raising revenue by doing things like modestly limiting the tax deductions, the wealthiest americans can take to the same level that it was at the end of the reagan years. same level that was under ronald reagan. some are concerned that this will dramatically reduce charitable giving, for example. but statistics show that's not true. and the best thing for our charities is a stronger economy that we will build with health care reform. but we can't just raise revenues. we're also going out to to make spending cuts. in part by examining inefficiencies in our current medicare program. there are going to be robust debate about where these cuts should be made. i welcome that debate. but here's what i think these cuts should be made. first, we should end over payments to medicare advantage. [applause]

>> today we are paying medicare advantage plans much more than we pay for traditional medicare services. this is a great deal for insurance companies. it's a subsidy to insurance companies. it's not a good deal for you. it's not a good deal for the american people. and by the way, it doesn't follow free market principles for those who are always talking about free market principles. that's why we need to introduce competitive bidding into the medicare advantage program. a program under which private insurance companies are offering medicare coverage your that alone will save $177 billion over the next decade. just that one step. . .

[applause] these are drugs used to treat illnesses like anemia but right now there is no pathway of the fda for approving generic versions of these drugs. creating such a pathway will save us billions of dollars. we can save another roughly $30 billion by getting a better deal for our poor seniors while asking are well-off seniors to pay a little more for their

drugs, so that is the bulk of what is in the health reserve fund. i have also proposed saving another $313 billion in medicare and medicaid spending in several other ways and one way is by adjusting medicare payments to reflect new advances in productivity gains in our economy. right now medicare payments are rising each year by more than they should, these adjustments will create incentives for providers to deliver care more efficiently and save roughly $109 billion in the process. another way we can achieve savings is by reducing payments to hospitals for treating uninsured people. i know hospitals rely on these payments now, legitimately because of large number of uninsured patients that they treat. but if we put in a system where people have coverage and a number of uninsured people goes down with our reforms, the amount we pay hospitals to treat uninsured people should go down as well.

in reducing these payments gradually as more and more people have coverage will save us over $106 billion and we will make sure the difference goes to the hospitals that need it most. we can also save about $75 billion through more efficient purchasing of prescription drugs. and we can save it -- [applause] at about $1 billion more by rooting out waste, fraud in a broader system that no one is charging more a service that is worth or charging a dime for a service that they don't provide. let me be clear, i am committed to making these cuts in a way that protects our senior citizens. in fact, these proposals will actually extend the life of the medicare trust fund by seven years and reduced premiums for medicare beneficiaries by roughly $43 billion over the next 10 years and i am working with the aarp to uphold the commitment. now for those of you who took out a pencil and paper, all

together these savings mean that we have put about $950 billion on the table. and that doesn't count some of the long-term savings that we think will, about from reform from medical i.d. for example or increase investment and prevention has so that staff in congressional jargon is not score a goal, the congressional budget office want count that as savings so we are setting that aside. we think that is going to, but even separate and apart from that we put $950 billion on the table. taking us almost all the way to covering the full cost of health care reform. in the weeks and months ahead i look forward to working with congress to make the difference so at health care reform is fully paid for in a real accountable way. and let me add that this does not count logger term savings.

i just want to repeat that -- by insisting that the reforms that are introducing our deficit neutral over the next decade. and by making their reforms that will help slow the growth rate of health care costs over the coming decades, bending the curve, we can look forward to faster economic growth, higher living standards and falling instead of rising budget deficits. let me just wrapped up by saying this -- i know people are cynical whether we can do this on not. i know there will be disagreements about how to proceed in the days ahead. there's probably healthy debate within the ama. that is good. i also know this -- we can't let this moment pass us by. the other day a friend of mine, congressman earl blumenauer, handed me a magazine with a special issue titled: the crisis in american medicine.

