{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://iastate.aviaryplatform.com/iiif/bc3st7fg61/manifest","type":"Manifest","label":{"en":["Magraw, Richard M., John Ross, and L.W. Swanson, What's Right and What's Wrong with the Delivery System?"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/004/original/ISULogo.png?1601681107","metadata":[{"label":{"en":["Preferred Citation"]},"value":{"en":["What's Right and What's Wrong with the Delivery System? 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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and","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=34.42,36.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as the president of the Eastern Virginia Medical Authority.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=36.85,40.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Next to him on my right is Mr. John 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Adams.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=184.1,185.713"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/71","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's a great pleasure to be here.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=186.67,188.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/72","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm under the spell of the Midwest and","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=188.46,191.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/73","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of this university, being on this campus reminds me","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=191.97,196.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/74","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the enormous goodwill which the 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because","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=326.27,330.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/109","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that moves us into a sort of a commodity frame or reference","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=330.64,333.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"than with due 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indirectly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=423.15,425.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to your taxpayer, to fellow taxpayers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=425.81,428.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/138","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it is no longer the kind of private two party 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payers.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=434.484,438.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/141","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that third party refers really","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=438.72,441.275"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/142","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by indirection to the basic 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presentation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=459.85,463.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/149","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that's the way I started, to make a simple catalog.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=463.64,466.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/150","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I'm going to say some of those 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afternoon","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=475.57,478.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/153","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or to the citizenry of Iowa as it considers these issues","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=478.38,483.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/154","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then it will be to establish rather a conceptual framework","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=484.24,489.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/155","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about what the delivery system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=489.62,491.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/156","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and please, I have a hard time with that word.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=491.9,494.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/157","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I want a filter on it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=494.2,495.033"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/158","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What the system of health services is actually like.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=495.033,500.033"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/159","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There was a Swiss historian who about 50 years ago","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=500.22,505.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/160","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"coined an epigram and said that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=506.32,508.333"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/161","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"The denial of complexity is the essence of caring.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=509.467,513.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/162","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we are in a situation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=513.29,515.861"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/163","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that I think exemplifies that very well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=515.861,519.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/164","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We are dealing with one of the most complex set","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=519.67,522.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/165","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of institutions and arrangements in our society","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=522.78,526.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/166","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and it behooves us to be very 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Minnesotan,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=536.506,540.923"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/169","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Lyndon has given his name to","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=542.88,547.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/170","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a law that takes its place along with Parkinson's law.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=547.65,551.333"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/171","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that is that all problems come from solutions.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=553.11,556.733"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/172","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we in medicine and health 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disability","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1004.44,1009.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/304","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and custodial care of those things are remedial.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1009.95,1014.017"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/305","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We were talking in the luncheon","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1015.47,1017.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/306","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"before coming here among ourselves","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1017.8,1020.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/307","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and Dr Shane Shaft made the point that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1020.1,1024.883"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/308","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"quoting a recent publication, that about 80%","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1025.73,1030.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/309","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of what doctors do or what the health system does","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1030.94,1034.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/310","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is sort of useless, because it's essentially","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1034.23,1036.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/311","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"locking the barn door after the horse is out.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1036.75,1039.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/312","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I mean really, what good does it do","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1039.07,1041.353"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/313","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to operate on cancer of the lung","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1042.547,1045.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/314","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when you have a five-year survival rate","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1045.77,1047.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/315","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of less than 10% and as compared say","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1047.99,1052.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/316","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to blocking out those forces in society that promote","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1052.62,1057.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/317","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or maintain smoking?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1059.977,1062.153"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/318","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And what, you know I mean, that really is futile.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1063.46,1068.457"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/319","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's like trying to blot out the spill","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1069.353,1073.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/320","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from the washing machine with a single Kleenex","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1078.46,1080.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/321","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and yet an awful lot of what we do","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1080.61,1083.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/322","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is precisely that way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1083.54,1086.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/323","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Nonetheless, that is what we","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1086.53,1090.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/324","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as individuals who are suffering with","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1090.43,1093.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/325","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it's a great mistake to make the immediate","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1093.16,1096.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/326","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one to one relationship between medical care and health.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1098.03,1102.933"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/327","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We speak of this as health services.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1106.542,1109.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/328","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that's one of the ways with which we confuse ourselves.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1109.28,1112.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/329","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Medical care has much more to do","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1112.31,1114.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/330","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with what the philosophers call,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1114.17,1116.317"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/331","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"the anguish of living, existential anguish\",","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1116.317,1119.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/332","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"than it has to do with the actual health of the population.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1119.81,1124.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/333","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think, I'd just like to state that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1126.066,1128.193"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/334","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as a axiom and we can argue about it among ourselves.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1128.193,1132.826"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/335","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Okay.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1132.826,1133.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/336","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"All right, so what I'm saying is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1133.75,1136.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/337","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that if you think of those,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1136.99,1138.473"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/338","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if you think of those categories that I speak of,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1138.473,1140.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/339","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"most of what we're doing well","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1140.87,1142.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/340","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is in the declared illness part of it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1144.01,1147.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/341","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And particularly the non-custodial part, because","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1147.15,1152.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/342","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the warehousing of the elderly, the warehousing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1154.19,1157.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/343","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the grossly disabled or retarded,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1157.29,1162.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/344","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it is not something that we're doing well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1163.02,1166.186"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/345","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It is however, perhaps a little bit of a cop out to declare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1166.186,1171.186"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/346","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that as a problem with the system of delivery,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1173.39,1176.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/347","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"since that is I believe much more a problem of our mores","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1176.36,1180.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/348","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as a society.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1180.63,1181.817"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/349","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now the delivery system so-called, really does not","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1183.291,1188.291"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/350","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"do a very good job","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1188.36,1190.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/351","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of health education or health maintenance.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1190.62,1195.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/352","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I think","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1195.54,1196.373"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/353","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that the delivery system here is a pretty exact mirror","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1196.373,1199.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/354","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the motivations of individuals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1199.96,1202.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/355","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the priority to society.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1202.83,1204.383"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/356","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now here again, let's not kid ourselves about how specific","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1205.587,1210.072"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/357","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and how much benefit there is actually","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1210.072,1213.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/358","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in prevention, preventative medicine can easily","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1213.62,1217.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/359","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"become a kind of a rhetorical device really when","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1217.18,1221.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/360","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"things become truly preventable","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1221.93,1223.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/361","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they are applied very quickly.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1224.77,1227.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/362","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I mean, almost move outside of the delivery system, per 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involved,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1265.42,1267.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/373","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we're in that situation right now","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1267.58,1269.591"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/374","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with regard to 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culture","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1276.539,1277.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/377","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we're ready to enforce","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1277.6,1279.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/378","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"immunizations in young people.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1279.51,1282.093"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/379","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Okay, let me move","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1283.22,1284.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/380","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on to another way of thinking about the system of services.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1284.09,1288.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/381","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And now I want to harken back","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1288.69,1292.834"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/382","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the two-party transaction that I spoke of earlier.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1292.834,1297.834"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/383","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm not sure if I didn't notice the time we started.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1300.527,1304.678"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/384","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(speaks away from mic)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1304.678,1305.511"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/385","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e There's no shortage.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1305.511,1307.344"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/386","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(both speak away from mic)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1308.848,1312.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/387","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You've talked about 20 minutes.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1312.05,1312.883"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/388","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I hope you heard that sigh.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1312.883,1314.507"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/389","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(man chuckles)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1314.507,1317.255"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/390","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Said you can't have said much I've only got one note.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1317.255,1320.282"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/391","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(multiple people laugh)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1320.282,1323.615"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/392","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'll have to pull myself up, (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1324.59,1326.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/393","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"All right I'm gonna make a few more comments.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1327.73,1331.183"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/394","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One way of thinking about this system of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1333.01,1335.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/395","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"health services, is to harken back to a simpler time.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1339.77,1344.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/396","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And there was a time, and some of us who are still","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1344.76,1349.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/397","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in medical practice can remember when this","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1349.888,1351.805"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/398","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"was true enough so that we can all more say.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1351.805,1354.732"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/399","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1354.732,1356.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/400","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"When this was in fact a two-party transaction","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1356.5,1361.077"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/401","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and there was a provider over here","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1361.077,1365.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/402","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and there was no question that that provider was a doctor","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1365.02,1368.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/403","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and there was what we now call a consumer over here","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1368.33,1371.322"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/404","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that person was the patient.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1371.322,1373.872"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/405","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm gonna use the word consumer because it's more abstract.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1373.872,1378.872"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/406","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You remember patient or purchaser or payer","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1379.593,1383.001"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/407","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and they all, (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1383.001,1385.414"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/408","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, (clears throat), this was a two-party 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is.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1408.66,1411.265"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/415","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And this person helps to define it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1411.265,1414.218"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/416","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now that is not so much,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1414.218,1416.218"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/417","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a matter of (mic distortion).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1417.196,1421.029"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/418","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As it is a negotiation about value 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there,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1809.329,1811.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/511","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"patients whose doctors, (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1811.723,1814.999"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/512","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, here again, the Midwest in 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up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1849.02,1851.296"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/525","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm taking longer than I had intended, madam chairman.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1851.296,1853.675"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/526","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm gonna stop at this 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Okay.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1857.192,1858.025"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/529","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you Dr McGraw.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1858.025,1860.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/530","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Our second panelist for this 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Agency.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1922.5,1925.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/553","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Ross.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1925.21,1926.043"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/554","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1927.25,1929.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/555","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Given the old adage that nothing's perfect","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=1929.88,1932.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/556","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I guess the question 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individuals.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2045.6,2048.833"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/601","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Using a complex set of assumptions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2050.02,2052.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/602","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"our office currently estimates that 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afternoon","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2613.55,2617.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/777","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and spend hours undertaking.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2617.38,2619.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/778","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"However I'd like to reserve as much time as 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here.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2624.22,2625.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/781","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you very much for the opportunity to be here.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2625.54,2628.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/782","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you Mr Ross.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2628.74,2630.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/783","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another perspective on the question that we're looking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=2630.39,2633.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/784","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at this afternoon should be 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medically.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3255.93,3258.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/995","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And this, you have to take into consideration.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3258.51,3261.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/996","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I spoke a minute ago about the fact that 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room.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3360.9,3365.537"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1031","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And he works nowhere else.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3365.537,3367.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1032","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"He has no privileges to practice medicine except","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3367.17,3369.792"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1033","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the emergency room, because this is what he wants to do.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3369.792,3372.738"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1034","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And this is the need that he 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July.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3507.173,3509.747"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1085","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And most of the doctors in our area appreciate it very much.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3509.747,3513.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1086","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So the emergency room doctor really fills a 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weekends","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3520.4,3522.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1089","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at his own convenience for what may be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3522.74,3525.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1090","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a relatively trivial illness.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3525.45,3526.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1091","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another thing that we have in our hour that is normal","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3528.8,3531.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1092","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think is that private, city, County","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3531.73,3536.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1093","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"hospital and volunteer ambulance services are available","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3536.01,3539.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1094","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"throughout the state.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3539.21,3540.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1095","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They're pretty generally available","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3540.82,3543.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1096","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and they will help the patient get into the 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in","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3555.49,3557.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1101","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"almost every area now.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3557.32,3558.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1102","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"He can go to the emergency room he's 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there.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3563.11,3565.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1105","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So there really isn't any excuse in my opinion","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3565.23,3567.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1106","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for a patient not knowing how to get 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care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3571.537,3573.053"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1109","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In short, then,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3575.21,3576.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think Iowa has a pretty 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talking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3582.59,3584.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1113","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about medical care rather than healthcare,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3584.94,3587.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1114","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because as Dr. McGraw indicated,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3587.59,3589.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1115","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"healthcare includes a whole lot","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3589.96,3591.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1116","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of things like where you eat, what you eat, where you live,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3591.67,3595.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1117","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"how you live and so on your economics, as low as your state","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3595.27,3599.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1118","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of happiness and what you do to abuse or disabuse yourself.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3599.33,3602.733"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1119","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But from the standpoint of delivery of medical care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3603.575,3606.125"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1120","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think the doctors in Iowa","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3607.14,3608.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1121","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"have worked out a pretty good medical care system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3608.67,3612.047"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1122","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we're constantly working to improve it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3612.047,3614.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1123","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with the aid of the state medical society","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3614.51,3616.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1124","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the University of Iowa Medical School.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3616.43,3619.485"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1125","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3619.485,3620.318"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1126","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Our last panelist who'll be able to represent","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3621.89,3623.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1127","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"another point of view on these issues of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3623.85,3626.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1128","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"medical delivery system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3626.23,3628.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1129","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Charles R Lyndon is a hospital administrator","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3628.15,3631.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1130","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who is the administrator","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3631.54,3632.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1131","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the Boone County hospital, a position that he's","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3632.67,3635.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1132","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"held now for 11 years.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3635.49,3637.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1133","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Lyndon received a bachelor's degree","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3637.76,3639.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1134","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in public administration","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3639.61,3640.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1135","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from the University of Minnesota in 1956","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3640.87,3643.187"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1136","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and a master's degree in hospital administration","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3644.12,3646.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from the University of Iowa in 1958.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3646.39,3649.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1138","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"He served an administration residency","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3649.42,3651.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1139","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the VA hospital in Iowa city","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3651.57,3654.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1140","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and worked at St Luke's hospital in Cedar Rapids.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3654.21,3657.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1141","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In addition to his current position as administrator","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3657.23,3659.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1142","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the Boone County hospital, he is also currently","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3659.31,3662.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1143","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the board of directors of the Iowa foundation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3662.13,3664.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1144","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for medical care, and is chairman of the 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association","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3670.34,3674.077"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1147","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and has also been a past member of the governor's","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3674.077,3676.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1148","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"medical emergency service advisement council.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3676.57,3679.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1149","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr. Lyndon.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3679.97,3680.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1150","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3683.73,3684.563"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1151","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I used to think we had one heck of a delivery system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3684.563,3686.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1152","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"'till I saw in the paper that they delivered six","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3686.38,3688.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1153","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of them within a minute and 20 seconds in Denmark","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3688.63,3691.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1154","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that's gotta be a record.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3691.57,3692.986"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1155","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(multiple speakers laugh)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3692.986,3694.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1156","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If you saw that in the paper","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3694.49,3695.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1157","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it was a scribbled about that long.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3695.56,3698.239"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1158","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"A the same time in the 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\"satisfying\",","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3705.78,3708.015"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1161","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"enjoyable\", \"magnificent\" and then in the bottom","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3708.015,3710.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1162","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is a little corner thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3710.79,3711.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1163","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that says, \"Warning, the Surgeon General has determined","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3711.95,3714.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1164","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that cigarette smoking is dangerous to your health\".","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3714.45,3717.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1165","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's really what we're talking about","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3717.47,3718.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1166","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is priorities, what's right or wrong","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3718.87,3721.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1167","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and this is an American and a public decision","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3721.85,3724.561"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1168","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we've gotta make.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3724.561,3725.394"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1169","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And as I looked at the task we had, it said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3725.394,3728.307"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1170","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"what's right and what's wrong with the delivery system?\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3728.307,3730.494"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1171","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I went at it in a very simplistic way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3730.494,3733.993"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1172","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I thought now, there's 10 things that are right,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3733.993,3735.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1173","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"now there's 10 things that are wrong","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3735.83,3736.663"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1174","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I've done my job.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3736.663,3738.873"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1175","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, it isn't that simple,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3738.873,3740.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1176","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as it's been pointed out.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3740.02,3741.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1177","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Because we're talking about a large, costly,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3741.72,3744.993"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1178","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"emotional, a political system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3744.993,3748.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1179","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that's everybody's business","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3748.55,3750.174"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1180","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because everybody that makes directly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3750.174,3751.882"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1181","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or indirectly sooner or later.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3751.882,3754.273"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1182","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"However, I'm going to be simplistic for a few minutes","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3754.273,3756.447"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1183","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and try to list some things that I think are right.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3756.447,3758.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1184","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And some things that I think are wrong","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3758.52,3760.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1185","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if you'll recognize it, it's not black and white","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3760.98,3762.877"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1186","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we're in a gray area.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3762.877,3764.173"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1187","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What's right?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3765.41,3766.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1188","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"American medicine, American hospitals,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3766.88,3768.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1189","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"American healthcare are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3768.89,3770.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1190","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or the people involved are the best trained,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3772.12,3775.594"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1191","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"provide the best care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3775.594,3776.