022.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/320","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we're hearing the same (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1023.886,1024.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/321","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"were going to have a national health program","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1024.94,1028.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/322","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the inference that you withdraw","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1030.19,1033.226"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/323","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the implication given","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1033.226,1035.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/324","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is that somehow it isn't going to cost much.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1035.77,1038.273"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/325","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There is going to be a reduction in cost.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1040.32,1043.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/326","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I can't say if they are wrong.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1044.861,1047.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/327","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But historically speaking history says they are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1047.27,1050.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/328","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because every governmental program has been inflationary.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1051.1,1054.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/329","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's been expansive. Its not (indistinct),","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1054.9,1057.593"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/330","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it's not (indistinct) ever been able to be reduced","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1057.593,1060.093"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/331","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and particularly not in the healthcare field.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1061.06,1064.223"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/332","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There's always been an insatiable demand for more.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1065.364,1069.531"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/333","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now there are several mechanisms on how to change this,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1073.45,1078.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/334","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we tried several of them the experimentation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1078.07,1080.362"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/335","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it has been raging on and","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1080.362,1081.195"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/336","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and one of my colleagues is spoken rather well","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1081.195,1084.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/337","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I wanna cover that there two ways that, two philosophies","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1084.32,1088.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/338","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that says we are gonna do something about it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1088.8,1091.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/339","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How we control the cost? What are the alternatives?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1091.42,1094.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/340","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one is change the form of method payment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1094.78,1097.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/341","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in order to change economic insanity, incentives.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1097.89,1101.513"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/342","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And my friend mentioned one of these deductibles","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1103.32,1107.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/343","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and co-insurance (indistinct) technical terms are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1107.28,1110.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/344","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I apologize but if you wanna know later I will explain it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1110.87,1113.307"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/345","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but I wanted to mention them as a technique in this area.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1113.307,1116.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/346","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Health maintenance, organizations,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1116.59,1118.563"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/347","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"school's still out on HMO.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1119.4,1120.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/348","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Some of them have done very well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1121.718,1123.608"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/349","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Some of them have broken even,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1123.608,1125.584"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/350","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"some of them have been dismal failures,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1125.584,1127.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/351","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they have not reduced the cost a bit.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1127.47,1129.323"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/352","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They have not reduced the cost","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1131.35,1133.163"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/353","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but school is still out, jury is still 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Association,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1138.35,1139.837"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/356","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"supported the development of it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1139.837,1141.564"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/357","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on an experimental basis rather than evaluation in 5 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facilities","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1150.1,1153.477"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/360","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"such as hospitals.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1153.477,1155.089"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/361","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The other alternative is, control directly the quantities","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1155.089,1159.209"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/362","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of resources used and the quality of services produced","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1159.209,1163.726"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/363","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and rented by the profession.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1163.726,1165.916"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/364","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Other than this you get, (indistinct) professional standard","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1165.916,1169.737"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/365","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"review organization limits on the total budget","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1169.737,1173.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/366","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that can be available to the provider,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1175.526,1178.588"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/367","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"other than that we are talking about some cost evaluation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1178.588,1181.668"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/368","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1181.668,1184.085"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/369","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"particularly national health insurance.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1186.821,1190.071"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/370","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1193.074,1195.491"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/371","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"have a baby is have my teeth worked on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1200.65,1202.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/372","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the dentist said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1203.44,1204.537"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/373","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"now you got make up your mind","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1204.537,1205.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/374","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so I know how to regulate this chair.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1205.98,1208.107"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/375","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1209.083,1212.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/376","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I will leave you with this thought,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1212.01,1213.777"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/377","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"once the government gets the responsibility","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1216.68,1219.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/378","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for total health care, they no longer","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1221.927,1226.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/379","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"becomes the priority.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1227.95,1229.297"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/380","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It becomes a budgetary hardship.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1230.743,1232.743"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/381","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There has been no single 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it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1248.8,1252.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/388","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And then what quality and quantity.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1252.13,1253.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/389","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If you wish to leave those decisions to the 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and","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1261.71,1264.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/392","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as an individual and exercise that freedom","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1264.85,1268.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/393","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and individuality that 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priority,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1284.08,1286.523"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/398","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it's a budgetary hardship.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1287.96,1289.153"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/399","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you very much.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1290.38,1291.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/400","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you, Dr (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1299.302,1302.067"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/401","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you Dr. Gardner,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1302.067,1303.773"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/402","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think the four three speakers we've had at this point","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1305.57,1310.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/403","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"have raised ethical 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us,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1323.74,1327.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/408","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"even in the context in which Dr. Gardener spoke","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1327.77,1332.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/409","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"are those 17% who are uncovered,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1334.266,1337.073"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/410","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the public program which has responded","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1340.51,1344.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/411","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"most vigorously with such figures it 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Medicaid.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1353.45,1355.063"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/414","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The next gentleman is probably as well","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1357.45,1360.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/415","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"informed from the consumers point of 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country.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1373.9,1377.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/420","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And it is my pleasure to introduce","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1378.547,1381.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/421","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the man who is here really","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1381.04,1382.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/422","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because of that experience and not because of this,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1384.166,1386.716"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/423","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) position he now serves","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1388.237,1390.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/424","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in Kansas City, the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1390.21,1392.787"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/425","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"First Chairman of the joint commission on human resources","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1392.787,1396.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/426","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the Iowa legislature who has wrestled with","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1396.57,1399.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/427","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"day after day, Mr. Tom (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1399.32,1401.797"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/428","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you very much Jerry for that generous introduction.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1403.34,1406.843"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/429","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I want to emphasize that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1409.01,1412.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/430","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am speaking from my perspective as a former legislator,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1412.88,1417.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/431","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and not in any sense of the word","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1418.22,1420.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/432","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as a representative of the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1420.95,1423.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/433","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"department of Health Education and Welfare.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1423.28,1426.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/434","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm a new to the federal service then.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1426.03,1428.417"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/435","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think what I just said, it's known 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America.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1608.12,1609.694"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/490","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Two programs, I want to pick two examples","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1609.694,1612.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/491","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which I believe do have an 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scanners.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1630.66,1634.435"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/498","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't believe it has been determined if the calf scanners","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1634.435,1637.487"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/499","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the presence or absence of calf scanners","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1637.487,1640.068"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/500","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"does have an impact upon public health.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1640.068,1643.233"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/501","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think there are three calf scanners (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1643.233,1647.144"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/502","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I am not sure those three could really be justified.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1647.144,1651.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/503","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The point is that in the 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sure,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1658.48,1661.