^M00:00:11 [ Rooster crowing ] ^M00:00:13 [ Silence ] ^M00:00:16 [ Music ] ^M00:00:50 >> Gene Rodgers: I'm Gene. >> Dave Dauber: And I'm Dave. >> Gene Rodgers: And we're the -- >> Gene and Dave: -- Gene and Dave Show. >> Dave Dauber: Hey, thanks for watching the Gene and Dave Show. We've got a special episode for you today. We got a call from Marge Petty's team. Who's Marge Petty? >> Gene Rodgers: Marge Petty is the Region 6 Director of the Department of Health and Human Services which covers Texas, Mexico, Louisiana, Oklahoma, and I forget where else, but it's quite a big area. >> Dave Dauber: Yeah, and somebody from her office actually called us, wanted to get some time with the Gene and Dave Show, and wanted to explain to us about the Affordable Care Act and the things that are going on in this area, this region, and she wanted to use our show to talk to us so that we could reach back to you, our lovely viewers -- we thank you so much for watching -- >> Gene Rodgers: Thank you. Thank you. >> Dave Dauber: -- about details and things about the Affordable Care Act and how it's going to help us, all of us as a nation. >> Gene Rodgers: Yeah, they really wanted to talk about the preexisting condition insurance program, but they've got so many programs, they gave us all kind of Web addresses and phone numbers so -- which we'll have posted on our Web page. But she was very open to us, she was telling us, you know, if we've got questions, they can send speakers out to talk to groups about the Affordable Care Act so -- >> Dave Dauber: -- yeah, the Affordable Care Act is huge. It's -- there's a lot to it, and it's very hard to put a grasp on it or, you know, even just get your mind around it. It took them several years just to write and to get it in, but she explains it pretty well from a high level here in this interview, and I hope that you'll get something out of it. >> Gene Rodgers: Hey, folks, we're here today with Health and Human Services Regional Director, Marge Petty who is responsible for guiding and coordinating Health and Human Services policies in the states of Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. With us, of course, my cohost Dave and Mr. Dennis Borel with the Coalition of Texans with Disabilities. Ms. Petty, do you mind if I call you Marge? You know, we're -- >> Marge Petty: Absolutely. >> Gene Rodgers: -- here in Texas. We'd like to get to know you folks. >> Marge Petty: Absolutely. May I call you Gene? >> Gene Rodgers: Um, no, Mr. Rodgers -- sure you can call me Gene. [ Laughter ] it's a real honor. >> Marge Petty: For me, too. >> Gene Rodgers: Well, that's what I meant. [ Laughter ] ^M00:03:51 We're here today so you can explain to us the Affordable Care Act. What in a nutshell is it and why should people with disabilities care? >> Marge Petty: Well, ACA -- it's difficult to put ACA in a nutshell because it is so expansive in terms of the impact that it can have on people throughout the country, all people. I think it's been noted for a long time that there have been a number of people, 42 million uninsured folks across the country; escalating health care costs; small businesses, the cost of covering employees in small businesses escalated 85 percent in since 2000. So all those factors have converged to provide the impetus for this new legislation that was passed in March of 2010. The important pieces of this affect people all across the country, all ages, and it makes basically health care more affordable more accessible for people all over the country. The date, 2040 is the target date because by 2014 insurance should be available to all folks without any kind of ability for people to discriminate or turn down people for insurance options. One of the key pieces of the ACA legislation that went into place is called the Preexisting Condition Insurance Plan, and one of the reasons it's so important to Texans is probably there are more uninsured people in Texas that might be eligible for this particular program than -- I think they're about the second in the country in terms of numbers of people who are eligible. What people I think know is that often times insurance companies have turned down people with asthma, or they may have discovered that there was cancer and then they've terminated their insurance coverage, and so this is possible coverage for people that haven't had access before. ^M00:06:15 >> Gene Rodgers: I know a lot of us folks with disabilities, say, maybe go through college or some training program, I'm sure guys like me and Dave will get snapped up by big companies, but then we lose whatever, say, Medicaid or Medicare we have, and then we're looking at paying insurance at the big companies or having no insurance at all. They exclude us because of preexisting conditions. But with this Affordable Care Act, we won't need to worry about that, will we? >> Marge Petty: Well, one of the -- one of the important aspects of the ACA, of the Affordable Care Act, which began in July of last year, is