one article notes, soaring charges, another war is about the volume of utilization of services. another asks, if we can find a better way than fee-for-service for paying for medical care. it speaks to many other challenges we face today. the thing is the special issue was published by harper's magazine in october of 1960. [laughter] before i was born. members of the american medical association, and my fellow americans, i am here today because i don't know -- i don't want our children and their children to still be speaking at a crisis in american medicine 50 years from now. i don't want them to still be suffering from spiraling costs that we did not stem or serious is that we did not cure. i don't want them to be burdened with massive deficits we did not curb. or worsening economy that we did not rebuild i want them to

benefit from a health-care system that works for all of us where families can open a doctor's bill without driving what is inside. where parents are talking to their kids and getting them to have regular checkups and testing themselves were preventable illness and where parents are giving their kids healthier foods and kids are exercising more, where patients are spending more times with their doctors and doctors can call up on a computer all the medical information and latest research there will ever want to know to meet patients' needs. we're orthopedists and neurologists, on colleges are all working together to treat a human single -- human being. or what is best about the american health-care system has become the hallmark of america's health-care system. that is the health care system we can build, that is the future i am convinced is within our reach. and if we're willing to come together and bring about that

future then we will not only make americans healthier, we will not only unleash america's economic and venture but we will reaffirm the ideals of that lead you into this noble profession and will build a health-care system that lets all americans feel. thank you very much, ama. appreciate it, thank you. [applause] ♪ ♪ [applause] ♪

people like to have books. it is a very sticky medium, you have seen this medium obviously be sticky since about 15 or 68

centuries iraq tonight on the communicators the co-chairman of a grossman, owner of random house on how the publishing industry is changing. >> when you read something great you want to be a kind of heirloom product for you personally. and when you have digital media it is harder to read that to be true, you can't actually be proud of a bookshelf and that is a memory stick. >> the future of publishing, tonight at 8:00 p.m. eastern on the communicators on c-span2. >> later this summer there will be freezing in the secure side passenger id system, we talked about at this morning on the "washington journal" were about 30 minutes. >> host: kip hawley, head of the transportation security administration from 2005 to 2009 joining us from mountain view, california. thanks for being with us. >> guest: thanks to be here. >> host: looking at the

baltimore sun reporting about this tsa to require a gender, birth date of wires as part of secure allied airlines last passengers buying tickets to provide their names exactly as it appears on a government issued identification a plan to use when travelling later this summer there also began asking passengers to ride their birth dates and gender. what sort of issues does this present number one to fires and number two to the airlines to have to implement the policy? >> guest: fourth wires i think it is going to be a great thing because right now the airlines do the matching between the watch list of passengers and because they're careful to make sure nobody who is watch listed gets on it without being checked, they sweep in a lot like thousands and thousands of people every day to be screened potentially as if on the watch list and by having the government keep the watch list inside into the matching itself, that will eliminate all the

extra scrutiny for the people who there is no reason to give them extra scrutiny just a piece of their name matches a piece of the name of somebody on the watch list so i think it will sharply reduce the number of people who think they might be on the watchlist. >> host: who is responsible for taking a look at that watch list and where along the process when i buy an airline ticket how does it get looked at for matching against the watch list? >> guest: the way it works today is at tsa sense of the watch list out to every airline that flies to the u.s. and that is all over the world. the no-fly list and the other so-called select the last and that is confidential government information going out all over the world so that's its own security problem but then the second piece is in the airline then on their own try to match the names on the watch list and the names on the passengers, some do a good job and some do not. the problem is if somebody has a

name that has a piece of a part of a name that is on the watch list, they get pulled out and questions asked and think, with a minute, what am i on the watchless when they are not on the list. so the government will be able to have the names of the people on the watch list and because of these extra identifiers, the gender and date of birth, if you have the full name, you can get within over 99 percent accuracy so you don't have the people thinking that they might be watch listed one of the have the same close to somebody who is. >> host: kip hawley is with us to talk about secure flight in its implementation, (202)737-0002, democrats, 202737 for independence, a recent article in the business section at the have lifeline question no nicknames and neck security step involves will formal names on

tickets. address again the responsibility of the flyers so a fire going when the secure five is implemented will have to put his or her full name including any sort of junior or the second or things like. but if they have ideas, multiple ids a driver's license may be different from their passport size -- how they rectify backtracks. >> guest: it is very simple. by having the gender and date of birth and the name that you use that is associated with your government id, they can 08 ride in and they have accounted for misspellings, they will learn when you're nickname as so you should put it like for instance, my official name is edmund although i go by kip on everything so i have on my plane tickets and men and then that will clear. it is not a particularly big deal and remember what tsa is