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/506","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it was being made 50 different States","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1662.76,1666.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/507","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by five 50 different budgets subcommittees","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1666.48,1668.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/508","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of virtually all of them","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1669.55,1672.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/509","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"were ill prepared to meet their tasks.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1672.12,1676.173"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/510","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And so as a consequence, those 50 budget subcommittees","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1677.5,1681.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/511","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we're relying for their 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access","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1688.459,1691.568"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/514","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the legislature, of course under the first amendment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1691.568,1693.691"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/515","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they are to, actually do have.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1693.691,1696.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/516","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The point is that information was about the only information","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1696.26,1701.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/517","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which was receiving,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1701.32,1702.679"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/518","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in which does receive those budget subcommittees.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1702.679,1705.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/519","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That opens up a whole nother area,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1705.26,1708.198"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/520","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think of the lack of staff","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1708.198,1710.302"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/521","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and lack of adequate sources of 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is.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1715.81,1718.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/524","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The villain if you will,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1720.59,1723.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/525","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in this matter, at least of high healthcare costs","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1723.58,1726.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/526","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is widely disputed as Dr. Gardener points out,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1726.59,1730.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/527","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I have heard some very good explanations","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1731.92,1734.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/528","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of who or what combination of villains there might be.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1734.01,1738.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/529","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One certainly is the technology to which you loose","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1738.61,1742.123"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/530","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and so called Cadillac technology which operates in lieu of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1742.123,1747.123"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/531","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a more 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(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1756.12,1757.551"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/534","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I trust that we will and won't be as necessary to engage","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1757.551,1762.551"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/535","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"very, very expensive technological pieces of equipment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1763.54,1767.157"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/536","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that rather the development, hopefully breakthroughs","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1767.157,1771.221"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/537","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"new breakthroughs in (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1771.221,1773.879"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/538","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and other kinds of sciences like that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1773.879,1775.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/539","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and will make those Cadillac technology obsolete.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1775.98,1780.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/540","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But the meantime, that is a very very serious problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1780.95,1783.913"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/541","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) inner study has focused","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1785.631,1788.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/542","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"some of his discussions on the whole issue","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1788.96,1791.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/543","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of third party payment the fact that it does in a sense","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1791.63,1796.199"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/544","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in (indistinct) to the real cost involved.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1796.199,1799.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/545","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And to a certain extent","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1799.68,1800.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/546","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I believe does encourage over utilization","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1800.63,1803.949"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/547","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"although I am no expert on that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1803.949,1805.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/548","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am just quoting what he says.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1805.17,1807.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/549","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Certainly it's true that when","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1807.98,1809.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/550","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it cost General Motors more for the health insurance","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1809.74,1813.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/551","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that its employees have and it does for the steel","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1813.34,1817.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/552","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that they put in their cars,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1817.22,1819.626"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/553","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it clear that we have a 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economy","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1833.33,1837.145"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/558","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I believe that fee for service system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1837.145,1841.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/559","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"does (indistinct) some over utilization.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1841.26,1845.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/560","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We went through a very long tractive fight","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1845.29,1849.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/561","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that is not yet over in the eye of our general assembly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1849.51,1852.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/562","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with respect to the structure","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1852.62,1855.243"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/563","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for paying radiologists and pathologists in this state.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1855.243,1859.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/564","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I discovered as a result of our investigation, radiologists","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1860.836,1864.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/565","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and pathologists had an income an average income","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1864.02,1867.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/566","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the state, considerably an excessive of $7500 a year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1867.18,1871.887"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/567","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I know how that system works (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1872.861,1877.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/568","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a few of them have a lab and they got it all.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1878.823,1881.688"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/569","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And since the census their cost is (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1881.688,1885.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/570","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on a, on a fee for service basis there","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1885.91,1889.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/571","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there are that many more tests that are 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the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1896.527,1899.053"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/574","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that the other causes which have been identified","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1899.053,1902.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/575","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or are diminished in any way","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1902.54,1905.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/576","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the focus of our discussion well could be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1905.62,1909.693"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/577","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what Professor Shakeshaft alluded to in his opening remarks","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1909.693,1914.693"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/578","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"its its it is indeed the food that we eat,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1915.207,1918.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/579","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the cigarettes that we smoke, the booze that we drink","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1918.23,1922.182"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/580","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you know which causes us","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1922.182,1924.182"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/581","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and what continuous to causes","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1925.44,1926.273"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/582","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am afraid they are the most serious healthcare problems.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1926.273,1930.153"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/583","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But just so in the absence of an overall or rational","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1931.76,1935.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/584","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or coherent health policy","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1935.55,1937.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/585","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we will unfortunately to continue to spend","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1937.74,1942.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/586","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a hundred million dollars a year in tobacco subsidies","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1942.35,1945.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/587","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at a time when full well the effects of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1947.467,1949.713"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/588","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of smoking cigarettes are.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1949.713,1951.573"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/589","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I, I, I do want to touch upon,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1953.21,1955.913"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/590","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"even though Dr. Gardener has mentioned it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1957.33,1960.187"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/591","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I do want to touch upon the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1960.187,1962.309"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/592","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what I think are the very serious","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1962.309,1965.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/593","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"ethical implications of all of this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1965.01,1967.857"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/594","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It strikes me that it is the nature of the package","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1968.935,1972.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/595","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which is the most 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that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1980.16,1984.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/598","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Dan outlined.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1984.16,1985.033"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/599","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm afraid of who is gonna draw the line as is Dr. Gardener","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1987.01,1992.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/600","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I am afraid of where the line will be drawn.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=1992.285,1995.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/601","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Where Dr. Gardener and I disagree, I think is 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line.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2003.023,2006.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/604","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that that in fact we should continue","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2007.289,2010.283"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/605","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"free choice.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2012.439,2013.439"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/606","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It seems to me that if that is in fact the case,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2014.476,2016.893"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/607","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that it will indeed be the poor","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2018.855,2020.857"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/608","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who will come on the short end of the stick.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2020.857,2023.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/609","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If it's not going to be decided,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2023.45,2027.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/610","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if you will in a public arena,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2027.54,2029.793"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/611","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then the failure to make the decision","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2030.68,2033.115"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/612","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"will I suspect be down to the ultimate detriment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2033.115,2035.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/613","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of poor people are more than any other segment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2035.59,2039.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/614","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in our population","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2039.15,2040.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/615","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that the system can ethically consume","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2042.878,2046.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/616","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"every dollar we put into it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2046.49,2047.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/617","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Its been said that you can't get enough healthcare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2049.28,2052.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/618","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that's true, and if we allow the thing to continue","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2052.94,2057.904"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/619","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2057.904,2059.047"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/620","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then there's no doubt in my mind,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2059.047,2061.