this Preexisting Condition Insurance Plan, and the criterion -- actually there's three criterion: You have to be a U.S. Citizen in good standing. ^M00:07:03 You have to have been without insurance at least for six months, and you have to have a preexisting condition that has precluded you from getting insurance. So -- and one of the great things about the way Texas has operated is that it is, in fact, possible for people to go through a broker to get documented that they have some preexisting condition that is precluded them from having any insurance. Also within the last couple of months -- actually, more recently than that, probably about the last month -- they made it possible for -- if you had a physician or a physician's assistant or a nurse practitioner that verified, in fact, there was a preexisting condition or something that would preclude you from getting insurance, that you could be covered then and be eligible under that third criterion. ^M00:07:59 >> Gene Rodgers: Yeah, this is scary to be without insurance, I mean -- >> Marge Petty: Terribly scary. >> Gene Rodgers: Like, a trip to the emergency room could cost tens of thousands of dollars. >> Marge Petty: Terribly scary. You know, one of the great things about this insurance plan, too, is that more recently they have scaled down the premium costs so they've become more affordable, and they are tiered in terms of the age, like 0 to 18 is -- let's see, I can tell you exactly what is 0 to 18 -- >> Gene Rodgers: Just off the top of your head, what would you say it is? >> Marge Petty: It's $133, 0 to 18. And somebody from 19 to 24 -- now that's under the standard option. >> Gene Rodgers: That's very reasonable. ^M00:08:48 >> Marge Petty: That's not a lot. It's very reasonable. Now, one of the great things about this program, and what Texas opted to do -- Texas has been extremely supportive and they opted to have the federal government basically administer their plan. What happens is people with preexisting conditions that are put into a pool of people that do not have any preexisting condition which lowers the cost of the premiums for everyone. So -- >> Gene Rodgers: Is this unfair to the folks that don't have preexisting conditions? >> Marge Petty: Well, of course, my feeling is no. What it makes possible is insurance available to everyone and people that have not had the opportunity to be covered. I mean, you know, we talk about fairness, is it fair for people to have been precluded at some point in time for having coverage when they needed it. >> May I ask a question in follow-up to Gene's question, Marge? ^M00:09:48 Texas has I believe the highest percentage of uninsured people in the entire nation and certainly of children -- uninsured children. Do such states with a higher percentage of uninsured people stand to benefit more -- more greatly than states that have less uninsured people? >> Marge Petty: Well -- >> Are we a high-benefit state for the ACA, is what I'm asking? >> Marge Petty: Well, it -- it depends on how you're defining "benefit." The reality of it is when you've got a higher population that are uninsured and -- for a program like this where there was specific money set aside for claims that would occur for people who are eligible and sign up, that money has already been set aside. They're second only to California in terms of resources that are available for those claims. ^M00:10:45 So we all have a real investment. I mean, I'm a Texan. I have an investment in making sure all those people who are eligible and need to know about this because there are resources available to support them in getting the health care they need that right now is not being accessed. So it's -- it's critical programs like yours and Dave's to get the word out so that people can access what's available to them. >> So what is the easiest way for people to access that information and figure out, where do I go how, do I start, you know, I don't have insurance right now. What do I do? >> Marge Petty: Okay. Well there's a couple of things. The first and probably the easiest is to go to pcip.gov if they've got access to a computer, and what will come up is a national map, click on Texas if you're from Texas, and what you'll see is a link that can take you directly to a form that will be filled out. ^M00:11:51 Three of the questions, of course, they would need to ask themselves : Are they eligible because they're a U.S. citizen? Do they have a preexisting condition? And have they be without insurance for six months? Those are the three keys. But there's a form that they can fill out and have a doctor or a physician -- a physician's assistant or a nurse practitioner verify, in fact, that they do have a condition that either has precluded them from being insured or would preclude them from being insured. And, again, they have to be without insurance for six months. So just those documents, being able to fill out that form and have verification that they have a preexisting condition, then you