factor. >> senator airlines are subject to the requirements of part 21 whether commuter airlines or mainline carriers. >> they did recommend a minimum salary. >> there is one recommendation airlines prepare pilots to operate the equipment they are flying and it is a respected of the amount of money. >> you said seniority dictates. if i was home on a particular day, i would see an airplane on my window into landing in the hudson river. the building i live in new jersey is right on the ram river and a high eighth that

i live where the pilot had to head for a lower altitude. captain sullenburger the private from u.s. airways flight 1549 known as the "miracle on the hudson" said here in the house earlier this year that his pay has been cut to 40% in recent years and he started a consulting business to maintain a middle-class standard of living. this is a guy with terrific experience and great skills. so i think we're at a point* in time where we have to say that there are certain standards that must we match. i do not out to implement them. that is not my job. sick and to protect the safety of the public to

whatever extent we can possibly do it. and those that are relatively high risk we should avoid. what we are looking at salaries and what is happening look being at the major regional stare doing pretty well with profitability with skywest made 200 million of through the years 2009 and american eagle made 122 million and express made 60 million anna nicole been made the 76 million so what is to say they should exert themselves a little to attract the best

they can get and once they get them to keep them alert and satisfied? to pay attention to the minute detail? and now particularly when jobs are too few, few, mr. barimo, it cannot be left to a negotiation. i don't think between the union and the company because people want to work. but the willingness to work has to be accompanied by the ability to be skillful and alert and in command as they can be. do you agree? >> i certainly agree. [laughter] i was not sure. with the silence that i heard. >> what i will say is the industry has taken a baby teeing since september and has impacted every employee

in the industry and not just pilates. you mention a few airlines posting profits but the industry continues to lose billions of dollars each year so i would be hesitant to view a couple of data points that show of been the black that the industry is performing well. >> it is a commodity like air travel. do we have to look back where we were at one time in history and say just because you can raise money to start a new airline does not mean you ought to be in the industry and what we're paying for the whole infrastructure? the faa and airport development and six cetera.

we will not have the time or the ability to answer this question in its entirety but thank you very much to all of you. very interesting testimony. thank you, mr. chairman. >> thank you very much. let me ask a question, ms. gilligan let's assume your recommendations are done all when the sees them come in the door and says we will work on this quickly and move it out. dot says the process is complete it will give us more providence to do work

in this area with the cold and crash and the pilot flew from seattle to mend his then dead ahead on fedex then flew to laguardia and the pilot flew from florida up two laguardia. there is no evidence either of them having a hotel. there is evidence of both being in a crew rest launch and the left seat pilot was doing e-mails throughout the night. and it appears with respect to whatever caused the crash may be the pilot of our co-pilot understands what a stick pusher means have a call up instead of pushing it down because of vice it is possible because that was fatigued but assuming

everything you are doing is done and we're all ready to announce significant progress for the first time in many years how would it have affected the circumstances will the pilot and co-pilot i have described both who flew across the country without any evidence of rest prior to the flight on the regional carrier? >> i think as we have heard, there will always be responsibility for the pilots to manage rest periods appropriately and their rule will offer an opportunity for rest with sufficient time to sleep consistent with what the science tells us you should sleep between seven and eight hours per night. the end of the day the pilots have to take responsibility that they take advantage of that last opportunity that prepares them to report to work and

the operator has a responsibility to determine the crew member is prepared to work at that time. the regulatory framework can only set the framework that allows for the operator in the pilot to properly prepare themselves to provide safe transportation. >> i and stand the responsibility of the pilot that is the responsible of a professional to himself and also to the passengers transporting. but i do not understand when we finish the process and nothing will have changed with respect to the circumstances in that cockpit if it is a cause of the crash because if we have the chart that shows the coal been committed to, -- teemu tolino what has changed with respect to air travel in this country.