doing, there are not try to chippy opt, there are trying to eliminate you from the list of people there are concerned about some other system is designed particularly because with the gender and did your birth they can account for some of the very -- princes that lots of people have and clear you without hassles so it is not meant to chippy lap. the more detail you put into the more material that can hear you. >> host: you worked as head of the tsa for four years and help develop this secure flight program over the last couple years. i read an article, i don't have in front of me, that pierre riss saying their role of the administrator is two stop attacks, how much does this new system and. >> guest: a great deal actually. one of the problems that you face if you are tsa is with your allied countries and intelligence services or law enforcement, our own fbi as they are developing means of terrorist plots in action, that

material is available to us, but if we have to send it around the world to all the airlines, these other people that certain intelligence service is looking at right now but might be plotting attacks, that will leak out and disrupt the investigation so the ability to keep those laws confidential means that whenever there is somebody going on around the world, that we can quietly put those folks on of the no-fly list and be sure that they are not going to be flying. the way the system works today is in any kind of series of events like the 2006 liquid bomb plots in the u.k., we had to wait until the last minute before some of that confidential information could get distributed. so this means you'll have more time to plan, less disruption for passengers, and i thank you have a tremendous impact on our ability to stop attacks as early as we would like to. >> host: let's hear from callers, pittsburgh, good morning on our democrats line.

>> caller: good morning. i wanted to ask if you please answer the first question that you asked and that is, are you asked how this is going to actually affect passengers, how this is going to work? how is the information getting to tsa? you answer that by saying how it happens now but we already know that, we want to know what's going to happen in the future. >> guest: good question. so the answer is that when you make the reservation whether the airline were on-line with the travel agent or in person with a travel agent they ask who are you, what is your name so there will be fields to fill out, what is your full name, what is your gender and did a bird so in those fields are available to you when online or talking to someone on the phone that will be the difference. give them your full name, gender commentator birth and from there on is to be seen as because after that point they will do the matching and say you are not

watch listed, not a problem and then the discarded the data seven days later sunland of this is kept beyond seven days unless you are a potential match. >> host: this doesn't add extra step in line to security at the airport? >> guest: no, it clears that happen means that you don't have to resolve -- and there are a lot of people who can get their tickets at the kiosk in have to go to the desk and convince i am really not the person you want. this all happens before you get to the airport and that music can be printed your boarding pass at home or the kiosk. it really will make a major convenience difference. for the passengers today to end up with these airport hassles. >> host: next call from alabama on our independent line. >> caller: how are you surprised my question is, the first caller and i want to know, you have to put your name and your gender in your full name

like on your driver's license, right? >> guest: yes. >> caller: my question is, i know a lot of people have been exchanges. how would you do that with those people because they really tell you i am a male or female and can be confusing for security and i wondered how you would do that tracks. >> guest: there is a category you put under janet -- and gender that indicates that and that is a combination in the system. >> host: kip hawley, what about different airlines and travel sites, or bets, etc. use proprietary system for booking tickets, how will this affect what they do online? will then need to be in homogenous type of booking system on-line for all travel sites? >> guest: all the have to do today, everybody has a field for your name and they will have to add gender and date of birth and say please write your full name. but you raise a great point

races is not just the airlines to have to make the changes, it is all the online folks all the travel agents have to adjust their systems. it's a pretty simple a thing changing the forms, just adding another field with this information on but getting everybody to do it is what takes time and, in fact, there are four airlines today that an operating within and unable to do it. over the next year the rest of the airlines and the travelosity and its media and all the travel agents will have their systems windup. >> host: which of the four airlines currently operating under the new security? >> guest: i don't know off the top of my head but not the majors unfortunately. there are some borden progress of airlines that are willing to step up and do it. i think the major so-called want to take a cautious approach to its but my theory is once one of them jumps in the system that would be such a benefit to the customers that the others will

have to for competitive reasons, but it really needs to the airlines to get behind it and make it a priority and push it through so it is totally in place in 2010. >> host: arkansas, this is little rock, good morning on our democrats line. >> caller: yes i would like to know the policy that you're trying to put forth, would it have a -- would it cause 9/11 problems? >> guest: well, if they were on a no-fly selectee absolutely so the key to it is you raise an important point. if you know somebody, if you have a suspect, if you know this person is involved with tears activity then you have the name and, yes, it will stop them. it will not stop the unknown terrorists, so there are folks out there who are unknown to the government. this particular system does not get at that but that is why you to check by screening and that is why the have behavior

