Charlie Baker

Top fitter and yeah welcome back to solid number 1123. Out of three of ignorance or a hot. I may have succeeded WRKO with Todd fiber of my cost in -- pick a president and CEO. Of not happen. Yes I do yeah that's a good thing president and CEO of -- some people's egos you know some after you present it yeah this. Is exactly right in that it in the beneficiary of some of the splendid health that we enjoy here in Massachusetts I gotta tell publicity radio audience. You know challenge challenge is on crutches and the cast and all the rest that -- little vacation accident as he took some time out with the family so hot how commune -- Charlie. Because he is the really the acknowledged expert on health -- and in. They're -- don't have any question oh we have lots -- while you might not okay yeah you go to the the only yeah -- about the budget to -- is that -- you and I spent some yesterday's -- so so we have health care problems which then involve the budget and create its own kind of ramifications as you know. In -- got so many articles that have been appearing on health yeah. Doctor -- over there at -- recently about primary care physicians. You folks right on the front page of the paper today it says this insurers to -- drugstore clinic. Visits co payments and all the rest exciting news. About want to talk generally about drug costs because we're gonna have weakened and needs some. -- from the drugs for you because you're completely different -- and that's pretty August and then the federal way vote you know what happened that is the big that you should say yeah that's hot hot hot so we welcome jolly -- who's been with us. Off from time to time just to bring us up to speed on what's going -- can set the table title of the -- I just cause trouble because -- because this trouble and he's he's very very critical if you probably know of the legislature in general Democrats in particular that he gets confused as Jimmy's comments since -- means has with -- My theory and it's everything's right with you frequently. As one dies slips or who rationale hop hop hop hop doesn't let the rest of -- the hook up their -- is tied together. Health care costs in Massachusetts with this new let's cover everybody health care for all kind of approach. Ian budget costs. An associate with that pushing out Costa and others tell it what should take on what's going on. It's been bid Robbie was take credit for and -- and I'm not sure whether it would continue to battle on this as it now we evolves to another perhaps not sustainable face what you take.

I think the the short term story and that is the a big driver behind the original reform plan with the fact that the state had this federal waiver. Sort of hang out there and federal waivers just 22 words but they represent about 400 million dollars in federal.

Money and that waiver is basically the government saying this pot of money that is intended for a certain purpose were going to broaden the the purpose for your benefits you can experiment with this plan to -- the way.

I mean a waiver was originally part of a deal was cut with the federal government when I was -- in the moon while the ministers and and and it was designed to basically be used by justice expand coverage to. Two people we added a couple 100000 people -- to the Medicaid program but that a big piece of it was also to support. Care that was provided and in hospitals for people who inept coverage and couple years ago the -- administration and and the -- basically said we'd like to use this waiver money instead of just paying for services it -- hospitals would like to use -- to cover. People who don't have insurance we'd rather cover of people and just pay for care institutions. And and that led to the health care reform bill -- passed and you know the map on the health -- of people need to remember here is that the if the map on the health care reform goes off by. I had say this for a couple hundred million it's actually met a gigantic number in the grand scheme of a basically billion dollar program. I mean there's a lot of money at stake here in a lot of money at play and we're three years into with the states and -- more people than they thought they are all. That's created some issues form. Man they've made some decisions along the way on the margin animated difference of amid the program a little more expensive Charlie -- either going to have a I mean you get out their couple years from now I'm. --

Pretty -- gets worries of how many people covered today in Massachusetts. That we're not -- before this new law took effect. Somewhere between 30350000. Token and it and I think the point that I take from you you your first comets it targets are reached first response to a question was that. The and they now get the health coverage because they average shoe as opposed to chests on a Padilla has shown up at the -- What has been declining ER utilization. We're here if I assume a problem not covet and I have an insurance policy -- less likely. To show up in the media by the way I used to under the old plan the old the old rules there's been a big drop in in the areas since the implementation of form go. Like 30%. That is spec that is a big big number no question about. A year on the front lines along with. Folks like these killings worth who's present at the blue cross blue shield. Jim Roosevelt that tops. In tough times you folks at least as -- the about the logic cultural a lot of society movies books and everything else. They absolutely land based HMO that you guys have kind of like HMO which is supposed to -- it -- the yeah yeah the bad guys is no question about it and it -- people in a lot of people. Who's you know kind of point say it's the insurance it's of those guys that's -- sodium expensive here in Massachusetts in an America. 20/20 530%. Of health care dollar consumed by. Add -- managers who just look at to deny claims leverage to scrap the is -- the -- crap. Well that's -- given him a chance to -- based back.