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1192","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"provide the most comprehensive service and range of services","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3776.97,3780.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1193","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and are involved in more research","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3780.52,3782.302"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1194","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and more continuing education","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3782.302,3784.068"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1195","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"than any nation in the world.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3784.068,3785.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1196","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We don't have to take a back seat to anybody.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3785.72,3788.494"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1197","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that's one thing I think that's right about it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3788.494,3791.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1198","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The vast majority of men","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3791.57,3792.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1199","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and women who are involved in the delivery system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3792.69,3794.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1200","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"are concerned about their patients are concerned","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3794.72,3798.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1201","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about their research and are concerned","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3798.09,3799.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1202","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about the products that they manufacture and deliver.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3799.77,3802.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1203","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They are devoted to providing service when needed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3802.57,3806.245"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1204","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and they have a desire to provide high quality service.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=3806.245,3809.18"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114","type":"AnnotationPage","label":{"en":["English [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30114/annotation/1205","type":"Annotation","motivation":"subtitling","body":{"type":"TextualBody","value":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/114/original/AV167973_Whats_Right_and_What_s_Wrong_with_the_Delivery_System_a.vtt?1624899286","format":"text/vtt","language":"en"},"target":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/114/original/AV167973_Whats_Right_and_What_s_Wrong_with_the_Delivery_System_a.vtt?1624899286"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30115","type":"AnnotationPage","label":{"en":["AV167973_Whats_Right_and_What_s_Wrong_with_the_Delivery_System_a.txt [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630/transcript/30115/annotation/1206","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"- Was in Iowa. This topic for this afternoon's panel is what's right and what's wrong with the medical delivery system. The four panelists who'll be speaking this afternoon. I'd like to just briefly introduce these four individuals now and then before each of them speaks I'll give further introduction. Over here on my extreme right, your left, is first, Dr. Richard McGraw, who comes to us from Norfolk, Virginia, and as the president of the Eastern Virginia Medical Authority. Next to him on my right is Mr. John Ross who is from the Des Moines and is the executive director of the Iowa Health Systems Agency. On my left, first here is Dr. LW Swanson, who is from Mason city and is president of the Iowa Medical Society and is also engaged in private practice in Mason city. And last on my left here is Mr. Charles R Lyndon who is the administrator of the Boone County hospital. The format we're gonna be using this afternoon is as follows, we'd like each of the panel members in the order that they appear in the program and that I just briefly introduced them to make a presentation on the topic before us. These will vary some in terms of the length of time they'll be, but they'll all be fairly short. Then after all four panelists have presented their initial views, we will then probably take a very short break and give you a chance to move around, to get something to drink after that, we hope everyone comes back after the break we will first give each of the four panelists an opportunity to make any rebuttal that they would like to what their fellow panelists had spoken to. And then after that, we'll take questions from the floor. All right, our first speaker this afternoon is Dr. Richard McGraw. He, after receiving his MD degree in 1944 from University of Minnesota, he spent several years in private practice. In 1950 until 1969, he was a faculty member in the departments of Psychiatry and Neurology and Internal Medicine at the University of Minnesota. For one year, while he was on leave from the University of Minnesota in 1968 and 69, he served as deputy assistant secretary for Health Manpower with the department of HEW. From 1969 to 1973, he was deputy executive dean and professor of Internal Medicine and Psychiatry at the University of Illinois College of Medicine. Since 1973, he has held his current position as president of the Eastern Virginia Medical Authority, which as I understand is it is a regional public agency. Throughout his career Dr. McGraw has published numerous articles on various topics in this field, the quality of his publications as evidenced by his receipt in 1966 of an award given by the National Association of Blue Shield Plans for the most distinguished writing in medical care and medical economics. Dr McGrath.\r\n\r\n- Thank you Dr. Adams. It's a great pleasure to be here. I'm under the spell of the Midwest and of this university, being on this campus reminds me of the enormous goodwill which the citizenry of this country and I think there's nowhere better exemplified than the Midwest. As for healthcare, on their children and on their own future it really is, most impressive institution. I'm not only under the spell of the university but also of your third clinic here, . Rather of that clinic as an example of the kind of medical collectivity which seems to be in the Midwest and is characterized in Midwestern medicine more than any other part of the country. On the Eastern seaboard, there are very, very few such multi-specialty practices. And in consequence, the organization of health services is much more disheveled and anarchic and I'm using some rather pejorative terms. And I really don't mean that quite as it's coming out but it's much less attuned to current needs. And that gets me into what I want to say today a little bit prematurely but let me make the point and I'll come back to it. We're asked to address the topic of what's right, and what's wrong. And I think all of the panelists found that to be a somewhat polarized presentation. It isn't that we're avoiding controversy, but the reality is much more complex than that. And I think we want to think in terms of what's more satisfactory and what's less satisfactory about our system of health services. I boggle on the term, \"delivery system\", because that moves us into a sort of a commodity frame or reference than with due apology to our economist moderator. I feel like we can't help ourselves through this complex kind of thinking by misusing our basic ideas and terms. And we're dealing with a service here and not a commodity and delivery is not a very appropriate metaphor. Anyway in the, it makes some difference whether we consider what's right and what's wrong or what's more or less satisfactory as to whether we think of this, a system of services in a personal or individual terms or in social terms. And not the least of the problems that we have in front of us is that in my lifetime in the practice of medicine, what used to be a rather simple two party transaction has now changed, both because of changing technology and because of changing modes of payment. So that if any of you go to see a doctor, go to the hospital, your care and become something which transcends your own interest it actually becomes of interest in your own family. It becomes of interest to your fellow subscribers to Blue Cross and Blue Shield, to your fellow citizens since they paid for and other humans, for the care that you're getting indirectly to your taxpayer, to fellow taxpayers it is no longer the kind of private two party arrangement. Let's keep in mind that the slang term for the insurers is third party payers. And that third party refers really by indirection to the basic transaction of the two party process. I'll get back to that in a moment. I was asked to lead off in this, and it's kind of tempting to make a catalog of what I think is better or not so good about arrangements. And I indeed, when I got to working on this presentation that's the way I started, to make a simple catalog. And I'm going to say some of those things but let me say that that simple catalog will be, I think a blessed use to us this afternoon or to the citizenry of Iowa as it considers these issues then it will be to establish rather a conceptual framework about what the delivery system, and please, I have a hard time with that word. I want a filter on it. What the system of health services is actually like. There was a Swiss historian who about 50 years ago coined an epigram and said that, \"The denial of complexity is the essence of caring.\" And we are in a situation that I think exemplifies that very well. We are dealing with one of the most complex set of institutions and arrangements in our society and it behooves us to be very precise and very accurate in our analysis. You know, Eric Sevareid, a fellow Minnesotan, Mr. Lyndon has given his name to a law that takes its place along with Parkinson's law. And that is that all problems come from solutions. And we in medicine and health are in precisely that situation because we're a long way along now with a reformation, a restructuring, a reforming of our arrangements for health services. We entered into a crescendo of change following world war two. During world war two, you know, we had because we had a freeze on increases in salaries and wages. There was a widespread move in industry to recruit by enhancing fringe benefits. And it was during that time that the practice of industries paying for medical and health services through a third-party reimbursement mechanisms came into flower and had it not been for that accident of history we would perhaps not have had thrust upon us that particular solution as rapidly as a team it came during world war II. The consequences immediately at the end of the war, we had another problem. It came from that solution. And the problem was a shortage of hospital beds because we were now then paying for hospital care. So we immediately, and with the best will in the world, most benevolent intent in the world we came up with another solution which was to build hospital beds under Hill-Burton. And many of the problems that you'll hear about today stem from that benevolent solution. I mean, that's where some of our problems came from. Another thing we did was to invest enormous amounts of money, enormous amounts of money for 25 years there was a 25% increase annually in the amount of federal money going into research we invested enormous amounts of money in discovering new things about health. Now that you might think would be an unmixed blessing but I think social history tells us time and again, that any culture can only assimilate change at a certain rate without kind of choking on the process of change. There are many, many civilizations, you know that have come to grief as more advanced Western cultures were sort of imposed on them and the civilizations in effects fell apart and have never been reconstituted. Well, in a way that has happened to us in medicine we doctors of my age in a sense are immigrants to a new culture. It isn't recognizable now what is was when we were young and not only are the doctors immigrants to this culture but we all are, and we've got a rather massive kind of economic, philosophical, technological indigestion that results from this. Please, I'm not arguing about cycling discovery. I mean, now I'm simply analyzing where we're at. We, another solution we undertook when given problems of access was to grant purchasing power in medical and health services to those persons that didn't have it. And this was done on a very wide scale and with again, partial solutions but one of the problems we have with these changes in reimbursement mechanisms is that a central and essential function that used to take place between doctor and patient has now been abrogated. And that was the rationing function the function of deciding, you know, what is really worth it what are the trade-offs of hospitalizing or taking an x-ray or going one therapeutic route with surgery or medication, as opposed to another. Are you understanding me? Am I confusing you with what I'm saying? The doctor, when I entered practice in 1943 and 44 many of my decisions, many of the decisions that the patient and I made together had to do with what x-rays cost, what hospitalization cost. And it's been many years since that was a major consideration in most of medicine. And that has, if you really want to uncover the issue of medical care and hospital costs, it starts right there with that, with the abrogation, passing away of that process of rationing. Well, what I'm saying is that we are in a time of a transition and I, what I would like to do, what I would like to present you primarily are sort of two approaches to the nature of this system of health services and highlight where some of our better and not so good adaptations or arrangements show up in this process. You know, one way of thinking about medical care is to talk in terms of, or health services, is talk in terms of whether the care has to do with the maintenance of health, whether is has to do with the diagnosis, if you will, the recognition and management of illness or conditions that are not illness. Of abnormalities that are latent and undeclared or whether this sector, whether the care has to do with the treatment recognition and management of actual illness of a symptomatic disease. Whether it has to do with the care and rehabilitation of chronic illness and disability whether it has to do with the custodial care and management of essentially irremediable conditions. Now, almost everything we do in regard to health services can be put in one or another of those categories. There is perhaps one I should have started with which is education, health education, advice to people either individually or on, of what they can do to maintain their wellbeing or to establishing and maintain their wellbeing. But almost everything that goes on can be put into one of those categories. Now, it's in general true, however, that the profession and the institutions do what they are paid for and things that are not they do differentially well or intensively, things that are paid for. In general, we pay we are much more concerned about actual illness than any other of those things I speak of. And so we see a sort of a lopsided effort that goes toward actual clarity on this, pain, symptomatic illness, and recognized disability and custodial care of those things are remedial. We were talking in the luncheon before coming here among ourselves and Dr Shane Shaft made the point that, quoting a recent publication, that about 80% of what doctors do or what the health system does is sort of useless, because it's essentially locking the barn door after the horse is out. I mean really, what good does it do to operate on cancer of the lung when you have a five-year survival rate of less than 10% and as compared say to blocking out those forces in society that promote or maintain smoking? And what, you know I mean, that really is futile. It's like trying to blot out the spill from the washing machine with a single Kleenex and yet an awful lot of what we do is precisely that way. Nonetheless, that is what we as individuals who are suffering with it's a great mistake to make the immediate one to one relationship between medical care and health. We speak of this as health services. And that's one of the ways with which we confuse ourselves. Medical care has much more to do with what the philosophers call, \"the anguish of living, existential anguish\", than it has to do with the actual health of the population. I think, I'd just like to state that as a axiom and we can argue about it among ourselves. Okay. All right, so what I'm saying is that if you think of those, if you think of those categories that I speak of, most of what we're doing well is in the declared illness part of it. And particularly the non-custodial part, because the warehousing of the elderly, the warehousing of the grossly disabled or retarded, it is not something that we're doing well. It is however, perhaps a little bit of a cop out to declare that as a problem with the system of delivery, since that is I believe much more a problem of our mores as a society. Now the delivery system so-called, really does not do a very good job of health education or health maintenance. But I think that the delivery system here is a pretty exact mirror of the motivations of individuals and the priority to society. Now here again, let's not kid ourselves about how specific and how much benefit there is actually in prevention, preventative medicine can easily become a kind of a rhetorical device really when things become truly preventable they are applied very quickly. I mean, almost move outside of the delivery system, per se. One of the best examples I know is the prevention of iodine deficient goiter by inserting iodine in salt. It becomes a matter of legislation. And now this thing moves slowly, sometimes, witness flooring and water supply, but nonetheless when things become truly preventable they tend to be moved into the general machinery of society. There, again, there tends to be a long latent period while society kinda comes up to speed and recognizes what's involved, and we're in that situation right now with regard to immunization. We have not really decided as a culture that we're ready to enforce immunizations in young people. Okay, let me move on to another way of thinking about the system of services. And now I want to harken back to the two-party transaction that I spoke of earlier. I'm not sure if I didn't notice the time we started.\r\n\r\n- There's no shortage. You've talked about 20 minutes.\r\n\r\n- I hope you heard that sigh. Said you can't have said much I've only got one note. I'll have to pull myself up, . All right I'm gonna make a few more comments. One way of thinking about this system of health services, is to harken back to a simpler time. And there was a time, and some of us who are still in medical practice can remember when this was true enough so that we can all more say. When this was in fact a two-party transaction and there was a provider over here and there was no question that that provider was a doctor and there was what we now call a consumer over here and that person was the patient. I'm gonna use the word consumer because it's more abstract. You remember patient or purchaser or payer and they all, . Now, , this was a two-party transaction, very important, it remains important. It remains sacred to the whole operation. Because among other things, this is a negotiation with which the person who I asking for help presents himself in a variety of ways in terms of what his problem is. And this person helps to define it. Now that is not so much, a matter of . As it is a negotiation about value systems. A negotiation about value systems. That whole transaction, very complicated, right there. However, again, without adding , infinitely more complicated. And what we are all about, , is really, . This simple concept here. For example, what used to be something that the doctor did has now become something that, . And they go through all the care, . And those people also have contracts, . Then there is the medical . And now, every doctor is . And one of our problems is that, except in places. Most of our process doesn't have any good models for putting. The interesting thing now, there is a medical \"Humpty Dumpty\" has now been recognized at law and it has been held that the hospital staff has direct contractual responsibilities for individual patients. And that this patient in the hospital is not well cared for that patient can indeed sue this doctor but can also sue those doctors who are, . That occurred not when but that exact contract, . Now, then there is the hospital. And that hospital also has clearly defined law, a contractual responsibility for this patient. Now, none of those contracts supersede this basic contract. They are all complementary. They are all add-ons. Remember what, said, . And now we have an infinitely more complicated procedure. And truth to tell, the situation is more complicated than, I'll come back to the providers side of the equation in a minute. Now we need to go over the consumer side. Remember when I said about the payer side. We once had a situation in which a patient paid a doctor, . And now that's become extremely complicated by virtue of the arrangement for pay, . Of now believing if you go to the hospital, and you have an, and you have, . You have a quadriplegic or a paraplegic in your family, and they're sick or something, we'll give them care, not really an issue between the patient and the family and this set of individuals. But it becomes a concern to the other payers to that ensure, or the other citizens who are paying taxes and paying it that way. And what has happened actually, is not only that this doctor has obligations to each of those sets, and he has those right through, he has those obligations, he needs to meet those obligations to third party authorities by the way he conducts his care of patients. By whether or not the patient is discharged or at a certain time that all, , much on the doctor's shoulders, he's got all these kinds of obligations but at the level of the medical collective, the group practice, there are also certain obligations. Usually you do not have the authorities of law. They are not entirely understood. But it makes a great deal of difference to a community whether the doctors get themselves organized, or if there is a formal way in which there is 24 hour coverage for all the people in a community or whether the doctor is, , for the hospital's emergency. There's a phrase called, the phrase, \"the collusion of anonymity\" that refers to the business of kind of, you know, the slipping through the cracks in the system. I'm not talking about patient slipping through the cracks. I'm talking about the providers taking refuge in signing out, you know, they are not there, patients whose doctors, . Now, here again, the Midwest in comparison to other parts of the country is really blessed, not because every doctor is in that kind of organization, because there is enough of that organization . Well, we got major problems here. One of the things wrong with our medical care system has to do with hospital emergency rooms and how they are staffed and whether the doctors on the medical staff get themselves organized so that that care is provided or whether they manage to out fumble the system and let the thing be picked up. I'm taking longer than I had intended, madam chairman. I'm gonna stop at this point. I'll talk more about the specific problems-\r\n\r\n- Okay. Thank you Dr McGraw. Our second panelist for this afternoon is Mr. John Ross and Mr. Ross served in the United States Army for 20 years before receiving his university education. His academic training includes a master's degree from Indiana university in 1965 with a major in counseling and guidance and a minor in management and personnel administration. He's also done post-graduate study in business administration and has had training in the field of health resource statistics. From 1965 to 1969, Mr. Ross was assistant director in the office of student services at the University of Kentucky Medical Center in Lexington, Kentucky. After that he became associate director of a Ruth Glass Regional Health Planning Council. Next he, from 1973 to 1976 he served as executive director of the Southwestern Michigan Comprehensive Health Planning Association. And since 1976, moved in his current position which is executive director of the Iowa Health Systems Agency. Mr. Ross.\r\n\r\n- Thank you. Given the old adage that nothing's perfect I guess the question addressed to this panel as to what's right, and what's wrong with the delivery system is adequately not aptly put that I approached the task of preparing my comments and answer the question I resolved to attempt to strike a balance between right and wrong as I find it existing in the Iowa health service area. With due apology of course to the gray areas that will mark your position where right stops and wrong begins and vice versa. I think though, that during the past year and a half while my agency compiled its first health systems plan I did do indeed hear much debate about the things that were right with the system and the things that were wrong with the system. Of course, much of the rightness and much of the wrongness was dependent upon the debaters perspective of the system. This comes about because our healthcare delivery system is so broad and diverse. And I might add the word complex as Dr. McGraw has described too. This healthcare system raises from community health protection services, such as water and frequent sewage treatment plants to prevention and detection services such as our immunizations program. The system also includes debilitation and rehabilitation services, maintenance services and support services, such as clinical laboratories and blood banks. By far and away the most widely used and most often discussed set of services within the system are those which we refer to as diagnosis and treatment. To this particular part of the system then that I would address the bulk of my remarks. The largest amount of diagnosis and treatment service is provided through the primary care physician. There are over a thousand primary care physicians in our service area and this amounts to about one for every 2,400 individuals. Using a complex set of assumptions our office currently estimates that 90% of the demand for primary care services is being met in the Iowa health service area. Unfortunately, we have 12 counties where less than 60% of the demand is met and 20 counties where 110% of the demand is met. It seems then that one of the things right with the system is that we need a substantial amount of the demand for primary care physicians in our service area. What's wrong with the system is that we have an obvious maldistribution of primary care practitioners around the state. Another big provider of diagnosis and treatment services, of course, are the hospitals. Now we have a representative of the Iowa hospital association on the panel. So I'll not dwell on the role of the general hospital in diagnosis and treatment. I would like to point out however that over 99% of our population is within 40 minutes travel time to a hospital. Now that's a right in our system, showing ready availability. We also currently have 5.89 beds per 1000 population in our health service area. And this is a huge excess and that's not so right. Our agency staff maintains that 4.5 beds per 1000 would maintain that ready availability I referred to and it's still time have time to serve for constraining the cost of healthcare. Now we also have considerable specialty diagnosis and treatment capability in this health service area. For example, in the treatment of renal disease we have eight dialysis centers located throughout our area and three of the facilities serving our health service area perform kidney transplants. Thus we have ample treatment facilities for those afflicted with renal disease. This gives us the appearance that these things then are all right, but this part of the system what's wrong with the system is if we do not have enough kidneys for transplantation. We currently have 60 citizens needing transplants and very few organs available to meet their needs. It's noteworthy also that we have a substantial amount of cardiac, catheterization and surgical services available to us in this area. Only portions of five counties are more than 90 miles from catheterizations and only portions of 11 counties are further than 90 miles from cardiovascular surgical service. This indicates ready availability of the service but here too, there's a maldistribution problem. While several counties have no service within 90 miles of the residence, some portions of Tama, Poweshiek, Linn and Benton Counties have six such services available to them. But this point, I'd like to move away from the technical aspects of our healthcare delivery system and report to you how I view our agency fitting into the development of and changes to access. The charge to our agency under the federal law that created it is to improve the health status of the citizens of this health service area by modifying the healthcare delivery system that impacts on that statement. Certainly this means simply that our job is to try and find a way to make people better and do it through changes in their healthcare delivery systems. Certainly the problems that I've outlined to you earlier are major problems for you and all of the people we serve several of your speakers yesterday made references to the health systems agency. And I thought I might give you just a glimpse of how we are approaching our mission. During the past year and a half, we have compiled our first health systems plan which is a 336 page document that I honestly hope will become familiar to each, this particular document contrary to some popular beliefs is not a statement of how to make change, but outlines for you all specific and goals and objectives, which if achieved would create a better healthcare delivery system. In other words, it's not a how to do it plan, but rather a where to get to plan. The responsibility for those achievements rest with both the consumer of healthcare services and the providers of those services. Now the consumer's role is to make reasonable choices and objective decisions in support of the plan that will encourage the providers to modify their own roles within the system in order to help you the general public make these reasoned choices the health systems agency will provide a large and competent staff, a nonprofit organizational structure controlled by consumers, and most importantly, an open process in its planned development. I'd like for you to know that during the past year a non, excuse me, we involved over 400 volunteers with our agency that the draft document that I showed to you was taken to 11 separate communities in all parts of Iowa for public debate. I feel quite strongly that the openness of the process is the only manner in which we can achieve proper decisions to perhaps avoid some future connotations of wrong solutions that Dr. McGraw referred to. Many of the problems that confront our system today were brought about by the lack of coordination between the provider. Although I'm sure that each in their own wisdom over the years thought they were moving towards the best interest of their communities, when the decisions were analyzed for the community of the whole, of our area we discover that many errors of admission as well as permission of taking place. Now for the first time, the general public has an agency which I wish them to consider as theirs to bring about decisions in the future that will consider the community as a whole. There will, of course be those that contend that our agency is not truly representative of the people or that the planning for an improved healthcare system should rest with the providers of healthcare, rather than the consumers. A response to the first contention. I would simply point out that all of our staff and the volunteers who currently work with our agency are dedicated to the open process I mentioned earlier. To gain wider awareness about our agency and its function on Monday of this week my board authorized an expenditure of $50,000 to be used to make the public more knowledgeable about our activity and to develop new forms for their participation. My contention is that the open process and awareness will produce an agency that is representative of the people. To respond to questions that may arise regarding the contention that providers can best plan to healthcare system for the people it serves, my personal position is that I accept the wisdom of the Congress of the United States which passed public law 93 dash 641 and appropriated monies to support the health systems agency network across the United States. And it was the Congress, the best of their control of an agency in the consumers of healthcare services. Certainly, providers have been incorporated into our process to the widest degree possible for each area of concern addressed in our health systems plan, we convened 16 separate technical task forces and nearly 100% of these groups were comprised to providers. Our staff recognizes the technical expertise that the various professionals and their organizations can provide the planning process. We have solicited their input every occasion and have provided detail analysis of their technical input to our board of directors and sub area advisory councils so that the appropriate decisions could be reached. Certainly there are many areas regarding our healthcare delivery system system that we could discuss this afternoon and spend hours undertaking. However I'd like to reserve as much time as possible for your questions and we'll close here. Thank you very much for the opportunity to be here.\r\n\r\n- Thank you Mr Ross. Another perspective on the question that we're looking at this afternoon should be provided from our next panelist. He is Dr. LW Swanson and is the current president of the Iowa medical society and is currently engaged in private practice in Mason city, Iowa. Dr Swanson received his MD degree from university of Iowa in 1936. He interned at Albany hospital in New York and completed his residency in internal medicine after University of Iowa where he subsequently did some teaching. Dr Swanson has been very active in the Iowa medical society. He has been a member of numerous committees during the past 19 years, and he has also served as one of the Iowa medical society delegates to the AMA for 15 years. He became president of the Iowa medical society in may of 1977. Dr Swanson.\r\n\r\n- She says, I'm a practicing physician taking care of patients as late as 9:30 this morning. We physicians in hospitals have been criticized as a cottage industry. Totally unorganized. As Dr. McGraw stated, we are not really an industry subject to the usual industrial economics. We are a service, a professional service, but nevertheless organized better than is often realized. With that in mind I'd like to tell you something about what's right, in my view, with the Iowa, specifically Iowa, medical care delivery system. Iowans were pioneers in creating a health system for themselves without federal financing or dictation. They organize it on a statewide basis as needed and as it became feasible. As early as the turn of the century, boards of supervisors at each County were legally required to appoint overseers at the core and contract with doctors and hospitals for needed medical care which was really a fine approach or including everyone in the medical system and on an equal basis, for instance in our County to this day, no patient, no laboratory person knows whether the patient is a County patient or a state patient or a private patient. They all are treated exactly the same way. Contracts were set up in those early years with most County medical societies to provide such care. And also with the nearest hospital for hospital care. Either primary care or secondary medical care, as you know not every County in Iowa has a hospital. So many times the adjoining County hospital was the subject of the contract made by the board of supervisors. I assume you all understand what we're referring to when we say primary, secondary and tertiary medical care. Is there any doubt about that? Primary care means your first approach, the primary care physician usually assumes charge of all of the patient's medical care and engineers it from there on, as far as he can go with it. Secondary would be one level up, tertiary would be the level of the care at the highly specialized centers such as the university of Iowa hospital. Tertiary care at the university of Iowa hospital was initiated in this state about 1900. In 1915, the general assembly passed the Perkins act, recognizing state responsibility for specialized medical care for children who could not afford it otherwise. Children's hospital at the University of Iowa was the first facility of the current West Side Health Science campus. And it was in that hospital that some of you may remember Dr. Styler, the chief of orthopedics performed orthopedic surgery on polio paralyzed patients, children that made him and the University of Iowa first world famous. Probably most of you now have never even seen a case of polio because this has gone by the board via immunization and vaccination as was referred to by Dr McGraw. Thank goodness I can tell you that. In 1919 the Haskell-Klaus act was passed by the state legislature and this extended centralized state care to adults not just children. And each County was assigned an annual patient quota at the teaching hospital at Iowa city. Increasing demand for this service from all parts of the state led in 1924 to the funding with a matching grant from the Rockefeller foundation for a 900 bed general hospital which was completed in 1928 at Iowa city. And it's still the basic format of the much improved institution there. Transportation in those days was paid down to Iowa city from all parts of the state via bus or train tickets paid for by the County supervisors or the state. And this included an escort from the family if the individual was too sick or too young to go alone. And this continued until the university hospital started its own statewide ambulance service in 1932 which still exists. I'm sure you've all seen university of Iowa hospitals cars which is an ambulance service all over the state. Since that time tertiary medical care capabilities at the university have grown to their present worldwide leadership roles and specialized medical resources or care medical care for patients also for teaching because this is the state medical school and for research which, as you know, has been very active and very angrily financed by the federal government in the last 20 years in particular. In addition Hill-Burton funds previously referred to have helped provide some small primary care hospitals throughout the state. Not all of the smaller hospitals are ill burdened hospitals, but a good many of them are. Good relationships and good referral patterns exist between the doctor's offices, primary care smaller hospitals, secondary care hospitals which are usually those in the 100 to 400 bed capacity range and the tertiary center of Iowa city. The relationships and referral patterns back and forth are excellent and always have been. The university staff at the university hospital tries its best to improve that relationship regularly. In addition in our own County and regional public health nurses are pretty generally provide also by law. They are managed usually by the state department of health and paid for by the local level and stationed at the local level, they function pretty efficiently, pretty well, they're not completely as physician's assistants or however or independent nurse practitioners that you've heard about but they could fit into that category if we chose to go that direction. Older retiring physicians in many of the small towns are not being replaced in recent years as you know, particularly in the last two decades younger doctors and their wives, don't forget that part, prefer a broader base practice and living area. To counterbalance that to a degree the university developed with the aid of the legislature and at the direction of the legislature, developed a physicians assistant program, similarly community hospital training programs for family practice residents almost all except one affiliated with the university medical school are evolving now with two new ones in Waterloo and Sioux city being developed this year, just getting started. One of these is in Mason city which accounts for my interest in the field of medical education on a local level. It is hoped that many of these family practice resident physicians will locate in smaller towns. And so far a good proportion of the graduates of the program have done so. It's not far enough along yet to be sure but roughly 60% of them so far have stayed in smaller towns that is below 10,000 population. Statistics and studies of why doctors are where they are indicate that they're inclined to stay within 50 or 100 miles of where they finished their final training. In other words, if the resident spends the last two years in Waterloo or Sioux City or Mason city, he's apt to stay in the general area because he's gotten acquainted with it. He knows the place, the area knows him. His wife knows him and found it's a good place to stay and so a good many of them do. And this is the thesis upon which the family practice residencies throughout the community have been developed upon. A corollary of that of course is, as Dr. McGraw is working on currently in his present position, there aren't enough medical schools and medical school hospitals to train all these people at one time in one place. It has to be centralized or decentralized. At the same time affiliated for the sake of quality with the medical school. So this is developing in the state. And so far, it looks to be producing good results. Meantime until we get more doctors or more sources of medical care in smaller areas, good transportation via cars or ambulances over excellent roads make medical care relatively easily accessible to all Iowans willing to ask for it. Mr Ross has pointed out no one is really very far good medical care in the state of Iowa if he wants to seek it. However, and this is the point that has not been raised by either the speakers, Iowans will not be regimented medically. And this, you have to take into consideration. I spoke a minute ago about the fact that doctors wives won't be regimented, much less, the patients in general. And this is true. If they want medical care for even minor illnesses or worries at a secondary center instead of a primary center, they demand it and they go get it. If they want to go through a clinic as a status symbol or to satisfy themselves a basis of reassurance they demand it and they get it. In North Iowa, for instance, for many years even though it is very fashionable for people to go through the clinic, at Mayo clinic in Southern Minnesota, which is an excellent institution. But the point I'm making is that you cannot devise the system and force people to go to it. They want to go to it they have to go to it and the field of education that Dr. McGraw mentioned don't tell me there aren't efforts that have to be made over long periods of time by the patients involved. And of course all this complicates what the HSA is attempting to do with achieving its goal because we can work out a fine plan on paper but if the patient pays no attention to it then we haven't made very much progress. Now, these public demands that I mentioned have increased the burden of doctors so much that some patients have been referred to in hospital emergency rooms all over the state. Dr McGraw mentioned this too as a change in the pattern of medical care a new class of doctor, then, the emergency room doctor has appeared who works only in the emergency room. And he works nowhere else. He has no privileges to practice medicine except in the emergency room, because this is what he wants to do. And this is the need that he filled. Now why is this the case? Some of it I'm sure is what Dr McGraw referred to as, . And I'm sure we've all been guilty of that particularly in some instances, notably, well in our hospital, for instance, until July 1st of this year all of us took turns being on call for the emergency room at night and weekends we averaged about one week out of the year for about 60 or 70 doctors on our staff. A lot 50 of them participated in the program. No one of us ever objected to getting out of bed and going seeing someone in the emergency room in the middle of the night or four o'clock in the morning when he is truly sick. But if he's a transient going through or he's had a cold for a week, or he's a waitress coming home from the nightclub at 2:30 in the morning and decides she should have a checkup as to why she's been tired for the last two weeks. This does create a little bit of a strain on the practicing physician who has to lose his sleep and then work all the next day just as though he'd slept all night. So this kind of a burden has caused some rebellion on the part of practicing physicians, sometimes of necessity because of, I used to be able to work all night and all the next day and not think anything of it but I have to confess, now I get a little tired when I do that, particularly if it's two nights in a row as happens on the weekends occasionally. So the emergency room physician isn't a doctor, he goes and works only in the emergency room. He develops the care there for the patient. And if it's something that he can take care of for the moment, start them on treatment and refer them to someone else for continuing care afterwards, fine. If he can't, he thinks they're too sick, they need to be admitted to the hospital. Then he has a list of those who will come and take care of that patient after he's been worked on. But it has been determined that he is sick enough that he needs to be in the hospital. And really this system is working out quite well so far in our area. I'm pleased with it, I know I'm getting more sleep than I did with the old system before the 1st of July. And most of the doctors in our area appreciate it very much. So the emergency room doctor really fills a need especially for the individual who seeks immediate care or night at night or on weekends at his own convenience for what may be a relatively trivial illness. Another thing that we have in our hour that is normal I think is that private, city, County hospital and volunteer ambulance services are available throughout the state. They're pretty generally available and they will help the patient get into the system if he doesn't know how to get there any other way. One of the things that we hear that is critical at the system is that the patient does know how to get in. Well now there are two ways that he can get in almost every area now. He can go to the emergency room he's in when he gets there or he can call an ambulance and he's in when the ambulance gets there. So there really isn't any excuse in my opinion for a patient not knowing how to get into the medical system, if he's really sick and needs emergency care. In short, then, I think Iowa has a pretty good medical delivery system. I would like to specify that I'm talking about medical care rather than healthcare, because as Dr. McGraw indicated, healthcare includes a whole lot of things like where you eat, what you eat, where you live, how you live and so on your economics, as low as your state of happiness and what you do to abuse or disabuse yourself. But from the standpoint of delivery of medical care I think the doctors in Iowa have worked out a pretty good medical care system and we're constantly working to improve it with the aid of the state medical society and the University of Iowa Medical School. Thank you.\r\n\r\n- Our last panelist who'll be able to represent another point of view on these issues of medical delivery system Mr. Charles R Lyndon is a hospital administrator who is the administrator of the Boone County hospital, a position that he's held now for 11 years. Mr. Lyndon received a bachelor's degree in public administration from the University of Minnesota in 1956 and a master's degree in hospital administration from the University of Iowa in 1958. He served an administration residency in the VA hospital in Iowa city and worked at St Luke's hospital in Cedar Rapids. In addition to his current position as administrator of the Boone County hospital, he is also currently on the board of directors of the Iowa foundation for medical care, and is chairman of the board of the Iowa hospital mutual insurance corporation. He is the past president of the Iowa hospital association and has also been a past member of the governor's medical emergency service advisement council. Mr. Lyndon.\r\n\r\n- Thank you. I used to think we had one heck of a delivery system 'till I saw in the paper that they delivered six of them within a minute and 20 seconds in Denmark and that's gotta be a record. If you saw that in the paper it was a scribbled about that long. A the same time in the paper that was in the paper, center page, full page add with the words, \"pleasure\", \"satisfying\", \"enjoyable\", \"magnificent\" and then in the bottom is a little corner thing that says, \"Warning, the Surgeon General has determined that cigarette smoking is dangerous to your health\". That's really what we're talking about is priorities, what's right or wrong and this is an American and a public decision we've gotta make. And as I looked at the task we had, it said, \"what's right and what's wrong with the delivery system?\" and I went at it in a very simplistic way. I thought now, there's 10 things that are right, now there's 10 things that are wrong and I've done my job. Well, it isn't that simple, as it's been pointed out. Because we're talking about a large, costly, emotional, a political system that's everybody's business because everybody that makes directly or indirectly sooner or later. However, I'm going to be simplistic for a few minutes and try to list some things that I think are right. And some things that I think are wrong if you'll recognize it, it's not black and white and we're in a gray area. What's right? American medicine, American hospitals, American healthcare are or the people involved are the best trained, provide the best care, provide the most comprehensive service and range of services and are involved in more research and more continuing education than any nation in the world. We don't have to take a back seat to anybody. And that's one thing I think that's right about it. The vast majority of men and women who are involved in the delivery system are concerned about their patients are concerned about their research and are concerned about the products that they manufacture and deliver. They are devoted to providing service when needed and they have a desire to provide high quality service.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118630#t=0.0,3814.104"}]}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631","type":"Canvas","label":{"en":["Media File 2 of 2 - 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[Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e And I think we're farsighted enough","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=0.6,2.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we can continue to do this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2.14,4.073"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think that's right for our system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=4.073,6.937"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Peer review, critical self analysis is being accomplished.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=6.937,10.887"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd like to have you, as the professionals,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=10.887,13.703"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that do serious peer review,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=13.703,15.283"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"other than the medical profession,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=15.283,16.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which has gone a long ways down the road,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=16.68,18.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it still has a long ways to go, but it's doing it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=18.56,21.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't see that being done in a heck of a lot","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=21.5,23.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of other areas, but it needs to be done.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=23.37,25.538"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that's right about the system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=25.538,27.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"peer review and self-critical analysis.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=27.4,29.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Okay, now what's wrong with it?