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/621","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that the worst kinds of decisions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2061.81,2064.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/622","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"will come down as to where that line is drawn.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2064.0,2066.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/623","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What I am suggesting is that it is,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2066.89,2069.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/624","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"now is the time to begin to build the linkage between","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2069.76,2074.268"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/625","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"healthcare planning and health care financing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2074.268,2077.213"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/626","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that it is essential,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2077.213,2079.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/627","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that those of us who are not providers be heard","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2079.64,2084.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/628","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and determine what that linkage is going to be.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2084.02,2088.203"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/629","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't know where the line exactly has to be drawn either","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2088.203,2092.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/630","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what disturbs me is that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2092.38,2094.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/631","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there is precious little discussion or debate or study","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2094.25,2098.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/632","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"really being given to that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2098.1,2099.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/633","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that we, most assuredly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2100.45,2103.261"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/634","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"are going to confront that 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procedure","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2113.91,2115.934"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/639","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and conceivable practice that might be undertaken.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2115.934,2119.583"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/640","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I would hope that that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2120.53,2123.483"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/641","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that as the consideration is given to them","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2123.483,2127.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/642","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is given to where that line ought to be 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providers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2132.957,2136.669"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/645","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in making that decision.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2136.669,2138.423"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/646","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am one who believes very strongly that Medicare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2139.53,2142.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/647","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and Medicaid were not only a very good thing,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2142.84,2145.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/648","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but really the very best thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2145.25,2147.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/649","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that has ever happened to healthcare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2147.23,2149.885"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/650","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in this century in the United States","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2149.885,2151.712"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/651","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with exception of course the great medical discoveries","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2151.712,2155.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/652","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that were made since the end of the Second World War.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2155.24,2157.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/653","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It does not bother me, that we have had some problems","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2158.8,2162.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/654","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in Medicare and Medicade I think that ought to be expected","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2162.64,2165.881"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/655","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in any kind of undertaking of undertaking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2165.881,2167.467"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/656","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of this magnitude and complexity.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2167.467,2169.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/657","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I would agree that we are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2169.98,2171.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/658","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in a different time now, it is not 1965 any longer","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2171.34,2176.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/659","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the (indistinct) decisions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2176.04,2178.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/660","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"are going to have to be made with (indistinct) more urgency.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2180.31,2185.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/661","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Perhaps we have not been able to face those decisions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2185.02,2187.934"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/662","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the past, it is important","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2187.934,2189.861"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/663","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we have our say so in there.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2189.861,2193.263"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/664","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you Mr. (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2197.43,2198.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/665","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There are a couple of things to be said","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2202.16,2204.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/666","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"before calling on the next gentleman.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2205.13,2206.688"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/667","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think, sitting here being impressed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2206.688,2209.771"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/668","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you mentioned (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2212.04,2215.068"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/669","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"About how it seems to me like great baseball players","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2215.068,2217.668"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/670","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the ideas simply recur to different generations.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2218.77,2221.813"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/671","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Walter McClure has said about third party payers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2223.39,2225.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/672","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and asking the cost of care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2225.81,2227.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/673","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Which Dr. Gardener said, was said by Martin Seinfeld","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2227.14,2229.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/674","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in 1970 was set by Herman summers in 1962,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2229.74,2234.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/675","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"was said by Ray Brown in 1958","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2234.74,2237.006"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/676","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and a said by Bob Sigma in the 1956.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2237.006,2239.143"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/677","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But that's All right.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2240.31,2241.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/678","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We all go through our cycle of heroes from Ty Cobb through","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2241.4,2245.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/679","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2247.84,2250.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/680","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One thing that is that Dr. Gardener,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2250.63,2254.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/681","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"remark particularly touched on and also Higgins.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2254.22,2257.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/682","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that is the pressure","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2258.33,2260.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/683","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which Seinfeld is also cited of technology on costs.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2260.21,2263.763"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/684","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Prompts me to tell you that we tried","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2266.61,2269.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/685","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"every way we could think of to get Dr. Lewis Thomas here","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2269.15,2274.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/686","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for this program from New York.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2274.54,2276.313"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/687","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who has written some of the most sensitive things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2277.9,2281.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/688","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about the sort of mid-state state Dr. Gardner","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2281.47,2284.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/689","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the medicine is in at the moment,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2284.59,2286.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/690","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with a a particular plea for increased money for research.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2287.997,2292.997"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/691","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If being Dr. Thomas thesis based upon","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2293.57,2296.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/692","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"his historical observations that to go with","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2296.11,2299.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/693","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when we pour some of the money into research,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2299.49,2302.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/694","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we usually come out with a much cheaper cure.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2302.53,2306.143"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/695","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Dr. Thomas is a five (indistinct) lecturer,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2308.33,2310.853"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/696","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"this year for that (indistinct) organization","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2311.75,2314.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/697","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and is unavailable for trips to Iowa.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2314.89,2318.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/698","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Nobody has used the term triage","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2321.36,2323.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/699","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I'm glad that is not happening.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2323.26,2326.123"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/700","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I now refer to my colleague at your extreme 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the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2337.72,2339.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/703","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"rod Carew of the evening tonight, Mr. (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2340.38,2344.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/704","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I'm inclined to think that the most 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break","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2358.714,2361.594"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/709","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from here then we can hear from them?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2361.594,2362.443"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/710","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Or isn't that the kind of comment you wanted me to make.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2362.443,2366.064"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/711","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2366.064,2368.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/712","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I'm just being courteous sir, I also 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attention","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2386.805,2389.206"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/719","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in regard to the pathologist, he did not initiate any tests","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2389.206,2393.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/720","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"himself there ordered by the 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slides","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2411.28,2413.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/729","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and do the things that pathologists do.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2413.57,2415.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/730","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So its a small number of 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microscope","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2441.44,2444.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/739","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"looking at the slides, and not necessarily the pathologists.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2444.24,2449.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/740","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I did want to place 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(indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2470.157,2474.996"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/747","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Many more of the poor are seeing physicians","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2474.996,2479.044"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/748","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the course of the year than the middle 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rest.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2485.918,2489.091"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/751","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And you can put two interpretations on that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2489.091,2491.706"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/752","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one is provided as as that a","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2491.706,2494.039"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/753","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because there is more access, to utilize more often.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2494.913,2498.174"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/754","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that's true,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2498.174,2500.632"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/755","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but I also think it is true to say that that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2500.632,2503.068"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/756","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the poor are seeing physicians more often more often","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2503.068,2506.406"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/757","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because the poor are more sick than the middle class.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2506.406,2510.823"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/758","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) back to a point that I tried to make","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2512.132,2517.132"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/759","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"very strongly that is if we are serious,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2517.37,2519.