woo has a different opinion is that we can operate in that exclusive economic zone that they claim conducting the types of activities that we were conducting, and we're going to continue to do that. .. >> first off, i am a great

proponent of the combat ship as you know, we havefreedom that is out, and has been operating, and very pleased with what we see in that ship. we have the second lcs independence, which is an extraordinarily interesting design, and i ship that i believe has great capability. that ship should be at sea this week. so, we are very eager to see that happen. i am encouraged by the trends that i am seeing, as the companies that are involved begin production on the second ship of each ferrying, so, you know, we are seeing the time to produce similar assemblies coming down which means that cost is coming down. we have a drive to bring the cost down. i know that -- and there are members of the industry here who

have the same passion, to get the costs down, because when i talk about capacity, lcs is the ship that will alleviate the capacity issue. but we have to get the costs down and that is something that industry will be working on and that is something we will be working on, to ensure that we do not add anything more to that ship, that causes change to occur which then causes for costs. and we are all committed to that. >> a follow-up? on the question of this... [inaudible] also on lcs, are you confident that you are going to meet the congressional cost cap for the 2010 ships or will you have to ask for -- >> we're in discussions on the cost caps. but, with regard to the 313, my perspective is, is one of having been a fleet commander in the pacific and the atlantic. seeing the demands and the needs and the opportunities that exist, and then being in a

position that i am in, i am in now and seeing what the combatant commanders are asking for, that, to me, that four of 313 is still a valid number. that doesn't mean that it is not going to be a challenging process to get this. but i believe lcs is key. the fact that we have reverted to a more predictable cost ship in the ddd-51, will help us increase not just the numbers slightly there. but, also, give us the capability that we need. yes, sir. >> with 2 s csi. -- 21 csi, we have seen as the nation the cost of a hot war, and the cost in terms of people, and blood and treasure. can you talk a little bit, is the key to it looking at the benefits of deterrence and how

you put a price tag on that. >> absolutely. i think that there is no question that it is -- it is not -- and it's not just a cost issue, either. i mean, the need to do everything that we can to prevent war is more than a dollar value. it is this cost of human treasure. and so i believe you will see as an outcome of the qdr, the types of capabilities that will allow us to be more in the prevention regime, and that is why i feel quite good about the strategy that we have set, where we clearly articulated in our strategy, almost two years ago, that preventing wars is important as winning war.

and why you you know -- the increased emphasis on things like maritime security regimes, where we can go in and work with friends and partners, to alleviate the type of activity, you know, transnational criminal activity that can produce those types of frictions that can then resulted in conflict. and why we believe there is value in the proactive humanitarian assistance missions that we have been cutting. as i mentioned, over 400,000 patients in four years, hospital ship comforts in central america right now, we have dispatched the pacific partnership, and another ha mission and africa partnership station has concluded and that was an extremely successful one, but it also allows us to not only touch people in other countries but brings leaders together, dialogue takes place, and as

churchill said, you know, jaw, jaw, jaw is better than war, war, war. yes, ma'am? >>iest yesterday was the deadline on -- murray man from ogilve, yesterday was the deadline of pullout of troops from iraqi cities and i would like to ask you to comment in your role as a member of the joint chiefs on how wellee equipped you feel the iraqi governments is, to self-governor and protect their assets? . >> i believe that the -- the timeline that we are on, and the adherence to that timeline, and the work that has gone into getting to the point where we are, by the iraqi government, by the iraqi armed forces and by the american and coalition forces, that have been on the ground, in iraq, to prepare for this day, i believe that the time is now. the -- you know, will there be

violence? i'm sure that it's not going to stop. but i believe that the timeline was appropriate, and i applaud the effort of all parties to get us to that. yes, sir? sn>> i am paul hughes from the u.s. institute of peace. recently, the perry schlessinger commission released its strategic posture review report and in it made the connection between deterrents and nonproliferation activities and emphasized that america's deterrent role is important to preventing other countries from proliferating nuclear weapons. some of the east asia allies have indicated that they are concerned about the credibility of america's deterrent force. so i'd like for you to give us an update on the follow-on projects, that you have for the ohio class and its systems and, also, whether the navy intends