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=30.79,33.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Under the present system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=34.04,35.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there exists little or really no incentive","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=35.34,38.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for the patient to be selected by his case.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=38.98,41.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Why?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=41.48,42.313"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"90% or more is paid by some third party.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=42.313,46.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So he doesn't put a price tag","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=46.01,47.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with a value or a service.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=47.89,49.718"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They're two different things.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=49.718,51.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's wrong.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=51.48,52.363"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another thing I think is wrong,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=54.21,55.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/25","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is the non-existence of a national health policy.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=55.5,59.375"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/26","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We've talked about it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=59.375,60.789"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We've talked about a national health policy,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=60.789,62.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but we don't have one.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=62.93,64.207"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/29","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What has it resulted in?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=65.521,66.604"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/30","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It resulted in regulation by state,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=66.604,68.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/31","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by the federal and by the law.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=68.75,71.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/32","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Regulation which has resulted in duplication,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=71.0,74.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/33","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which resulted in contradictory policies and procedures,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=74.15,76.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/34","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so much so that there are people who estimate that 25%","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=77.79,81.705"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/35","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of our healthcare dollar is necessitated or paid off","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=81.705,84.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/36","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because of these regulations, duplications,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=84.72,87.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/37","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the situations that are caused by this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=88.59,90.727"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/38","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And these are stifling situations,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=90.727,92.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/39","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they stifle initiative, they stifle creatability,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=92.59,95.779"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/40","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or creativity.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=95.779,97.496"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/41","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the reaction finally gets to be reactionary,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=97.496,100.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/42","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"defensive, and that's wrong when we have to go","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=100.27,102.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/43","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and defend our system, instead of talk the good about it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=102.67,105.993"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/44","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think it's wrong that the political and the bureaucrat","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=107.64,110.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/45","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"do not reflect the public's desire.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=110.57,113.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/46","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Or that they do not recognize that no one system will work,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=113.43,118.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/47","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that they create a single system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=120.19,122.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/48","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which they hope will be universal.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=122.14,125.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/49","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As they say, national healthcare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=125.2,126.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/50","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or universal healthcare is now the new term,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=126.76,128.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/51","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to get rid of this national healthcare term.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=128.76,130.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/52","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And what has happened,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=132.03,133.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/53","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because of this political and bureaucratic approach,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=133.52,136.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/54","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we have piecemeal legislation and laws","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=136.12,139.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/55","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which require that we're talking about budgetary medicine,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=139.88,143.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/56","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which may lead to a rationing of healthcare.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=143.5,145.847"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/57","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I don't wanna be involved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=145.847,147.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/58","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the rationing of healthcare.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=147.43,148.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/59","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's wrong when the politics,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=148.86,151.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/60","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the bureaucrat and the American public","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=151.21,154.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/61","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"do not want to recognize what priorities are.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=154.05,157.373"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/62","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One last thing, health education of the population.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=158.7,162.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/63","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We've talked about it for years.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=162.52,163.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/64","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're not doing it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=163.83,164.663"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/65","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We haven't even scratched the surface.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=164.663,167.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/66","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What we need to do is focus on health education","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=167.12,170.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/67","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"being a part of our basic school system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=170.12,172.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/68","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We ought to teach health","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=172.49,173.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/69","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"just like we teach reading, writing and arithmetic.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=173.49,176.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/70","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"These children are going to use those things all their lives","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=176.89,179.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/71","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and they're going to use their body","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=179.39,180.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/72","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and their health all their lives.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=180.44,182.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/73","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think it's too late","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=182.06,183.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/74","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for somebody my age to change and adapt.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=183.26,186.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/75","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I like to have a little drink now and then,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=186.05,188.347"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/76","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I like to eat a little too much,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=188.347,189.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/77","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and then all the things that are bad.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=189.75,192.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/78","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's probably too late","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=192.26,193.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/79","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for me to change my lifestyle, but it's not too late","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=193.18,196.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/80","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to change the lifestyle of the children.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=196.1,198.484"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/81","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And they're are the future.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=198.484,199.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/82","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We have to start teaching in our school systems,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=199.89,202.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/83","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"healthcare and what it means","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=202.77,204.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/84","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and how to do it and how to go about it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=204.81,206.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/85","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"probably in kindergarten and all the way through.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=206.64,210.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/86","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's a problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=210.46,211.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/87","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How are we going to fund this?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=211.293,212.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/88","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How's it going to be done?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=212.46,213.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/89","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How are we going to get school boards to accept it?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=213.5,215.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/90","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's wrong if we don't try to do the job that way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=215.76,219.037"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/91","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's wrong when the healthcare professional","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=220.87,223.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/92","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"doesn't get involved in health education.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=223.19,225.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/93","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"To summarize, I guess in one it's wrong.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=226.96,229.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/94","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd like to say this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=229.89,230.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/95","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think it's wrong, when there is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=230.723,234.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/96","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there are those who need help,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=234.86,236.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/97","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in fact, I know it's wrong,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=236.65,238.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/98","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when there are those who need help","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=238.58,240.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/99","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but because of regulation, because of laws,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=240.52,243.312"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/100","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because of inflexibility of those who are responsible,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=243.312,247.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/101","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that there are those that do not receive","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=248.24,249.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/102","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the care and treatment they need.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=249.88,252.504"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/103","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=252.504,253.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/104","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=253.81,254.643"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/105","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think we've had a lot of different issues","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=255.87,258.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/106","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on this problem that have been brought up today.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=258.57,261.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/107","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Before however we pursue these,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=261.05,262.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/108","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and before we allow some rebuttal and questions,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=262.71,265.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/109","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think it would be a good idea","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=265.31,266.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if we could take a little break now.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=266.61,268.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/111","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Why don't we all try to get ourselves back here,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=268.01,270.165"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/112","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"say in 10 minutes.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=270.165,272.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/113","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And then we can resume discussion on this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=272.01,274.243"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/114","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(people chattering)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=275.8,277.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/115","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Okay, now that we've had a nice break,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=277.47,279.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/116","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we'd like to return to our topic","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=279.42,281.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/117","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we'll first like to give each of the panel members","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=281.78,284.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/118","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a chance if they wish,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=284.61,285.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/119","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to rebut anything that others brought up","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=285.99,288.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/120","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or make any additional comments","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=288.15,290.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/121","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that they would like to at this point.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=290.56,293.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/122","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"First, Dr.McGraw, do you have anything to add?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=293.07,295.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/123","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Yes, I'd like to be sure I'm understood.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=295.43,299.359"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/124","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think we've got a good set of arrangements","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=299.359,304.037"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/125","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but far from perfect.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=307.67,309.677"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/126","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think our system is sufficiently systematized","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=310.56,314.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/127","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or aware of itself as a system module.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=314.94,318.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/128","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that the system understands","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=318.44,320.952"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/129","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"fundamentally what it is addressing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=320.952,322.752"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/130","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"When Mr. Ross spoke, he was speaking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=324.82,328.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/131","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from the standpoint of the whole system, the region.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=328.31,331.463"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/132","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"System of course has two elements.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=332.64,335.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/133","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It has a provider and a consumer element","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=335.18,339.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/134","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and those things have to be reconciled.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=339.15,340.577"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/135","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"To come back to my drawing over here,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=340.577,344.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/136","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we used to have a very simple system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=344.64,346.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one doctor and one patient.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=346.67,348.223"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/138","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And now it's infinitely more complex.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=349.696,353.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/139","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we have an arrangement where","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=353.51,358.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/140","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there really is no such thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=358.1,362.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/141","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as a fully independent medical practitioner anymore.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=362.13,366.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/142","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There's note even such a thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=366.09,367.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/143","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as a fully independent community hospital.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=367.91,371.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/144","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The hospitals are by their very nature","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=371.33,375.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/145","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the economic arrangements","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=375.66,378.158"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/146","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the complexity of the technology,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=378.158,379.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/147","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the scarcity of resources linked in a network,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=379.63,382.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/148","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"linked in a syncytium.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=384.288,387.161"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/149","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I'm sure that Mr. Ross could tell us","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=387.161,391.219"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/150","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about the kind of lack of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=391.219,393.302"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/151","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"understanding about that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=396.668,398.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/152","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that characterizes hospital administrators,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=398.38,401.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/153","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"board members,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=401.4,403.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/154","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"communities and medical staff.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=403.24,405.303"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/155","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We are in this, I don't mean this to come across as sharp","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=406.37,411.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/156","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and carping criticism, but I'm just again saying it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=411.28,413.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/157","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"like it is, we are doing what Marshall McLuhan described","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=413.97,417.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/158","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as walking backward into the future.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=417.91,419.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/159","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That is to say, we're looking at how things were","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=419.81,423.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/160","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and kind of acting on that premise.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=423.08,426.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/161","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now I put this, the organization of this system in terms","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=426.12,429.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/162","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of hospitals relating to one another, but it's just as true","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=429.78,432.827"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/163","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about the medical staff in its relation to the hospital","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=432.827,436.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/164","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and vice versa.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=436.26,437.093"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/165","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Duties have a sense of common purpose.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=437.95,440.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/166","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And are they addressing a community as a whole?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=440.68,445.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/167","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Do they think about what the community needs?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=445.7,448.157"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/168","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let me give you an example.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=448.157,449.287"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/169","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I don't mean to sharply contradict","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=449.287,452.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/170","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what Dr.Swansen said, but it's not universally true","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=454.01,457.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/171","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that when somebody gets to an emergency room","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=457.75,459.939"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/172","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they get in the system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=459.939,461.413"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/173","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They may, they will get in the system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=461.413,464.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/174","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"under these circumstances.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=464.64,466.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/175","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If they have a real, full blown, all out illness,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=466.06,469.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/176","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if they've got a broken leg, he'll get brought","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=469.89,472.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/177","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"into the hospital and they will get a doctor","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=472.45,476.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/178","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and they'll move on from there.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=476.32,478.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/179","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If it's something less, you know,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=478.61,480.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/180","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there is a phenomenon called easy disengagement","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=480.7,483.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/181","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where they kind of get sort of brushed off","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=483.28,486.443"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/182","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and it makes a great deal of difference.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=486.443,489.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/183","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Whether the medical staff of the hospital","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=489.97,494.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/184","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the hospital say to themselves,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=494.14,499.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/185","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"collectively, look, we got a problem, let's solve it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=499.5,503.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/186","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But whatever the medical staff in effect said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=503.52,505.768"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/187","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you know, we got all, we can do it all we got, you solve it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=505.768,510.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/188","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Under those, a lot of circumstances,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=510.22,512.905"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/189","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I wasn't suggesting that was true at all,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=512.905,515.276"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/190","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I mean, you can see, Dr.Swansen and I discussed this,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=515.276,516.893"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/191","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but there's too many places, I mean a lot of circumstances","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=518.207,520.223"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/192","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then people getting into the emergency room are,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=520.223,523.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/193","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you know, they've only got one toe in the system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=523.7,526.265"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/194","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but they're not fully in.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=526.265,527.505"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/195","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You count out any real certainty that they'll be.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=527.505,530.467"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/196","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So my concern about how we're depicting this","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=531.41,535.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/197","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is that we do, and we have indeed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=535.93,538.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/198","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"made monumental progress.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=538.85,540.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/199","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I take great pride.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=541.01,542.126"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/200","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Very few times do professions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=542.126,544.543"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/201","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who've got everything going for them, or sectors of society","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=548.23,553.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/202","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"really reform and restructure themselves.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=554.61,556.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/203","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think we've done it, under a lot of pressure.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=556.99,560.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/204","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We are doing it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=560.24,561.769"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/205","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I would think contrast what's going on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=561.769,563.458"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/206","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the health sector with what's going on,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=563.458,565.103"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/207","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"say, in the justice sector of our society.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=565.103,568.406"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/208","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Frankly, I think there's very little comparison,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=568.406,571.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/209","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but you know, I might be prejudiced.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=571.3,574.934"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/210","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But nonetheless, I think that we have not recognized","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=574.934,579.934"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/211","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the dimensions or the adaptations which must be made.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=581.992,586.409"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/212","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think it partly comes back to our training.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=588.781,591.996"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/213","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I'm a medical educator, and I'll say this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=591.996,594.083"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/214","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"When I went through medical school, I and my contemporaries","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=595.196,598.763"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/215","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"emerged with a sense of being","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=599.676,602.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/216","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"independent practitioners.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=604.6,605.923"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/217","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"God knows it was difficult,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=607.51,609.112"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/218","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we came out of that experience feeling as though","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=609.112,611.189"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/219","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we'd done it all ourselves.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=611.189,612.539"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/220","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And let's dispose to this one to one","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=613.632,615.432"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/221","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"mode of operation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=618.595,620.332"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/222","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and doing it very well,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=620.332,622.045"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/223","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but having very little understanding","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=622.045,623.752"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/224","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the new complexities that were coming in the system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=623.752,627.187"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/225","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that indeed we really did need","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=627.187,628.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/226","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to get Humpty Dumpty back together,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=628.59,631.033"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/227","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to conduct our work in that way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=632.296,633.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/228","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we saw it as an entirely optional thing,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=633.95,637.254"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/229","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"whether we went into solo practice or functioned","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=637.254,640.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/230","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in a self-consciously integrated way with other doctors,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=640.49,643.463"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/231","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"just as we saw it as an entirely optional thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=644.44,647.753"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/232","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"whether we saw ourselves as a member","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=647.753,650.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/233","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of a hospital staff or not.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=650.52,652.384"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/234","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In my time, years and years ago,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=652.384,653.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/235","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when we were doing this, we were oftentimes","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=653.72,655.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/236","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"members of several hospital staffs, if we were in the city,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=655.78,660.175"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/237","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we kind of played one off against another.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=660.175,662.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/238","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now the fact of the matter is that times have changed.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=662.67,667.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/239","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The range is being fenced.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=667.93,670.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/240","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The buffalo are gone.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=670.29,672.118"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/241","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're part of a much more organized set of arrangements,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=672.118,675.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/242","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we haven't done our business that way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=675.88,679.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/243","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I hope this doesn't come across as some kind of a,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=679.69,682.199"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/244","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you know, thumbs down on medicine.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=682.199,684.153"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/245","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Because I don't feel that way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=684.153,685.933"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/246","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We had adaptations to make.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=685.933,688.087"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/247","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think that what I've just said about physicians","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=688.087,692.388"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/248","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is true in spades also of hospitals.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=692.388,695.388"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/249","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"American community hospitals were the glory","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=697.611,700.486"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/250","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of our system of services in the last generation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=700.486,703.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/251","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as individual, independent organisms.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=703.99,706.579"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/252","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They were highly contended.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=706.579,708.087"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/253","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They remain that way, and that is what we need.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=708.087,711.187"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/254","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We need a greater awareness of the hospitals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=711.187,715.061"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/255","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of Iowa, for instance, our own need, a network","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=715.061,719.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/256","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"without a totally independent and competitive","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=719.08,722.993"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/257","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"mode of operating,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=722.993,724.493"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/258","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"serving the public in the best way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=726.014,728.931"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/259","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that's the rebuttal.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=731.955,733.015"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/260","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Okay, fine.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=733.015,734.038"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/261","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mr.Ross.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=734.038,734.871"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/262","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I have no rebuttal to make of any of our speakers,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=736.531,739.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/263","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"However, I have a couple of addendums","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=739.49,741.904"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/264","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that I would like to add.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=741.904,743.154"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/265","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think the first of these deals with","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=744.24,747.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/266","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the emergency room physician,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=750.95,753.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/267","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I won't go on too deeply into that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=753.13,755.513"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/268","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but the system must provide continuity of care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=756.56,760.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/269","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and in our urban areas,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=762.07,763.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/270","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which I am well acquainted with from prior experiences,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=763.92,767.513"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/271","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in our urban areas particularly,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=768.44,770.