submit that form online, and I mean, one of the great things is there is not a waiting period. If, in fact, you are eligible, say you apply on the 14th, by the first of the next month, those -- that coverage would be available to you and -- ^M00:12:56 >> Gene Rodgers: Two weeks is nothing for the Federal government. ^M00:13:00 >> Marge Petty: That's -- that is the eligibility timeline. >> Gene Rodgers: Wow. I understand you can see how our show is part of the outreach. What kind of outreach efforts are there in, for say, if they don't have the access to the Internet or perhaps even the TV? >> Marge Petty: That is -- that is a great question. ^M00:13:21 We have a CMS team at -- in Dallas that is actually -- they have gotten groups of not only through their staff but groups through communities that have investment in folks with disabilities, foundations like the Cancer Society, like the Heart Association where there are people who have chronic conditions. The outreach is directly to those groups. We've talked with the National American Heart Association, we've talked with the Susan Komen Group. They're -- they have grants throughout the country, 2500 grants where there are people that -- with breast cancer who have accessed those community groups. So the outreach is just not limited, I'll say that. ^M00:14:15 We are reaching out to every foundation, every group, faith-based groups who can get word to their congregations about people that would eligible. So part of what our interest is is in listing those partners that would be spokespersons for us as well to get the word out. PCIP.gov. >> Dave Dauber: And there's a lot more to it as well. I mean, we've got people on insurance now, but there's also been the promises of improving prescription drug coverage for folks that are on Medicare, extending the life of Medicare trust funds by at least 12 years, and other things. Can you talk about some of those others that are going on over these next few years? ^M00:15:08 >> Marge Petty: Thanks, Dave, yes. One of the points that Dave raised is that expansion -- the extension of the Medicare trust fund, and that is it a direct impact from the Fraud and Abuse work that has been done as a result of the ACA. They're very diligent teams they have gone out and -- actually, Houston, San Antonio there are two or three commun -- Waco -- there are two or three communities in Texas who have actually had some real problems, serious problems on fraud and abuse with some of the scooters, some of the inventory that has been fraudulently said, we've got this available, we've got people that want to access this, and then have billed Medicare as a result of that in a fraudulent way. So it's incredible just in the last year, in 2010, there's been over $4 billion that's been put back in to the Medicare Trust Fund, extending the life of that trust fund. ^M00:16:13 So that's just one small aspect of the ACA. You know, the funny thing to me, you know, many people have said, oh, golly, there's just, you know, it's such a big document, you know. The important thing for people to know is, yes, it is a big document because it is so comprehensive. People have looked at service delivery for health care; they've looked at labor and people delivering those services; they've looked at cost -- >> Gene Rodgers: Is there input from the disability community or in planning this or [inaudible]. >> Marge Petty: And they are a part of that. They are a part of the input particularly on this PCIP program. So, of course, it's going to be lengthy because it's comprehensive. ^M00:17:05 You know, it's not just, as one might say, a flash in the pan. It's intended to be substantive, long lasting, and have impact throughout the country. >> Marge, Medicaid is of huge importance to a lot of our Texans with disabilities for many reasons including long-term services and support. There's so much disinformation -- misinformation about the ACA. How will that impact Medicaid? >> Marge Petty: Well, certainly there is expanded coverage in terms of eligibility on Medicaid, and there has been substantial financial support for states all over the country [inaudible]. CHIP is another example of expansion of services to young people who are from families that are a little bit higher than that poverty threshold but would also be eligible to get medical coverage. ^M00:18:09 So the idea is that by 2014 there won't be categories of people. That by 2014 insurance will be available to everybody regardless of their level of income, regardless of their disability, regardless of their condition, regardless of their health status. So, you know, it's -- it's interesting most people don't recognize that as far back as Teddy Roosevelt there were discussions going on about the need for changes in health care. >> I'm not surprised at that. >> Marge Petty? So [ Laughter ] this is a significant, you know, banner opportunity for the country, the nation, and the people that care about others and people in their community, to