The hum. Lacrosse tufts and Harvard pilgrim just victory very. -- Edmund costs represent somewhere between six and nine cents. Of our premiums that we collect so if you opinion dollar in premium less than a -- has been -- to fund. My costs of administration overhead and whatever march and I have ninety cents of that dollar or more has been spent on health care services provided by -- hospitals drugs all the.

Well what do you say then two people advocates single Payer they say why have all these different organizations out there crunch this may be against down 5% error or 4% or 3%.

The big issue I have a single Payer is as look at the Medicare program and Medicare provides coverage people over the age 65 took. Almost forty years in the institution of the program to get around to creating a drug benefit. It's basically one plan designed there's no variety at all there's very little choice the rules of the rules the rules. And you know this is a country with 300 million people and generally speaking people in this country like choice.

But that's the nature of having a social program in other words that's Universal Health Care that's not the problem with single -- and you you can you can leave the system the way it is and have single parent bring down costs now.

I don't think well I think you could. It's theoretically possible and you could bring down the cost but the thing you have to remember is if you bring down the costs through a single Payer approach you also take. All of the choice that basically assists in the current system out of it mean -- Carolina about service because. You know somebody doesn't think I'm doing good job servicing. Their business they can take it somewhere else same goes with. Product designer Carolina about what I do with regard to product that -- lot of bomber relationships with providers -- Carolina bomber relationships my members. Because people have choices if you end up in a situation where it's. One set rules one player that saw. Then where is the incentive deal with the Soviet Union always telling me what -- you can have any tell you want to point is black I mean -- I just think the.

Well anyway errors -- differences between which I mean I go to the doctor I don't know which planet have until they say show me your car and and I look at said oh I forgot. And I give -- it's meaningless to me what insurance company -- Is anyway I don't what's the difference between now.

How much time you go and time do you spend with doctors have fortunately he's not a lot okay well I mean that's part of it I mean I think the I think for people who don't use the system very much -- probably is relatively meaningless until they actually have to use it and -- it would matter a lot. Into employer let me jump in here -- an employee Europe and you -- you know whether it's at 1010 person -- 5000 person for a I think you'd like to be in the position of saying have -- of -- which Olympic -- people and have a program offer meet. To modify my employees in terms of designed plant and G aren't going to get the people from -- inherent blue cross blue -- by the like a little competition to shop and I would think. Everyone's game and everyone's like assassination.

Except the game doesn't show benefits of carpet just want to shows is hugely spiking -- year after year here and and to the point. That the socialists are feeling justified in wanting to socialize so he did it to me that it's totally a 180 degrees where your -- him.

That we kind of if -- hit his if he had six or seven sensitive if if if that's the cut if that's the premium dollar six -- seven cents for a what Charlie baker have a -- provide. Despite it costing you wonder when he I have been that 101214%. Medical inflation aspect because as a government from. Then I mean I'm not making a commercial for Chao Li an and blue cross blue shield the tops the spike in costs is coming from a runup in everything so when you do show up. Really thank god because you're healthy guy but when you do show up and okay -- the you're not expecting the treatment that they were given in the 1950s for glaucoma.

Or -- treatment 2000 name in the 1990s or even early to even 2000 until I don't want the 2008 treat and is so why has its better insurance companies investing argue how do you know every Carol you'll get involved in specific treatments. Well we get involved in financing the care that's provided of people saw somebody needs new machine doctor eventually we pay for sure -- overpay for a through the -- to pay for the services that are audio but that's different than if you're front in the -- becoming a partner basically in their practice and saying you guys need to have this here's the capital go by this -- 5000 -- we did do that people would. Give us an enormously hard time bill one of the I'm I'm not suggesting is shown to China and selling sang in terms of being that your investment.

I think I mean that the simple truth of the matter is one of the reasons health care cost co -- is because the system can do more things for more people every year upswing it's very inexpensive to say there's nothing we can do for you that is really cheaper cost nothing and doctors are going to have them well but they don't have to say that as often as they used to and there are a lot of opportunities note that used to be this up and we can do for you -- now here three -- things would like to try. Let's see what half.

That's an important point about the rising costs of health care I think -- is that we do have. Unrealistic expectations or will have a rich -- expectations we all expect to be treated like we've got all the money in the world and that comes back on you guys on the insurers. But I'm not sure that. You know if we really want to bring health care costs down that that we have any choice other than to us have somebody start making those decisions.