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/272","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when we, as a system, become increasingly reliant","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=770.16,775.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/273","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"upon that spot care that you see","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=775.1,776.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/274","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in that the emergency room.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=776.87,779.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/275","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Something tends to happen to this concept of health","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=779.19,782.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/276","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that Mr. Linden talked about.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=782.26,785.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/277","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think it's partly this concept of crash care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=785.28,789.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/278","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"episodic care, point care, any terminology","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=789.04,792.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/279","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that you want to put on it that leads towards","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=792.293,795.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/280","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a general impression that we as individuals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=795.78,799.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/281","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"totally disregard our bodies,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=800.95,802.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/282","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we abuse ourselves because","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=802.46,804.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/283","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"these physicians can make us well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=805.58,808.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/284","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"These hospitals can make us well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=808.38,810.233"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/285","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And there's always that point of contact","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=811.427,813.688"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/286","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that when my body fails, or when I'm in an accident,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=813.688,817.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/287","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there is always that point of contact that I can reach.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=817.2,820.083"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/288","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think this thing really","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=821.167,822.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/289","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"stifles our own ability to look out for our own health.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=825.07,828.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/290","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd like to say something else too.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=828.91,830.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/291","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that's regarding, what Chuck said","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=830.42,832.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/292","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about health education and our lifestyles.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=832.08,834.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/293","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I guess we all get hung up on lifestyles","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=834.93,837.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/294","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from time to time.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=837.21,838.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/295","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How much of the medicine","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=841.07,844.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/296","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that these honorable physicians delivered to us","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=844.21,847.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/297","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we could deliver ourselves","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=849.6,852.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/298","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"have we forgotten?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=852.22,853.263"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/299","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Iowa as a frontier state,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=855.9,857.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/300","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm sure, with its hardy pioneer stock,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=857.97,861.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/301","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"cured many of the ills that today's society","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=861.26,865.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/302","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"carry to the physician's office,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=865.31,867.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/303","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or to the hospital emergency room.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=867.29,869.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/304","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Not only you we ignorant about accessing the system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=871.27,874.913"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/305","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we're not teaching our young.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=876.53,878.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/306","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we haven't been for many years,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=878.69,880.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/307","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because I don't know those things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=880.24,883.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/308","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that are presymptomatic that we can do for ourselves","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=884.36,887.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/309","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"before we need the physician's care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=887.51,889.573"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/310","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It works a tremendous burden on pediatricians","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=890.69,894.623"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/311","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to see all the snotty noses in town, if you will.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=894.623,897.603"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/312","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think most pediatricians will agree","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=898.766,900.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/313","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that it works at tremendous burden upon themselves.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=900.52,903.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/314","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So let's not only talk about accessing the system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=903.99,907.59"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/315","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let's not talk only about education,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=907.59,909.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/316","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of efficient and effective use of the system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=909.91,913.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/317","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let's talk, and let's not talk about, you know","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=913.18,916.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/318","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the symptomatic pain that when we have a cardiac arrest,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=916.06,919.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/319","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because we pass out and that's gone in an instant,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=919.18,922.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/320","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"let's really educate our young people","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=922.37,925.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/321","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the era of the future about self care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=925.31,929.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/322","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as well as self-help lifestyle.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=929.32,934.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/323","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think that's my addendum to Chuck's comments.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=934.54,937.143"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/324","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Thank you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=938.305,939.821"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/325","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Dr.Swanson?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=939.821,940.738"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/326","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=942.797,943.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/327","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd like to comment on this education business","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=944.652,947.029"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/328","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a little bit, too.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=947.029,948.529"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/329","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It sounds great, and it is great, Mr.Ross,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=951.06,954.493"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/330","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it's a whole lot easier said than done.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=955.37,958.933"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/331","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(men laugh)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=958.933,960.501"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/332","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And if you spent as much time trying to do","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=960.501,963.494"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/333","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what you're talking about as I have,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=963.494,965.887"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/334","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you get pretty frustrated.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=965.887,968.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/335","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And there are lots of experiments on the record","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=968.09,971.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/336","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in which the doctor goes into the patient","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=971.21,975.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/337","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to give him instructions as to what to do","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=975.39,977.384"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/338","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when he goes home.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=977.384,979.079"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/339","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Sometimes he takes a tape recording of it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=979.079,980.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/340","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so he can play back and hear everything that's been said.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=980.78,984.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/341","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Then you wait 15 minutes,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=984.7,986.732"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/342","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and then have another doctor go in and say,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=986.732,988.737"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/343","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"did he tell you anything","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=988.737,989.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/344","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about what to do when you got home?\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=989.67,990.797"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/345","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"Well, no, he didn't tell me a thing.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=990.797,993.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/346","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So, it's not easy.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=993.47,996.913"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/347","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There's an article in the same paper this morning,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=997.81,1000.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/348","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I believe it's today's paper.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1001.7,1003.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/349","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Reading \"Ph.D and Nutrition\" at John's Hopkins, I think,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1005.99,1010.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/350","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"telling us that we ought not to just ignore fat people","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1011.07,1015.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/351","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when they come in the office,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1016.163,1016.996"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/352","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we oughta motivate them to reduce in some way.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1016.996,1019.563"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/353","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well that's a lot easier said than done, too.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1019.563,1023.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/354","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And sometimes it's impossible.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1023.12,1024.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/355","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So all of these things make this business of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1025.48,1028.965"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/356","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"education of the public very difficult.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1028.965,1031.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/357","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I recall one patient that I had","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1031.7,1033.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/358","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and used to see some years ago","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1033.92,1035.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/359","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who weighed 285 pounds.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1035.15,1038.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/360","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think there'd be argument that she was overweight,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1038.0,1041.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/361","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but when I put her on a reduction diet,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1041.45,1043.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/362","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and convinced her that this was she should should do,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1043.26,1045.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/363","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"she became psychotic.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1045.12,1046.293"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/364","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well which is worse?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1047.35,1048.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/365","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"To have a psychotic patient on your hand,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1048.44,1050.988"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/366","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or somebody's who's just fat?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1050.988,1053.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/367","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, I gave up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1053.43,1054.263"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/368","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I said, just probably a fat, psychotic patient.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1054.263,1057.271"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/369","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1057.271,1059.619"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/370","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, she's still functioning.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1059.619,1060.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/371","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"She still has a job.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1060.96,1061.793"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/372","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I never yet, since have ever said a word about reducing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1061.793,1064.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/373","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because I don't want to deal with the psychosis involved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1064.76,1067.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/374","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and she doesn't want to have it either.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1067.97,1069.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/375","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, maybe she snowed me.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1069.94,1073.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/376","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't know.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1073.7,1074.533"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/377","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But at least the less of it that she was completely","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1074.533,1077.957"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/378","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"inoperative, she couldn't work,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1077.957,1080.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/379","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"she couldn't hold her job, she couldn't handle her family,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1080.76,1083.407"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/380","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"she couldn't do a thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1083.407,1085.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/381","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I've never forgotten it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1085.51,1087.477"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/382","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So these are some of the things that are involved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1087.477,1089.793"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/383","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in patient education","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1089.793,1091.108"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/384","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that makes it a very difficult affair.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1091.108,1094.036"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/385","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't know how many people quit smoking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1094.036,1095.723"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/386","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because of all the advertisements about it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1095.723,1098.361"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/387","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I suspect, I think the market for cigarettes is gone up,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1098.361,1101.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/388","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"hasn't it, during all this, instead of lower.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1101.15,1103.511"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/389","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Certainly the market for alcohol has gone up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1103.511,1106.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/390","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So it isn't all simple.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1106.5,1109.917"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/391","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another comment I would like to make","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1110.95,1112.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/392","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in reply to some of the complexity that Dr.McGraw mentioned.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1114.524,1119.524"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/393","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You brought up the subject of full payment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1120.92,1124.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/394","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by third party payers has aggravated the problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1124.23,1126.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/395","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think there's any question","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1126.67,1128.916"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/396","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about that in the minds of hospital administrators,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1128.916,1131.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/397","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"certainly physicians and certainly Blue Cross executives.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1131.95,1135.213"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/398","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I still remember the experience of the Michigan Blue Shield","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1136.29,1140.438"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/399","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of 1949, when they announced","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1140.438,1143.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/400","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that they would pay for one chest x-ray","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1143.34,1146.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/401","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for each Blue Shield subscriber per year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1146.45,1149.183"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/402","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But there was no educational campaign with it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1150.38,1153.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/403","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about, don't have an x-ray unless you need it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1153.38,1156.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/404","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Nor did they take the doctors into the thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1156.22,1158.469"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/405","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"ahead of time, and say, don't order this x-ray","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1158.469,1160.296"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/406","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"unless there's a reason for it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1160.296,1161.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/407","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well what happened?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1161.49,1162.323"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/408","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Every Blue Shield subscriber in the state of Michigan","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1162.323,1164.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/409","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"went to his doctor and said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1164.97,1165.803"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/410","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"I am entitled to a chest x-ray,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1165.803,1167.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/411","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and by golly, I want it.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1167.68,1169.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/412","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The result was, the Blue Shield of Michigan","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1169.87,1172.726"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/413","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"went one million bucks in the red in one year's time.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1172.726,1175.083"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/414","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And they abolished that system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1176.03,1177.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/415","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And as you know, Blue Shield and Blue Cross","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1177.88,1180.694"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/416","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"have shied away from out-patient","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1180.694,1183.361"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/417","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"trifles of that sort ever since.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1184.677,1187.565"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/418","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You can't buy a Blue Shield or Blue Cross policy now","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1187.565,1189.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/419","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that pays for a chest x-ray in the office,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1189.89,1192.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/420","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"unless it's associated with an injury,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1192.33,1194.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/421","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and then you have to have a rib fracture","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1194.86,1196.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/422","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"before they'll pay for it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1196.22,1197.614"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/423","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If it's broken, they will.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1197.614,1198.447"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/424","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If it's not, then they won't.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1198.447,1199.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/425","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, this is the kind of thing that's involved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1199.49,1202.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/426","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in patient education that is not all easy,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1202.98,1206.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/427","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but the thing I'm getting to is,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1206.61,1209.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/428","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if we're going to get away from this business","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1210.32,1212.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/429","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of making medical care more expensive","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1212.53,1215.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/430","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by virtue of the","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1215.92,1216.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/431","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"third party paying the bill in full,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1219.86,1222.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/432","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"don't you think that we're really gonna have to do","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1222.49,1225.418"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/433","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is to go back","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1225.418,1226.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/434","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the idea of having a patient","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1226.26,1227.663"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/435","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"take part of it himself out of his own pocket","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1227.663,1230.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/436","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"each time he goes to the doctor,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1230.453,1232.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/437","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"each time he goes the hospital,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1232.08,1233.167"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/438","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"each time he has an operation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1233.167,1235.218"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/439","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so that he's aware, each time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1235.218,1237.649"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/440","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that if he stays an extra day in the hospital,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1237.649,1239.537"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/441","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or an extra, has this or has that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1239.537,1243.503"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/442","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that it comes out partly from his own 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patient","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1250.95,1252.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/445","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who was depressed in the hospital.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1252.74,1255.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/446","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And he did a routine physical examination on her","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1255.5,1257.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/447","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and saw nothing wrong.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1257.71,1258.543"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/448","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The psychiatrist said she was depressed,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1258.543,1261.234"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/449","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but the family were convinced","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1261.234,1262.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/450","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that this depression might be the result","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1262.6,1265.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/451","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of some organic growth.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1265.1,1267.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/452","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So they demanded the brain scan, the (indistinct),","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1267.08,1269.152"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/453","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"chest x-ray, stomach x-ray, gallbladder x-ray,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1269.152,1271.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/454","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"kidney x-ray and bowel x-ray,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1271.85,1273.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/455","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and bone scan be sure","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1273.99,1275.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/456","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there isn't a hidden malignancy someplace.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1275.16,1277.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/457","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, for those of you who don't know","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1277.49,1279.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/458","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that's about 750 bucks worth of x-rays,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1279.91,1283.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/459","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all because the family wondered if the doctor is correct","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1283.21,1286.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/460","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in saying that this patient is depressed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1286.49,1289.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/461","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because he's psychiatrically ill,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1289.57,1291.798"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/462","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or because it might be secondary to some organic growth.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1291.798,1295.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/463","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, I don't know how you're going to avoid","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1295.9,1299.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/464","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"some of these things, unless we go back to the system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1299.25,1302.909"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/465","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of insisting that the patient paid part of the fray.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1302.909,1306.123"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/466","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"No, I know, we listened to way back in the '30s","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1307.15,1309.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/467","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to long frangs by Wilbur Cohen, who's now a professor","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1309.61,1313.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/468","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of education at University of Michigan,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1313.65,1316.397"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/469","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but who was an ATW expert at that time","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1316.397,1319.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/470","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who helped write the social security law,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1319.17,1320.757"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/471","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the Medicare law, and a few other things.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1320.757,1323.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/472","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"He said to have the patient pay part of it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1323.31,1325.989"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/473","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or have him go get welfare money","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1325.989,1328.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/474","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to pay part of this was demeaning.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1328.58,1330.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/475","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And so we didn't do it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1331.37,1332.203"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/476","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We were gonna pay the bill in full","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1332.203,1333.563"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/477","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so that everybody could have mainstream medical care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1333.563,1336.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/478","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"paid in full like everybody else.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1336.93,1339.227"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/479","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The poor or the rich alike.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1339.227,1340.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/480","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But what happens?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1340.63,1341.463"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/481","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You get an over-utilization, and I don't see, really,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1341.463,1344.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/482","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"any good way to backtrack from that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1344.92,1347.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/483","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"except to make the patient partly responsible for it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1347.11,1350.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/484","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I wondered if you'll see the same thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1350.44,1352.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/485","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let me ask one more question and then I'll shut up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1352.8,1355.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/486","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This one is to Mr.Ross.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1355.01,1357.243"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/487","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Your HSA organization is made up, as you said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1358.25,1362.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/488","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of both consumers and providers,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1362.01,1363.879"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/489","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it seems to me there are an awful lot","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1363.879,1367.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/490","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of uninformed consumers in the organization","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1367.53,1371.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/491","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that either need to be informed about something,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1371.67,1374.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/492","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or else do you need a whole lot more providers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1374.23,1376.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/493","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who are informed who can tell something","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1376.24,1377.928"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/494","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about what goes on.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1377.928,1379.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/495","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"For instance, at one of the sub area meetings","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1379.43,1383.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/496","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that I heard about,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1383.1,1384.053"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/497","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one of my partners is on a sub-area board of directors,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1384.92,1387.993"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/498","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they were talking about priorities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1389.12,1391.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/499","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now the priority they were discussing was","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1391.01,1393.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/500","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"vaccination of children, for all vaccinatable diseases,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1393.67,1397.127"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/501","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"making this the number one priority for HSA","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1397.127,1399.927"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/502","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in that area.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1400.98,1402.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/503","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And they talked for an hour and a half about it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1402.23,1405.387"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/504","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, this is great.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1405.387,1406.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/505","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who's against, I'm certainly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1406.5,1408.142"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/506","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for getting the kids polio vaccine","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1408.142,1409.527"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/507","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and all this kind of thing, but finally,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1409.527,1412.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/508","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"after an hour and a half of this kind of discussion,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1412.76,1415.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/509","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one of the doctors timorously said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1415.79,1417.927"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/510","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\"Well, do you know that the legislature passed the law","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1417.927,1421.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/511","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that all this is going to be required","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1421.69,1423.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/512","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for all the kids in the state, beginning of this fall?\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1423.29,1426.187"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/513","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(laughs) Hour and a half down the drain, you see.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1427.228,1430.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/514","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"22 people sitting there, when maybe if they'd been","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1430.27,1433.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/515","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a little better informed about the situation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1433.81,1436.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/516","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"there'd been a whole lot of time saved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1436.51,1438.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/517","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the part of a lot of volunteers.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1438.03,1440.394"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/518","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So, I think your objective of getting consumers involved","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1440.394,1444.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/519","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is good, but it should be,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1444.82,1446.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/520","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think, consumers would know something","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1446.63,1448.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/521","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about what's going on.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1448.31,1449.403"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/522","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you for listening. (laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1452.07,1454.423"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/523","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Before we go, Mr.Willard,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1454.423,1455.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/524","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"do you want to respond to that (indistinct)?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1455.78,1460.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/525","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I certainly do, because","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1460.33,1462.