Included with the report is a letter from Mark McClellan, the Medicare administrator.

Mark McClellan, a domestic policy adviser, said only "our goal is to stay out of deficits by restoring economic growth as quickly as possible."

"I'm not going to have any comment," Mark McClellan said in a telephone interview last week.

Mark McClellan said the costs naturally increased when actuaries computed the costs in 2014 and 2015.

As the transport process finished and the sparkles faded away, Mark McClellan was left vulnerable and disoriented.

Mark McClellan looked around as Dan crouched next to him.

By now pretty spooked, Mark McClellan froze and watched.

Elbowing aside a piece of collapsed roof material, Mark McClellan blinked through the settling dust.

Mark McClellan shoved his brother around to face him.

Mark McClellan worked his way up from the Kaiser furnaces to management.