when they can leverage that rate no matter what the hca does it doesn't make a difference because the providers can do what they want. >> when you say providers demean insurance providers for healthcare providers or the doctors themselves? >>caller: no no no. insurance at kaiser permanente. >> that's interesting because we hear medicare is called the 800-pound gorilla which means when medicare set the rate for something, the private insurers tend to follow. because medicare is such a big player in the market so it's interesting to hear it is the other way around and with the private insurers set the rateu the government has to follow. thatlo is intriguing to me. host: do you have a follow-up? >>caller: medicare does rule the rates. she is right butn we have thousands upon thousands of my state people that are not medicare or medicaid eligible that's with a leverage happens. people that are under that medicare age, yes they can leverage whatever they want. >> i see. that make sense. host: follow her reporting at nytimes.com also on twitter thank you for the conversation we appreciate h