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/526","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I hear this all the time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1463.95,1465.123"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/527","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I want to say that it's an extremely difficult problem","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1465.123,1468.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/528","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for me, and for our staff, and for our volunteer agents.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1468.8,1473.033"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/529","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There do exists in this country, and in this state of Iowa,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1477.01,1482.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/530","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"many informed consumers of healthcare.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1482.14,1485.273"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/531","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They sit with hospital boards,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1486.61,1488.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/532","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they sit with nursing home boards,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1488.44,1491.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/533","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they sit on local boards of public health,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1491.06,1493.789"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/534","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"et cetera, et cetera.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1493.789,1495.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/535","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Right, and in fact, I'm sure, that Dr.Swanson could give","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1495.29,1498.193"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/536","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a long, long list of informed consumers.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1499.493,1502.627"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/537","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, there's only one problem with that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1504.81,1507.363"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/538","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Under the law under which we operate,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1508.8,1512.091"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/539","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by their acceptance of a physician on a board of directors","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1512.091,1515.996"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/540","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with a hospital, under the rules which our agency operates,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1515.996,1520.996"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/541","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they have disqualified themselves as a consumer","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1521.889,1525.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/542","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the health system's agency board.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1525.34,1527.483"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/543","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now it's quite difficult now for us.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1529.419,1532.163"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/544","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I would hope, however,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1532.163,1534.458"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/545","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that over a period of time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1534.458,1536.871"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/546","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that if we continue to see the involvement,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1536.871,1538.773"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/547","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that if I extend this money judiciously and vigorously","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1538.773,1543.317"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/548","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to bring consumers into our system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1543.317,1546.164"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/549","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as we have done this past year,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1546.164,1548.082"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/550","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that there will be more and more and more informed consumers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1548.082,1551.713"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/551","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"across this health service area.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1551.713,1553.623"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/552","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And of course, I see that then as being my only salvation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1554.83,1559.166"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/553","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because it consumes an inordinately high","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1559.166,1561.855"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/554","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"amount of staff time and budget,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1561.855,1565.367"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/555","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for educational programs and conferences,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1565.367,1567.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/556","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to help the consumers become informed.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1567.96,1571.127"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/557","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So I plead guilty on the count that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1572.129,1574.778"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/558","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the information level on many of our consumers","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1574.778,1578.455"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/559","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is not to the level that Dr.Swanson,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1578.455,1582.131"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/560","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the medical society, or perhaps even myself","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1582.131,1584.177"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/561","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and many of our volunteers would like to have.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1584.177,1588.737"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/562","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I would also like to go on, though,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1588.737,1590.92"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/563","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to reassure Dr.Swanson and all of you","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1590.92,1593.923"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/564","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that they will not be uninformed consumers for very long,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1595.09,1598.603"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/565","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and that they will, indeed, become more efficient","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1599.98,1603.529"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/566","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in making objective decisions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1603.529,1605.827"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/567","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from analysis and data that our research and data","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1605.827,1608.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/568","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in this style can provide to.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1608.67,1611.567"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/569","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Thank you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1611.567,1612.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/570","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Mr.Swanson--","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1613.752,1614.585"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/571","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Seems like it's--","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1614.585,1615.418"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/572","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e One more addendum on,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1615.418,1617.376"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/573","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"excuse me, John.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1617.376,1618.709"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/574","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I wanted one more addendum, though,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1619.664,1621.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/575","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that, mine is very brief,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1621.1,1623.675"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/576","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"copayment is finally ending","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1623.675,1626.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/577","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the commercial health insurance field.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1626.94,1629.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/578","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You look very close to your major publications nicely,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1629.57,1632.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/579","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I have advanced copies of them,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1632.39,1634.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/580","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you'll find that Aetna Health Insurance","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1634.41,1636.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/581","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is putting on a very strong campaign to have more and more","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1636.77,1640.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/582","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of their people involved in copayment policies","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1640.43,1644.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/583","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which they contend will reduce their cost","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1644.52,1647.899"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/584","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the consumer remarkably.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1647.899,1650.149"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/585","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I was gonna say, it's kind of pick on John day,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1652.371,1654.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/586","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I don't mean to, but...","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1654.29,1655.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/587","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1655.78,1656.705"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/588","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e John's used to it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1656.705,1657.677"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/589","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I hope what you said, you really didn't mean,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1657.677,1660.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/590","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that you depend on the wisdom of Congress,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1660.48,1662.803"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/591","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs and groans)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1663.676,1664.696"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/592","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because as collective body,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1664.696,1665.529"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/593","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they scare the hell out of me.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1665.529,1666.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/594","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think it points it out when they say hospital trustees","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1668.2,1671.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/595","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who cannot serve on your board because they're","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1671.08,1673.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/596","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"considered consumers yet on a hospital board of trustees,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1673.62,1676.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/597","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"they represent the consumers and are consumers, in fact.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1676.91,1680.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/598","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So their wisdom deviated slightly","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1680.15,1682.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/599","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when they didn't allow one.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1682.39,1684.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/600","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I guess the main point is that this is","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1684.16,1687.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/601","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a political ball game that we're in","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1687.07,1689.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/602","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the decisions are made in Washington","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1689.33,1693.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/603","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by people that represent us.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1693.09,1694.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/604","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we have to communicate with them what we want.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1694.87,1697.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/605","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I don't know how you do this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1698.81,1700.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/606","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There's many ways to do this, but I think it's","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1700.53,1702.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/607","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"extremely important because the decisions they make","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1702.23,1705.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/608","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"become reality of what we have to live with","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1705.28,1707.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/609","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for the next number of years.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1707.25,1708.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/610","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So I think it's a political ball game with","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1710.89,1712.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/611","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a lot of economics in it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1712.98,1714.473"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/612","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I don't know if you can separate the two","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1714.473,1715.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/613","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at the Washington level.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1715.75,1717.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/614","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e All right, audience, it's not your chance to talk.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1719.561,1721.376"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/615","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Oh, don't I get rebuttal?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1721.376,1722.246"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/616","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1722.246,1723.947"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/617","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(woman's voice drowned out by laughter)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1723.947,1724.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/618","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Chuck, I didn't say that I would stand behind","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1724.96,1727.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/619","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all of the decisions of Congress.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1727.03,1728.511"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/620","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1728.511,1732.145"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/621","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Okay, questions from the floor.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1732.145,1733.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/622","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Yes.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1733.98,1734.813"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/623","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(woman speaking away from microphone)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1735.852,1739.667"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/624","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I'm curious (indistinct) to reply","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1739.667,1744.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/625","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that the immunization of primary schools","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1745.232,1748.565"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/626","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is appropriate plan because immunization (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1749.453,1754.033"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/627","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I think that it won't be appropriate (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1754.033,1758.623"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/628","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that there is a plan to restore (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1758.623,1763.623"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/629","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"during their first year of the primary going to school","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1763.707,1766.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/630","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1766.99,1769.847"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/631","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"rather than (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1769.847,1774.543"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/632","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I don't think the final rules","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1774.543,1777.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/633","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on that yet have come out from the Department of Health.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1777.32,1780.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/634","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I think their plan is to have all the children","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1780.81,1784.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/635","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"pretty well immunized.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1784.04,1785.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/636","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You remember the big fight","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1785.38,1787.104"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/637","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the legislature was,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1787.104,1788.803"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/638","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"sponsored by the chiropractors,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1790.56,1792.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/639","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"was that anyone who didn't want to be immunized","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1792.04,1793.717"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/640","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"should be permitted not to.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1793.717,1795.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/641","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, fortunately that didn't prevail, but if there","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1795.9,1798.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/642","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is a medical reason why you shouldn't be, that's one thing,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1798.65,1802.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/643","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or if you have certain religious convictions,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1802.12,1804.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/644","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that's another thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1804.01,1805.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/645","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Otherwise they will all be listed, I think,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1805.62,1808.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/646","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as candidates for immunization, which the medic--","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1808.14,1811.177"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/647","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(woman talking away from microphone)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1811.177,1813.014"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/648","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Primary school is pretty late to start immunization.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1813.014,1817.141"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/649","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And it really does involve (voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1817.141,1822.141"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/650","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But it's not known or sure (voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1828.562,1833.562"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/651","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Boy, that's right.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1835.168,1836.359"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/652","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Doesn't solve that problem at all.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1836.359,1837.583"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/653","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1837.583,1841.416"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/654","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Better than nothing though.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1855.324,1856.734"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/655","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I think the other angle, the one you're worrying about","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1856.734,1858.977"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/656","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"has been pretty well taken care of by the pediatricians","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1858.977,1861.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/657","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and family practitioners in Iowa","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1861.14,1863.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/658","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for quite some time.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1863.48,1864.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/659","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Please, when you're asking questions,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1867.41,1868.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/660","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"do as, the first questioner did,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1868.57,1871.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/661","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"please stand and speak as loudly as you can","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1871.24,1874.029"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/662","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"so that we can all hear.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1874.029,1875.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/663","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Other questions?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1875.2,1876.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/664","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And if you wish, please direct these","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1876.19,1878.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/665","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to specific individuals or the panel as a whole,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1878.24,1880.809"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/666","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if that's what you prefer.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1880.809,1881.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/667","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Yes.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1881.88,1882.713"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/668","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I'd like to address the panel.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1884.244,1886.501"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/669","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1886.501,1888.839"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/670","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"To discuss the problems that are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1888.839,1891.172"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/671","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1891.172,1893.313"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/672","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd like to know how we Americans make legislation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1893.313,1897.222"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/673","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1897.222,1901.055"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/674","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Are you thinking of some specific legislation?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1903.392,1907.096"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/675","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(man's voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1907.096,1911.429"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/676","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Okay, this is,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1912.502,1914.358"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/677","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on putting certain types of restrictions","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1914.358,1917.078"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/678","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"just really on revenues, is it not?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1917.078,1919.822"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/679","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Cost caps is the most predominant thing (indistinct).","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1919.822,1923.418"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/680","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well, who wants to start?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1923.418,1925.668"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/681","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I think that's a great question, because yesterday,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1926.632,1928.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/682","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was sitting out in the audience and I asked","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1928.57,1930.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/683","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the very same question\n(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1930.17,1931.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/684","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the four experts that were up here.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1931.46,1933.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/685","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Maybe you could tell the audience that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1933.37,1935.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/686","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for those who don't know, what this is.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1935.45,1936.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/687","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Okay, there is legislation or administration bill,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1936.96,1940.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/688","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a thumbnail sketch, an administration bill","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1941.366,1942.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/689","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to put a lid or a cap on hospital revenue.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1942.95,1947.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/690","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In other words, they're talking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1947.62,1949.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/691","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"about a 9% lid on the dollars of revenue","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1949.37,1952.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/692","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a hospital could have.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1952.58,1955.823"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/693","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the question, of course, comes what will this","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1956.69,1959.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/694","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to quality of care, volumes of care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1959.46,1963.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/695","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and then it comes down, they're talking","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1963.21,1964.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/696","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a lot of pass-through costs,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1964.84,1966.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/697","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"such as any wage or hour wage increases","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1966.61,1969.95"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/698","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to non-supervisory people would be passed through.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1969.95,1972.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/699","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's not part of the 9%.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1972.17,1974.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/700","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Certain other types of costs would be passed through,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1974.253,1978.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/701","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"were not affected in that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1978.02,1979.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/702","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So I think in reality,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1979.43,1980.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/703","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the 9% as was stated yesterday,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1980.58,1983.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/704","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if you pass through these things,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1983.27,1985.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/705","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as an inflation keeps at the pace of this,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1985.4,1987.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/706","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It could be a pretty livable thing,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1987.46,1989.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/707","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and would make hospitals tighten their belts in some ways,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1989.49,1992.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/708","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"look at different ways of doing things,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1992.22,1994.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/709","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and probably promote some efficiency,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1994.15,1995.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/710","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but I don't see a great change in it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1995.69,1997.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/711","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And as was mentioned yesterday, again","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1997.7,1999.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/712","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from those that knew what they were really talking about","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=1999.31,2001.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/713","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is that this is a tentative program that they're","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2001.48,2003.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/714","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"talking about as an interval period until","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2003.83,2006.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/715","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a more definitive type of approach can be, to put a lid","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2006.88,2010.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/716","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the expenditures or the total cost of healthcare.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2010.98,2015.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/717","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And billions of dollars were passed around","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2015.56,2017.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/718","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as what is being spent right now.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2017.99,2020.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/719","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So I don't know if that's answering your question,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2020.43,2022.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/720","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it's an attempt to curb the healthcare costs","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2022.65,2026.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/721","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in a budgetary way and not reflect on service or quality","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2026.55,2030.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/722","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or expansion or new technology.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2030.32,2032.523"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/723","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Would you like add, too, Steve?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2035.112,2037.416"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/724","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I think that's a good answer.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2037.416,2038.481"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/725","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I maybe talked to one small point of this.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2038.481,2041.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/726","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't really think","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2041.54,2043.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/727","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we're being pushed around by Washington.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2043.2,2046.533"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/728","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that we have it in our own hands","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2047.82,2052.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/729","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to make our local systems work.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2053.14,2054.817"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/730","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And the biggest problem is one","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2055.984,2057.728"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/731","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of comprehension, it's not one of villains.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2057.728,2062.556"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/732","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's not the medical profession,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2062.556,2064.233"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/733","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it's narrow-minded and reluctant.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2064.233,2068.517"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/734","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's not a group of hospitals' invested interests.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2069.795,2073.043"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/735","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's that the problems really are complicated,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2073.043,2075.745"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/736","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and at the time you've got a lot of other complicated things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2075.745,2078.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/737","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to deal with as a society.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2078.34,2080.641"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/738","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2080.641,2081.474"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/739","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I have great optimism that we're moving along pretty well.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2084.071,2088.117"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/740","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I just like to say, let's not muddy the waters","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2088.117,2091.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/741","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by saying those guys are louts made up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2091.66,2095.553"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/742","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I mean, there's a little help in after.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2095.553,2098.335"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/743","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's not the real problem.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2098.335,2101.408"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/744","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I'd like to speak in opposition to the cost caps.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2101.408,2105.475"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/745","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Standing from where I am, being a leader of provider,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2105.475,2108.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/746","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or I guess, a consumer eater in this middle ground","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2108.33,2111.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/747","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that I get from both sides.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2111.43,2113.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/748","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'd like to speak in the opposition of the cost caps,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2113.16,2116.863"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/749","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"variously.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2117.99,2118.823"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/750","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"First of all, I think that they'll tend to","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2121.36,2123.537"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/751","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"create a floor.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2123.537,2124.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/752","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think every hospital administrator in the United States","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2124.37,2126.951"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/753","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"will try to expand his budget","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2126.951,2129.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/754","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the full 9% plus all of the pass-throughs","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2129.68,2131.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/755","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that he can put on","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2132.68,2133.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/756","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to his next year's budget.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2135.44,2136.987"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/757","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think, too, that to control a single percentage figure","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2137.98,2142.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/758","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"out of Washington will allow for","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2142.01,2145.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/759","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all of the inefficiencies of all of the states","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2145.3,2148.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/760","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that have inefficiencies to keep going that much further,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2148.71,2152.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/761","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then what the devil will it do for Iowa,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2152.38,2155.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/762","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where we might build some efficiencies into the system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2155.42,2158.173"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/763","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There are no incentives along with it other than","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2159.168,2161.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/764","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to create a floor.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2161.89,2162.823"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/765","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, cost cap, to be administered","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2163.924,2167.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/766","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the way that they are proposed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2167.13,2169.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/767","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by the current administration are utterly ridiculous.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2169.49,2173.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/768","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think would be unacceptable","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2173.23,2175.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/769","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to the public, not the provider.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2175.34,2178.093"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/770","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think that they could be unacceptable","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2178.95,2180.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/771","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for two or three reasons.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2180.49,2182.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/772","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think I've outlined the most important ones too.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2182.37,2185.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/773","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But finally, they're going to lead away from local autonomy.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2186.03,2191.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/774","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They're going to lead to a blanket,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2191.04,2192.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/775","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a commonness of mediocrity, if you will,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2192.8,2195.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/776","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"throughout the healthcare industry","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2195.38,2197.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/777","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all across the United States,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2197.82,2199.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/778","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we in Iowa will have to accept that mediocrity.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2199.55,2202.473"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/779","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Why?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2204.06,2205.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/780","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We can take it into your own hands.