than 10%-- i am sorry, medicare does and medicaid woefully underpaid so many doctors won't even accept the medicaid patients because they can afford to do it. who is paying for that is private insurance. the estimates came out a few weeks ago and whether they are entirely right or not i don't know but in the range of everybody paying $1,000 to support public programs to have private insurance. so i think this kind of transfer of the private sector dollars in health insurance to support the public programs like medicare and medicaid are not going to be able to happen if you lose the private system. i think the bigger question is, is that quite fair? is that quite a appropriate? why might make that transparent and in fact why should medicare or medicaid under pay for care of a patient's, and that is the

discussion we really have not had as a matter of fact. and medicaid in particular has been bankrupting states left and right, so i think that before we say the answer is a single-payer government system the public has to be in on the dialogue of exactly what has been that good things and the bad things about the two biggest public programs, but medicaid and medicare. >> host: we hear from another student from a francis khlek of competition. go ahead. >> i am from overland park kansas'. dr. healy earlier you were talking with pedro about the changes in malpractice laws and what that would mean to the doctors but what would it mean for the american public and the patients? >> guest: well, it is very important that patients have the ability to seek recompense if they have been harmed and medicine is a powerful field, and the sick patients are, the more likely they are to be, to

be either out errors or out right now practice and even if it is malfeasance up to have the ability to pursue that rahm. so i don't think anyone would be against, anyone would support not have been malpractice. it is a free them. the concern is that it has gotten out of control and the area of pain and suffering so i think it is a technical jargon that really is separating the legitimate plea that the patient has when they feel they have been wronged versus some of the astronomical court judgments which might be 30, 40, $100 million in some cases not justified and i think many doctors now, you talked to almost anyone and they have been sued many times, and fairly so. that kind of sin as their sole, a good doctor who is torn apart by something that is not justified so we have to clean up the system.

we don't for any moment want to say no patients don't have the ability to sue. of course they should have the right to sue. >> host: one of the discussions taking place is the creation of health exchanges. how will they couldn't see as overall picture of the healthcare plan? >> guest: public exchanges are probably something we should have done a long time ago. basically this is central place where everybody who is offering health insurance us to register their products in a very transparent way. most of this will be officially done online. what their fees are and they have to open it to anybody. and other words they can't cherry-pick. anyone who applies for what they have been that health exchange of they choose that company they have to accept them so the insurance is portable and there are no exclusions because of prior ms and the most important thing about the health the changes that it seems to be agreed on by everyone, is that it will create competition among insurance companies so that patients have a choice. i don't know how pedro but most

often when patients get health insurance from the plays they were, they maybe get one choice or two choices. they really don't have the choice even of the national opportunity of numerous, numerous health insurance companies. and, that would really inspire competition and i think there's no question it would bring down the price for the netherlands has a very aggressive in vigorous health insurance private health insurance effort. i think 90% of the population is supported by private health insurance and the only people who are unhappy about it are the health insurance because the competition has become so robust. >> host: do you think there will be that we the competition that there is a public plan offered because one of the concerns is the mail this competition because insurers will just drop out. >> guest: i think you are absolutely right. i think you have this big a role at the table that basically the stroke of a pen can decide what

rates and decide the regulations. is not is that they have the deep pockets. they have the ability to have that company in any way they want to do it, maybe without the big financial reserves but more and partly they could, they control the regulatory environment, as though it is a little bit questionable that the government would have that kind of control at the table if you are going to have the public plan. you would have to so isolated from the other parts of government that he would say why have it at all? i guess my own bias is, why not start with the health exchange among the privates and let's see what it does in terms of making insurance there come a more affordable and accessible and portable. and without any preexisting conditions. let's see the works. if it doesn't work, then i think we can consider adding a public auction but it will be very different day that. >> host: at our next call is from the kerber washington,

susan on our democrat line. >> caller: hi pedro. pedro? >> host: go ahead. >> i am a-- harms patient's dude to the medical care. i was the eighth crohn's patient as well as arthritis. i am sure she is aware of the confusion i went through. there were charges but they never went after the drug pusher who is now pushing for even idf symptoms, because we can make money. liford doctors prescribing it even for football injuries. anyhow, it made up my bank, so that became another class-action which is the halprin which you know is tainted from where we can say yet. the klute would have been when they were having the fda go to the counties in china and saw pigs without years, that they