I mean in defense of what Todd sand if you look at the way this question does join them a lot of other countries they've created. National. Entities typically public private entities that do technology assessment and make decisions about which technologies. They would choose to pay -- which once they were.

Outside of the reassure voters I -- I mean there's an agency of sandwiches -- well what you can get rationing the fashion ultimately than a minute -- the funny thing about it in Great Britain the thing is called nice. And I see you call initially national institute for comparative effectiveness and ice and we should use that I Nevada like that but only let's sign me up with an interest and.

Thing about it is what they basically do is they say as new technologies develop they make the call on whether -- not. They're going to be integrated into the system and they make the call about. For what services and we'd. We don't we don't do that came in the US. Basically what you have to do with a new technology is demonstrate. That the new technology has. The capacity to do something but there's never -- question that's raised about whether or not. Cost benefit analysis or it's more effective than -- less expensive treatment that's already available and that's a big difference between the US and most of the country.

Tom RR call as part of this yeah absolutely Metallica he always takes balls and it talks in politics I even if we had actually gotten -- book about -- and I wanted to -- for governor now -- no I did say that let's just let's get through 2008 let's put everybody get a little -- of them but I don't get through a little -- presidency -- how the program for several -- now. And I believe it's at two perhaps three years in a -- top rated debt Al Gore forty warriors -- voice is already pays any attention to operate on on two. Members' satisfaction and clinical as clinic in clinical effectiveness of that I mean it is that is really 8000. Sweep of the number one in the country and -- And just aren't enough. That's the advertisement that's pretty good and Massachusetts says it's a few of the top ten -- Massachusetts has weren't. Well fool in the top twelve so what we're collecting your messages to know on our industry as you find out when that prostate situation. 6172666868. Is that number we're going to take calls with jolly big Peter jolly pick a name for number years. He is the president CO private pilgrim in my opinion the most knowledgeable guy. About health care health care complex city costs challenges all that stuff. -- was also a top top finance guy -- the welding and salute she had been so people can ask him anything just about -- if he's like is a renaissance man and -- that's a good thing because we need a little elevation in the studio this morning no question about that and last but not least you may have heard his name be added about a political circles as possibly possibly. A future candidate for a for elective office here in Massachusetts which would be a very good thing for us to talk about it so becomes timeouts yet isn't it about it -- has left little I followed a temporary. Write -- Let's go to Jeff college from Salem -- few -- out of the box. With jolly -- from how the pilgrim.

Thank you gentlemen good morning. Couple things I and I believe it was on our tail that he. City. It's that skyrocketing going to the -- that way in my city and Salem and number two. Why is that I -- 15000 dollars a year out of my pocket. Insurance in the -- my wife but few months ago twisted her ankle. Went to the emergency room they put a bandage on it -- screen NG it was Welling up and turning black envelope. And I picked it can get an X ray predicting and it she'd said no you have to leave -- get a referral from your primary care position. Now she what if I didn't have insurance a primary care physician boy and get -- what do I was an illegal aliens. Big that you would get the old boat you would get extra day you would get a doctor you would get any medication would need and they pay nothing.

Bush is why Barack Obama said recently that all Americans and easily learn to speak Spanish. A W wise guys out there a couple of questions to their knowledge -- taken which everybody wants the cost of the policy the treatment that is -- I've received and then this other controversial issue AG in all the people are shown up they don't have anything and they get that they get that soup to -- street and Jeff.

I guess the first thing I would say is I don't know of any policy -- issue by any plan where if you show up in the yard and your injured. You have to get a referral for anything that is bizarre to me and I'm sorry if we're one of my members. My money gets a phone number off the air and talked about it afterwards is that it doesn't work their way and it's not supposed to work that way and and I I don't understand why.

Well they might have made the decision one wasn't necessarily I think I have you want to challenge to go see your doctor error -- referral when she she wouldn't -- and -- office that the make any sense. Ominous for a lot of things happen economics piano. As far as the second part of concern. I do think as a general rule. The most of the people I know work in the yard in the arts when standard care mean they've basically provide the same level -- service to everybody from them insured or uninsured -- insurer which is why -- find it. Really distressing that somebody with -- treated differently simply because there's post treat everybody the same basing their presenting symptoms.