i will describe it this way. put that down. just for a moment. north dakota, where i grew up, the airline's served our capital city for the republican and regional carrier and they did not fly a small planes but dc-9s and western airlines and northwest and frontier all of them flew jets 727 and the district of columbia nine. the people and the cockpit my guess is there was not somebody in the right see with any one of those carriers 30 years ago that was being paid to the equivalent of today's $20,000 per year that is not the case. then our system morphed into something different. those carriers merged and merge again and became much

larger and created a network our regional characters characters-- carriers that flew smaller equipment and had a different different system of hiring so now 1/2 on the flights are one-fourth of the of passengers were carried with less experience in the cockpit. of as we have more often to the new system we have a chart that shows everybody is commuting everywhere. should not be lost on any of us in including captain prater that this chart is demonstration of a significant potential problem broke you have people whose work station is on the east coast flying all

of the country just to get to a station to go to work and ms. gilligan are you are saying is it is a responsibility. the obvious question atlas air a cargo company was having problems attracting qualified pilots so they have gateway pilot program they paid commuting pilots to come to the duty station and they provide hotel accommodations and require them to be there overnight. that is how one cargo company decided to do it. if you have people living in seattle or los angeles working out of new york, how does that happen? my great concern and i am not suggesting people should not commute but i am suggesting that if you have the substantial commuting, you better understand there will be problems related with

respect to 50 domestic carriers and the pilots get there and have rest and find bed and have sleep negative show up in the cockpit fully rested. that was not the case in the colgan plane. and standing of the facts that neither of those pilots and i believe and i feel badly because they are not with us to defend themselves but it appears neither of them had a nice sleep and when we're done with the issue comity 15, i don't think we have altered the circumstances that allowed that to exist and we must prepare your response? >> as i mentioned the rule-making committee did not make recommendations in this area. we're looking to see how the federal government might address it in a regulatory framework for it can be difficult. people drive from

fredericksburg to work and washington or the dc and that is a long drive. how to do it is hard but we need to address it weather in the rule is sell for guidance or training material for the airlines would not completely reach that conclusion that we agree it is a risk factor to be addressed by the airlines and the pilot. >> it seems to be when would be a better or more. required time to do now when you are addressing fatigue in the cockpit? mr. prater my guess is you run the pilates organization and you'll want to say they have a right to commute and they have the responsibility to get the rest before they fly bid you believe there is no issue at all with the substantial commuting that

has morphed into the regional carriers? not only the faa but with the employers to find a solution to the problems. this is the reality nine more so than ours and the companies keep moving. the regional characters especially man is a contract then people who have lived in cincinnati 20 years flying at of home-based now have to commute overnight. those decisions go on throughout the system. we need to do a better job working with the carrier's to make sure the pilots if they have to fly to get to work are able to do so quickly come easily, it is a

mirror image of the atlas program that you have identified. other operators, cargo operators to the same thing. fedex, ups, they give pilots to if they pick up their flight overseas their systems out there and we can do a better job as a union as employers and the association's letter represented to ensure that they show up ready to go. >> mr. voss is committing part of the issue? >> yes, sir, clearly committing sets up a situation where things can go wrong. we have seen some things go wrong. we have a problem but it is difficult to deal with in a regulatory framework. they're past to be the obligation for the airline to provide the opportunity for rest.

and then they have to take the opportunity of. the management system has not been explained well so it put sensors into the operation if you have a problem on a given set the segments because of tired pilots or poorly trained pilots, you can get the data and put in place of vacations those of the type of things we need to do what i am such a supporter of the dated driven and more sophisticated approach is i can take. >> mr. barimo? >> i would reiterate commuting is a part of the commercial airline business today. we are much smarter today and get smarter each day when it comes to fatigued

management. we have a charter was on how to factor commuting into fatigues management. we recognize that as an issue and committed to resolving it. however that turns out to me. >> with this is like looking at a picture and not seeing it. the three view suggests commuting is part of an issue or part of a problem what ms. gilligan will give us is something that does not address that. it seems to be that all of these things relate to the circumstances that i know cause additional risk. from the hearings i have felt i was on a regional carrier, i knew from the hearings of the type of training that particular carrier did they have identical training requirements so i felt this is interesting identical in