make these kind of resources available. ^M00:19:01 >> Now, follow-up with another Medicaid question. >> Marge Petty: Sure. >> Advocates -- disability advocates in Texas here voted that the legislature passed a bill indicating that the state would pursue a block grant in Medicaid. And I understand that the Feds have the ultimate say in that, but, you know, this whole idea of block granting Medicaid seems to be getting a lot of talk not only in Texas but other states. What impact would that be -- I mean, you perceive it as -- as a way to [inaudible] available Medicaid funds. Wouldn't that be counter -- counterintuitive to the ACA? >> Marge Petty: Well, Medicaid, of course, is a joint federal and state program and states have always had the opportunity to set certain thresholds that didn't undercut what the federal government expected. ^M00:19:57 A lot of states are requesting waivers because of the financial -- the economic conditions across the country. I think that it's one method that states are exploring. You know, I would have personal concerns about who's making some of the determination at a community level. You know, my belief is that most communities and states care about serving their clients and those that are in need, and it's a just a tough time now to decide how that money gets spread out. Again, that becomes a determination as they're reviewing the waivers on whether block grants are a solution. They're obviously not as prescriptive when it's a lot higher, you know, so there's -- I think many of us would have a cautionary note about that. ^M00:21:00 [ Pause ] ^M00:21:05 >> Gene Rodgers: Will Health and Human Services monitor states to ensure that the budget cuts that are implemented are not violating the Olmstead Decision which I'm sure you're familiar with? >> Marge Petty: Oh, absolutely, yes. And, of course, there will -- I mean that's part of the charge for the federal government is to monitor and audit on a regular basis the resources that are available and how often they should serve to make sure the federal guidelines are being met. >> Gene Rodgers: And will there been some sort of 800 number or something where folks can call into report violations of that? ^M00:21:48 >> Marge Petty: That's a great question. And I know that there are access points at the state -- at the regional level in terms of reporting, and certainly our CMS office that handles Medicare and Medicaid are available. We have resource people and outreach people all the time that are gathering data. And so certainly, but my -- my number -- I'm -- somebody's referred to me as the switchboard operator so -- [ Laughter ] >> Gene Rodgers: So you're open and available. That's fantastic. >> Marge Petty: Certainly. We are accessible for them. That kind of communication we welcome. ^M00:22:34 >> Dave Dauber: We have a lot of groups and a lot of fans that like our show, that watch our show, and a lot of them are some of the grassroots campaigners here in Texas, including ADAPT and Dennis' CTD as well as I also got a message from someone at Advocacy Incorporated here in town and they're all, you know, very excited but -- with anticipation and -- but also just want to make sure that everybody's best interests are taken into account. And they also are looking for more information and where they can find more basic information about this. And is there anything else out there that -- I know you have Web sites -- that we can go to, videos that we can watch, is there also ways that they can set up people to come in and possibly speak to their organizations and get more information? ^M00:23:35 >> Marge Petty: Absolutely. We would welcome that opportunity. You did mention the Web sites. You may have referred to them before, but healthcare.gov is a great Web site because you can individualize not only your state, your specific situation, your age, it has an incredible amount of information; lists of things to discuss with your doctor. But lots of opportunities to individualize. In addition, across the top, if you want to learn about the law and go through each of those sections, there's that information available as well. But in addition, as you say, the speakers, we have speakers that are available to come out and discuss specific -- particularly the PCIP, because that is the major push right now because it's money that's available to cover people's needs, and we just need to be sure they know how easy to see to check whether they are eligible and access that resource. ^M00:24:44 So we've got people willing to come out and talk in every community across Texas. >> That's great. That's very good to know. >> Jessica: You know, Texans are so fortunate because we also have the Consumer Health Assistance Program operating in this state, and that is a section of the Department of Insurance here in Texas, and they are here to help answer PCIP questions or any health insurance related question that folks might have. You know, until 2014 when things really begin to change