Charlie from here better position of the you know at the top of how the pilgrim and you're looking over the lunch large scale of the operation. We hear from time to time -- an explosion and pharmaceutical drug costs that's really driving a big part of the picture so on and so forth. What's your experience of what is the data show he is did not cost benefit analysis that you go through is there an efficacy standard that you look at in terms of the OK we'll pay a hundred dollars a hundred dollars per pill for these pills because it's gonna. Forestall us from a two week hospitalization -- you go about that.

Generally speaking the -- the interest -- thing about drug costs is drug costs last couple years have actually not been. As dramatic in terms of their increases they were you know 567810. Years ago when the reasons for that is that is -- Miller's the decisions that the plans made. To basically give people -- co pays on generics and a higher co pays for. Brand name drugs come that actually worked mean if you look at. Harvard -- on experience in the of 2000 is somewhere in that vicinity about 40% of our. Prescriptions were generics and if you look at today it's about almost 70%. It's has been tremendous movement for a few bucks okay for people to move from from brand name drugs to generic and that's actually creating competition. Around where you land on the foreign military. Among the drug manufacturers and drug trend the last few years has basically been 67%. Which isn't. Two or 3% but it's -- hackable less than the trend deceit for the rest of healthcare.

She's saying it's striving more producers to get into the generic business because you guys are more willing to buy them.

Well generics are cheaper to the consumer yes okay which. Fundamentally is where the thumb is where the difference is comprised of the action on this is that Todd Feinberg and Tom Finneran act as rational consumers when we get a prescription and we can get a generic substitute. In your healthcare plan tells me hey Tom -- if you want the brand. Lipitor -- five -- yet do you generic you know it's 55 so I've -- I'm a rational consumer hasek and keep the twenty in my -- a minute ago with the -- ultimately.

Probably do you say your dock you know as a generic the same as the print job and your dark and 99% of cases -- set and Massachusetts actually. We're generic -- state by statute yeah regulation which basically means that there's generic equivalent available there. Supposed to scribe with a dark unless that I -- over rights exactly yeah.

Maybe you guys are requiring that that generics young.

No just the opposite the the notion here is -- not matter -- we get we get to choose whatever we choose the high brand the high cost -- we're gonna pay off the other thing that's happened has mail order has increased a lot. And we've used cocaine says that you know you can get.

Seeing at the knockoffs and Shannon's. -- Look at that he says is it over the development I think they get all over me about it at that you know you ever think of the word punk how serious this is this that would cut our. Yeah I get nervous you got all these emails saying you can get this drug cheaper and I'm thinking who knows what they've put in this thing I know that's coming from.

Different issues but I but the -- generally speaking. The movement toward generics and away from brand has not been a bad thing for the consumer or the health care system and and most physicians frankly think this is okay because they appreciate the fact -- to the generic the last. That's a good thing for their --

It's great six went 72666868. Is the number with talking and Talley -- he's the president and CEO of how the pilgrim. Most knowledgeable guy on the planet I'm gonna exaggerate and a rabbi reintroduce him a reset at the scene the most knowledgeable on the planet on health yeah. And he's been doing a for a while and he knows what the hell he's talking about I -- immediate health care questions that they were going to get to those. And I want to talk about primary Q positions -- when we come back coming up on break. And I take some calls Leo we're going to tech columnist primary care of positions. -- saying is that an idea -- and rash ration care and a different way when I talked about all that stuff when we come back Todd vibrant Tom Finneran and jolly -- Willoughby back to you and mama bunny and succeed WRKO. Welcome back. Job generating here on theater it's for money at 680 WRKO Michael post in the act KO studio is -- by aggregate to delight to have him back and also a delight to welcome to the studio continue our conversation which -- baker. President and CEO of how the pilgrims and knowledgeable about a multitude of things start it was about healthcare he knows more about that in the top rated health plan even that nation for years in a row on two. Appointed management consumer satisfaction and clinical outcomes quality outcomes while it is quite a comic that. Jolly date he should be proud of not only -- promised that the performance of your -- team the team to put together over -- you're gonna have a program now for our news 19 years -- changed how we gonna. It's -- the themes of hope and change and audacity you know those that let's take some calls first however let's go to bill. -- is calling from -- bill welcome your idea with Charlie -- in Todd vibrant.

Good morning mister baker right and a member of for a long time and really enjoy the the services. I'd like -- know. Hello. Yeah we you know yeah. I know I have a -- a replay has more quickly its single payment for single people. Married people would be so people -- in a fairly in which would be three or 43 members -- more.