every respect on the other hand, my guest if you fly a regional, you might get on one and you know, more about it than others and see people in the cockpit that have a few hundred hours and wonder if there able to handle this plan as well as ibm? speaking of yourself? to make things a changed regionals are an important part and we need them but we need to make sure that we're dealing with the issues to relate and those that have become self-evident. the issue of fatigue is not just a regional issue by relates to every carpet every where and how we address that. ms. gilligan i have not amend it to hector you have all but i do intend to in

the future. [laughter] >> i look forward to it. >> it is very important babbitt is a new administrator of a great deal of promise and he knows the industry and has been in the air command a airplanes and i have high hopes for some excellent work coming out of the faa that includes your work and others but it is essential we consider these things tata urgent are dire as a captain indicated and important to be scions space-bar after all of these years and after the many, many years and lives have been lost to get this done. i will be a burr under the saddle but really keep pushing because we need to get this done. i appreciate we have gone longer but i appreciate the

four of you have come to testify who have the administrator here next week and begin to reach a conclusion on some of the issues. i hope ms. gilligan all right to the administrator i also hope to talk to some length about commuting in addition to the other fatigue issues. i thank you very much. this hearing is adjourned. [inaudible conversations]

[inaudible conversations] they want us toight states that domestic abuse ise e problems in bitterly, bitterly know, one ofis united states the things that i'd say to my

the presiding officer: the

senator from illinois. mr. durbin: mr. president, there's a saying in iowa and in illinois that any old mule can illinois that any old mule can >> host: there is a saying and speed 13 that any carpenter can kick down a barn door but it takes a carpenter to build one. i would say it can we any elephant. we're debating health care reform the american people follow this closely because it affects us in this room and in the galley and watching. this is one of the few things we will debate that you can bet will affect you and your family personally. it is rare in issue comes before us of this gravity and reaches every single person in america. maybe the biggest single issue we have everett tackled on the floor of the united states senate with

the terms of the scope and impact on the future of every single one of us. a lot of people have been working hard to have a piece of legislation with a positive impact on health care. it has involved link the committee hearings we have sat in the teachings hour after eric debt -- hour after hour day after day considering amendments it for part of the bill that is before us today and the senator from iowa is part of that committee he met personally over 60 times with the democratic senators and his own side to come up with a bipartisan approach and i commend him for his good faith effort. it spent even more days and

deliberation and adopted over 100 republican amendments to the bill and not won a single republican senator would vote for the bill. one senator, senator snowe voted for the senate finance committee for that version of the bill. so today us 74 page bill with a one-page ad is senator reid's amendment. created by these two committees in the senate and taking place in the house. for at least 10-- the bill in its entirety has been available for public review. i ask anybody interested to ones to read the bill as any

member should to go to the senate democratic website google it and you will find and the bill in its entirety sitting there to re-read and reviewed as should be. then i invite you for comparison's sake to go to the senate republican and a website. to look at the bill produced by the senate republican side and take a look at the health care reform bill. take a look at what they propose to change the health care system in america and the proposals to make it more affordable and the senate republican proposals for dealing with health insurance companies that are denied because of pre-existing conditions. look at the senate republican approach to pass health care reform and not

add to the deficit and you will be disappointed because as the senator from iowa nose, when you go to the senate republican website, there is no senate republican bill. in fact,, we will find is the democratic bill. for more than one year while the labor to produce the monumental historic legislation the republicans on the other side of the aisle have not broken a sweat to produce their own answer to the challenge facing america. all they can do is come before us and criticize this bill. any old and you'll can kick down a barn door but it takes a carpenter to build one. we have a working almost one year to build the health care reform package. here is what we know prick the we have seemed a report

from the cbo, the referee that takes a look at what we do and tells us whether it will reduce the deficit, add to the deficit or reach or fail the stated goal. it is maddening to have a separate agency looking over your shoulder but they do. they reported yesterday that this bill will make health insurance more affordable and lack add to the cost of others. i wish it would do more and bring down costs even more dramatically. weeks and months we have heard from the republican side our health care reform proposals would run it premiums sky-high but it turns out they are wrong. of the bill we have produced moves toward more affordable health care insurance and any american that pays attention knows that is absolute essentials.