to pursue a t-lam end replacement. >> as you know we are in the process of doing the nuclear posture review currently as parts of the quadrennial defense review. the discussions that are taking place are not only on the strategic weapons, but also, on t-lam-n as well, and with regard to the replacement for the ohio class, in the budget that we submitted, and that is on the hill, is the beginning research and development for that submarine, so, we have committed the funds to do that. there are some who would look and say, gosh, aren't you going early? but if you look at the develop men timeline for the ohio class, and where we are starting with replacement for the ohio class, we are just about in the same ballpark, and as you know, we are working with the united

kingdom, because, they also have the need replace their strategic deterrence and we are moving forward with that replacement. we have put the money in the budget. and, of course, that budget is up on the hill. but the ability to get started on developing that new class of ballistic missile submarines is extremely important. >> yes? >> [inaudible]. >> that is part of the nuclear posture review. >> admiral, mike lawson, american enterprise institute, for the past week we have gotten reports about one of our destroyers, the jonathan king, shadowing a north korean ship that might or might not be carrying weapons parts or contraband according to the most recent security council resolution. from the navy's point of view can you give us a sense of how you see the effectiveness, playing out of shadowing the ship without enforcement mechanisms being part of the

resolution, and what that would mean, both in this particular case, we don't know where -- it is ending up this week but also in future cases if we have the intelligence that allows us to go forward an shadow other ships. >> right. i think you no, again, kind of going back to my point on being a global navy, the ability for the united states navy in the western pacific to be able to maintain contact on that ship is a function of being there. you know, you don't whistle it up from the continental united states and send it forward. so the fact that we have some very good information is no coincidence. you made the comment about no enforcement. and i think that the resolution that is in place has significantly closed down on a lot of options for that type of

proliferation to occur. because the ship is prevented from bunkering for either fuel or water. and there are some provisions in the resolution that call for states to do more than they have in the past, and i'm -- i believe that it has been helpful, in that regard and we'll see how events play out here, in the coming weeks. but, i do believe that the resolution with the added aspect of not giving a ship a place to go, gets pretty lonely out there, and you only have so much water and only have so much gas, and you have to make some decisions. yes, sir? sn>> sir, david bachman, sic corporation. you mentioned energy in your comments in the beginning and i

was wondering how think what the navy's energy risks and challenges are, versus your prioritization is, given finite resources, the energy play. >> i tell my staff and i'm not a big power pointed guy andy auto hate them and this about took me to the edge, right here. [laughter]. >> but, the -- there are two slides that have just really gotten my attention. since i have become chief of naval operations, one is total ownership costs of what we buy. we are very quick to say, gee, we have a good price on the ship, so we'll buy it. but we have not been looking at total ownership costs. total ownership costs get to the manpower bill, that i was talking about. get to what it costs to operate some of the very sophisticated equipment, and imbedded in that total ownership cost is the other slide, that got my attention, and it is the locations and the estimated

longevity of oil reserves, globally. and i'm not a novice to this. i grew up in the middle east, with my dad, who is in the oil industry, and so, it has been an interest item for me, for decades. and, it is, therefore, very important that we, as a navy, do everything that we can possibly do, to radio dues the expense and reduce the reliance, particularly on fossil fuels. the challenge that we have, as a navy, right now, we are a navy of 283 ships. which is -- is where we are, but if you look at the navy that will exist in 2020, it is 215 of those 283 ships will be around in 2020, so it is not as if you can say, okay. we are all going to get real energy efficient, all the old stuff is gone. will be around for a long time.