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/760","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I think we are, about improving the health care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2519.77,2524.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/761","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in this country, maybe instead of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2524.26,2526.643"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/762","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"concentrating all of our resources on technological aspects","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2526.643,2531.643"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/763","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to it would be wise","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2532.076,2533.488"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/764","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for us to concentrate some of our resources","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2533.488,2536.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/765","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on eliminating poverty.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2536.66,2538.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/766","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2543.406,2545.989"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/767","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Moderators like to say two things(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2550.05,2554.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/768","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that is the reference to patient abuse,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2555.475,2558.973"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/769","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"could well be as Mr. Higgens says (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2562.13,2567.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/770","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"reflection of the fundamental","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2567.4,2569.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/771","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"pathology socially would exist with the poor.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2570.96,2575.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/772","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And which we can't shake and which","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2575.3,2577.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/773","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"rhetoric will not make go away.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2577.35,2579.243"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/774","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Secondly, I, on the strength of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2581.43,2585.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/775","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"examination of the deal of the literature in the past year,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2585.77,2588.227"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/776","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I don't pretend to read it all.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2588.227,2590.033"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/777","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm not impressed that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2592.216,2593.413"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/778","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"necessarily the empty bed cost anything.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2595.18,2597.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/779","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It depends upon the arrangements.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2597.42,2600.404"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/780","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And secondly that you can almost directly 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perhaps","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2617.265,2619.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/785","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"been more cost effective than anything else,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2619.53,2622.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/786","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for that matter.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2622.23,2623.063"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/787","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Finally on the matter of the ethical considerations","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2624.15,2626.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/788","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Which Tom alluded to,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2626.28,2627.683"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/789","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and Dr. Gardner alluded to.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2630.33,2633.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/790","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who's going to pull the switch?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2633.28,2634.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/791","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who's going to make the decision as to who gets what?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2634.71,2638.333"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/792","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the answer to this is as old","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2639.54,2641.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/793","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as Benjamin Cardozo,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2641.02,2642.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/794","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or even as old as Western Democratic theory.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2642.74,2645.223"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/795","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Society is gonna make that decision.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2646.48,2648.743"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/796","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And society affects the 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ill,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2653.76,2657.423"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/799","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the flat brainwaves, to what Dr. Gardener alluded","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2659.1,2662.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/800","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you will see more and more literature about this of 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centaury.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2678.34,2680.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/805","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Which was geared to","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2682.8,2683.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/806","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"handle just such matters,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2685.53,2687.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/807","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"although not in this not exactly the...","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2687.27,2690.983"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/808","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that decision will probably in the long 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panels","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2699.42,2702.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/811","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of combinations of medicine and clergy and family, but we'll","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2704.28,2709.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/812","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the end probably be adjudicated by judges","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2709.15,2712.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/813","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"wearing ethical or equity robes","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2712.62,2715.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/814","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as they do in trust matters, divorce matters and","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2716.18,2720.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/815","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the issuance of injunctions now.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2720.1,2722.283"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/816","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The floor is open for questions.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2724.37,2726.427"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/817","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Will you please stand","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2727.821,2729.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/818","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and state to whom you are directing your question.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2729.48,2732.703"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/819","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2734.639,2737.222"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/820","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e If you're including in that also the practice","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2780.46,2782.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/821","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of defensive medicine, which is again, inefficient or","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2782.74,2786.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/822","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"over utilization of people and materials and technology.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2786.24,2789.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/823","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's estimated about 8 or 10% currently.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2789.75,2792.143"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/824","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) as moderator I've got to strong","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2795.248,2798.685"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/825","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"exception to your statement about PSRO","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2798.685,2800.962"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/826","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I want to hear you say, and I hope its acceptable","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2800.962,2804.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/827","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"counter balance for reading a statement","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2804.1,2805.697"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/828","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"issued by the booking institute, which (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2805.697,2808.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/829","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or generally reliable.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2808.66,2809.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/830","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There's been little experiences yet with PSRO","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2810.87,2813.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/831","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"themselves a recent study a summer","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2813.31,2815.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/832","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"programs that existed before PSRO were created","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2815.18,2818.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/833","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"concludes, that such evidence as there is,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2818.58,2821.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/834","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is not to show that they are effective either","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2821.41,2824.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/835","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as cost control, or as quality control measures.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2824.18,2826.853"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/836","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In theory, PSRO has a potential cut cost by eliminating","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2827.733,2831.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/837","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"unnecessary stays in short (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2831.84,2835.236"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/838","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in practice there is no evidence (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2835.236,2839.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/839","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in medical care which had potential actually had any effect.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2840.459,2844.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/840","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"More generally, PSRO may increase or decrease cost","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2844.47,2848.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/841","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"since they require some services, not already prescribed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2848.59,2852.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/842","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as well (indistinct) routine used before.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2852.11,2855.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/843","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Their potential effect is quality control measures","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2855.26,2857.493"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/844","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"equally on control, equally unclear.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2857.493,2860.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/845","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the more so since much of what is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2860.76,2862.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/846","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"accepted practice is not based on full efficiency.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2862.62,2866.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/847","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2867.07,2869.487"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/848","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Also if I may I ought to pick on Tom again.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2872.87,2876.036"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/849","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2876.036,2876.869"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/850","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think its fair in a discussion like this","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2876.869,2878.739"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/851","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"particularly solitary example,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2878.739,2880.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/852","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of some guy whom is not a pathologist","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2880.5,2882.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/853","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and bringing a derogatory statement, highly technical","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2882.56,2887.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/854","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"specialized area on the basis.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2887.14,2888.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/855","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Someone, if he's guilty fraud,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2888.81,2890.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/856","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we all say could be prosecuted.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2890.35,2892.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/857","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Make him the example","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2892.72,2893.553"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/858","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but don't use the whole don't condemn the entire situation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2893.553,2897.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/859","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the basis of a bad example.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2897.38,2899.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/860","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think that's fair","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2899.73,2900.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/861","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in particular if you say he wasn't a pathologist","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2900.75,2903.557"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/862","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and then its not (indistinct) to all.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2903.557,2906.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/863","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e No, I am sorry I think you misunderstood my remarks,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2906.55,2908.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/864","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I wasn't suggesting that any particular physician in","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2908.92,2912.434"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/865","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) is committing fraud.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2912.434,2913.853"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/866","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What I was suggesting was that the...","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2913.853,2917.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/867","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e You didn't like the not money he was making.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2917.71,2920.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/868","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well it was about two 225000 yeah, that's...","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2920.01,2922.972"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/869","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e So you are taking exception to it?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2922.972,2924.255"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/870","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Yes.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2924.255,2925.088"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/871","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e But you wouldn't want to get rid of any services","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2925.088,2926.521"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/872","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"would you?