Bill we do in some cases do you buy your -- you buy your coverage educate you can overseer employer do you buy -- very -- it's all. We do make those we do have we do have those plans available to town Wellesley. Is part of a purchasing collaborative. May be that the purchasing whoever it doesn't buy it though way. But we do we do and have made those plans available that way to people in the past.

Your your problem bill is that is the big wacky get gone from single family right.

Well I I consider -- you know we have retirees that are you know including myself is only my lights and I -- learn there's no immigrant make apparently so like to repay a higher rate.

Not a good it's never stopped trying to build the my. You given up the Hubble once bought and by the way they got some great techniques of -- I don't know.

I will will. Oh candidates but that we do so we do so these kinds of plans to other employers -- find out why why it is that that's not offered through through the Wellesley collaborative that's a good commercial bill made about his present positive experience that would have -- so that's great call 6172.

666860. -- the ability to we have so let's go to bill in New Hampshire next on parents forum AM 680 WRKO. --

Thank you guys it's again in this debate thank you are speaking. -- it will literally are you about the the system in Britain -- validates new technologies and decides whether or not -- you know and you stated that we don't do that here. I worked for companies that does medical products and one of our customers. As just -- The very system are -- the United States. Make -- diagnostic tool or. Neurology. And because. Technology and shortcut that system and take colleges. Specialist the equation at least diagnostic. They are unable to get their product. Approved by the -- Or. Payment from the insurance companies so partners market it uses product. My reasons.

So you're suggesting even -- others in -- government agency standing in the way of of new ways to treat two illness or is that insurers themselves. Are looking to save money. Is that accurate that you guys Steve do you must have to make judgments like that done.

Generally speaking the the point are trying to make before bill was that in Britain is today. It's it's it's that does the thing work that's question number one of them a quick second question is is -- cost effective -- the US we usually only do I didn't mean we didn't do it all adjustment in the US we typically just do the first question which is. Doesn't actually do what -- report.

Without regard for the -- without regard to -- who's asking those questions -- US insurance usually -- the -- I'm assuming that in this case medical device of some sort all all what did not also possibly -- I had a doctor you know hospital which on the salesman with a new --

nine you gotta get you gotta get somebody like CM mass which is the federal institute has for Medicare or the FDA or one of the federal regulatory bodies though I -- believe there's a federal regulating. Regular federal regulating agency involved here.

Because those guys are responsible for so many dollars of health care that they would have to sign our effort to be viable -- zealously okay. So it is so it's so we have more a mishmash approach rather than a top down bureaucracy that's saying is one nor you have to get through right you know -- you want some -- don't know he's got a.

And on unfortunately. Unfortunately Kazaa I would I would look to a followed up what that a get a little bit more detail let's go to great and Alec didn't -- you've been on the -- deal on hold for a while thanks awaiting you're on the which -- baker and Todd Feinberg.

Good morning good morning Greg nodded. You know from time to put purposes in the state of -- we do about Universal Health Care. Are we going to start being some. Numbers and statistics on. You know who's going to the emergency room while refusing -- medical system without it because I'd I'd like to see I'm kind of curious you know if they're both sides of the argument probably illegal aliens are here. Like this -- you know what percentage. Because I get hit -- what we went to pick up. In the end right when someone goes to the hospital without insurance. Well we'll go into a tax write off. We spend that money the state doesn't get which then all Indians do pay for that in that visit right.

Most of hospitals that do business of Medicare which is pretty much all of them are required under federal law. To take care somebody who presents in the emergency room.

Domestically you've college and I mean I think that as a society you have to out of out of place.

about war where's the money come from this estate fund to reimburse. How many cents on the dollar for a for indigent patients treated in the emergence here.

It depends but the average stay right it's probably about fifty or sixty cents.

But you're seeing another what's the bigger -- remember -- you know how many people are shown up without. Insurance.

Yeah I mean we talked about this'll earlier in the program Greg the use of the -- Mum for uninsured people has dropped by about 30% since implementation of the reform bill.

Which has 300000 people on federally insured 300000 plus but have you seen the numbers and another way and in the way that I Greg is talking about do we know what percentage of people are using emergency rooms -- what percentage of the dollars coming out of emergency rooms are actually the result of people going in there as their primary care physicians.