about $6,000 a year. now they buy it on average for about $12,000 a year. and in seven or eight years, it will go up to $24,000 a year in premiums, projecting that it will eat up 40% of your income for health insurance in just eight or ten years. well, that's an impossible situation. we know it is. it's unsustainable. businesses can't offer health insurance that expensive. individuals can't buy health insurance that expensive. and so if we do nothing, we will reach a situation where the current health care system in america will start to collapse. i don't want to stand idly by i don't want to stand idly by >> we will reach a place where the current health system will start to collapse. i don't want to stand idly by. neither does president obama. on the other side of the aisle, the senate republicans have not

produced a bill, an alternative, nothing. they come before us in criticism of what they've done. and yet they cannot produce a bill. and i'd also tell you the same congressional budget office tells us that the bill we put together will reduce the federal deficit by $130 billion. this 2,075 page bill will cut more deficit than any piece of legislation we've enacted. senator from iowa is concerned about the debt? where's the republican reform that will reduce the deficit. in the second ten years, think that far advance. i asked the senator from iowa with all of his concern about the federal deficit, where is

the senate republican bill that will reduce the federal deficit by $750 over 20 years? the answer, i'm sorry to tell you, is it doesn't exist. they either haven't or cannot right a bill. they are legislators, but frankly they come here to be critical of what we've done. anti-and not offer an substitute for alternative. there's something else the bill does. it's a travesty? america today that 50 million people don't have health care. a lot of these folks are children. a lot of them are people in low-wage jobs with no benefits. a lot of them are the newly unemployed. 50 million of our neighbors in america who go to sleep at night because the peace of mind of having health insurance protection. in my life it happened once. newly married college student. baby on the way. no 00. and our baby had a problem. and i ended up carrying for

eight years medal bills that i slowly paid off year after year. that goes back many years ago as you might imagine. but it was troubling and heartbreaking to be the father of a child and not have health insurance. the sit in the room in washington that was set aside and wait until my number was called to bring my wife and baby in for a check up. . i didn't have health insurance. i never felt more helpless in my life. 50 million americans go to bed each night with that feeling. they don't have health insurance. what does this bill? this 2,075 page bill do it about it? it expands the coverage of health insurance, the peace of mind and protection of health insurance to 94% of americans. it is the largest extension of health insurance in our history. where is the republican alternatives?

that offering coverage for 94% of americans? it doesn't exist. they haven't written that bill. they don't know how to write that bill. they do know how to come and criticize this bill. but they cannot produce a bill which covers 94% of americans, and provides tax credits and tax assistance to help those americans pay their premiums. if you are making under poverty wages, less than $14,000 a year, and i've got friends of mine in my state who are, you are covered by medicaid. the federal government compensates the pays, all the way up to $80,000 for a family of four, we provides credits and help to pay your premiums. as we should. because premiums can break the bank. not only for businesses, but for families. there's also something that we do that i never hear from the

other side of the aisle. i'll tell you why in just a second. we give consumers across america a fighting chance when the health insurance company goes to war with you. you know what i'm talking about? somebody in your family gets sick. you know it's going to require a hospitalization or surgery and you know the cost is going to go sky high. you say thank goodness i have health health insurance. the health insurance comes back and says we dispute the claim. we're not paying. wait a minute, i've been paying premiums for this year just for this day, and you're telling me i don't have coverage? it happens thousands and thousands of times each day. you know why? health insurancecare cans are propertiable when they say no. what are the reasons for saying no? well, you've failed to disclose a preexisting condition when you applied for the insurance. turns out they go to