in the marketplace, certainly there are a lot of questions, lots of things that people are not sure about, so the Texas Consumer Health Assistance Program, Tex CHAP, you may also access them online at texashealthoptions.com. ^M00:25:31 They have the telephone number that's toll free, 1 (855) 839-2427, and they have been a huge instrumental piece of why we've been able to see some successes and really get out in the forefront of this program. Since April when the preexisting insurance plan enrollment number was 1528, they have jumped enrollment up 300 percent. We're now at 1798. Last fall when this began, we were at 348 enrollees in the state of Texas, and they've been huge, you know, in getting us to the 1700 number that we're at now, but we know that we're not finished and there's much more work to be done. ^M00:26:19 So they are on the ground every day, and they're also a huge resource for people to take advantage of. >> Gene Rodgers: For you folks that didn't get those 800 numbers or Web addresses just go to the geneanddaveshow.com and look for this show on the Affordable Care Act and we'll have all that information there. It will all be documented so it will be easy to retrieve. >> I've heard that for kids with disabilities there's already been some progressions invoked, right? Can you explain that as for -- previously where they would have been excluded from their parents' employer-provided coverage in some cases. How does that work? >> Marge Petty: Well, there are a couple of things. Actually children -- young people up to 26 can now be included in their families insurance. >> Today? ^M00:27:11 >> Marge Petty: Today, right. That went into effect -- that's been in effect since September of last year. But also children that have asthma that had been previously excluded from their parents' coverage can now be included. >> As well as other disabilities. >> Marge Petty: Absolutely. ^M00:27:32 >> And in other words, no child whose parent would have been allowed to cover that child had that child been healthy can no longer be excluded for a preexisting condition like asthma or cerebral palsy. >> Marge Petty: That's correct. ^M00:27:50 >> Man, that's not a -- there were many parents in this state that if you brought that to my attention that mentioned how important that was. >> Marge Petty: That's huge. ^M00:28:01 >> The impact, just almost inconceivable what the means to families because their kids are very important to them and they want them to receive health care and to not was a situation previously was just plain flat out bad public policy, in my opinion, cruel, but I'm glad to see that that has changed. ^M00:28:22 >> Yeah, Dennis practically lives at the legislature. >> Yeah. Oh, I'm sorry. Am I starting to lobby you? [ Laughter ] ^M00:28:30 >> Marge Petty: Well, we're so grateful to you, Dave, both, for you allowing us to be on the program to help get the word out because it's phenomenal this resource that's available, and we want to be sure that everybody that needs it knows about it, and, you know, can -- can get the information they need. As Jessica mentioned the CHAP program at the Texas Department of Insurance, that's a bilingual staff, there are people there that are both knowledgeable and accessible, and so that 855 number is critical for people in Texas to be able to access. ^M00:29:15 >> Gene Rodgers: I've got to ask a question. I've got a tell you I'm just still not real clear on health insurance. When t comes to health insurance I'm as confused as a cow on astroturf. I understand some aspects of health insurance but in terms of attendants, how do they fit in, is that something covered by this the ACA? ^M00:29:45 >> Marge Petty: Good question. Jessica, can you speak to it? >> Jessica: As of right now the Preexisting Insurance Plan has a number of great accessible benefits, you know, preventative care is covered 100 percent, and there are a number of benefit options available for which people can sign up. ^M00:30:01 At this time, you know, Medicare does not pay for custodial care, Medicaid currently does but the Texas CHAP really is available to answer those nitty-gritty in the weeds questions and if they're unable to do so, they know where to get the answers. So, you know, to my knowledge at this point we're looking at preventative care and then after that you know Medicare would pay for what's reasonable and necessary and certainly want to make sure folks have access to what they need, but I think a great place to start for some of those more custodial type questions would be it Texas CHAP program. >> Gene Rodgers: You used the word "custodial," I think a lot of people are afraid you might mean institutional -- >> Jessica: No, I am sorry. Custodial care is sort of what we refer to as care that, you know, involves the daily routine tasks, activities of daily living as we refer to them, and if those are taxing or difficult for someone to take care of, they would need what we call custodial care, things like bathing and dressing and feeding themselves and, you know, taking care of their regular daily life. ^M00:31:04 So that's what we mean by custodial care. We also on the flip side have skilled care, and that's when there is a medical necessity behind, you know, a treatment. There is a diagnosis that we're trying to treat there, so that's the difference. >> Marge Petty: And everybody has different case -- different situations. Every story is different, and that's why it's so helpful to have the CHAP folks where you can actually call and specify your particular situation. >> Gene Rodgers: Could we get that number one more time, Jessica. >> Jessica: Absolutely, it's 855-TEX-CHAP -- T-e-x-c-h-a-p, or it's 839-2427. 