so what we have done the last year is we have taken an approach that looks at the old and the new, in other words, what can we be doing to bring energy costs down, on the old stuff, then as we look to the the future and we make procurement discussions, we'll make them not on how much the item costs, but, rather, on what the cost to own will be over time. and, i think we have to do that. and, it's not just on the airplane ships and submarines. it also has to be on what is a fairly large shore infrastructure that we have in the navy. our bases. our communities where our people live. and, the same applies there. the old, how do you make the old more energy efficient and that which we put in place for the future has to be minimal. the amount of energy that the military uses as part of the national amount, i'm sure most

of you know is probably around 2%. not a large amounted. but, for me -- not a large amount, but for me, running the navy, energy is a huge bill that i pay. so, we have to bring that down. we, in the navy, are very proud of some of the accomplishments, for example, we run one of the largest solar generations in the united states. we are heavily involved, on the shore side with geothermal work. we are doing some work in tidal energy that we can derive from tides and currents and thermals. and we have stood up a task force, and i will tell you that it is not a faddish initiative to stand up a task force which sometimes is the case. but, this is very serious pa because, as i said, when you look to the future, how much will it cost to own and operate

and how dependent are we on hydrocarbons and we have to get serious about it. now is the time and we are off and running on that. yes, sir in in the back? >> richard wise, hudson institute. two specific questions. you talked a bit about the chinese navy in general. last week, we had our session of the defense council -- i wonder if you have a readout on e whether the issues you talked about, came up, particularly the navigation issues and admiral mullen just went to russia and there is a speculation, some kind of military agreement will be in next week's some and i'm not sure if there are any navy issues potentially involved in those discussions. >> right. i think when you talk about that with china or russia, all of the services have an interest in it. and whereas i have not gotten the full readout from the chairman's talks and the team has just gotten back from china,

the details i do not have. but i'm encouraged by some of the things that i hear, and, the importance of the mill-to-mill relationship is, i think, extraordinarily important to any relationship between countries, because we -- as i mentioned, the incidents in the chinese eez, the ability to pick up a telephone, and talk to someone that i know, and who knows me, though we may have differing opinions on some things, having that ability to talk is important. this ability for our ships to come together, off of the coast of somalia, whether the russian ships that, we have been operating with, or the chinese ships, that we have been operating with. i think, are extremely important. one of the outgrowths of my visit to china was an invitation that i extended to my counterpart, to have him send a couple of doctors down to our

hospital ship comfort for a couple of weeks. normally, that is a have lengthy process. -- that is a very lengthy process for them to approve and doctors were on board within about four weeks. so i think it is important that we have these discussions. that we continue to meet, that we make sure that we can articulate our interests, and positions. but, professionally, be able to work our way through that. so i am hopeful we will see increasingly robust opportunities. >> admiral, we have time for one more question. >> okay. yes, sir? >> currently you have combined task force operating in the persian gulf. stressing the mill-to-mill relationships, if china were to become part of that, because they are going to come into the gulf for energy, and it is known to everybody, would you entertain allowing some sort of mill-to-mill contact, vy -- be established with this iranian

navy? in >> i would say the type of relationship that would develop would be one that would be based on the broader national interests. and, then, the question also becomes, you know, there are various elements in iran, that are operating maritime forces, and you know, with whom would the relationship be? but that is a decision that really, i believe, is part of the broader diplomatic context, and you know, we will conform to whatever the commander-in-chief would require. >> admiral, thank you very much for your time. >> thanks a lot. [applause]. >> thank you. [applause] [inaudible conversations]

[inaudible conversations] [inaudible conversations]

[inaudible conversations] >> people have been trying to get me to say a figure now for about a me and the reason i won't do it is because it will be different every, single day. and, it will be based on how much training and advising an coordination is required and that will change each and every day and i will not put a number on it. it is a significantly smaller number than we have had in the cities now, but it has very specific missions. train the iraqi security forces,