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2926.521,2927.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/873","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e well, no what I, never the less, i","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2927.75,2931.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/874","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"well, I don't think (indistinct) had teeth either","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2931.3,2935.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/875","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but you know I don't","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2935.17,2936.003"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/876","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't know what that has to do with it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2936.003,2937.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/877","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think the $245000 is an excessive amount of money, yeah.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2937.9,2942.888"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/878","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well Dr. (indistinct) Mr. (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2942.888,2944.907"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/879","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"would probably shouldn't be saying (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2944.907,2946.551"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/880","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"since he had 600000 income before he quit the job,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2946.551,2949.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/881","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"correct?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2949.36,2950.193"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/882","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e No, the difference is that, doc...","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2951.24,2954.157"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/883","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"secretary California doesn't need to defend him","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2955.72,2958.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/884","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or his income but his fees","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2958.53,2961.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/885","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"were not paid for by the general public.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2961.69,2964.085"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/886","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2964.085,2966.375"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/887","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I take exception to that I tell you Mr. California","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2966.375,2968.843"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/888","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"will get a considerable amount of governmental programs","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2968.843,2970.879"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/889","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"under his law firm","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2970.879,2972.698"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/890","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"also he was paid his fee by the general public","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2972.698,2976.312"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/891","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so I doubt if he got it from over seas (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2976.312,2979.131"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/892","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Is there another question?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2979.131,2980.748"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/893","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2980.748,2983.581"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/894","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Yes sir.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2984.69,2985.955"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/895","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2985.955,2988.538"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/896","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from the administration possible cap on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2991.344,2994.594"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/897","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"cost, now we are talking bout cap on revenue","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=2998.979,3001.693"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/898","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3001.693,3004.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/899","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Mind if I identify you Mr. Linden?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3026.48,3027.753"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/900","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Linden is administrator of the Boone County hospital.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3027.753,3031.483"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/901","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the past president","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3032.319,3033.152"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/902","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the Iowa hospital association will be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3033.152,3035.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/903","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the program tomorrow to repeat the question","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3035.09,3038.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/904","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what will be the effects of the caps on (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3038.3,3042.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/905","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e If, if nobody else wants to address it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3051.33,3052.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/906","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"were you about to go Dan.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3052.97,3055.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/907","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Pardon?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3055.99,3056.957"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/908","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3056.957,3057.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/909","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e The... Okay.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3057.79,3059.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/910","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e For those of you weren't familiar with that term","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3061.11,3063.347"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/911","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"its lifts on revenue.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3063.347,3065.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/912","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e About revenue, right now, they're talking revenue.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3068.089,3070.817"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/913","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I think the basic assumption is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3071.76,3074.783"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/914","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that there is some kind of relationship","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3074.783,3077.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/915","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"between revenues and expenditures,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3077.24,3080.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/916","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"especially non-profit corporations (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3080.33,3082.927"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/917","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Actually the proposal that the Carter (indistinct) put up","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3085.73,3090.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/918","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"kind of a (indistinct) proposal as far as","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3091.28,3093.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/919","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"revenue limitations is concerned, why is that hospitals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3098.01,3102.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/920","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"ought to be limited to essentially","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3102.82,3105.267"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/921","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the overall increase in the cost of living","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3107.36,3111.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/922","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and then some more wasn't quite expressed that way but","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3111.92,3116.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/923","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it adds up to","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3117.57,3119.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/924","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"probably about 11%","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3120.893,3123.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/925","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3123.53,3125.947"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/926","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"increases on how to supervise your employees","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3131.422,3135.089"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/927","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think myself","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3138.582,3140.249"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/928","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that, that would have any negative effect on 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years.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3152.082,3156.582"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/931","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In number of states,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3157.893,3160.126"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/932","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where there has been intensive concern about","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3160.126,3163.793"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/933","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which can be described as a (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3165.086,3170.086"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/934","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with the cost going up about 15 % every year","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3170.902,3175.069"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/935","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3175.069,3177.486"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/936","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with no end in sight, number of the states","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3182.027,3184.757"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/937","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3184.757,3187.174"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/938","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and without any evidence of fraud","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3193.362,3196.112"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/939","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3197.329,3199.746"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/940","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and of course hospital executives are used to (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3223.279,3228.279"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/941","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that's what you live on,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3229.63,3231.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/942","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and if you don't put a budget in, and try to live under it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3231.723,3236.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/943","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3236.849,3239.349"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/944","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am inclined to think that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3243.557,3245.807"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/945","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3248.117,3250.534"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/946","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in general will be very easy","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3251.717,3254.351"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/947","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for hospital executives and boards to handle","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3254.351,3258.018"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/948","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and some research makes it easy to manage.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3259.423,3262.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/949","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3262.22,3264.637"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/950","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"...and make it easier.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3266.928,3268.146"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/951","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There maybe few institutions that have unusual (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3268.146,3273.146"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/952","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"hopefully before the legislation is passed,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3278.485,3281.156"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/953","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"cause nothing is passed yet, there will be procedures","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3281.156,3285.732"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/954","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to those kinds of situations.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3285.732,3288.675"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/955","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I, I, I don't think that this is (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3288.675,3293.675"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/956","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think it will have any adverse effect on quality.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3294.205,3297.541"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/957","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Actually the number of institutions,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3297.541,3301.134"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/958","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that use this as the basis for tightening up procedures","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3301.134,3306.021"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/959","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"tightening up the overall management to improve quality.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3306.021,3311.021"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/960","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) I am just gonna make one last point,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3311.151,3313.862"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/961","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that the assumption that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3313.862,3316.345"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/962","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"high quality and high (indistinct) necessity go together.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3316.345,3320.665"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/963","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"With one, two some of the remarks, that a","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3320.665,3324.082"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/964","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I just don't accept that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3326.038,3328.584"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/965","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3328.584,3331.001"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/966","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where improved efficiency","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3333.179,3335.281"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/967","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3335.281,3337.698"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/968","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3343.908,3346.491"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/969","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e The proposal put forward by the Carter administration,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3352.466,3356.619"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/970","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"does not provide incentives.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3356.619,3358.952"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/971","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But since that is proposed,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3359.982,3363.027"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/972","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct) half a dozen proposals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3363.027,3366.739"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/973","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and a number of very respectively proposal developed by","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3366.739,3371.526"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/974","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3371.526,3373.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/975","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but a number of them has (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3378.246,3382.051"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/976","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and my guess is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3382.051,3383.581"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/977","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3383.581,3385.998"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/978","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but the counter proposal","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3388.399,3390.505"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/979","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"was for a transitional (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3390.505,3392.645"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/980","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They just felt (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3392.645,3396.