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2205.21,2206.387"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/781","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Jim, I mean, we got it right now, just decide.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2206.387,2209.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/782","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You're going to pay that 9% for whatever goes along with it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2209.98,2213.644"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/783","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You got it in your own hands to make these decisions.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2213.644,2217.625"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/784","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think, you know, we've met the enemy and they are us.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2217.625,2222.208"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/785","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I guess if we go along with it, we probably are.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2223.35,2225.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/786","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2225.65,2227.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/787","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I'm not so sure that that's correct, doctor.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2227.79,2230.377"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/788","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In the first place, it doesn't take into consideration","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2231.96,2234.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/789","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for inflation.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2234.22,2235.87"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/790","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Suppose your food bill goes up 10%,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2235.87,2238.272"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/791","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and you're limited to 9%.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2238.272,2239.542"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/792","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Are you gonna just put a little less food","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2239.542,2240.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/793","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on these patients' trays?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2240.82,2242.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/794","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Suppose your other costs go up,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2242.72,2244.323"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/795","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"equipment costs go up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2245.74,2246.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/796","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Suppose the in the hospital who's already budgeted his 9%,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2246.85,2250.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/797","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"he has a major breakdown.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2250.88,2252.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/798","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"A boiler goes kaput, or a x-ray machine has to be replaced","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2252.12,2256.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/799","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or something, and you can't spend any money?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2256.36,2258.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/800","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It seems to me that it's an un-workable solution","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2259.66,2262.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/801","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and really won't hold water in the long run.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2264.22,2266.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/802","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I doubt seriously that many hospitals,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2266.74,2269.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/803","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if they can get away with it are going to hold still for it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2269.66,2273.186"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/804","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Does that answer your question?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2273.186,2274.655"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/805","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(man murmuring)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2274.655,2276.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/806","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well, now look.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2276.4,2277.727"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/807","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Is there, as things now stand,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2282.289,2286.203"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/808","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"any awareness in Mason City, you have a hospital","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2289.257,2294.257"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/809","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of a hundred and--","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2294.946,2296.225"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/810","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e 312 beds.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2296.225,2297.142"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/811","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Is there any awareness that the cost containment","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2298.727,2303.727"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/812","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in that hospital is a matter of concern,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2304.29,2309.138"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/813","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in autonomy or whatever else?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2309.138,2311.555"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/814","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Because it is.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2313.781,2314.948"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/815","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This state, the cost of Blue Cross and Blue Shield","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2316.31,2319.481"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/816","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in each state are a state concern.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2319.481,2321.816"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/817","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Their rates are made on a state-wide basis.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2321.816,2325.365"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/818","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And if you've got an extravagant hospital in boon,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2325.365,2329.532"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/819","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you should pardon the expression,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2333.441,2335.841"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/820","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"why, that's of concern to the other people that are","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2335.841,2340.722"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/821","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"bearing this on.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2340.722,2342.667"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/822","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I think you have your own mind to make of it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2342.667,2346.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/823","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't make it simple,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2348.304,2350.839"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/824","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but, you know, as Charles said,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2350.839,2352.376"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/825","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I see a bright future for complexity.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2352.376,2354.661"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/826","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2354.661,2357.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/827","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I really don't think the legislation is going to pass,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2357.03,2360.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/828","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or if it does, it'll be a major modification of it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2360.62,2362.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/829","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because there's a lot of other bills that are in the hopper","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2362.99,2364.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/830","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that may change it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2364.96,2366.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/831","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I guess that 9%, if that's a cap they put on,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2366.51,2370.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/832","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"next year it could be eight, seven, six, five.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2370.72,2373.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/833","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think we've seen so much","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2373.34,2375.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/834","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the regulation change the intent of the legislation,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2375.47,2379.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/835","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and twist it around so that where we start getting leery","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2379.26,2382.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/836","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of legislation that sets certain factors or controls,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2382.67,2386.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/837","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"not knowing what they'll be two, three years from now.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2386.72,2389.747"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/838","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well, I'm gonna say one thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2389.747,2391.297"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/839","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am too very optimistic.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2391.297,2393.284"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/840","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think these problems","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2393.284,2394.427"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/841","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"require much more local initiative and fine-tuning.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2394.427,2398.926"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/842","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But mind you, the legislation in its caucus","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2398.926,2402.509"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/843","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is a matter, really so of desperation.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2404.958,2408.125"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/844","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And it reflects the failure to deal with the problem","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2412.535,2415.437"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/845","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on a local basis.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2415.437,2416.595"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/846","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm not that sure that talking about it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2416.595,2419.182"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/847","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"isn't already having some cerebrious effects.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2419.182,2422.517"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/848","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm sure that it isn't really,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2422.517,2425.367"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/849","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"making all us board members, administrators,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2425.367,2429.164"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/850","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"physicians, community, citizens of the community,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2429.164,2432.843"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/851","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"think about what we want.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2432.843,2435.414"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/852","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We had a free ride here for a generation or more.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2435.414,2438.802"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/853","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We've had a cost plus arrangement.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2438.802,2440.844"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/854","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You know, any time you got cost plus 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isn't","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2446.465,2447.798"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/857","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a heck of a lot of fast decisions.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2447.798,2450.631"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/858","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Hi, other questions.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2452.597,2453.702"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/859","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Yes.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2453.702,2454.651"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/860","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e One thing I (static drowns out 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mechanisms","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2527.783,2531.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/865","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from there","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2535.1,2535.933"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/866","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in this particular plan.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2537.587,2539.863"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/867","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There is a, I guess it's been called","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2539.863,2542.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/868","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a preoccupation in some parts of the state.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2542.38,2544.823"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/869","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There is detailed information about the supply","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2546.46,2550.032"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/870","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of beds and the supply of services available.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2550.032,2553.593"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/871","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There is not however,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2555.0,2556.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/872","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a direct addressment of the efficiencies","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2558.931,2562.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/873","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and reimbursement mechanisms.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2562.04,2564.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/874","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I'd like to go on to point out the 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system.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2570.2,2572.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/877","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Not only in the nursing homes in the state.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2572.02,2574.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/878","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, it's been said that health planning is nothing more","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2574.56,2579.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/879","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"than omnibus tinkering, and when you take","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2579.0,2582.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/880","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and try to push down the head of this monster here,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2582.45,2585.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/881","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"another one that comes to the surface somewhere else.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2585.54,2588.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/882","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think, you know, that our plan probably 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quickly.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2597.76,2600.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/885","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I won't make apologies for that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2600.05,2604.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/886","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It certainly will be addressed in the 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constraints","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2617.51,2620.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/891","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as they develop these plans.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2620.28,2621.703"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/892","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And this is by no means a comprehensive document,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2622.709,2626.353"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/893","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but the law does require us to revise every year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2628.84,2632.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/894","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, currently we put the largest 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facilities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2642.66,2644.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/899","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And most of the operators know then,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2646.07,2649.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/900","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"since that's where the most of the money is,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2649.35,2650.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/901","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that is the greatest opportunity to massage profit margins.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2650.93,2655.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/902","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If you're talking about millions of dollars","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2656.29,2658.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/903","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"versus thousands of dollars,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2658.55,2659.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/904","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"where do you want to do 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available.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2664.11,2666.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/907","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Currently, we're spending most of our money in this state","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2666.7,2669.302"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/908","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in intermediate care facilities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2669.302,2672.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/909","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's a middle level of nursing home care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2672.13,2674.303"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/910","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're spending very little money on residential 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facilities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2682.57,2684.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/913","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The payment rate, of course, for the residential care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2684.9,2688.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/914","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and Chuck, maybe somebody could backstop me","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2688.06,2691.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/915","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on my recollection of the figures.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2691.33,2693.463"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/916","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Is in the neighborhood of $12 per day for residential 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pot","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2704.0,2706.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/919","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to pay for those levels of care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2707.8,2709.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/920","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in our Department of Social 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care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2715.67,2717.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/923","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Mental retardation gets care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2717.53,2719.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/924","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"through the intermediate care facility arrangement.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2719.79,2722.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/925","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that's where the mental health people have","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2722.2,2724.32"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/926","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the largest amount of their dollars to pay.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2724.32,2727.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/927","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, I've already tried to foreshadow some","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2727.89,2731.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/928","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the complexities of the system,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2731.3,2733.407"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/929","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and why trying to give you an honest explanation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2733.407,2736.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/930","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of why within a period of 18 months,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2736.16,2738.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/931","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"this issue couldn't be dealt with in the blank,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2738.94,2741.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/932","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but I assure you, the cause of this complexity","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2741.43,2743.852"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/933","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the cause of inter-relationships","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2743.852,2746.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/934","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that are necessary for change","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2746.33,2749.06"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/935","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"will be dealt with in future plans.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2749.06,2751.107"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/936","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Dr.Swanson would like to respond to this too.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2753.21,2754.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/937","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Yeah, Professor (indistinct), the nursing home problem","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2754.44,2758.947"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/938","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the intermediate care area is complex,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2758.947,2762.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/939","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it is made complex by federal regulations.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2762.86,2766.303"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/940","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If you, maybe you do know all the 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courses","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2773.911,2776.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/943","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and take examinations, and they're licensed now.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2776.38,2779.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/944","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They have to have certain amount of 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dietician.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2787.15,2788.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/949","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They have to have a pharmacy committee.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2788.82,2790.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/950","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They have to have a medical director,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2790.44,2792.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/951","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all of which costs money,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2792.45,2793.963"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/952","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the federal government keeps writing more","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2794.817,2797.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/953","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and more regulations that increase the cost,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2797.12,2799.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/954","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and then they complain about the bill.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2799.73,2801.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/955","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If the federal government would let the right hand","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2802.73,2805.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/956","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"know what the left hand is doing on occasion,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2805.83,2808.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/957","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it would certainly help.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2808.01,2809.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/958","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If they pulled together for once instead of separately,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2809.42,2812.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/959","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it would help a great deal more.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2812.46,2814.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/960","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, I don't agree with you that these are local controls.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2814.2,2818.756"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/961","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The skilled nursing home finance mechanism, as you know,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2818.756,2822.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/962","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is mostly federal money.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2822.47,2823.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/963","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's more federal money than it is state,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2823.64,2825.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/964","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the legislature puts in what they feel 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short.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2829.33,2830.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/967","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"They had to put in an $8 million","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2830.98,2832.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/968","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"emergency appropriation to get them","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2833.8,2835.577"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/969","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"through the end of the year.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2835.577,2838.21"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/970","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So it isn't all locally controlled.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2838.21,2840.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/971","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is state and federal control.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2840.6,2842.637"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/972","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We have to meet state and federal standards,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2842.637,2844.952"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/973","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and they all cost money.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2844.952,2847.555"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/974","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And they get good care, good institutions,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2847.555,2851.03"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/975","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but another problem is we simply don't have","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2851.03,2853.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/976","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"custodial institutions in the state.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2853.27,2855.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/977","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In the state in Mason city there isn't","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2855.58,2857.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/978","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a single custodial institution.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2857.71,2859.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/979","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"To get a patient in for custodial care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2860.1,2861.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/980","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we have to send them to another town.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2861.94,2864.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/981","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, this costs money and is inconvenient for families","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2864.34,2866.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/982","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and people and patients, and it's all due basically","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2866.9,2870.99"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/983","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to federal regulations.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2870.99,2872.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/984","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So I would like to add to this complexity","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2872.15,2875.28"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/985","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that everyone is talking about, that federal regulations","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2875.28,2878.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/986","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"are responsible for a whole lot of it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2878.07,2880.343"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/987","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"much too much.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2880.343,2881.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/988","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e You wanna respond to this?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2884.616,2886.455"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/989","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/45610/file/118631#t=2886.455,2887.288"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/990","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Yes, among the cost of things,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2888.221,2890.721"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/991","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I've been trying to (voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2892.147,2895.819"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/992","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and it concerns me, and I wondered","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2895.819,2897.821"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/993","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2897.821,2901.394"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/994","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What about preventative medicine?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2901.394,2902.921"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/995","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How much does that actually run?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2902.921,2904.819"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/996","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What about hospitals, primary physicians,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2904.819,2908.236"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/997","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or out-patient care (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2909.457,2912.649"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/998","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What about increasing the technology?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2912.649,2915.731"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/999","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Is it that, or (voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2915.731,2920.731"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1000","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e All right, I guess there's several questions in there.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2935.744,2938.52"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1001","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Some of these still hinge on topics","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2938.52,2939.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1002","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we talked about yesterday too, but we'll see","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2939.91,2942.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1003","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what people would like to address these.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2942.9,2945.877"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1004","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e I just, I think you probably answered","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2947.064,2950.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1005","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a lot of your question in just,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2950.45,2952.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1006","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in what is causing the increased cost","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2952.33,2954.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1007","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in let's say, hospital care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2954.57,2956.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1008","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"'cause that's what I'm more familiar with","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2956.13,2957.774"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1009","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is combination of demands of the public","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2957.774,2960.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1010","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for more quality service, more and more service.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2960.85,2963.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1011","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Every time they see something on television that","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2963.54,2966.45"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1012","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Dr.Welby is now done","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2966.45,2968.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1013","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that becomes the standard for the nation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2968.64,2971.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1014","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and Dr.Welby, you never see sending a bill.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2971.07,2973.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1015","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You never see him in a hurry to do anything,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2973.86,2977.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1016","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"yet he can take care of everything under the sun.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2977.24,2979.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1017","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, that's not reality.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2979.25,2980.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1018","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But, the demand by the patient is he sees what he needs","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2982.76,2987.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1019","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and he has every right to demand quality care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2987.12,2989.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1020","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But the wide breadth of it sometimes costs a lot of money.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2989.26,2992.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1021","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Research costs money.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2992.79,2995.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1022","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Then we're faced with just the general inflation.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2995.02,2997.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1023","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The energy costs are just tremendously having effects","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=2997.23,3000.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1024","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on hospital costs and hospital budgets.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3000.16,3002.243"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1025","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That and wage an hour laws and as wages,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3003.6,3007.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1026","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and is as hospitals try to pay compensation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3007.0,3009.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1027","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to their employees that is equal","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3009.74,3011.5"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1028","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in compensation to what is being paid","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3011.5,3013.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1029","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the local community.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3013.13,3014.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1030","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Our employees deserve just as much compensation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3014.36,3018.085"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1031","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as those that are in other lines of endeavor.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3018.085,3022.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1032","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As we face this kind of a problem, the costs are going up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3022.25,3026.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1033","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So there is no one single thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3026.09,3027.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1034","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's a combination, as I see it, of everything going on,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3027.69,3031.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1035","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"plus the regulation","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3031.16,3032.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1036","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the laws that require additional people","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3032.65,3035.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1037","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and new standards and higher standards of care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3035.76,3038.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1038","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all cost money.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3038.01,3038.843"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1039","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So it's a combination of that kind of a thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3038.843,3041.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1040","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in my job.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3041.11,3041.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1041","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think a number of things can be attempted","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3042.86,3046.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1042","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to be done about it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3046.3,3047.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1043","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is to eliminate duplication wherever possible.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3047.34,3050.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1044","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we've hear a lot about this duplication","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3050.82,3052.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1045","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of \"not every hospital can be everything to everybody.\"","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3052.7,3056.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1046","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And this is part of Dr.McGraw's that there has to be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3056.67,3058.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1047","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a network and a flow of patients through the system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3058.73,3063.16"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1048","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and an allocation of special facilities","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3063.16,3065.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1049","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the CAT scanner, I guess, is the ideal one.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3065.91,3067.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1050","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"How many CAT scanners does Iowa needs?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3067.85,3069.93"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1051","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So I think we have to,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3069.93,3071.33"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1052","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as institutions work together in organizing a system","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3071.33,3075.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1053","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of delivery that eliminates duplication","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3075.66,3078.05"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1054","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and unnecessary care and treatment.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3078.05,3079.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1055","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think we can educate the public to make better","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3083.04,3085.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1056","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"use of the facilities.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3085.54,3086.82"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1057","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And it was talked about the emergency room at three o'clock","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3086.82,3089.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1058","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the morning, the person coming in with a cold,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3089.81,3092.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1059","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"well really that should be seen in the office or","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3092.14,3094.15"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1060","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"during daytime hours and not have to staff certain things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3094.15,3097.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1061","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at night to cover this kind of thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3097.6,3098.