1 (855) 839-2427. >> Now, that's just for Texas? >> Jessica: That is for Texas, and as I've said, we're really lucky to have them here. Not every state has this awareness program on the ground really trying to share that information with every community. So we're very fortunate they're here to assist with this. ^M00:32:01 >> Gene Rodgers: Our show's been accessed by folks in 41 different countries so I wouldn't be surprised if other states in the country watch our show. How would they find the number to -- >> They would go to the pcip.gov website -- p-c-i-p, dot, g-o-v, you can select your state and find out which resources are available there. Other states do actually have the consumer health assistance program in place as well. Not every state does, but, again, as Ms. Petty said it is best to start with pcip.gov to find out all the information that's available relative to your geographic location, but in Texas we're very fortunate to have the consumer health assistance program. >> Gene Rodgers: Very good. >> As we talked about earlier, this legislative session here in Texas has been grueling as it has been all over the United States with cutbacks, cutbacks, cutbacks and, you know, you can't turn on the news and watch it for more than five minutes without seeing something affecting the federal deficit and all the scrutiny that Obama ^M00:33:05[ Audio cuts out ]^M00:33:07 under the deficit. One of the figures I have from the CDO is that this bill is actually going to decrease the deficit by $143 billion over the first decade and then $1.2 trillion over the second decade. But there's a lot of folks that are not believing that and some others that are on the other side of the coin saying that it's going to increase the federal deficit for -- well, it's got one figure here more than 700 billion in the first 10 years, so, of course, we hope that it decreases it, but can you speak to how it's going to decrease it and why people should really be on board for this? >> Marge Petty: When the bill was passed, every -- many of you remember that there was a lot of challenge and time that was spent in working through all the pieces of it, and part of the reason was because for each proposal, there had to be a marched, identified funding source. So there are companion costs, it is not -- the point is that it has been funded just like with the PCIP. There is already money set aside that has funded that. But obviously part of the promotion of it involved what's going to be the impact on the out [inaudible], and so it -- part of gathering the support for it was because, in fact, not only would it decrease costs for health care overall, but partially because health care is such a huge part of our GNP that we could not afford to allow it to continue to escalate as it was doing in terms of the percentage. So, again, these are projections, terms of the cost savings, but also the pieces that are in it currently have been funded over time so there shouldn't be any surprises as long as things are maintained, things are -- stay it same. >> [Inaudible] well, the public is really hearing mixed messages about this. I saw -- actually a Texas Congressman John Culberson interviewed on TV last week. He was talking about the debt ceiling, and he said the way to solve the debt ceiling was to repeal the Affordable Care Act which, of course, didn't make any sense to me at all, but I only bring this forth as, you know, citizens out there hear all this stuff and it's been demagogued to death, if you ask me. How do we answer, you know, questions like that that people pose to us like, you know, isn't it true that it's going to bankrupt the country and all that stuff. I always answer, well, no, as a matter of fact, independent fiscal analysis has shown that it would be a cost savings. Well how could it be? >> Marge Petty: Well, it's, of course, what you're describing is the political cacophony. [ Laughter ] ^M00:36:31 You know, and there's a lot of that dialogue going on. You know, I'm very optimistic that people are asking questions about what's going to contain health care costs, and what part of it the ACA has in doing that. Let me give you one other example. There's a lot that's been talked about the health information technology and how technology can help us reduce