and advise them as we continue to move forward, and enable them in order to potentially, if they need some help with aviation, logistics, et cetera but almost as important, coordinate and help us to continue our situational awareness of all situations, within iraq. and that will help us to better support the iraqi security forces. . >> general to follow-up briefly i'm disappointed you did not give us this scoop after a month of holding out but i wonder if you could at least give us a -- as -- is it a few thousand, if you can give us a ballpark, several thousand would that be a reasonable ballpark to use? >> again, again, there is hundreds of cities around. and we have hundreds of you know -- and i have let the local commanders work this out and so for me to give a number would frankly be inaccurate and i don't want to do it. there will be trainers, advisors, helping throughout all of the iraqi cities, where we

continue to support and advise the iraqi security forces. >> whatever the number is, how are you going to convince them, basically, the u.s. forces remaining, not to jump in and be helpful where, perhaps, you would prefer that the iraqis take the lead? what will be different about what they are told to do in a situation where they might think their first instinct is, gosh we could do that better. >> again, i call this a -- we are working on changing our mind sets in the city. and i equate to it when we first started the surge, where we had to change our mindset and pushing our soldiers back the out and getting back into the communities, and really, partnering with this iraqi security forces. and, today, it is the same kind of thing, we have to change or mindset. when we are in the cities, there is very specific things that we'll do, and actually, we have

been out of the cities, a large majority of the cities, now, for the last 8 months. so, it is really only mosul and the last remnants we have had in baghdad that have pulled out, over the last few weeks and we have actually been implementing this in many parts of baghdad for a long time. and they understand what their mission is. they understand what we expect them to do. and, we have worked this very closely with all of the leader of iraq, i've worked closely with this mfinister of defense and the interior and operational commanders in order to work this out and i feel comfortable with where we are at. >> see the entire briefing tonight at 8:00 eastern, on c-span.

>> now a discussion on health care policy. the national institute for health care management, invited health care policy experts, and insurance company executives to talk about how the health care system is funded, this is just over three hours.

[inaudible conversations] >> hi, we are going to go ahead and get started, right on time, i'ms nancy chalkly, the president and ceo of the foundation and i'm delighted to welcome you here and thank you for crowding in. we got a bump from a larger -- bumped from a larger hearing room and we are delighted to have c-span filming the event as well. we are at a very exciting and challenging time. as we grapple with health care reform. this conference is part of our 15th anniversary, conference and we have invited our board and members of our advisory board to speak today about very important issues, we'll be touching on the financing, we'll be touching on access, we'll be touching a lot on payment reform and how to control health care costs. we brought in some great examples, of some things that

are working at the state level. i'm going to go ahead and push right through. we are going to hold questions, until the end, we do have a microphone here. and, there is a purple paper, in your slide -- packet of information, that you can go ahead and fill out, if you have questions. you have a yellow one. so, yellow, sorry. yellow one. so you have a yellow question card there, or you can join us at the microphone here and we will hold questions until the ends so we can make it through all of our speakers. so, let's start, with bob reischauer. we is president of the urban institute. and, former director of cbo, under clinton. and he has been through this once before. he is really uniquely positioned to understand the incredible need for health care reform. the politics around health care reform, the economics and of course the arcane language of scoring which is becoming

increasingly important. and i have learned to always listen to bob. because not only is he very insightful, with his analysis, and judgment, but he is almost always right and so i have -- am always asking him, not only me, but the -- always asking him to handicap things, so here he. >> guest: bob reischauer. [applause] >> thank you, nancy, one correction. it wasn't under clinton that i served. i predated him but he outlasted me. [laughter]. >> so i think through his -- to his relief. let me add my welcome to all of you. to that of nancy. i also want to make the opportunity to congratulate

nihcm and its staff on the 15th anniversary and after the last decade and-and-a-half, nihcm has been an influential voice on health policy and has done this in a number of ways, first through the issue briefs, called expert voices, which top analysts summarize succinctly the state of knowledge on a particular issue, and, then, add their unique perspective, and for those of you who haven't accessed one of those, i think there is probably some out on the table, i would. i have a little stack of them, somewhere in my office, that i refer to quite frequently. it is also -- had influence through the reports, that it generates from its research projects. on a wide range of topics, from childhood oty