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1062","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So it's an education of the public","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3098.86,3100.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1063","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to know what it is costing them.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3100.67,3102.27"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1064","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I guess I get back, you know, we hear that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3104.52,3106.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1065","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"it costs, somebody quoted and I think it's a misquote,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3106.69,3109.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1066","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but it costs more for the healthcare of General Motors","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3109.02,3111.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1067","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"than the steel in their car.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3111.08,3112.6"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1068","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think that has any comparative anything.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3112.6,3114.57"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1069","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So what it?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3114.57,3115.403"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1070","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It costs more for the healthcare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3115.403,3117.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1071","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"than the amount of aluminum in a Maytag washer.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3117.1,3119.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1072","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's not a relative thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3119.55,3121.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1073","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The priority of what we're going to spend on healthcare","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3121.56,3124.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1074","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is what's really up to the American public,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3124.61,3127.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1075","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and 8.3% of the gross national product","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3127.86,3131.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1076","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"now spent on healthcare.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3131.24,3132.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1077","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't know, maybe it ought to be 10%,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3132.54,3134.583"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1078","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but how do we control it?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3135.65,3136.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1079","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I can't answer you except that we,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3136.96,3138.41"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1080","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"as individuals, must try to control our own costs","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3138.41,3140.977"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1081","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and our own inputs and what we do.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3140.977,3143.13"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1082","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I want to differ a little bit with you.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3143.13,3145.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1083","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You said that a cap would automatically make","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3145.67,3147.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1084","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"all hospital increases in administrators,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3147.64,3150.31"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1085","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"come up to the level.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3150.31,3152.04"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1086","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think we've got to recognize that we have","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3152.04,3153.75"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1087","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a board of trustees","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3153.75,3155.71"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1088","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who we have to be accountable to, and the public.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3155.71,3158.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1089","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And it is administration and these trustees","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3158.81,3161.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1090","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that have to look at the overall cost","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3161.85,3163.23"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1091","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and try to hold them down,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3163.23,3164.1"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1092","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which is extremely difficult.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3164.1,3165.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1093","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now I've gone a long ways around telling you,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3165.49,3167.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1094","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I really don't know (laughs) the answer to your question,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3167.8,3170.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1095","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but I know we have to look at it in different ways","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3170.68,3173.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1096","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and different controls.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3173.09,3174.403"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1097","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well in a way, you asked a very profound question,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3177.355,3180.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1098","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and when people say that, they may as well have an answer.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3181.827,3182.957"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1099","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(audience laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3185.103,3186.144"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1100","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I do think that the,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3186.144,3187.193"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1101","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we may well have, sort of, let the wind","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3189.791,3193.023"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1102","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"out of the bag, as Ulysses did, you know,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3194.347,3196.905"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1103","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when we kind of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3196.905,3198.155"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1104","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"move in all these multiple way solves our problem,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3200.736,3205.053"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1105","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we set a lot of things in motion.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3205.053,3207.778"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1106","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And at the same time we did that, we were circumventing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3207.778,3212.501"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1107","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for good and benign reasons,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3212.501,3214.432"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1108","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we were circumventing some of the means of rationing control","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3214.432,3217.744"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1109","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for all the good of that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3217.744,3219.571"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I agree with Dr.Swanson.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3219.571,3220.827"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1111","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think we've got to get some costs awareness","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3220.827,3224.577"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1112","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and rationing back, it's just, I don't know","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3226.277,3228.918"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1113","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"whether that'll do it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3228.918,3231.183"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1114","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I guess that's, you know,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3231.183,3232.637"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1115","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if we were gonna go back as characters,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3232.637,3234.233"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1116","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we'd chop that out and see if it really did it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3234.233,3237.118"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1117","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Before we move very fast, we better, kind of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3237.118,3240.077"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1118","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"tinker with the system a bit and see how it works.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3240.077,3242.485"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1119","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But it makes good sense to me,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3242.485,3244.098"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1120","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I've been in this game for a long time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3244.098,3246.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1121","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that doctors and patients and families,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3246.26,3249.51"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1122","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"everybody'll think a little differently about this","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3251.514,3253.919"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1123","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if there's a very eager awareness of cost.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3253.919,3257.419"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1124","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think we have a very simple situation, do we?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3258.69,3263.042"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1125","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You know, just think about the business of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3263.042,3266.343"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1126","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"dialysis and chronic renal disease.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3266.343,3269.759"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1127","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now, those physicians of my age remember","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3269.759,3272.482"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1128","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when chronic renal disease was","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3272.482,3275.674"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1129","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"something you kind of shrugged your shoulders about.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3275.674,3278.495"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1130","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"People were gonna die.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3278.495,3280.126"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1131","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now we don't do that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3280.126,3281.453"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1132","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We spend $25,000 a year to keep these people alive.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3281.453,3285.271"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1133","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And quality of life is not all that shot.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3285.271,3288.963"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1134","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And, you know, this whole question","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3288.963,3291.796"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1135","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of who shall live and who shall die is (indistinct),","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3293.272,3298.272"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1136","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and not really very easy solution.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3298.306,3301.139"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think that these things get right to the heart","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3303.016,3306.331"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1138","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the way we live, and the inequities in our society.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3306.331,3310.831"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1139","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Because we're talking here about,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3312.083,3314.833"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1140","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you know, there's no question.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3316.367,3318.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1141","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If I'm John Rockefeller,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3318.01,3320.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1142","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or John Kennedy or whatnot, I'm gonna have","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3322.625,3324.893"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1143","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"more than a million dollar care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3324.893,3327.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1144","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If I'm somebody who was less advantaged in our society,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3329.349,3334.349"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1145","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"am I gonna have the same care?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3335.346,3337.846"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1146","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You answer.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3340.899,3341.732"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1147","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e If you have Blue Cross or Medicaid you do.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3341.732,3344.017"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1148","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That's the way the system--","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3344.945,3345.968"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1149","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e If you can still afford it.\n(man laughs)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3345.968,3347.042"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1150","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e That's the way the system words in Iowa.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3347.042,3348.83"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1151","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I think she deserves an answer","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3348.83,3350.91"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1152","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"on the business of increasing technology and the cost of it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3350.91,3354.253"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1153","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I'm sure this plays a tremendous part.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3355.78,3357.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1154","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"For instance, the whole subject of","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3357.88,3360.96"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1155","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"intensive care started, you know, with coronary care units.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3360.96,3363.76"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1156","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This goes back only to 1962.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3363.76,3365.88"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1157","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We've had one, the first one was developed","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3365.88,3368.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1158","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in Kansas City, Missouri, in 1962.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3368.09,3371.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1159","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We had one in Mason City since '67,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3371.09,3373.483"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1160","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and about two years after that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3374.41,3375.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1161","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we started a general intensive care area","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3375.86,3378.114"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1162","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and now has eight, six beds in it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3378.114,3381.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1163","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We have nine beds in the coronary care unit","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3381.69,3383.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1164","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and frequently all of them are full.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3383.66,3385.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1165","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is a tremendous expense that wasn't there before","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3385.37,3388.86"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1166","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because we can do all kinds of things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3388.86,3390.383"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1167","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we weren't able to do before.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3390.383,3392.09"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1168","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In intensive care alone, you've all heard about respirators,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3392.09,3395.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1169","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the New Jersey case,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3395.34,3397.466"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1170","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the girl who appears now was on a respirator","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3397.466,3400.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1171","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for a year when they could have turned it off before,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3400.94,3402.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1172","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"nothing happened because she's still alive,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3402.68,3404.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1173","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"she's still breathing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3404.58,3405.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1174","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Well, how do you know on things of this sort?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3405.97,3410.02"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1175","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But the increased technology, all of which costs money,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3410.02,3412.66"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1176","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"will do an awful lot of things.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3412.66,3413.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1177","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We now measure blood gases in the, in the patient","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3413.78,3416.69"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1178","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"who was in intensive care","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3416.69,3417.523"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1179","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"with some kind of respiratory difficulty.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3417.523,3419.47"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1180","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We may do it, we may have to do it almost every hour","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3419.47,3423.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1181","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if it's a critical case.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3423.17,3424.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1182","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We may have to measure blood electrolytes,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3424.79,3426.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1183","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we check sodium and potassium and nitrogen,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3426.79,3430.12"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1184","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and so on, and sugar.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3430.12,3431.393"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1185","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're using pulmonary function tests at the same time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3432.745,3437.745"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1186","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we have other chemistry, blood counts","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3437.95,3439.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1187","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and all this sort of thing.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3439.84,3441.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1188","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And it does add up to a tremendous amount of expense.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3441.39,3446.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1189","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now this is all progress because we're saving lives now","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3446.86,3449.333"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1190","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we didn't save before.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3449.333,3451.38"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1191","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We're spending a lot of money doing it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3451.38,3453.46"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1192","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I don't think the doctors really want to be","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3453.46,3455.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1193","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the position of deciding","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3455.67,3457.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1194","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which life they're going to save.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3457.07,3459.01"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1195","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We go into the picture now of trying to save all the lives","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3459.01,3462.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1196","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we can, within reason.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3462.22,3464.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1197","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If we get to the point, as was mentioned here","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3464.7,3466.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1198","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a little bit ago, of rationing medical care,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3466.73,3469.14"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1199","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"then this is going to have to be something","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3469.14,3470.94"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1200","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that society gets involved in,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3470.94,3472.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1201","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"not this doctors alone, because very few doctors really","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3472.55,3475.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1202","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"want to play God on something of that sort.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3475.36,3478.24"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1203","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We'll keep people going within reason as long as we can.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3478.24,3480.9"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1204","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't see any sense in simply prolonging","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3480.9,3482.982"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1205","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a comatose life just for the sake of prolonging it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3482.982,3487.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1206","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't agree with that at all.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3487.19,3489.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1207","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I've seen people unconscious on respirators,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3489.29,3492.576"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1208","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"from drug overdosage for instance, as long as five days","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3492.576,3496.61"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1209","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and come out of it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3496.61,3497.443"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1210","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Now years ago, there was no way they would have","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3497.443,3499.53"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1211","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"lived through that.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3499.53,3501.22"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1212","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But this takes money.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3501.22,3502.07"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1213","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This has all kinds of expense.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3502.07,3504.26"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1214","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And this is one of the things","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3504.26,3505.759"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1215","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that's increased the cost of medical care.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3505.759,3507.3"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1216","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I don't think at this point, we're ready to give it up.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3507.3,3510.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1217","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think we've got to figure out some way to pay for it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3510.18,3512.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1218","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Is it all progress though?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3512.48,3514.668"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1219","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"As you said, you know,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3514.668,3515.73"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1220","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the fact is the position of being able","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3515.73,3518.17"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1221","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to turn on a faucet, from which emerges","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3518.17,3521.468"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1222","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a golden stream.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3521.468,3522.801"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1223","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And you know, I can walk off and leave that faucet running,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3523.768,3526.295"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1224","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"whether it's a respirator,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3526.295,3528.124"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1225","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or it's renal dialysis, or whatnot.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3528.124,3531.689"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1226","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And I think","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3531.689,3532.606"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1227","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you may disagree with me if this is a ration,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3536.26,3539.692"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1228","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but I think we have a trust here,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3539.692,3542.442"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1229","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"a public trust to utilize these resources","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3543.953,3546.767"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1230","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"very, very carefully.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3546.767,3548.573"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1231","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we are asked to make regiments about","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3548.573,3550.178"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1232","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"one of those golden streams,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3550.178,3552.48"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1233","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"which is days in the hospital.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3552.48,3554.737"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1234","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We make those judgements in terms of hospital utilization,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3554.737,3557.962"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1235","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"peer reviews, and so forth.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3557.962,3559.474"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1236","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"That branch, and we're expected to make that,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3559.474,3563.224"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1237","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because it's in our professional sphere of expertise.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3564.785,3569.202"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1238","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We may not want to think of ourselves as gods,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3570.833,3572.807"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1239","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"but when we send somebody home,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3572.807,3575.39"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1240","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you know, on the basis of some judgment at that time,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3577.466,3582.186"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1241","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3582.186,3584.7"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1242","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It's quite possible to send somebody home post-operative","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3584.7,3588.807"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1243","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and have them suicide, for example.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3588.807,3590.56"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1244","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3590.56,3592.977"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1245","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I don't think we can be so purist about it,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3595.21,3598.123"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1246","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and say, hey you aren't involved in that decision.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3598.123,3602.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1247","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think they have to be made in our domain","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3603.407,3606.326"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1248","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and in the public domain surely.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3606.326,3608.663"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1249","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But we're in public domain.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3608.663,3610.913"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1250","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e That's one of the difficulties with solely the cost,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3613.302,3615.845"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1251","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and I'd like to make a comment here.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3615.845,3618.223"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1252","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that is that medical service delivery","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3618.223,3621.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1253","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is just about the most elastic thing","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3622.58,3626.35"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1254","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that we've ever experienced in our society.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3626.35,3628.803"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1255","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Stop and think about it, you know.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3630.849,3631.78"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1256","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Go back to eat from McDonald's","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3633.02,3634.44"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1257","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"the first time the body was cut open,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3634.44,3636.74"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1258","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you know, we go back and now then we go","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3636.74,3638.607"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1259","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and we pass the body through an x-ray machine","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3638.607,3640.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1260","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and the computer tells us what the hell's with it.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3640.77,3644.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1261","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Medical services delivery,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3644.84,3647.55"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1262","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"maybe we're talking about healthcare,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3647.55,3649.943"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1263","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is just so elastic and the opportunity to make it","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3649.943,3654.19"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1264","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"even so much more elastic in the future is so broad.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3654.19,3657.49"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1265","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Before I tell you how much new technology we'll have","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3657.49,3660.81"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1266","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"to absorb into the healthcare industry in the next 10 years,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3660.81,3663.97"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1267","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let me point out that if one half of 1%","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3663.97,3668.62"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1268","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of that new technology was absorbed by all Iowa hospitals","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3668.62,3673.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1269","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"over the next 10 years,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3673.43,3675.29"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1270","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"our hospital care bills would go up $5 million worth,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3675.29,3678.243"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1271","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because there's $50 billion worth of technology,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3680.91,3685.18"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1272","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"not on the drawing boards,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3685.18,3687.4"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1273","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"not in somebody's mind, but nearing completion of production","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3687.4,3690.85"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1274","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"just like CAT scanners.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3690.85,3692.405"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1275","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"$50 billion worth of new technology","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3692.405,3695.68"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1276","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that will have to be absorbed in the next 10 years","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3695.68,3698.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1277","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or the guys who invented it are gonna lose their dollars","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3698.63,3702.728"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1278","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that they have in their investment.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3702.728,3705.587"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1279","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Who should control how fast we absorb it in Iowa?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3705.587,3710.413"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1280","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You should.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3711.59,3712.423"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1281","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What vehicle do you have for controlling","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3713.7,3716.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1282","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"how fast we absorb it in Iowa?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3716.11,3717.853"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1283","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I go back to my opening remarks.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3719.19,3721.25"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1284","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The health systems agencies.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3721.25,3722.65"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1285","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Support us.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3725.44,3726.64"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1286","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Yes, sir.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3726.64,3727.473"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1287","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(man drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3728.873,3732.54"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1288","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e You are aware of the services available","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3734.919,3738.597"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1289","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"(voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3738.597,3742.43"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1290","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the medical systems (indistinct)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3743.698,3748.698"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1291","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So what I'd like to say, (voice drowned out by static)","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3766.618,3771.618"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1292","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Okay, who wants to try advertising?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3801.468,3803.657"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1293","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003e -:\u003c/strong\u003e Well, I believe at the present time","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3803.657,3805.89"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1294","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"of the health dollar spent,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3805.89,3807.563"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1295","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"not going over-the-counter medications","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3808.44,3810.37"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1296","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and TV advertised things,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3810.37,3813.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1297","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"that the physicians got around 17%, is that correct?","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3813.2,3816.84"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1298","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think, of the total health dollar.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3816.84,3819.67"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1299","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"So if you took all the money away from all the doctors","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3819.67,3822.2"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1300","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and had all work for nothing, you'd save only 17%.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3822.2,3825.98"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1301","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I really don't see how advertising back and forth","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3825.98,3828.72"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1302","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"is really going to save anything very much.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3828.72,3831.34"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1303","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Our worry on advertising and it's not prohibited","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3831.34,3835.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1304","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"by our medical society or by the AMA,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3835.63,3837.337"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1305","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"you can advertise if you want to.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3837.337,3840.029"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1306","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we do.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3840.029,3840.862"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1307","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"If you look in the phone book, we have listings","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3840.862,3842.79"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1308","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"for our various specialties and our offices.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3842.79,3845.295"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1309","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We have announcement cards if we move,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3845.295,3847.63"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1310","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or we add a new partner,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3847.63,3848.8"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1311","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"or if we have a new service or something of the sort.