cast of thought that they were to become to toys really. the thing that is likely within health care, does the perform but when we look at hatch-waxman, soon to be the bachus waxman act, everything deals and plants, the clintons screwed up with-- for years and years they are not going to give back-- >> guest: the issue of iatrogenic illness is legitimate. the reader brings up something every medical student learns about and it is basically an illness that is associated with a treatment. sometimes for example in the world of cancer therapies, these iatrogenic illnesses are like wiping out your bone marrow are virtually inevitable when the patient understands it. sometimes it is a totally unexplained or unexpected side effect of a particular drug and

sometimes it is an error that has been made in one would have to call that iatrogenic as well, so it sounds like the caller has had a difficult time with a particular drug and i think that all obviously that is something that has to be dealt with in this sounds like you have done so, but i think the broader issue that you are bringing up is that drugs are dangerous medical therapy is dangerous. doctors are dealing with enormous medical powers and that is why it is important to focus on this issue of overtreatment and under treatment because neither one is that. >> host: another student honors c-span civic bus joining us from birmingham alabama. go ahead. >> my question concerns some of the recent criticism from the altar let such as belmar.

"the new york times" said today, how the clinton the administration says it was the overambitious of their plan that caused the demise the my question is whether not obama should consider things that completely ship the system away from employer base systems and the towards things like leckrone transferrer koren sisson system that is exclusively in the pelley paid for? a monthly premium and following up with that question is what with the opportunity cost the of a failed system of obama were to propose it? >> guest: i would say that a failed system is unacceptable because people are sick and people want to stay healthy, so this is an essential industry so to speak. and it is such a big and complicated one that i don't see it failing. i see it being harmed, i see it being moved back and forth but that is unacceptable and will not happen. you know, and the first question was? >> host: treating the payment, it is treating the insurance

like how you pay for auto insurance. >> guest: i think what is brought up in that question is, is there a way to do insurance reform? i think that discussion has not been had. look, we have unsustainable costs and unsustainable medical field. that is a legitimate concern and a legitimate concern of the president to bring it up every time that we must get these healthcare costs in line, and virtually all of that goes to both the private insurers or the government insures. they are the ones who hold the dollars. what we have to do is look of other models, whether it is a car insurance model in which we mainly have catastrophic coverage and a lesser ells of your car are taking care of fatah pocket. we do have some small programs like that, for 5 billion people covered by that kind of program. so i think that we ought to have that debate first before we decide that it is going to be a private system, is so public

system and i think one of the big debates here is, should we have a heterogeneous system or should we have a standardized system in which everybody is pretty much with the same program? that is really where it is boiling down right now, are we going to have pretty much the government calling the shots either of the table on the health insurance in exchange for which detailed regulations or is there going to be more freedom for the individual to make choices? and, that is the model of insurance reform and that really should be the central discussion here. >> host: rockville maryland, ellis, republican line. >> caller: thank you for taking my call. is anyone looked at the fact that a good way to handle the healthcare system would be to put it in the free marketplace where there is no insurance company, no government subsidies, to make a truly competitive. in other words a patient would pay for doctors' visits themselves and there could be a

large-- major catastrophe. >> guest: i think that is in essence the kind of debate that we should be have been. the problem with it being totally paid out of pocket so to speak is that the costs are astronomical when someone truly get sick and when you see bills that can be $100,000 or more, a bypass operation are treating a cancer patient. when people really get sick, those are catastrophic events that you need to have insurance that i don't care how wealthy why are, those bills won't break the bank. however, that this mean bebchuk what you are suggesting is unfeasible for a lesser cost. and, i think we need to look it that and i think that really is the essence of what went on and what was discussed during the past illegal campaign. there are two camps that have been saying more free market.