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/981","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"while we figure out more sophisticated control","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3396.63,3400.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/982","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so they didn't think in terms of other incentives","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3400.5,3403.559"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/983","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3403.559,3405.976"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/984","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"make any comments (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3406.886,3408.998"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/985","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Two or three points","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3408.998,3409.831"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/986","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"mostly along the same line, glad you went 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philosophies","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3570.73,3573.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1041","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we practice medicine level","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3573.51,3575.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1042","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of bureaucracy in regards to our hospitals and situations","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3575.85,3578.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1043","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or do we still believe in the integrity","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3578.88,3581.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1044","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the people are doing the best possible job they can.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3581.38,3584.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1045","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is a really political medicine.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3585.53,3586.657"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1046","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's what we're basically talking about.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3586.657,3589.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1047","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"All public queries","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3589.67,3592.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1048","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if you will take the scientists","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3592.89,3594.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1049","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that do that sort of thing that asks","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3594.93,3597.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1050","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the major problems confronting our society","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3597.17,3599.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1051","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in this country today, doesn't find any of this issues","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3599.37,3602.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1052","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"even in the first dozen and a half.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3602.4,3604.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1053","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Yet it is a health care crisis, and who is lying?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3604.89,3607.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1054","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And why?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3608.89,3610.118"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1055","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3610.118,3611.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1056","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Then the answer is fairly easy,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3611.18,3612.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1057","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"labor is always big on doing this,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3612.68,3614.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1058","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they want to liberate their funds as much as possible,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3614.98,3617.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1059","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so that they can elect the interesting people to office.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3617.11,3620.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1060","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Some of that comes out in the health and welfare fund","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3620.51,3622.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1061","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which of course is the current story","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3622.58,3624.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1062","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if they want to change it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3624.04,3626.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1063","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Its also a very provocative thing like I will give you","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3626.09,3629.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1064","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"food and clothing and health","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3629.24,3630.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1065","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when you are running for office.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3630.47,3632.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1066","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the same way about regulations,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3632.47,3635.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1067","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"this is still political measure.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3635.78,3637.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1068","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're going to save you all a lot","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3637.72,3638.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1069","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of money because we're going to regulatorily enforce a cap","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3638.69,3642.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1070","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because there's a lot of people are untrustworthy","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3642.15,3645.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1071","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the health professions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3645.36,3646.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1072","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that are not handling the things right.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3646.5,3648.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1073","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So we, as your saviors and being elected","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3648.34,3651.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1074","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by you are going to do these things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3651.18,3653.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1075","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and impose these restrictions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3653.54,3655.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1076","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because they're not trustworthy or efficient or honorable.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3655.73,3659.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1077","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"See the idea the idea I get to","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3659.51,3661.692"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1078","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"this is political.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3661.692,3663.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1079","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's really not talking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3663.7,3664.533"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1080","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about quality or cost or anything else.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3664.533,3666.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1081","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This political issue that's been (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3666.43,3668.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1082","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by certain people that they'll look the control","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3668.84,3672.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1083","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of healthcare is a governmental responsibility","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3672.33,3674.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1084","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and they don't want to trust it to the citizenly.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3674.66,3678.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1085","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Speaking of the idea, of the idea.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3678.31,3680.513"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1086","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't see why, I guess healthcare should be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3683.75,3688.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1087","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"any different an enterprise","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3690.137,3692.824"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1088","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as government than say education.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3692.824,3695.574"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1089","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We have a budget restraints which the government imposes","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3697.754,3700.503"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1090","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"upon education in this state, I suspect most states do.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3704.06,3707.803"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1091","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That districts are limited","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3708.889,3710.189"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1092","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the amount that they can increase their budget.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3711.67,3713.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1093","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This university,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3713.46,3714.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1094","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"functions under a budget imposed by government,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3714.69,3719.503"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1095","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"certainly an argument could be made","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3721.62,3724.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1096","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we could improve the quality","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3725.707,3727.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1097","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of education in our school districts or in our universities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3727.76,3731.892"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1098","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If there were no limits on the budget,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3731.892,3734.753"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1099","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but point is of course,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3736.14,3737.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1100","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that that we don't have that much money.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3737.74,3740.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1101","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And similarly it strikes me that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3741.342,3743.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1102","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if we don't have that much money not to have","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3743.66,3747.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1103","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"some budget limits placed on healthcare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3747.29,3750.257"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1104","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the alternative is that is that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3752.68,3755.913"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1105","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in very many other areas which do impact on healthcare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3755.913,3759.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1106","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there simply will not be enough money to do,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3759.95,3762.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1107","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to maintain a minimum effort.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3762.92,3764.927"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1108","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I I cannot imagine","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3767.498,3769.887"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1109","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"any third alternative","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3771.12,3772.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as far as determining","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3773.2,3774.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1111","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"policy and let's face it budget control determines policy.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3774.4,3778.773"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1112","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And if I understand Dr. Gardner correctly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3780.81,3784.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1113","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"he is suggesting that budget not to be imposed by government","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3784.05,3789.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1114","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if not by government, then by who?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3789.19,3791.123"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1115","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't want to any interest group dictating there.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3792.4,3796.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1116","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And as long as government","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3796.98,3798.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1117","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is spending your tax dollars pay for it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3798.4,3802.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1118","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Then I think the government owns the responsibility","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3802.18,3806.015"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1119","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to its constituents to impose certain restraints.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3806.015,3809.472"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1120","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3809.472,3810.905"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1121","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I think the essential, difference here","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3810.905,3814.015"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1122","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3814.015,3817.116"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1123","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what the Carter administration is proposing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3817.116,3819.539"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1124","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3819.539,3823.119"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1125","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is that the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3823.119,3824.036"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1126","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"majority of health scholars at this point","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3826.966,3831.151"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1127","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"do no trust the government, and the Carter administration","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3831.151,3836.151"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1128","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"has proposed a tax on all hospital (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3836.55,3841.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1129","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The proposed tax does not apply","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3846.866,3849.449"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1130","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"only to the government expenditures","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3851.524,3854.694"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1131","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am not arguing with that kind of laws,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3854.694,3857.732"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1132","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am just trying to clarify that point","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3857.732,3859.849"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1133","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3859.849,3862.266"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1134","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the legislation did apply only Medicare and (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3865.432,3870.432"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1135","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which does account to about half (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3871.196,3876.196"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1136","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but now he has decided","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3877.83,3879.663"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=3880.603,3883.02"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120","type":"AnnotationPage","label":{"en":["English [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30120/annotation/1138","type":"Annotation","motivation":"subtitling","body":{"type":"TextualBody","value":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/120/original/AV167975_Current_Programs_Problems_and_Prospects_in_Financing_Health_Care_b.vtt?1624899310","format":"text/vtt","language":"en"},"target":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/120/original/AV167975_Current_Programs_Problems_and_Prospects_in_Financing_Health_Care_b.vtt?1624899310"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30121","type":"AnnotationPage","label":{"en":["AV167975_Current_Programs_Problems_and_Prospects_in_Financing_Health_Care_b.txt [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633/transcript/30121/annotation/1139","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"- It 3 o'clock in the morning which is when when you're drunk and stayed on the doorstep for being man of the man of the cloth spirit but that was for months, finally said the Lord will forgive me for this transgression but I can't stand it anymore. 