detection, checking your id and checking your belongings so that will catch somebody who is not known to be involved with terrorists. >> host: new jersey, independent, good morning. >> caller: i'm with you yes. >> host: go ahead. >> caller: my question is, could 9/11 possibly happen if the cockpit's had been secured in as the israelis had suggested to us? >> host: it would have been secured? >> caller: the cockpits is mike the cockpit door is our strength and, that is one of the persons down after 9/11 and the federal air marshal system is up and operating and when you compare to israeli security those are two of the critical pieces of in-flight security that we have in place today. so the visible security on board the aircraft is dramatically better than it was pre 9/11. >> host: to a republican line in coleman, new york, you are

on. >> caller: i have one comment. ever since they have this hassle and security as tight as it is at the airport i have thought stopped flying. i am about to do the same thing about not going to canada because of all the security and everything you have there to appear in a sari, but pifer and simeon and taking my freedoms away. >> guest: make i make a quick comment on that. one of the problems tsa has had because previously polls show up with this check point in you don't know who they are, it is anonymous person and it gives a feeling that tsa is treating everybody as if they were terrorists and that is extremely unpopular and obviously we all live nancy most people are not in black terrorists. by having the system in place it will give tsa the flexibility to changeup their screening and focus on those who have been identified as high threat and i

think it will, in fact, made the blind process and security process smoother. >> host: on a different issue the business travel news kip hawley wrote about the house passage of the transportation security administration, authorization planning the bill would return benefits to a program that tsa has largely reduced to a front of a line offering. they're talking about the house bill calling to reinstate an initial and continuous security threat assessments, the program known as registered traveler -- tie that into the secure flight. >> guest: well, there are separate. one is for this secure fight, it is the government information related to who might be terrorists and the upside, everybody would like to get to the line faster in sight i know i am not a terrorist and do a background check, let me through. the problem is that we have that as a private-sector operation and there really was up to what they want to make it which was for their business model in

front of the line thing. i think that already today there are a lot of variations tsa screening for people that have the black diamond lanes and expert traveler, family and it would lanes, and when i traveled and now i just travel as a private citizen, the lines are not to me a big problem so i think there is a business model for the registered traveler. i hope they do as some of the companies in europe do with a tie in things like expedited parking reserve, right up front, and the movie all the way through. there is an opportunity to do new things there. and i think that is a great entrepreneurially opportunity, but it is not to be confused with the security program that secure supply is. and one of the things to worry about is just because you don't have a permanent record doesn't mean you aren't a terrorists because they recruit people that don't have a criminal records.

so there are separate programs and have to make sure you don't cross the to lop. >> host: here is buffalo, new york, good morning on our democrats line. >> caller: how are you doing? >> guest: good morning. >> caller: you said that there is information deleted from the system, correct? >> guest: yes. >> caller: i was wondering what about the frequent fliers and does this policy in any way direct brosnan activity on will line given this is a cyberworld and people should be cautious about putting their information out on the web like back? >> host: we will get a response, thank you. >> guest: the reason it has taken so long for this to get up and running is to guarantee the privacy protections and for the risk of lawyers there were lots of legitimate concerns about specifically the privacy of the data. the whole system has been

rewritten to ensure the privacy of the data and the two best things are it only takes a very limited amount of data. you're name, gender and date of birth and is read of that seven days after you fly so take the minimum amount of data and get rid of it as fast as you can, i think are pretty good protection's. >> host: new york times says that it will begin to be kicked in later this summer, kenya pin that down for more exact date as far as you know? >> guest: no, i think that it is a moving target because it's up to the airlines and the travel agencies and everybody else to get it implemented here it as i understand from tsa, that the plan is to get a completely in place by the end of 2010 so that it says can of the airlines and everybody else time to do right, time to reprogram their systems and the connected and that sort of thing here it is really important ones the switchover to the government that everything go absolutely

smoothly and that as getting it done fast but downright eric in. the day to write down his 2010. >> host: you worked on the secure fi during your tenure at tsa, are you largely pleased it has gone through largely unchanged in the new administration? >> guest: yes, i think this is not a policy issue that would change that i am aware of the year ended it is really basic, matched the watch list against those traveling, and the government accountability office, the gao participated all the way to the billing of this until it was finally approved so i think this is a very limited program that is due to get going and i don't think there are policy issues whatsoever, not with the new administration. >> host: texas on our independent line. >> caller: thank you