costs. With health care -- if the banking industry operated as health care does now, we'd all be carrying around big sacks of dollars. I mean, banking operates with a very high tech operation, information is shared. So one of the things that was done is there were grants given to many states, key grants for health information technology, and there is -- there are resources like that in Texas, the Houston area -- there's one that I visited in Tulsa where they traced the cost that that could be saved by very precise patient and physician interaction on what could be saved, say, in referring someone, how long it took to refer someone. ^M00:37:50 He had -- this guy was just amazing. [Inaudible] from Harvard, he worked at Tulane, he was at Oklahoma State, and he had documented the savings of over hundred million dollars in transactions in a year's time. Well, you know, that was close to an Oklahoma budget deficit. So obviously health care expenses that are contained or reduced is a different realm than what's allocated legislatively. But all these aspects of finance converge when we're talking about economy and the economic health of the state. So we cannot exclude health care costs from a healthy economy and what needs to be corrected in making the economy work better. ^M00:38:52 That's just one example. And, you know, this was a bill that was -- that tackles every aspect -- health care technology, health delivery, labor force, access, health departments -- I mean, it's amazing that a legislative body I think could create such, quite frankly, a work of genius that has such potential. >> Gene Rodgers: Well, health care costs are reducing our ability to be competitive in the international markets -- >> Marge Petty: That's correct. >> Gene Rodgers: So I hope that we can see improvements in the health care costs in the near future, and we certainly appreciate all that you're doing for all of us here in Region 6 particular Texas. >> Marge Petty: Well, I appreciate what you all are doing to get the word out and serve your constituency. I know you've got a large listener group so I appreciate the opportunity. >> And your show is going international, isn't Gene? >> Gene Rodgers: That's right, international; 41 countries so far so [inaudible] ^M00:40:03 [ Laughter ] ^M00:40:06 >> Jessica: I have one other thing to say if I might jump in. You know, back to your question and your issue about escalating costs, I think it very well underscores the discussion here today because we know that untreated medical conditions as [inaudible] really affect our productivity and our ability to then go and create economics. So -- and back to the Medicaid question as well, we'll see the system transform through the provisions in this law, and I think preventive care and investing now for what is to come down the road is a critical part of that, and I know that you all have, you know, certainly measured that here today with this discussion. But the accessibility that this plan provides is very, very important to that -- that bottom dollar that we're trying to, you know, avoid hitting. We're trying to not break the bank, right, so that's what this is really laying the foundation for. >> Marge Petty: And it has also laid the foundation for incredible partnerships. ^M00:41:10 Another example of those partnerships is the partnerships with hospitals. You know, in 1999, 98,000 people died as a result of condition or an infection of something that was a result of them having been hospitalized. One of the things that this ACA does is create the partnership with all these hospitals, advocacy groups, patient advocates who have joined then to focus on, okay, what is going on in a specific hospital that could be corrected. ^M00:41:47 And it is so exciting what it -- Seton Hospital is a perfect example of that. They had -- they were not satisfied with their birth trauma count numbers. They weren't bad but they thought they could be improved, so what happened was voluntarily the team of providers, the nurses, the physicians, the OT, all the collaborative team started looking at what was affecting those birth trauma outcomes. It is now at zero -- >> Really? >> Marge Petty: -- in terms of birth trauma, and that affects the amount of Medicaid costs that end up being supportive of -- >> A lot of time. >> Marge Petty: - for a life time. So that in itself is just exciting. ^M00:42:37 We've had over 3000 people sign up to say we want to be partners. Another example would be something simple like at the Baptist Hospital in Dallas, we had basically a partnership celebration where there were -- there was a physician that came in and talked about a specific incident where nurses would say, well, we're not -- we're not spreading the infection. We never touch the patient when we go into their room. What they'd done was they were pulling the curtain across as they walked in, and the curtain was examined, and it was filled with bacteria. So what they did was it became routine to spray it with