Question-and-Answer Session
Operator
(Operator Instructions) Your first question comes from Daryn Miller - Goldman Sachs.
Daryn Miller - Goldman Sachs
Can you give us a sense for how much flu related costs are included in your guidance that you think you might see in the fourth quarter?
Bill Scheffel
We put in there more than we put in the third quarter based on what we were seeing. We’ve got the drug information for most of the month of October at this point for example, but I don’t think we want to put a specific number in there.
Daryn Miller - Goldman Sachs
Third quarter was 5.9?
Bill Scheffel
Yes.
Michael Neidorff
I think what’s important within that forecast, said we recognized it as a major flu incidence of increasing flu and we recognize that in what we see going forward, but we also have offsets one of which Bill commented was that Georgia rate increase that we are not recognizing in the guidance.
So what we’ve done is we’ve said let’s take an acceptable level of increases expecting it to be significantly greater than Q3, but we cannot sit here and say there is clear evidence of a widespread pandemic. We’ll also see that the flu incidences more and more are being treated by physicians by telling people to stay home and do certain things and it tends to be a milder version of the flu.
I will also add one more thing. I had a board dinner last night and we have a couple of board members, as you know that know a lot about this and we were talking about that there were 1000 deaths so far from this flu and I was reminded that in the United States in the average flu season, there are 36,000 deaths.
So while the paper is playing up to 1000 as a tragedy, we have to keep things in perspective as we look at this. We believe we are managing the business. Mary Mason has a Fluvention program in place and it has been there for sometime. So these are things we are proactively doing that end allow us, we believe to give you a reasonable sense of how we see the quarter, versus I don’t know where it is in a doom-and-gloom version, because we think that it could be a little bit less.
Daryn Miller - Goldman Sachs
Can you remind us what your long term target growth rates are both revenue and earnings and then just in addition to that when we look at the current dialogue around healthcare reform, expectations for Medicaid expansion and what that could potentially do to your long term growth rates?
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