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3848.8,3852.0"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1312","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We don't advertise fees necessarily,","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3852.0,3855.42"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1313","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"although our medical society has always","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3855.42,3858.36"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1314","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"encouraged doctors to discuss fees with patients","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3858.36,3860.77"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1315","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"if they want to ask any time.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3860.77,3862.233"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1316","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You may remember during the Nixon administration","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3864.306,3866.649"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1317","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"when there was price control","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3866.649,3867.58"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1318","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"we had to post fees in the office.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3867.58,3870.692"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1319","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It had to be written and plugged on the wall someplace.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3870.692,3873.442"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1320","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And that didn't make any particular difference","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3875.067,3877.08"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1321","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"in the fee schedule arrangement.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3877.08,3879.11"},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1322","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The thing that we worry about from advertising.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=3879.11,3881.263"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116","type":"AnnotationPage","label":{"en":["English [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30116/annotation/1323","type":"Annotation","motivation":"subtitling","body":{"type":"TextualBody","value":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/116/original/AV167973_Whats_Right_and_What_s_Wrong_with_the_Delivery_System_b.vtt?1624899293","format":"text/vtt","language":"en"},"target":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/030/116/original/AV167973_Whats_Right_and_What_s_Wrong_with_the_Delivery_System_b.vtt?1624899293"}]},{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30117","type":"AnnotationPage","label":{"en":["AV167973_Whats_Right_and_What_s_Wrong_with_the_Delivery_System_b.txt [Transcript]"]},"items":[{"id":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631/transcript/30117/annotation/1324","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"- And I think we're farsighted enough that we can continue to do this. And I think that's right for our system. Peer review, critical self analysis is being accomplished. I'd like to have you, as the professionals, that do serious peer review, other than the medical profession, which has gone a long ways down the road, it still has a long ways to go, but it's doing it. I don't see that being done in a heck of a lot of other areas, but it needs to be done. I think that's right about the system, peer review and self-critical analysis. Okay, now what's wrong with it? Under the present system, there exists little or really no incentive for the patient to be selected by his case. Why? 90% or more is paid by some third party. So he doesn't put a price tag with a value or a service. They're two different things. That's wrong. Another thing I think is wrong, is the non-existence of a national health policy. We've talked about it. We've talked about a national health policy, but we don't have one. What has it resulted in? It resulted in regulation by state, by the federal and by the law. Regulation which has resulted in duplication, which resulted in contradictory policies and procedures, so much so that there are people who estimate that 25% of our healthcare dollar is necessitated or paid off because of these regulations, duplications, the situations that are caused by this. And these are stifling situations, they stifle initiative, they stifle creatability, or creativity. And the reaction finally gets to be reactionary, defensive, and that's wrong when we have to go and defend our system, instead of talk the good about it. I think it's wrong that the political and the bureaucrat do not reflect the public's desire. Or that they do not recognize that no one system will work, and that they create a single system which they hope will be universal. As they say, national healthcare or universal healthcare is now the new term, to get rid of this national healthcare term. And what has happened, because of this political and bureaucratic approach, we have piecemeal legislation and laws which require that we're talking about budgetary medicine, which may lead to a rationing of healthcare. And I don't wanna be involved in the rationing of healthcare. It's wrong when the politics, the bureaucrat and the American public do not want to recognize what priorities are. One last thing, health education of the population. We've talked about it for years. We're not doing it. We haven't even scratched the surface. What we need to do is focus on health education being a part of our basic school system. We ought to teach health just like we teach reading, writing and arithmetic. These children are going to use those things all their lives and they're going to use their body and their health all their lives. I think it's too late for somebody my age to change and adapt. I like to have a little drink now and then, and I like to eat a little too much, and then all the things that are bad. It's probably too late for me to change my lifestyle, but it's not too late to change the lifestyle of the children. And they're are the future. We have to start teaching in our school systems, healthcare and what it means and how to do it and how to go about it, probably in kindergarten and all the way through. That's a problem. How are we going to fund this? How's it going to be done? How are we going to get school boards to accept it? It's wrong if we don't try to do the job that way. It's wrong when the healthcare professional doesn't get involved in health education. To summarize, I guess in one it's wrong. I'd like to say this. I think it's wrong, when there is there are those who need help, in fact, I know it's wrong, when there are those who need help but because of regulation, because of laws, because of inflexibility of those who are responsible, that there are those that do not receive the care and treatment they need. Thank you.\r\n\r\n- Thank you. I think we've had a lot of different issues on this problem that have been brought up today. Before however we pursue these, and before we allow some rebuttal and questions, I think it would be a good idea if we could take a little break now. Why don't we all try to get ourselves back here, say in 10 minutes. And then we can resume discussion on this. Okay, now that we've had a nice break, we'd like to return to our topic and we'll first like to give each of the panel members a chance if they wish, to rebut anything that others brought up or make any additional comments that they would like to at this point. First, Dr.McGraw, do you have anything to add?\r\n\r\n- Yes, I'd like to be sure I'm understood. I think we've got a good set of arrangements but far from perfect. I don't think our system is sufficiently systematized or aware of itself as a system module. I think that the system understands fundamentally what it is addressing. When Mr. Ross spoke, he was speaking from the standpoint of the whole system, the region. System of course has two elements. It has a provider and a consumer element and those things have to be reconciled. To come back to my drawing over here, we used to have a very simple system, one doctor and one patient. And now it's infinitely more complex. And we have an arrangement where there really is no such thing as a fully independent medical practitioner anymore. There's note even such a thing as a fully independent community hospital. The hospitals are by their very nature of the economic arrangements and the complexity of the technology, the scarcity of resources linked in a network, linked in a syncytium. And I'm sure that Mr. Ross could tell us about the kind of lack of understanding about that, that characterizes hospital administrators, board members, communities and medical staff. We are in this, I don't mean this to come across as sharp and carping criticism, but I'm just again saying it like it is, we are doing what Marshall McLuhan described as walking backward into the future. That is to say, we're looking at how things were and kind of acting on that premise. Now I put this, the organization of this system in terms of hospitals relating to one another, but it's just as true about the medical staff in its relation to the hospital and vice versa. Duties have a sense of common purpose. And are they addressing a community as a whole? Do they think about what the community needs? Let me give you an example. And I don't mean to sharply contradict what Dr.Swansen said, but it's not universally true that when somebody gets to an emergency room they get in the system. They may, they will get in the system under these circumstances. If they have a real, full blown, all out illness, if they've got a broken leg, he'll get brought into the hospital and they will get a doctor and they'll move on from there. If it's something less, you know, there is a phenomenon called easy disengagement where they kind of get sort of brushed off and it makes a great deal of difference. Whether the medical staff of the hospital and the hospital say to themselves, collectively, look, we got a problem, let's solve it. But whatever the medical staff in effect said, you know, we got all, we can do it all we got, you solve it. Under those, a lot of circumstances, and I wasn't suggesting that was true at all, I mean, you can see, Dr.Swansen and I discussed this, but there's too many places, I mean a lot of circumstances then people getting into the emergency room are, you know, they've only got one toe in the system but they're not fully in. You count out any real certainty that they'll be. So my concern about how we're depicting this is that we do, and we have indeed made monumental progress. I take great pride. Very few times do professions who've got everything going for them, or sectors of society really reform and restructure themselves. I think we've done it, under a lot of pressure. We are doing it. And I would think contrast what's going on in the health sector with what's going on, say, in the justice sector of our society. Frankly, I think there's very little comparison, but you know, I might be prejudiced. But nonetheless, I think that we have not recognized the dimensions or the adaptations which must be made. And I think it partly comes back to our training. And I'm a medical educator, and I'll say this. When I went through medical school, I and my contemporaries emerged with a sense of being independent practitioners. God knows it was difficult, and we came out of that experience feeling as though we'd done it all ourselves. And let's dispose to this one to one mode of operation, and doing it very well, but having very little understanding of the new complexities that were coming in the system, that indeed we really did need to get Humpty Dumpty back together, to conduct our work in that way. And we saw it as an entirely optional thing, whether we went into solo practice or functioned in a self-consciously integrated way with other doctors, just as we saw it as an entirely optional thing whether we saw ourselves as a member of a hospital staff or not. In my time, years and years ago, when we were doing this, we were oftentimes members of several hospital staffs, if we were in the city, and we kind of played one off against another. Now the fact of the matter is that times have changed. The range is being fenced. The buffalo are gone. We're part of a much more organized set of arrangements, and we haven't done our business that way. I hope this doesn't come across as some kind of a, you know, thumbs down on medicine. Because I don't feel that way. We had adaptations to make. And I think that what I've just said about physicians is true in spades also of hospitals. American community hospitals were the glory of our system of services in the last generation as individual, independent organisms. They were highly contended. They remain that way, and that is what we need. We need a greater awareness of the hospitals of Iowa, for instance, our own need, a network without a totally independent and competitive mode of operating, serving the public in the best way. And that's the rebuttal.\r\n\r\n- Okay, fine. Mr.Ross.\r\n\r\n- I have no rebuttal to make of any of our speakers, However, I have a couple of addendums that I would like to add. I think the first of these deals with the emergency room physician, I won't go on too deeply into that, but the system must provide continuity of care and in our urban areas, which I am well acquainted with from prior experiences, in our urban areas particularly, when we, as a system, become increasingly reliant upon that spot care that you see in that the emergency room. Something tends to happen to this concept of health that Mr. Linden talked about. I think it's partly this concept of crash care, episodic care, point care, any terminology that you want to put on it that leads towards a general impression that we as individuals totally disregard our bodies, we abuse ourselves because these physicians can make us well. These hospitals can make us well. And there's always that point of contact that when my body fails, or when I'm in an accident, there is always that point of contact that I can reach. And I think this thing really stifles our own ability to look out for our own health. I'd like to say something else too. And that's regarding, what Chuck said about health education and our lifestyles. I guess we all get hung up on lifestyles from time to time. How much of the medicine that these honorable physicians delivered to us that we could deliver ourselves have we forgotten? Iowa as a frontier state, I'm sure, with its hardy pioneer stock, cured many of the ills that today's society carry to the physician's office, or to the hospital emergency room. Not only you we ignorant about accessing the system, we're not teaching our young. and we haven't been for many years, because I don't know those things that are presymptomatic that we can do for ourselves before we need the physician's care. It works a tremendous burden on pediatricians to see all the snotty noses in town, if you will. And I think most pediatricians will agree that it works at tremendous burden upon themselves. So let's not only talk about accessing the system, Let's not talk only about education, of efficient and effective use of the system. Let's talk, and let's not talk about, you know the symptomatic pain that when we have a cardiac arrest, because we pass out and that's gone in an instant, let's really educate our young people in the era of the future about self care as well as self-help lifestyle. And I think that's my addendum to Chuck's comments.\r\n\r\n- Thank you. Dr.Swanson?\r\n\r\n- Well, I'd like to comment on this education business a little bit, too. It sounds great, and it is great, Mr.Ross, but it's a whole lot easier said than done. And if you spent as much time trying to do what you're talking about as I have, you get pretty frustrated. And there are lots of experiments on the record in which the doctor goes into the patient to give him instructions as to what to do when he goes home. Sometimes he takes a tape recording of it so he can play back and hear everything that's been said. Then you wait 15 minutes, and then have another doctor go in and say, \"did he tell you anything about what to do when you got home?\" \"Well, no, he didn't tell me a thing.\" So, it's not easy. There's an article in the same paper this morning, I believe it's today's paper. Reading \"Ph.D and Nutrition\" at John's Hopkins, I think, telling us that we ought not to just ignore fat people when they come in the office, we oughta motivate them to reduce in some way. Well that's a lot easier said than done, too. And sometimes it's impossible. So all of these things make this business of education of the public very difficult. I recall one patient that I had and used to see some years ago who weighed 285 pounds. I don't think there'd be argument that she was overweight, but when I put her on a reduction diet, and convinced her that this was she should should do, she became psychotic. Well which is worse? To have a psychotic patient on your hand, or somebody's who's just fat? Well, I gave up. I said, just probably a fat, psychotic patient. Now, she's still functioning. She still has a job. And I never yet, since have ever said a word about reducing because I don't want to deal with the psychosis involved and she doesn't want to have it either. Now, maybe she snowed me. I don't know. But at least the less of it that she was completely inoperative, she couldn't work, she couldn't hold her job, she couldn't handle her family, she couldn't do a thing. And I've never forgotten it. So these are some of the things that are involved in patient education that makes it a very difficult affair. I don't know how many people quit smoking because of all the advertisements about it. I suspect, I think the market for cigarettes is gone up, hasn't it, during all this, instead of lower. Certainly the market for alcohol has gone up. So it isn't all simple. Another comment I would like to make in reply to some of the complexity that Dr.McGraw mentioned. You brought up the subject of full payment by third party payers has aggravated the problem. I don't think there's any question about that in the minds of hospital administrators, certainly physicians and certainly Blue Cross executives. I still remember the experience of the Michigan Blue Shield of 1949, when they announced that they would pay for one chest x-ray for each Blue Shield subscriber per year. But there was no educational campaign with it, about, don't have an x-ray unless you need it. Nor did they take the doctors into the thing ahead of time, and say, don't order this x-ray unless there's a reason for it. Well what happened? Every Blue Shield subscriber in the state of Michigan went to his doctor and said, \"I am entitled to a chest x-ray, and by golly, I want it.\" The result was, the Blue Shield of Michigan went one million bucks in the red in one year's time. And they abolished that system. And as you know, Blue Shield and Blue Cross have shied away from out-patient trifles of that sort ever since. You can't buy a Blue Shield or Blue Cross policy now that pays for a chest x-ray in the office, unless it's associated with an injury, and then you have to have a rib fracture before they'll pay for it. If it's broken, they will. If it's not, then they won't. Well, this is the kind of thing that's involved in patient education that is not all easy, but the thing I'm getting to is, if we're going to get away from this business of making medical care more expensive by virtue of the third party paying the bill in full, don't you think that we're really gonna have to do is to go back to the idea of having a patient take part of it himself out of his own pocket each time he goes to the doctor, each time he goes the hospital, each time he has an operation, so that he's aware, each time, that if he stays an extra day in the hospital, or an extra, has this or has that, that it comes out partly from his own pocket. For instance, yesterday, one of my colleagues was called to see the patient who was depressed in the hospital. And he did a routine physical examination on her and saw nothing wrong. The psychiatrist said she was depressed, but the family were convinced that this depression might be the result of some organic growth. So they demanded the brain scan, the , chest x-ray, stomach x-ray, gallbladder x-ray, kidney x-ray and bowel x-ray, and bone scan be sure there isn't a hidden malignancy someplace. Well, for those of you who don't know that's about 750 bucks worth of x-rays, all because the family wondered if the doctor is correct in saying that this patient is depressed because he's psychiatrically ill, or because it might be secondary to some organic growth. Well, I don't know how you're going to avoid some of these things, unless we go back to the system of insisting that the patient paid part of the fray. No, I know, we listened to way back in the '30s to long frangs by Wilbur Cohen, who's now a professor of education at University of Michigan, but who was an ATW expert at that time who helped write the social security law, and the Medicare law, and a few other things. He said to have the patient pay part of it, or have him go get welfare money to pay part of this was demeaning. And so we didn't do it. We were gonna pay the bill in full so that everybody could have mainstream medical care paid in full like everybody else. The poor or the rich alike. But what happens? You get an over-utilization, and I don't see, really, any good way to backtrack from that, except to make the patient partly responsible for it. And I wondered if you'll see the same thing. Let me ask one more question and then I'll shut up. This one is to Mr.Ross. Your HSA organization is made up, as you said, of both consumers and providers, but it seems to me there are an awful lot of uninformed consumers in the organization that either need to be informed about something, or else do you need a whole lot more providers who are informed who can tell something about what goes on. For instance, at one of the sub area meetings that I heard about, one of my partners is on a sub-area board of directors, they were talking about priorities. Now the priority they were discussing was vaccination of children, for all vaccinatable diseases, making this the number one priority for HSA in that area. And they talked for an hour and a half about it. Well, this is great. Who's against, I'm certainly for getting the kids polio vaccine and all this kind of thing, but finally, after an hour and a half of this kind of discussion, one of the doctors timorously said, \"Well, do you know that the legislature passed the law that all this is going to be required for all the kids in the state, beginning of this fall?\" Hour and a half down the drain, you see. 22 people sitting there, when maybe if they'd been a little better informed about the situation, there'd been a whole lot of time saved on the part of a lot of volunteers. So, I think your objective of getting consumers involved is good, but it should be, I think, consumers would know something about what's going on. Thank you for listening.\r\n\r\n- Before we go, Mr.Willard, do you want to respond to that ?\r\n\r\n- I certainly do, because I hear this all the time, and I want to say that it's an extremely difficult problem for me, and for our staff, and for our volunteer agents. There do exists in this country, and in this state of Iowa, many informed consumers of healthcare. They sit with hospital boards, they sit with nursing home boards, they sit on local boards of public health, et cetera, et cetera. Right, and in fact, I'm sure, that Dr.Swanson could give a long, long list of informed consumers. Now, there's only one problem with that. Under the law under which we operate, by their acceptance of a physician on a board of directors with a hospital, under the rules which our agency operates, they have disqualified themselves as a consumer on the health system's agency board. Now it's quite difficult now for us. I would hope, however, that over a period of time, that if we continue to see the involvement, that if I extend this money judiciously and vigorously to bring consumers into our system, as we have done this past year, that there will be more and more and more informed consumers across this health service area. And of course, I see that then as being my only salvation, because it consumes an inordinately high amount of staff time and budget, for educational programs and conferences, to help the consumers become informed. So I plead guilty on the count that the information level on many of our consumers is not to the level that Dr.Swanson, the medical society, or perhaps even myself and many of our volunteers would like to have. I would also like to go on, though, to reassure Dr.Swanson and all of you that they will not be uninformed consumers for very long, and that they will, indeed, become more efficient in making objective decisions from analysis and data that our research and data in this style can provide to. Thank you.\r\n\r\n- Mr.Swanson--\r\n\r\n- Seems like it's--\r\n\r\n- One more addendum on, excuse me, John. I wanted one more addendum, though, that, mine is very brief, copayment is finally ending the commercial health insurance field. You look very close to your major publications nicely, and I have advanced copies of them, you'll find that Aetna Health Insurance is putting on a very strong campaign to have more and more of their people involved in copayment policies which they contend will reduce their cost to the consumer remarkably.\r\n\r\n- I was gonna say, it's kind of pick on John day, and I don't mean to, but...\r\n\r\n- John's used to it.\r\n\r\n- I hope what you said, you really didn't mean, that you depend on the wisdom of Congress, because as collective body, they scare the hell out of me. And I think it points it out when they say hospital trustees who cannot serve on your board because they're considered consumers yet on a hospital board of trustees, they represent the consumers and are consumers, in fact. So their wisdom deviated slightly when they didn't allow one. But I guess the main point is that this is a political ball game that we're in and the decisions are made in Washington by people that represent us. And we have to communicate with them what we want. And I don't know how you do this. There's many ways to do this, but I think it's extremely important because the decisions they make become reality of what we have to live with for the next number of years. So I think it's a political ball game with a lot of economics in it. And I don't know if you can separate the two at the Washington level.\r\n\r\n- All right, audience, it's not your chance to talk.\r\n\r\n- Oh, don't I get rebuttal?\r\n\r\n- Chuck, I didn't say that I would stand behind all of the decisions of Congress.\r\n\r\n- Okay, questions from the floor. Yes.\r\n\r\n- I'm curious to reply that the immunization of primary schools is appropriate plan because immunization and I think that it won't be appropriate that there is a plan to restore during their first year of the primary going to school and rather than\r\n\r\n- I don't think the final rules on that yet have come out from the Department of Health. But I think their plan is to have all the children pretty well immunized. You remember the big fight in the legislature was, sponsored by the chiropractors, was that anyone who didn't want to be immunized should be permitted not to. Well, fortunately that didn't prevail, but if there is a medical reason why you shouldn't be, that's one thing, or if you have certain religious convictions, that's another thing. Otherwise they will all be listed, I think, as candidates for immunization, which the medic--\r\n\r\n- Primary school is pretty late to start immunization. And it really does involve But it's not known or sure\r\n\r\n- Boy, that's right.\r\n\r\n- Doesn't solve that problem at all.\r\n\r\n- Better than nothing though. But I think the other angle, the one you're worrying about has been pretty well taken care of by the pediatricians and family practitioners in Iowa for quite some time.\r\n\r\n- Please, when you're asking questions, do as, the first questioner did, please stand and speak as loudly as you can so that we can all hear. Other questions? And if you wish, please direct these to specific individuals or the panel as a whole, if that's what you prefer. Yes.\r\n\r\n- I'd like to address the panel. To discuss the problems that are I'd like to know how we Americans make legislation\r\n\r\n- Are you thinking of some specific legislation? Okay, this is, on putting certain types of restrictions just really on revenues, is it not?\r\n\r\n- Cost caps is the most predominant thing .\r\n\r\n- Well, who wants to start?\r\n\r\n- I think that's a great question, because yesterday, I was sitting out in the audience and I asked the very same question to the four experts that were up here.\r\n\r\n- Maybe you could tell the audience that, for those who don't know, what this is.\r\n\r\n- Okay, there is legislation or administration bill, a thumbnail sketch, an administration bill to put a lid or a cap on hospital revenue. In other words, they're talking about a 9% lid on the dollars of revenue a hospital could have. And the question, of course, comes what will this to quality of care, volumes of care, and then it comes down, they're talking a lot of pass-through costs, such as any wage or hour wage increases to non-supervisory people would be passed through. That's not part of the 9%. Certain other types of costs would be passed through, were not affected in that. So I think in reality, the 9% as was stated yesterday, if you pass through these things, as an inflation keeps at the pace of this, It could be a pretty livable thing, and would make hospitals tighten their belts in some ways, look at different ways of doing things, and probably promote some efficiency, but I don't see a great change in it. And as was mentioned yesterday, again from those that knew what they were really talking about is that this is a tentative program that they're talking about as an interval period until a more definitive type of approach can be, to put a lid on the expenditures or the total cost of healthcare. And billions of dollars were passed around as what is being spent right now. So I don't know if that's answering your question, but it's an attempt to curb the healthcare costs in a budgetary way and not reflect on service or quality or expansion or new technology.\r\n\r\n- Would you like add, too, Steve?\r\n\r\n- I think that's a good answer. I maybe talked to one small point of this. I don't really think that we're being pushed around by Washington. I think that we have it in our own hands to make our local systems work. And the biggest problem is one of comprehension, it's not one of villains. It's not the medical profession, it's narrow-minded and reluctant. It's not a group of hospitals' invested interests. It's that the problems really are complicated, and at the time you've got a lot of other complicated things to deal with as a society. I think, I have great optimism that we're moving along pretty well. And I just like to say, let's not muddy the waters by saying those guys are louts made up. I mean, there's a little help in after. That's not the real problem.\r\n\r\n- I'd like to speak in opposition to the cost caps. Standing from where I am, being a leader of provider, or I guess, a consumer eater in this middle ground that I get from both sides. I'd like to speak in the opposition of the cost caps, variously. First of all, I think that they'll tend to create a floor. I think every hospital administrator in the United States will try to expand his budget the full 9% plus all of the pass-throughs that he can put on to his next year's budget. I think, too, that to control a single percentage figure out of Washington will allow for all of the inefficiencies of all of the states that have inefficiencies to keep going that much further, then what the devil will it do for Iowa, where we might build some efficiencies into the system. There are no incentives along with it other than to create a floor. Now, cost cap, to be administered in the way that they are proposed by the current administration are utterly ridiculous. And I think would be unacceptable to the public, not the provider. I think that they could be unacceptable for two or three reasons. And I think I've outlined the most important ones too. But finally, they're going to lead away from local autonomy. They're going to lead to a blanket, a commonness of mediocrity, if you will, throughout the healthcare industry all across the United States, and we in Iowa will have to accept that mediocrity.\r\n\r\n- Why? We can take it into your own hands. Jim, I mean, we got it right now, just decide. You're going to pay that 9% for whatever goes along with it. You got it in your own hands to make these decisions. I think, you know, we've met the enemy and they are us.\r\n\r\n- I guess if we go along with it, we probably are.\r\n\r\n- I'm not so sure that that's correct, doctor. In the first place, it doesn't take into consideration for inflation. Suppose your food bill goes up 10%, and you're limited to 9%. Are you gonna just put a little less food on these patients' trays? Suppose your other costs go up, equipment costs go up. Suppose the in the hospital who's already budgeted his 9%, he has a major breakdown. A boiler goes kaput, or a x-ray machine has to be replaced or something, and you can't spend any money? It seems to me that it's an un-workable solution and really won't hold water in the long run. And I doubt seriously that many hospitals, if they can get away with it are going to hold still for it. Does that answer your question?\r\n\r\n- Well, now look. Is there, as things now stand, any awareness in Mason City, you have a hospital of a hundred and--\r\n\r\n- 312 beds.\r\n\r\n- Is there any awareness that the cost containment in that hospital is a matter of concern, in autonomy or whatever else? Because it is. This state, the cost of Blue Cross and Blue Shield in each state are a state concern. Their rates are made on a state-wide basis. And if you've got an extravagant hospital in boon, you should pardon the expression, why, that's of concern to the other people that are bearing this on. But I think you have your own mind to make of it. I don't make it simple, but, you know, as Charles said, I see a bright future for complexity.\r\n\r\n- I really don't think the legislation is going to pass, or if it does, it'll be a major modification of it because there's a lot of other bills that are in the hopper that may change it. I guess that 9%, if that's a cap they put on, next year it could be eight, seven, six, five. And I think we've seen so much of the regulation change the intent of the legislation, and twist it around so that where we start getting leery of legislation that sets certain factors or controls, not knowing what they'll be two, three years from now.\r\n\r\n- Well, I'm gonna say one thing. I am too very optimistic. I think these problems require much more local initiative and fine-tuning. But mind you, the legislation in its caucus is a matter, really so of desperation. And it reflects the failure to deal with the problem on a local basis. I'm not that sure that talking about it isn't already having some cerebrious effects. I'm sure that it isn't really, making all us board members, administrators, physicians, community, citizens of the community, think about what we want. We had a free ride here for a generation or more. We've had a cost plus arrangement. You know, any time you got cost plus reimbursement for 30 years, like we have, we can't tell that there isn't a heck of a lot of fast decisions.\r\n\r\n- Hi, other questions. Yes.\r\n\r\n- One thing I and that is And I might add that\r\n\r\n- Unfortunately, we don't address the payment mechanisms from there in this particular plan. There is a, I guess it's been called a preoccupation in some parts of the state. There is detailed information about the supply of beds and the supply of services available. There is not however, a direct addressment of the efficiencies and reimbursement mechanisms. And I'd like to go on to point out the deficiencies and the reimbursement mechanisms exist all the way across our healthcare system. Not only in the nursing homes in the state. Now, it's been said that health planning is nothing more than omnibus tinkering, and when you take and try to push down the head of this monster here, another one that comes to the surface somewhere else. And I think, you know, that our plan probably is deficient in this area, is probably an area that needs to be addressed more quickly. I won't make apologies for that. It certainly will be addressed in the second, if not the second, then the third addition to the plan. I think though that the general public needs to know that health systems agencies operate under various severe time constraints as they develop these plans. And this is by no means a comprehensive document, but the law does require us to revise every year. Now, currently we put the largest amount of money in this state, just to reflect a little bit further onto this question. We put the largest amount of money in this state into intermediate care facilities. And most of the operators know then, since that's where the most of the money is, that is the greatest opportunity to massage profit margins. If you're talking about millions of dollars versus thousands of dollars, where do you want to do business? In the pool that has the millions of dollars available, rather than the thousands of dollars available. Currently, we're spending most of our money in this state in intermediate care facilities. That's a middle level of nursing home care. We're spending very little money on residential care, and we're spending even far less money on skilled nursing facilities. The payment rate, of course, for the residential care, and Chuck, maybe somebody could backstop me on my recollection of the figures. Is in the neighborhood of $12 per day for residential care. For skilled care, they're 30 something dollars a day, but there are no monies in either pot to pay for those levels of care in our Department of Social Services. Medicaid expenses the largest amount of monies into intermediate care. Mental retardation gets care through the intermediate care facility arrangement. And that's where the mental health people have the largest amount of their dollars to pay. Now, I've already tried to foreshadow some of the complexities of the system, and why trying to give you an honest explanation of why within a period of 18 months, this issue couldn't be dealt with in the blank, but I assure you, the cause of this complexity and the cause of inter-relationships that are necessary for change will be dealt with in future plans.\r\n\r\n- Dr.Swanson would like to respond to this too.\r\n\r\n- Yeah, Professor , the nursing home problem and the intermediate care area is complex, but it is made complex by federal regulations. If you, maybe you do know all the things that these these places have to do. They have to have administrators who take courses and take examinations, and they're licensed now. They have to have certain amount of staff. They have to have certain amount of room for each bed. They have to have an occupational therapist. They have to have a physical therapist. They have to have a dietician. They have to have a pharmacy committee. They have to have a medical director, all of which costs money, and the federal government keeps writing more and more regulations that increase the cost, and then they complain about the bill. If the federal government would let the right hand know what the left hand is doing on occasion, it would certainly help. If they pulled together for once instead of separately, it would help a great deal more. Now, I don't agree with you that these are local controls. The skilled nursing home finance mechanism, as you know, is mostly federal money. It's more federal money than it is state, and the legislature puts in what they feel like what they think is going to be, you know. Last year they were $8 million short. They had to put in an $8 million emergency appropriation to get them through the end of the year. So it isn't all locally controlled. This is state and federal control. We have to meet state and federal standards, and they all cost money. And they get good care, good institutions, but another problem is we simply don't have custodial institutions in the state. In the state in Mason city there isn't a single custodial institution. To get a patient in for custodial care, we have to send them to another town. Well, this costs money and is inconvenient for families and people and patients, and it's all due basically to federal regulations. So I would like to add to this complexity that everyone is talking about, that federal regulations are responsible for a whole lot of it, much too much.\r\n\r\n- You wanna respond to this?\r\n\r\n- Yes. Yes, among the cost of things, I've been trying to and it concerns me, and I wondered What about preventative medicine? How much does that actually run? What about hospitals, primary physicians, or out-patient care What about increasing the technology? Is it that, or\r\n\r\n- All right, I guess there's several questions in there. Some of these still hinge on topics that we talked about yesterday too, but we'll see what people would like to address these.\r\n\r\n- I just, I think you probably answered a lot of your question in just, in what is causing the increased cost in let's say, hospital care, 'cause that's what I'm more familiar with is combination of demands of the public for more quality service, more and more service. Every time they see something on television that Dr.Welby is now done that becomes the standard for the nation and Dr.Welby, you never see sending a bill. You never see him in a hurry to do anything, yet he can take care of everything under the sun. Well, that's not reality. But, the demand by the patient is he sees what he needs and he has every right to demand quality care. But the wide breadth of it sometimes costs a lot of money. Research costs money. Then we're faced with just the general inflation. The energy costs are just tremendously having effects on hospital costs and hospital budgets. That and wage an hour laws and as wages, and is as hospitals try to pay compensation to their employees that is equal in compensation to what is being paid in the local community. Our employees deserve just as much compensation as those that are in other lines of endeavor. As we face this kind of a problem, the costs are going up. So there is no one single thing. It's a combination, as I see it, of everything going on, plus the regulation and the laws that require additional people and new standards and higher standards of care all cost money. So it's a combination of that kind of a thing in my job. I think a number of things can be attempted to be done about it, is to eliminate duplication wherever possible. And we've hear a lot about this duplication of \"not every hospital can be everything to everybody.\" And this is part of Dr.McGraw's that there has to be a network and a flow of patients through the system and an allocation of special facilities and the CAT scanner, I guess, is the ideal one. How many CAT scanners does Iowa needs? So I think we have to, as institutions work together in organizing a system of delivery that eliminates duplication and unnecessary care and treatment. I think we can educate the public to make better use of the facilities. And it was talked about the emergency room at three o'clock in the morning, the person coming in with a cold, well really that should be seen in the office or during daytime hours and not have to staff certain things at night to cover this kind of thing. So it's an education of the public to know what it is costing them. I guess I get back, you know, we hear that, it costs, somebody quoted and I think it's a misquote, but it costs more for the healthcare of General Motors than the steel in their car. I don't think that has any comparative anything. So what it? It costs more for the healthcare than the amount of aluminum in a Maytag washer. That's not a relative thing. The priority of what we're going to spend on healthcare is what's really up to the American public, and 8.3% of the gross national product now spent on healthcare. I don't know, maybe it ought to be 10%, but how do we control it? I can't answer you except that we, as individuals, must try to control our own costs and our own inputs and what we do. And I want to differ a little bit with you. You said that a cap would automatically make all hospital increases in administrators, come up to the level. I think we've got to recognize that we have a board of trustees who we have to be accountable to, and the public. And it is administration and these trustees that have to look at the overall cost and try to hold them down, which is extremely difficult. Now I've gone a long ways around telling you, I really don't know the answer to your question, but I know we have to look at it in different ways and different controls.\r\n\r\n- Well in a way, you asked a very profound question, and when people say that, they may as well have an answer. I do think that the, we may well have, sort of, let the wind out of the bag, as Ulysses did, you know, when we kind of move in all these multiple way solves our problem, we set a lot of things in motion. And at the same time we did that, we were circumventing for good and benign reasons, we were circumventing some of the means of rationing control for all the good of that. I agree with Dr.Swanson. I think we've got to get some costs awareness and rationing back, it's just, I don't know whether that'll do it. I guess that's, you know, if we were gonna go back as characters, we'd chop that out and see if it really did it. Before we move very fast, we better, kind of tinker with the system a bit and see how it works. But it makes good sense to me, and I've been in this game for a long time, that doctors and patients and families, everybody'll think a little differently about this if there's a very eager awareness of cost. I don't think we have a very simple situation, do we? You know, just think about the business of dialysis and chronic renal disease. Now, those physicians of my age remember when chronic renal disease was something you kind of shrugged your shoulders about. People were gonna die. Now we don't do that. We spend $25,000 a year to keep these people alive. And quality of life is not all that shot. And, you know, this whole question of who shall live and who shall die is , and not really very easy solution. And I think that these things get right to the heart of the way we live, and the inequities in our society. Because we're talking here about, you know, there's no question. If I'm John Rockefeller, or John Kennedy or whatnot, I'm gonna have more than a million dollar care. If I'm somebody who was less advantaged in our society, am I gonna have the same care? You answer.\r\n\r\n- If you have Blue Cross or Medicaid you do. That's the way the system--\r\n\r\n- If you can still afford it.\r\n\r\n- That's the way the system words in Iowa. But I think she deserves an answer on the business of increasing technology and the cost of it. I'm sure this plays a tremendous part. For instance, the whole subject of intensive care started, you know, with coronary care units. This goes back only to 1962. We've had one, the first one was developed in Kansas City, Missouri, in 1962. We had one in Mason City since '67, and about two years after that, we started a general intensive care area and now has eight, six beds in it. We have nine beds in the coronary care unit and frequently all of them are full. This is a tremendous expense that wasn't there before because we can do all kinds of things that we weren't able to do before. In intensive care alone, you've all heard about respirators, and the New Jersey case, the girl who appears now was on a respirator for a year when they could have turned it off before, nothing happened because she's still alive, she's still breathing. Well, how do you know on things of this sort? But the increased technology, all of which costs money, will do an awful lot of things. We now measure blood gases in the, in the patient who was in intensive care with some kind of respiratory difficulty. We may do it, we may have to do it almost every hour if it's a critical case. We may have to measure blood electrolytes, we check sodium and potassium and nitrogen, and so on, and sugar. We're using pulmonary function tests at the same time, we have other chemistry, blood counts and all this sort of thing. And it does add up to a tremendous amount of expense. Now this is all progress because we're saving lives now that we didn't save before. We're spending a lot of money doing it, and I don't think the doctors really want to be in the position of deciding which life they're going to save. We go into the picture now of trying to save all the lives that we can, within reason. If we get to the point, as was mentioned here a little bit ago, of rationing medical care, then this is going to have to be something that society gets involved in, not this doctors alone, because very few doctors really want to play God on something of that sort. We'll keep people going within reason as long as we can. I don't see any sense in simply prolonging a comatose life just for the sake of prolonging it. I don't agree with that at all. But I've seen people unconscious on respirators, from drug overdosage for instance, as long as five days and come out of it. Now years ago, there was no way they would have lived through that. But this takes money. This has all kinds of expense. And this is one of the things that's increased the cost of medical care. And I don't think at this point, we're ready to give it up. I think we've got to figure out some way to pay for it.\r\n\r\n- Is it all progress though? As you said, you know, the fact is the position of being able to turn on a faucet, from which emerges a golden stream. And you know, I can walk off and leave that faucet running, whether it's a respirator, or it's renal dialysis, or whatnot. And I think you may disagree with me if this is a ration, but I think we have a trust here, a public trust to utilize these resources very, very carefully. And we are asked to make regiments about one of those golden streams, which is days in the hospital. We make those judgements in terms of hospital utilization, peer reviews, and so forth. That branch, and we're expected to make that, because it's in our professional sphere of expertise. We may not want to think of ourselves as gods, but when we send somebody home, you know, on the basis of some judgment at that time, It's quite possible to send somebody home post-operative and have them suicide, for example. I don't think we can be so purist about it, and say, hey you aren't involved in that decision. I think they have to be made in our domain and in the public domain surely. But we're in public domain.\r\n\r\n- That's one of the difficulties with solely the cost, and I'd like to make a comment here. And that is that medical service delivery is just about the most elastic thing that we've ever experienced in our society. Stop and think about it, you know. Go back to eat from McDonald's the first time the body was cut open, you know, we go back and now then we go and we pass the body through an x-ray machine and the computer tells us what the hell's with it. Medical services delivery, maybe we're talking about healthcare, is just so elastic and the opportunity to make it even so much more elastic in the future is so broad. Before I tell you how much new technology we'll have to absorb into the healthcare industry in the next 10 years, Let me point out that if one half of 1% of that new technology was absorbed by all Iowa hospitals over the next 10 years, our hospital care bills would go up $5 million worth, because there's $50 billion worth of technology, not on the drawing boards, not in somebody's mind, but nearing completion of production just like CAT scanners. $50 billion worth of new technology that will have to be absorbed in the next 10 years or the guys who invented it are gonna lose their dollars that they have in their investment. Who should control how fast we absorb it in Iowa? You should. What vehicle do you have for controlling how fast we absorb it in Iowa? I go back to my opening remarks. The health systems agencies. Support us.\r\n\r\n- Yes, sir.\r\n\r\n- You are aware of the services available in the medical systems So what I'd like to say,\r\n\r\n- Okay, who wants to try advertising?\r\n\r\n- Well, I believe at the present time of the health dollar spent, not going over-the-counter medications and TV advertised things, that the physicians got around 17%, is that correct? I think, of the total health dollar. So if you took all the money away from all the doctors and had all work for nothing, you'd save only 17%. I really don't see how advertising back and forth is really going to save anything very much. Our worry on advertising and it's not prohibited by our medical society or by the AMA, you can advertise if you want to. And we do. If you look in the phone book, we have listings for our various specialties and our offices. We have announcement cards if we move, or we add a new partner, or if we have a new service or something of the sort. We don't advertise fees necessarily, although our medical society has always encouraged doctors to discuss fees with patients if they want to ask any time. You may remember during the Nixon administration when there was price control we had to post fees in the office. It had to be written and plugged on the wall someplace. And that didn't make any particular difference in the fee schedule arrangement. The thing that we worry about from advertising.","format":"text/plain"},"target":"https://iastate.aviaryplatform.com/collections/1150/collection_resources/45610/file/118631#t=0.0,3886.176"}]}]}]}