3 o'clock door bang and he went near and he said I understand this discussion has gone on and on, I think it's wonderful that you have this concern about Northern Southern not Lutheran church, I want to speak to you, that is not even my . That it's three o'clock in the morning and I do have other duties to take me to other places to other people . Besides that you always attack me on this issue in a drunken state of affairs. Now, what do you have to say about that? And he says, doc, when I'm sober I don't give a about the United Luther Church. The point I am making, as long as people think it's not costing me anything are we have been telling them you're entitled they under the insurance program which we sell under governmental programs with provided them but is there a writing expectancy. They don't give a what it costs you see, because they act as if it was a free commodity. the decision makers and utilization of that care my profession in the hospitals. Also have come to accepted it the same way, because our incentives have been changed as well-known fact, not only by research but practicality places as the doctor. Now doctor, I don't have any insurance. Buy your judgments of what happens here is somewhat different than if he pulls out a full pay insurance policy or flashes America Medicaid or Medicare card. So that gives it to incentives provider and recipient. Now let me talk to you about and expand on those points. the incentives and the price structure. Now this is a democracy, a compassionate society of people I am most confident, feel not only deeply about our own people, body and soul. But you know why we extend this to all people everywhere? None of those are circumstances we are reacting to the climate. A big feeling, about each individual person, the passion for his needs the most significant one, is healthcare because without health you really have nothing wrong with problems result revolve around this incentive, incentive price structure . Has to be looked up to, under the circumstances under the circumstances . It has provided and accepted, then demanded that there'll be more doctor access. This profession, people, society there is doctors. As the Lord's doctor, ratio today there is no one doctor for every 551 people, surpassing what used to be the highest which now I have one for every 750. That's a whole nother debate . There is a lot of doctors access it will be 25% greater in five years which means there's going to be an awful lot of doctors around. We welcome that, here is the point I have to use there is an increase access it will not lower cost. It will intensify competition, which is always been in the profession anyway. but it will create more demand as well. Secondly, with that increase patient usage, there's obviously going to be greater utilization; hospitals, services, technology. Technology's exploding in the extraordinary complex technology today. I think probably the most common one everyone is familiar with so I will use it. Just one, but there are so many others right behind it, calf scanners, start out with a million dollars to buy one, today it's $300,000. Procedure used to cost four or $500 to do. Today it cost in the range of $80 to $250, depending on where, but they're proliferating all over the place. Technology what does it do? It gives us diagnostic opportunities. We didn't have before, painless ones I might say. Except what grams which are almost gone because of this where it is available it was very expensive. Who do you want to deny to? Where do you say your research stops here? We don't expand the technology any further than this, calf scanners are the option . I pass no judgment. I only pass it on to you as part of the problem. There's a gross inefficiency or the use of facilities. Why? Well, nursing home, for example, government regulation says you have to have a physical therapist there. An interesting question do you really? The kinds of personnel have to be in the hospital frequently affected today by governmental regulations. They insist on it. Yep. Same time programmers, planners and regulators they cost on the very thing they insisted on. So when it comes to the situation, or the barking dog that wags his tail, which end do we believe? And I suggest to you, the services can be provided, but they are very frequently they're inefficient, but no less costly. They're going to be demanded and regulated which enhances not diminishes supply for most very frequently inefficient. It is always costly, provisions are needed services. A common modality that happens today or insistence. For example, now you have another comparative . Every person in a nursing home has to be seen at least once a month. You know the doctor, if they're going to be accredited it is a very worthwhile in many instances, in many instances, they share interface with other people. It may sound uncompassionate to say that, but that's not true. The catatonic that's lying motionless in bed sustained very expensive life support procedures. It does not require a monthly visit by a physician. We insist upon, it is costly, we've demanded it. And there was nothing wrong with it, but we must we talking about the dimension of our problem. We have an additional thing, malpractice problem, my cost, the doctor is not great. Relatively speaking. I think it's a, for instance, $3,100 a year. My same colleague California is $40,000 a year because of the incidences, I was, a patient has less than a perfect result. Takes and sues, now there is no way. positions can recruit for $40,000 a year without passing this on again through one mechanism or another through a third party. The governmental they have another incident 1%, so I hate it gets mostly headline but it's 1% quality, when you're talking about billions. A billion dollars is a lot outright fraud. Now fraud does that, but the cost pass over a billion dollars a year. But let me talk about what really, the, other than just plain access and use. Some of the technology that is expanding and exploding, that we have just began to get the outer parameters on. So you understand where we're heading in this situation. Intensive coronary care units, in the hospitals which represent 10% of all care very expensive, three times more usual daily rate. Monitoring equipment, but who you say will be monitored, and who do you say won't be monitored? But one isn't no longer a fresh coronary, but an old coronary. An acute respiratory distress, where do you make the judgment and turn it on and off. Chronic pulmonary obstructive disease, how much analysis of these do they do? New life support equipment, like the new born, very expensive, kidneys dialysis machines, where do you draw the line? Is this affordable and possible but it's extraordinarily expensive for a small number of people but who will be the executioner? Who will say no? Are we doing on the basis of the dollar? Or will we do it on a basis for regulation? Are we doing it on the basis of saying no more technology. extraordinary sophisticated pediatric units, I am not talking about the new born, I am talking of those very involved problems, malformations of all sorts. Burn units, treating of burns is exploding, ordinary extraordinary prices. Organ transplant units, here again who will say it? Who we will not do it? Now we develop a new modality, chemotherapy for malignancy. Just again, this is a sophisticated piece of just beginning to be developed with the annotating radiology and surgery on the doorsteps and another threshold of therapeutic trial, very costly, demanding special personnel, special units special equipment, highly trained people. Where do we stop? From these units alone, in the last five years has increased hospital cost by 10% In 1975 it is 12.5%, excuse me, $12.5 per day extra costs. So now we come to the final consideration, I told you I could speak to. These are the value judgements to which I previously . And it gets into this difficult question, man was shot to death in close range by his wife. The coroner said, \"I suppose there is powder bone burns on the body. The police man said, \"no way son,\" pardon me, \"so I suppose there is powder marks on the body.\" The policeman said, \"yes that's what caused the shooting.\" And the value judgment here is where we are going to get to the shooting. Who will decide cause versus value? These are for each procedure, and each circumstance is the patient individually overall better off. I'm gonna give you an overdrawn illustration but an example happens all the time. Represents Oh 0.5 hospital bed occupancy in almost any major city, all the time from comatose patients but never regained consciousness monitor; day week, month, year on and on last important mechanism, unconscious no quality of life, no value judgment haven't gotten to a point of pulling the plug. But we are arguing about these costs, extremely high costs, expertise and personnel as well. Now life expectancy, on average is increasing, Why he would have died of that. And they all want to say, well where are all the people living be 200 years of age? No its not men, all kinds of reasons but your life expectancy is growing. All kinds of arguments going on, how you get there? But nevertheless, it is primarily a medical reason. At least the healthcare reasons, not a medical care reason but there's these kind of new care, high risks associated, and high cost and given the resources that are currently available, they are costly. Whatever is used for the benefit of the patient. with cost, has to be analyzed on what how much should be forbidden. In what quantities? And for whom? Now there is a concern, how much at what cost it obviously can and produce new technology, greater expansions but it's going to cost more, quality care is never changing. But if we wish to draw a dollar cost, then the value of judgements, the exercise and the methods that are gonna do it. And what level? And in what restriction? Responses and resources versus benefits. So for our nation, its been the same whatever that maybe helpful for all is what we want. Now that's what our value judgment at this time, all I can say if anyone want to argue with that may but you are gonna be stalling in the street. But this compassionate that said, \"whatever is necessary for all, is what value judgment is, we try to find ways to afford it.\" Medicare today on my way governmental people. The cause of propaganda issue that time, about what the cost is gonna be. The expectancy, reductions, demand, increase in competition are all gonna bring in loyal order of cheap care, quality by a lot of people . Now nobody really believed that at the time, it is a great fairly tale it is nice to read about but it's not transported into this real world. We're hearing none of the same arguments again today, except we kind of slid away to a different situation but yes we still want the poor, disabled those that can't or those that won't care for themselves . And we said that mutuality of concern through program only government can do but do we impose on 90% of the people, all the other funds. Now we have given these procedures for the most part giving of course to the fact that there still mal distribution and there is still some people disenfranchised but there is been a great change so today we're saying, we must have a governmental situation, because it's proven costly. I point back to you how we got there? And who provoked it? And how was this started? And we're hearing the same were going to have a national health program and the inference that you withdraw and the implication given is that somehow it isn't going to cost much. There is going to be a reduction in cost. And I can't say if they are wrong. But historically speaking history says they are because every governmental program has been inflationary. It's been expansive. Its not , it's not ever been able to be reduced and particularly not in the healthcare field. There's always been an insatiable demand for more. Now there are several mechanisms on how to change this, we tried several of them the experimentation it has been raging on and and one of my colleagues is spoken rather well and I wanna cover that there two ways that, two philosophies that says we are gonna do something about it. How we control the cost? What are the alternatives? one is change the form of method payment in order to change economic insanity, incentives. And my friend mentioned one of these deductibles and co-insurance technical terms are I apologize but if you wanna know later I will explain it but I wanted to mention them as a technique in this area. Health maintenance, organizations, school's still out on HMO. Some of them have done very well. Some of them have broken even, some of them have been dismal failures, they have not reduced the cost a bit. They have not reduced the cost but school is still out, jury is still out hasn't gone on long enough to say, the American Medical Association, supported the development of it on an experimental basis rather than evaluation in 5 years. See what happened so far, we don't reimbursement, particularly to healthcare facilities such as hospitals. The other alternative is, control directly the quantities of resources used and the quality of services produced and rented by the profession. Other than this you get, professional standard review organization limits on the total budget that can be available to the provider, other than that we are talking about some cost evaluation particularly national health insurance. have a baby is have my teeth worked on and the dentist said, \"now you got make up your mind so I know how to regulate this chair.\" I will leave you with this thought, once the government gets the responsibility for total health care, they no longer becomes the priority. It becomes a budgetary hardship. There has been no single place, where they have not been heard healthcare no longer becomes a priority once government has to deal with it it becomes a budgetary hardship because the government has exercised that value judgment, that says, who will get what and how much of it. And then what quality and quantity. If you wish to leave those decisions to the government this is the decision that you have to reconcile yourself to. You know of it, the private sector and as an individual and exercise that freedom and individuality that judgment because it is made by you for you by regulations. I restate once the government has a responsibility for health care it's no longer a priority, it's a budgetary hardship. Thank you very much.\r\n\r\n- Thank you, Dr . Thank you Dr. Gardner, I think the four three speakers we've had at this point have raised ethical issues, almost beyond comprehension, which some of the rest of us have known. And probably raised a number of questions in your mind. One that always haunts us, even in the context in which Dr. Gardener spoke are those 17% who are uncovered, and the public program which has responded most vigorously with such figures it has. I've done the title 19 program going under the popular name Medicaid. The next gentleman is probably as well informed from the consumers point of view about the problems of both recipients as well as about the budgetary problems of state government in dealing with all the problems with include. A significant portion of the in this country. And it is my pleasure to introduce the man who is here really because of that experience and not because of this, position he now serves in Kansas City, the First Chairman of the joint commission on human resources of the Iowa legislature who has wrestled with day after day, Mr. Tom .\r\n\r\n- Thank you very much Jerry for that generous introduction. I want to emphasize that I am speaking from my perspective as a former legislator, and not in any sense of the word as a representative of the department of Health Education and Welfare. I'm a new to the federal service then. And I think what I just said, it's known as but in any event, my own opinions have been have been drawn from my own experience obviously. I got into this thing about three years ago much later than the other members of the panel as a result of serving on the budget subcommittee that is dealing with Medicaid financing. We were caught in this state as every state in the union was by escalating Medicaid cost and shrinking budget, and when the clash came it was extremely painful affair. We went, we received the recommendation of the executive branch with respect to how we could go about controlling those costs. And they were, in my judgment a moral disaster essentially what recommendations of the council and social services amounted to was total elimination elimination of the so called medical the coverage by medicare via elimination of other services such as eye glasses, clutches and wheelchairs and so forth. In addition they proposed what I thought was a pilot arbitrary limit upon the amount of days they would be covered on hospital stay and as well as the limit on the amount of time they could be spending on nursing homes. That being the case, it felt to us to to either try raise the money from somewhere or come up with the alternatives in a very short period of time. Fortunately we were able to raise the money, and then we began to address the more fundamental questions the more difficult questions that Dr. Gardner has ably analyzed at least. Once I got into the thing of it appeared to me that the largest problem, if you will, was that that we function in the absence of a coherent overall healthcare policy in this country. And that in the absence of that policy the drift of the system if you will, or inertia of the system is determined more by special interest groups, and then it might be if the interest in needs of all people were taken into consideration. Thus we were busily cutting control projects in New York city, and we were I think are checking on our responsibility to provide an adequate nutrition for all people in America. Two programs, I want to pick two examples which I believe do have an impact upon the various industries of public health. While at the same time we were giving away to a wide spread wide open kind of competition among hospitals, for example in this country to determine who would get their first with those calf scanners. I don't believe it has been determined if the calf scanners the presence or absence of calf scanners does have an impact upon public health. I think there are three calf scanners and I am not sure those three could really be justified. The point is that in the absence of a coherent rational overall policy, a policy was being made to be sure, but it was being made 50 different States by five 50 different budgets subcommittees of virtually all of them were ill prepared to meet their tasks. And so as a consequence, those 50 budget subcommittees we're relying for their information upon the interest groups. Its not to say the interest groups are not to have access to the legislature, of course under the first amendment they are to, actually do have. The point is that information was about the only information which was receiving, in which does receive those budget subcommittees. That opens up a whole nother area, I think of the lack of staff and lack of adequate sources of information that are available to legislature, nevertheless, that is the fact that it is. The villain if you will, in this matter, at least of high healthcare costs is widely disputed as Dr. Gardener points out, I have heard some very good explanations of who or what combination of villains there might be. One certainly is the technology to which you loose and so called Cadillac technology which operates in lieu of a more of the fruits of a high science of course. We might get and I trust that we will and won't be as necessary to engage very, very expensive technological pieces of equipment and that rather the development, hopefully breakthroughs new breakthroughs in and other kinds of sciences like that and will make those Cadillac technology obsolete. But the meantime, that is a very very serious problem. inner study has focused some of his discussions on the whole issue of third party payment the fact that it does in a sense in to the real cost involved. And to a certain extent I believe does encourage over utilization although I am no expert on that, I am just quoting what he says. Certainly it's true that when it cost General Motors more for the health insurance that its employees have and it does for the steel that they put in their cars, it clear that we have a problem. Similarly I am inclined