the other free market has failed. it and i think you are kind of converging on a point that we need more discussion on. let's go one more student from birmingham alabama. goerss at. >> i am from okoboji sparer like i was and i was wondering how obama's new plan will alleviate overcrowding of emergency rooms. >> guest: our emergency rams are struggling and their overcrowded and by the way there is probably overtreatment. don't ever look your bill when you come out of an emergency room because he will find lots of expenses that you might not have to have. it is an area of great litigation costs and malpractice issues and that they clearly to have to address the problems in emergency rooms that all and in general people need help, healthcare whether they have insurance care or not will go to emergency res. we certainly have seen an

increase stress on the health system in massachusetts, who has had a mandatory program so that everybody is covered, so i think that what we have to do is back off and divide your question into two parts. one is let's see what we can do but emergency rooms. they should not have to deal with some of the lesser problems we have to find an alternative way for and the second issue is are we going to need more doctors and more resources for people it one henderson of people are covered? probably more doctors, more primary-care doctors but over all the stations we have to encourage them to come in and get their healthcare and that is a positive thing. the bottom line here is that the american has a web access to healthcare. i think we all agree on that and there many things that have come out in this past some of his best year on this type debate on healthcare and i think there is enough common ground, like let's deal with insurance reform, let's deal with the cost which are out of control in many

cases, and let's make sure that every american has access to affordable and good healthcare. let's go the former director of the national institutes of health, thanks. >> guest: thank you. >> republican senator john ensign of nevada has submitted to an extramarital affair with a married campaign staffer. he made a short statement this afternoon in las vegas. >> i am going to read a brief statement. i came back come to nevada to come forward and explain to the citizens of our state something that i was involved and about a year ago. last year, i had an affair. i violated the bows of my marriage. it is absolutely the worst thing that i have ever done in my

life. if there was ever any thing that i could take back in my life, this would be it. i take full responsibility for my actions. i know that i have deeply hurt and disappointed my wife, darlene, my children, my family, friends, my staff and all those who believe in me. and to all of them, especially my wife, i am truly sorry. i am truly blessed to have a wifelike darlene, who has founded in her heart to forgive me. last year we sought counseling, and through the strength of

family and friends, we have rebuilt their marriage to where now it is even stronger than ever. i will not mention any names, but the woman who i was involved with and her husband were both close friends, and they both worked for me. our families were very close. that closeness put me in to situations during a very difficult time in my marriage, which led to my inappropriate behavior. we caused deep pain to both families and for that i am truly sorry. i am committed to my server is in the united states senate, and my work on behalf of the people of nevada. and i will not be taking any questions. thank you.

>> now the confirmation hearing for the administrations nominee to head the consumer product safety commission. inez tenenbaum it is the east's former superintendent of schools in south carolina. this is still less than an hour and a half. >> i will go ahead and call us

to order here. i want to thank ms. tenenbaum for being here and thank senator rockefeller for asking me to chair this today. we are on a relatively tight timeframe here because we have a votes scheduled on the senate floor at 11:45 so what i would propose with my colleagues indulgence is that i will do a brief opening statement. senator hutchison is underway but she wanted me to go ahead and start. if she wants to do an opening statement that would be great and then i will introduce our introducers and then we will let the nominee speak and then we will try to keep our questions to five minutes if that all possible because we will try to move to these. we understand there are several senators on the way but they encourage me to get started given our timeframe this morning. i am very delighted to have ms. tenenbaum here. she is a real breath of fresh air. i am glad that the white house

saw fit to nominate her. i knew that we were in pretty good shape when the day she was announced we had several consumer groups as well as several business groups who came out in support of her. she also has the encouragement and support efforts to home state senators, and we all know on this committee, we understand the trials and tribulations of the cpsc over the last few years. i think just in layman's terms what is happened is this cpsc is that its budget cut in dwindling resources as challenges have increase, and when we saw this huge influx of products that were manufactured overseas, most notably china but from a lot of places overseas, the cpsc quite frankly was not able to keep pace with that, and was overwhelmed. and, we have been working on this over the last couple of years in this committee. we were able to pass the bill

last year, passed overwhelmingly, went through both houses, went through conference. in fortunately sins that bill's best there has been a lot of controversy about the implementation of that and most of that has been resolved at this point. there's still a few outstanding issues so ms. tenenbaum, assuming that she is, assuming she is confirmed which i don't think there's any question about that at this point based on what i know, she will inherit a lot of things that she has to get in order and things to fix, and we are very delighted that you are here. so, until senator hutchison gets here if i may, what they may do is introduce a senator lindsay graham of south carolina for a statement. >> welcome to the committee. >> thank you mr. chairman. i am honored to be here. this is a big honor for all of the people in south carolina to have buy nets. i call her i nets because

everybody that knows your feels very comfortable with there is a person. she is an enormously talented person. like to thank the president obama for nominating her. as you indicated this is an area where you can make is quickly. the chairman of the consumer product safety commission holds a public trust and i can assure you that the american consumer and their families are going to be in good hands with i nets at the helm of this very important public safety institution. she has a background that is perfect for the job. she was our superintendent of the education from 1996, excuse me 1990 to 2007. we have the best of the pence mckinney stake in the nation in terms of national testing among our student population and that was a desire for us to make sure students improved, and they did and at the end of her tenure, our state was recognized as having the most rigorous academic standards assessment and accountability system in the nation. i think that is important for this job.