Oh the interesting thing about that one is if you look at ER use generally. About 20% of people. Show opening are actually have insurance 20% 20%. 80% totally uninsured. -- and -- an excuse me 20% of private insurance manipulative. You know 20% of Medicaid Tony persona Medicare I mean it's pretty evenly distributed only about 20% of the folks who show up. Our allies for not urgent purposes are uninsured.

So that may okay that it might have Medicare and Medicaid all right Harvard pilgrim plant some kind of private right private plan. And 20% an inch was ever before and number rafter and number got busy you're indicating that this helped new health thing -- this what is I don't know other numbers are now. -- might be different now they -- have changed. I think at least two to call us and I suspect many many other calls wouldn't and we'll continue to raise -- this whole issue because that is awful lot of controversy around. The notion of you know a document that.

Citizens are -- yeah -- at this is resilient this is huge issue this is really mean conceptually I totally get it which is that mum what are we doing. Paying for the service for people who are here illegally to flip side of the island is if you're better in the yard and somebody shows. May have broken -- your war appendicitis -- some -- that you literally Europe only handle turn them away have a legal I want to federal important.

So yeah but there's also people go there to get their throats chapter whenever I mean they use it as a primary I don't that's that's the problem and actually -- from the minute clip takes some of the essence of -- I think -- a great development let's go to Johnny up in lol hey Johnny welcome here on the it would -- up.

Army and generally good money Charlie -- load is generally against that poppycock. Ha ha ha -- I'm right here -- jolly jolly is a regular elicited Johnny we know your regular calls this a match made in heaven.

But I get to questions fully. Single white suburbs like artwork of mentality going to -- will surely you month.

Totally depends on what kind of plan to buy journey but I'm.

Political -- one I got it didn't we got a discount stories about 500 -- at least we know the John. 44 when four. Is on the hill.

Now now I would say the I would say the least expensive plan for somebody. Falls into the category would probably be in the 250 to 300 dollars in earnings aren't. A month yup that amount and that's the least expensive that's -- that's a single by a single guy no fairgrounds.

Yeah much to ensure that has been gone -- Pop pop -- I don't Johnny Johnny -- If you wondered if you -- information and then -- I'm -- give. Is producing your phone number Amish -- ago that's -- that's reference Johnny Lola we'll take a sharp break be back with jolly -- it and your calls and Obama thought AM 680 WRKO.

Hey welcome back Tom Finneran you listening to -- foreign Todd fiber -- my call yeah I KO studio. And of course our special guest this hour has been Charlie -- president and CEO. A Harvard pilgrim who's been sitting by the way the most comfortable chair in New England it's -- friends separate Korea's leather furniture in Hampton falls New Hampshire it is a beautiful jet carries -- furniture brand name -- any true 45 to 60% up every -- debate we're not going to let you get out of -- studio without -- answering. A political question health care cost -- huge in all of our lives in a big big part of the state budget. The state budget itself and how that relates to the politics of the day today and the politics of tomorrow when the -- the -- you know we have name is always -- about jolly day couple boom -- very successful and -- jungle book you know what a couple of that's not about the combat -- that's Irish political. Clara political and I started yet but believable the rest of the story he has talked about as they'd likely candidate yes in a very impressive candidate for the governorship some days so how does Charlie -- respond to that one I'll let you go into the hands and a dark dodge and -- first this is -- okay. -- guys are nestled in hot hot hot topic right that your.

Stretches and two great -- asked -- to great chair I my in my view on the whole political thing commons. Is is is we should just off. Get through 2008. Once that happens -- exactly see what happens 2000 and pain and then. I'm it's too soon for -- so you want to accept a vice presidential nomination if it's offered I've been given road route I'd rather not too worried about them on.

I've been given the swerved before and just got the swerved from Charlie bake he won't even -- comment on the state budget which I think is precariously balanced if at all and I don't I don't want to use it would balance when I get out of the words dispel some mean disaster. It so pronounced precarious would it quite as an -- what -- yeah its.

I think I think that think people forget is that Massachusetts benefits enormously from -- gains tax revenue because we have so much financial services here. And and that number fluctuates a lot depending on the stock market and if you look at the stock market for the first six months of this year it doesn't look like there's going to be -- capital gains taxes.

You know as a nice ways and their news and bad -- there's a lot of bad news coming and I don't know it's very difficult yeah well -- program that's -- we will close with -- would make a special thanks from -- and myself for joining us from how good luck with the healing via process. He's on the crutches right now folks and but he continues to do a fabulous going to have a program -- general Grady health care if he's always welcome -- its foreign may have 680 WRKO.