disinfectant and the infection rate went down. Same thing in VA hospitals. ^M00:43:22 They did a research project to follow about 153 VA hospitals, and the reduction in infection rate was like 64 percent reduction in infection rate. So the target in the next three years for this partnership for patients is that infection rates would be reduced by 20 percent over the next three years and readmission rates would be reduced by 40 percent because of -- >> Gene Rodgers: Well, there's a reduction in the cost right there. >> Marge Petty: Exactly. >> That's fantastic. >> Marge Petty: One more example. ^M00:43:56 >> Gene Rodgers: Well, this is like -- consulting with the ACA is like a big onion peeling back layers and layers and getting more and more information and becoming more enlightened. So I'm looking forward to what we can learn in the future. And, gentlemen, you have any more questions that you - or comments?. >> No, this has been most informative, and I'll make sure that [inaudible] contain some of those Web sites and your phone numbers as well, because this is an area that -- it's -- well, like Gene said, there's not many layers to that onion that have been peeled back unexposed, it's still a big mystery to us, and [inaudible] this is incredibly important and we should [inaudible]. >> Gene Rodgers: Thank you so much, Marge and the post production we'll edit out Dave and Dennis so we look great. [ Laughter ] ^M00:44:54 >> Dave Dauber: Wow, Gene, I left that meeting my head spinning. I mean, there was so much going on. There was just so many more questions that, you know, I wanted to ask but we just kind of ran out of time. >> Gene Rodgers: We really did, but fortunately her office is open to responding to questions, so if you folks have questions you can either go directly to their Web page or call them or you can send some messages to us and we'll try to post them on our Web page and our Facebook page. >> Dave Dauber: And since you've visit thegeneanddaveshow.com quite often, it's all right there for you in the links. Everything that you heard about during the episode, the phone numbers -- which I noticed you corrected what she said on the phone number -- what she said, she was off by one digit, so just make sure that you look at the phone number on the screen, or for more clarification, go to www.thegeneanddaveshow.com. >> Gene Rodgers: There you go. >> Dave Dauber: There will be a section for the Marge Petty interview. You know, though, speaking of the interview, shortly after that, we received an e-mail of some people that were not too happy with some of the promises that have been made on the Affordable Care Act and then having a lot of these cuts come down from Washington, D.C. and, you know, filtering down into our own local and state governments. >> Gene Rodgers: Yeah, you know, as a form of social media, a lot of folks will send stuff to the Gene and Dave Show hoping we'll get it out on the air, and when we got that one complaint that you're talking about, it was disappointing to hear, but it's -- it's important we get this information out there. We'd like to read some of this complaint regarding the Affordable Care Act, and we're going to read it verbatim because it's -- it's important you have exactly what was said. >> Dave Dauber: "The organization" -- here they're referring to ADAPT -- "is particularly upset because Secretary Sebelius spoke before the National Disability Rights group in July, highlighting how the Affordable Care Act benefits people with disabilities, including potential to improve access to home and community based services. While the secretary gave rousing speeches and was applauded by our community, her staff were crafting guidance to states on cutting our services." This is from Rene Patrick of ADAPT Organizer in Chicago, Illinois. >> Gene Rodgers: And we'll have the full text of this on our Web page so you can look at it yourself and draw your own conclusions. >> Dave Dauber: Yeah, cuts are being made across the board everywhere, and it hurts, but we -- I still hope that the Affordable Care Act will be able to help many, many people out there. >> Gene Rodgers: I would say instead of cuts we should raise taxes for the rich, but -- but then again, the rich fund the re-election campaigns for all the Congressman so that will probably never happen. >> Dave Dauber: Well, as she said, the money that's being spent on the Affordable Care Act, they wrote in matching dollars for it and in ways to make money to make it happen, so really only time will tell. Well, right now it's pretty -- not to be a little bit nervous, but I think all Americans are because a lot of their favorite organizations and things that they need, their ways of life are being cut, and we've got to do something. >> Gene Rodgers: You're absolutely right, Dave. ^M00:48:49 [ Background conversation ] ^M00:48:55 >> You can go to thegeneanddaveshow.com for more information. Thank you, folks. Thanks. ^M00:49:01 [ Music ] ^M00:49:24 [ Silence ]