in education you can devise a test for the teachers and yourself or for the students and a lot of people made sure that everybody does well on the test. inez took a different path. she produce i think the most challenging test of the nation to appelee whitter stenson mccullough's to bring out the best in the students of south carolina, and she's going to do the same thing here. rigor will be applied to the products coming on line that will be put into the free market and i just could not think of a better person with the executive experience. she has been a tireless advocate for children allah for life. she is an environmental lawyer. she isdell the toxic waste issues. she is like i say bennett brown politics most of my life and is the type of person that-- she is the type of person that everybody would do you agree with her or not respects, and this is a job with the american consumer needs to understand

that they have somebody on their side. the only blemish on her record i can see a she is the bachelor of science from the university of georgia. [laughter] a law degree from south carolina kind of neutralize that. all joking aside i remember what last year was like what this committee went through and inez has the exact experience we need and more than anything else the hard for what we need here. she will look out for the american public and she will give the american people leadership they deserve and this organization leppert texas old will be in good hands and i recommend to this committee. on behalf of all south carolinians thank you for holding this hearing so timely and i look forward to having their confirmed soon. >> senator demint. >> thank you mr. chairman. and i to thank you for expediting this hearing. my only reservation in endure sing inez it is that that

endorsement by her with this committee, so i hope-- i hope that you will overlook that. we are very proud that she is representing south carolina and she has been an advocate for children. she has practiced environmental law and public interest law. she is a serious nominee for this position and she has dealt with all of the issues in a large, controversial public agency in south carolina. she did that with a lot of professionalism and style. and as some of you know, she and i were in a hard-fought race for the senate in 2004 and i was very excited to hear about the nomination and my support means that i hope she won't run against me again. [laughter]

but, we are delighted, and i know this committee has said a chance to meet her. there is absolutely no reason that we can't move for through in a hurry, and put her at the helm of this agency as the chairman has pointed out. she has a lot of challenges. we have increased the budget significantly. there will be a lot of people hired and there is probably no one better qualified to manage all of this then inez tenenbaum, so i adeptness support her and i look forward to her confirmation. >> thank you senator demint and we understand some point he may join us here on the committee and we would love to have that in senator graham you are certainly welcome to stick to run but we understand have a theory heavy schedule. senator hutchison's join this. would you like to say anything before we turn it over to where one and only witness today? >> no mr. chairman, i would like to hear from her and then i will incorporate my opening statement to my questions.

thank you very much. >> inez tenenbaum you come very highly recommended. we appreciate your interest in public service in your willingness to take on this agency and all of its very, very important tasks and responsibilities that it has to be would be delighted to hear your opening statement. >> good morning mr. chairman, ranking member hutchison's members of the senate commerce science and transportation committee. first of all i want to say thank you to mighty senators, jim demint and lindsay graham. it is an honor to have both of the senators from myte sta support me and i want to say that i appreciate so much your being willing to step forward in endorse me to this committee so thank you. i am honored by president barack obama's nomination of me to serve as the consumer product safety commission. i thanked the president for this tremendous opportunity and if confirmed by the senate i will do my utmost to ensure the safety and the well-being of america's children and families.

i want to introduce my husband, samuel. he and i just celebrated our 20 that he wedding anniversary and i thank him for his support in his encouragement during this nomination process. samuel and i were raised in georgia. he is from savannah and i from a small town called pined you. my mother was an elementary schoolteacher and my father had a career in the united states navy. consistent with preston obama's approach to governance if confirmed as chairman i will ensure that the commission is operated in an open transparent and collaborative way in a manner worthy of the the american people. as the new chairman i will be sure america's families that their government can and will protect them from the unknown and unforeseeable dangers in the products that the use. while emphasizing the life saving mission of the commission i will also ensure that industry knows that their views will be heard and seriously considered. i want to assure you that