to agree with those who have identified the whole system of fee for service as a serious problem in the function of our health economy and I believe that fee for service system does some over utilization. We went through a very long tractive fight that is not yet over in the eye of our general assembly with respect to the structure for paying radiologists and pathologists in this state. I discovered as a result of our investigation, radiologists and pathologists had an income an average income of the state, considerably an excessive of $7500 a year. And I know how that system works a few of them have a lab and they got it all. And since the census their cost is on a, on a fee for service basis there there are that many more tests that are run that might otherwise otherwise necessarily. I'm not trying to suggest that the that the other causes which have been identified or are diminished in any way the focus of our discussion well could be what Professor Shakeshaft alluded to in his opening remarks its its it is indeed the food that we eat, the cigarettes that we smoke, the booze that we drink you know which causes us and what continuous to causes I am afraid they are the most serious healthcare problems. But just so in the absence of an overall or rational or coherent health policy we will unfortunately to continue to spend a hundred million dollars a year in tobacco subsidies at a time when full well the effects of of smoking cigarettes are. I, I, I do want to touch upon, even though Dr. Gardener has mentioned it, I do want to touch upon the what I think are the very serious ethical implications of all of this. It strikes me that it is the nature of the package which is the most important the most important and most complex element in the, in the five areas that that Dan outlined. I'm afraid of who is gonna draw the line as is Dr. Gardener and I am afraid of where the line will be drawn. Where Dr. Gardener and I disagree, I think is that that he suggested at least by inference that government are not to be the ones to draw the line. And that that in fact we should continue free choice. It seems to me that if that is in fact the case, that it will indeed be the poor who will come on the short end of the stick. If it's not going to be decided, if you will in a public arena, then the failure to make the decision will I suspect be down to the ultimate detriment of poor people are more than any other segment in our population I think that the system can ethically consume every dollar we put into it. Its been said that you can't get enough healthcare and that's true, and if we allow the thing to continue then there's no doubt in my mind, that the worst kinds of decisions will come down as to where that line is drawn. What I am suggesting is that it is, now is the time to begin to build the linkage between healthcare planning and health care financing and that it is essential, that those of us who are not providers be heard and determine what that linkage is going to be. I don't know where the line exactly has to be drawn either what disturbs me is that there is precious little discussion or debate or study really being given to that. I think that we, most assuredly are going to confront that issue in the near future. Obviously, any national health insurance package whatever it is not going to be able to pay for everything for every conceivable procedure and conceivable practice that might be undertaken. I would hope that that that as the consideration is given to them is given to where that line ought to be drawn that we will have adequate representation of those who are not healthcare providers in making that decision. I am one who believes very strongly that Medicare and Medicaid were not only a very good thing, but really the very best thing that has ever happened to healthcare in this century in the United States with exception of course the great medical discoveries that were made since the end of the Second World War. It does not bother me, that we have had some problems in Medicare and Medicade I think that ought to be expected in any kind of undertaking of undertaking of this magnitude and complexity. But I would agree that we are in a different time now, it is not 1965 any longer and the decisions are going to have to be made with more urgency. Perhaps we have not been able to face those decisions in the past, it is important that we have our say so in there.\r\n\r\n- Thank you Mr. . There are a couple of things to be said before calling on the next gentleman. I think, sitting here being impressed you mentioned . About how it seems to me like great baseball players the ideas simply recur to different generations. Walter McClure has said about third party payers and asking the cost of care. Which Dr. Gardener said, was said by Martin Seinfeld in 1970 was set by Herman summers in 1962, was said by Ray Brown in 1958 and a said by Bob Sigma in the 1956. But that's All right. We all go through our cycle of heroes from Ty Cobb through . One thing that is that Dr. Gardener, remark particularly touched on and also Higgins. And that is the pressure which Seinfeld is also cited of technology on costs. Prompts me to tell you that we tried every way we could think of to get Dr. Lewis Thomas here for this program from New York. Who has written some of the most sensitive things about the sort of mid-state state Dr. Gardner the medicine is in at the moment, with a a particular plea for increased money for research. If being Dr. Thomas thesis based upon his historical observations that to go with when we pour some of the money into research, we usually come out with a much cheaper cure. Dr. Thomas is a five lecturer, this year for that organization and is unavailable for trips to Iowa. Nobody has used the term triage and I'm glad that is not happening. I now refer to my colleague at your extreme left to see if if he has any comments to make at this time even though he is the rod Carew of the evening tonight, Mr. .\r\n\r\n- I'm inclined to think that the most constructive comment I could make is that its time for a break. And I don't know if, do you think we can get this group to break from here then we can hear from them? Or isn't that the kind of comment you wanted me to make.\r\n\r\n- I'm just being courteous sir, I also have We'll take 10 minutes and I urge you to return. It will be your program.\r\n\r\n- Panelist colleagues for broad avenues of discussion that they brought to its been very interesting, often very good for a crowd, the only thing I would cause attention in regard to the pathologist, he did not initiate any tests himself there ordered by the people. So there are the narrow end of the funnel and they have no control over what test they are gonna be ordered by other health providers. And of course these are highly technically trained people of which there is small number because not everybody likes to do autopsies or setting laboratories and look at slides and do the things that pathologists do. So its a small number of fellows. So the consequences, again, they catch a lot of procedures but they themselves order nothing. They are the ones that only provide answers. They ask no questions.\r\n\r\n- Mr. Higgens.\r\n\r\n- Without responding directly to that except to say that in the laboratory people we sitting and were hovering over the microscope looking at the slides, and not necessarily the pathologists. I did want to place one slightly to cast a slightly different interpretation, upon its effect that Dr. Gardener has been brought up in his remarks he pointed out correctly, I think that upon the advent of Medicaid that very very many more . Many more of the poor are seeing physicians in the course of the year than the middle class, by the same of middle class were seeing physicians more often than the rest. And you can put two interpretations on that one is provided as as that a because there is more access, to utilize more often. I think that's true, but I also think it is true to say that that the poor are seeing physicians more often more often because the poor are more sick than the middle class. back to a point that I tried to make very strongly that is if we are serious, and I think we are, about improving the health care in this country, maybe instead of concentrating all of our resources on technological aspects to it would be wise for us to concentrate some of our resources on eliminating poverty. Moderators like to say two things and that is the reference to patient abuse, could well be as Mr. Higgens says reflection of the fundamental pathology socially would exist with the poor. And which we can't shake and which rhetoric will not make go away. Secondly, I, on the strength of examination of the deal of the literature in the past year, and I don't pretend to read it all. I'm not impressed that, necessarily the empty bed cost anything. It depends upon the arrangements. And secondly that you can almost directly correlate if you can tell, with the client length of stay to the advent of a governmental program of the PSRO irritating as it has been . A control that is perhaps been more cost effective than anything else, for that matter. Finally on the matter of the ethical considerations Which Tom alluded to, and Dr. Gardner alluded to. Who's going to pull the switch? Who's going to make the decision as to who gets what? And the answer to this is as old as Benjamin Cardozo, or even as old as Western Democratic theory. Society is gonna make that decision. And society affects the decision through the lens of government with respect to the terminally ill, the flat brainwaves, to what Dr. Gardener alluded you will see more and more literature about this of course. After the Quinlan case and as a personal viewpoint for you to think about. We invented the system of equity as a method of in the 15th centaury. Which was geared to handle just such matters, although not in this not exactly the... I think that decision will probably in the long run buried in some jurisdictions never been turned over totally the in-house panels of combinations of medicine and clergy and family, but we'll in the end probably be adjudicated by judges wearing ethical or equity robes as they do in trust matters, divorce matters and the issuance of injunctions now. The floor is open for questions. Will you please stand and state to whom you are directing your question.\r\n\r\n- If you're including in that also the practice of defensive medicine, which is again, inefficient or over utilization of people and materials and technology. That's estimated about 8 or 10% currently. as moderator I've got to strong exception to your statement about PSRO and I want to hear you say, and I hope its acceptable counter balance for reading a statement issued by the booking institute, which or generally reliable. There's been little experiences yet with PSRO themselves a recent study a summer programs that existed before PSRO were created concludes, that such evidence as there is, is not to show that they are effective either as cost control, or as quality control measures. In theory, PSRO has a potential cut cost by eliminating unnecessary stays in short in practice there is no evidence in medical care which had potential actually had any effect. More generally, PSRO may increase or decrease cost since they require some services, not already prescribed as well routine used before. Their potential effect is quality control measures equally on control, equally unclear. And the more so since much of what is accepted practice is not based on full efficiency.\r\n\r\n- Also if I may I ought to pick on Tom again. I don't think its fair in a discussion like this particularly solitary example, of some guy whom is not a pathologist and bringing a derogatory statement, highly technical specialized area on the basis. Someone, if he's guilty fraud, we all say could be prosecuted. Make him the example but don't use the whole don't condemn the entire situation on the basis of a bad example. I don't think that's fair in particular if you say he wasn't a pathologist and then its not to all.\r\n\r\n- No, I am sorry I think you misunderstood my remarks, I wasn't suggesting that any particular physician in is committing fraud. What I was suggesting was that the...\r\n\r\n- You didn't like the not money he was making.\r\n\r\n- Well it was about two 225000 yeah, that's...\r\n\r\n- So you are taking exception to it?\r\n\r\n- Yes.\r\n\r\n- But you wouldn't want to get rid of any services would you?\r\n\r\n- well, no what I, never the less, i well, I don't think had teeth either but you know I don't I don't know what that has to do with it. I think the $245000 is an excessive amount of money, yeah.\r\n\r\n- Well Dr. Mr. would probably shouldn't be saying since he had 600000 income before he quit the job, correct?\r\n\r\n- No, the difference is that, doc... secretary California doesn't need to defend him or his income but his fees were not paid for by the general public. I take exception to that I tell you Mr. California will get a considerable amount of governmental programs under his law firm also he was paid his fee by the general public so I doubt if he got it from over seas .\r\n\r\n- Is there another question? Yes sir. from the administration possible cap on cost, now we are talking bout cap on revenue\r\n\r\n- Mind if I identify you Mr. Linden? Mr. Linden is administrator of the Boone County hospital. And the past president of the Iowa hospital association will be on the program tomorrow to repeat the question what will be the effects of the caps on\r\n\r\n- If, if nobody else wants to address it were you about to go Dan. Pardon?\r\n\r\n- .\r\n\r\n- The... Okay.\r\n\r\n- For those of you weren't familiar with that term its lifts on revenue.\r\n\r\n- About revenue, right now, they're talking revenue. But I think the basic assumption is that there is some kind of relationship between revenues and expenditures, especially non-profit corporations . Actually the proposal that the Carter put up kind of a proposal as far as revenue limitations is concerned, why is that hospitals ought to be limited to essentially the overall increase in the cost of living and then some more wasn't quite expressed that way but it adds up to probably about 11% increases on how to supervise your employees I don't think myself that, that would have any negative effect on quality in terms of the way possible increase in recent years. In number of states, where there has been intensive concern about which can be described as a with the cost going up about 15 % every year with no end in sight, number of the states and without any evidence of fraud and of course hospital executives are used to and that's what you live on, and if you don't put a budget in, and try to live under it . I am inclined to think that in general will be very easy for hospital executives and boards to handle and some research makes it easy to manage. ...and make it easier. There maybe few institutions that have unusual hopefully before the legislation is passed, cause nothing is passed yet, there will be procedures to those kinds of situations. I, I, I don't think that this is I don't think it will have any adverse effect on quality. Actually the number of institutions, that use this as the basis for tightening up procedures tightening up the overall management to improve quality. I am just gonna make one last point, I think that the assumption that, high quality and high necessity go together. With one, two some of the remarks, that a I just don't accept that where improved efficiency\r\n\r\n- The proposal put forward by the Carter administration, does not provide incentives. But since that is proposed, half a dozen proposals and a number of very respectively proposal developed by but a number of them has and my guess is but the counter proposal was for a transitional . They just felt while we figure out more sophisticated control so they didn't think in terms of other incentives make any comments .\r\n\r\n- Two or three points mostly along the same line, glad you went first. Because the problem of quality as now is we don't measure very well. So it's kind of hard to know whether we very much given the lack of evidence one way the other. There is experienced during the cost of living council activity, that was concern was frequently expressed. And there was an effort made at that time to set up a group to checkout, such claims to see whether there is a hospital there was loss of quality in the community due to the cost of living council, in 1970s, that a team of Michael Lynn take a look and see if the evidence to support that there was no enthusiasm for such a team and that program nearly never got developed. And so there was really very little evidence developed one way or the other, but again that too was a short term program as the as the administration's current program is a short-term program, so that it is a transition into a longer term program in which the issues of quality might be more seriously engaged I would emphasize, as Bob said, the concept of the Lynn administration's program is a, is the cost of inflation plus a percentage of previous increases in growth. So there's still room in that proposal for growth in technology that the margin for growth in technology might very well be increased as it worked its way through the Congress. And similarly, there is an increase as Bob pointed out for increase in wages and non-supervisory workers. So the cap, which is up, they just say when you put in all the adjustments is up 10 11% is not appreciably different than the growth, the growth in gross national product as anticipated to this year. And so it's really not a good type cap, as Bob points out It's only tight, I guess it could play it against the 14 or 15% increases of recent years. But even those percentages are tending to the dow. What finally comes out of the Congress on the revenue cap, if anything comes out of the Congress might be even less restricted than, it's probably not restricted than what the administration has proposed.\r\n\r\n- It's not the idea of particularly the campus. It's the idea of the idea. And we're getting back into the same philosophies that we practice medicine level of bureaucracy in regards to our hospitals and situations or do we still believe in the integrity of the people are doing the best possible job they can. This is a really political medicine. That's what we're basically talking about. All public queries if you will take the scientists that do that sort of thing that asks the major problems confronting our society in this country today, doesn't find any of this issues even in the first dozen and a half. Yet it is a health care crisis, and who is lying? And why? Then the answer is fairly easy, labor is always big on doing this, they want to liberate their funds as much as possible, so that they can elect the interesting people to office. Some of that comes out in the health and welfare fund which of course is the current story if they want to change it. Its also a very provocative thing like I will give you food and clothing and health when you are running for office. And the same way about regulations, this is still political measure. We're going to save you all a lot of money because we're going to regulatorily enforce a cap because there's a lot of people are untrustworthy in the health professions that are not handling the things right. So we, as your saviors and being elected by you are going to do these things and impose these restrictions because they're not trustworthy or efficient or honorable. See the idea the idea I get to this is political. It's really not talking about quality or cost or anything else. This political issue that's been by certain people that they'll look the control of healthcare is a governmental responsibility and they don't want to trust it to the citizenly.\r\n\r\n- Speaking of the idea, of the idea. I don't see why, I guess healthcare should be any different an enterprise as government than say education. We have a budget restraints which the government imposes upon education in this state, I suspect most states do. That districts are limited to the amount that they can increase their budget. This university, functions under a budget imposed by government, certainly an argument could be made that we could improve the quality of education in our school districts or in our universities. If there were no limits on the budget, but point is of course, that that we don't have that much money. And similarly it strikes me that if we don't have that much money not to have some budget limits placed on healthcare the alternative is that is that in very many other areas which do impact on healthcare there simply will not be enough money to do, to maintain a minimum effort. I I cannot imagine any third alternative as far as determining policy and let's face it budget control determines policy. And if I understand Dr. Gardner correctly he is suggesting that budget not to be imposed by government if not by government, then by who? I don't want to any interest group dictating there. And as long as government is spending your tax dollars pay for it. Then I think the government owns the responsibility to its constituents to impose certain restraints.\r\n\r\n- I think the essential, difference here what the Carter administration is proposing and is that the majority of health scholars at this point do no trust the government, and the Carter administration has proposed a tax on all hospital The proposed tax does not apply only to the government expenditures I am not arguing with that kind of laws, I am just trying to clarify that point the legislation did apply only Medicare and which does account to about half but now he has decided","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45611/file/118633#t=0.0,3887.832"}]}]}]}