extreatments -- extremes to find an excuse. we know when you lose your job, you can't take your insurance with you. when your child reached the age 24, they are no longer carried on your health insurance. those are the realities of health insurance companies saying no. i have yet to hear the first republican senator come to the floor and say that is outrageous, and it has to change. we've got to tackle the health insurance industry. because the health insurance opposes this bill. the health insurance industry believes their profitability in their future depends on saying no. this bill starts saying to the companies that you can't say no. based on preexisting condition. based on losing your job. and we cover kids through the age of 26. we extend the family coverage to children to that age. and you know that's only sensible. a lot of kids are going to college and getting out without

jobs. you want them covered by your family plan. this bill does it. the republicans have yet to produce one bill, just one, that takes on the health insurance industry. instead what they tend to do, senator from arizona leads with this, is to protect the health insurance companies. the first thing that the motion to commit does, from the senator from arrest -- arizona, is to instruct the senator financial committee to protect a program called medicare advantage. this is a great idea for health insurance companies, and not a great idea for most seniors or taxpayers in america. allow me to explain. the health insurance companies gave to us several years ago and say medicare is a bureaucratic mess. the government can't run the programs. we are in the private sector, we understand competition, let us compete with medicare. well, they were given the right

to do that. private health insurance companies were given the right to write health insurance that provides medicare benefits. they said they could do it more cheaply. and in fact, some of them did. but at the end of the day, after years of watching them, it turned out the policies cost 14%, not less, 14% more than government-administered medicare programs. in other words, we were subsidizing health insurance companies, paying them for for the same medicare coverage people had received. they loved it. thousands and thousands of americans now covered by medicare advantage. these great subsidies comes from the federal government. talk about an ear mark, senator? 14%, what an ear mark that is. >> do you have any questions? since the gentle mentioned my name, i want to yield for a question. >> what the basic problem is

from the senator of arizona, and i'll yield to you in just a second. he is protecting the health insurance companies with medicare advantage. first thing he does. he's protecting this subsidies, this big fat earmark that we put in legislation, 14% bump in premiumed is protected by this motion to commit. now it's understandable that the health insurance companies want to keep this. it's a sweet deal. they are getting paid for something they promised us would never happen. they also -- and there's a vision in the motion to commit that says that we should take out of here the conflict of interest sections in medicare. you know what that's about? that's when your doctor also owns the laboratory which does your blood test, and the imaging center which does the x-rays, and says, i'm not sure what's wrong with you, but i know there's two things you need. you need a blood test and x-ray.

well, maybe you do. maybe you don't. and we say in this will, you have to disclose to your patient that you have a personal financial interest in this laboratory and this processing operation. and you have to give them an alternative to shop for another place that they want to? is that unreasonable? it's one of the provisions that he wants to take out. it's a savings in medicare. now that's unfortunate. we've got to do our best to eliminate the waste and fraud abuse, as material that old -- terrible that old cliche it. why does it cost twice as much or more in miami were florida? think we should take a look? maybe we should. i think there's some price gouging. i want to know. does that mean we're going to reduce the benefits for someone living in miami.

not necessarily, but it means that taxpayers won't be ripped off, medicare won't go broke, we are doing what we need to do to be responsible. taking money out of medicare means shutting out the subsidy for the private health for medicare advantage. it's means stopping the self-dealing of some doctors who are sending medicare patients to their own labs and their own processing company. it means finding out whether the waste is taken place. the senator from arizona saying we instruct the financial committee to take out those provisions in the bill. keep medicare advantage with the 14% subsidy that don't engage the doctors which it comes to these conflicts of interest. i don't think that's right. during the course of company for president, he suggested that we have a pretty substantial cut in

medicare and medicaid. in fact, during the company, senator from arizona called for $1.3 trillion in reforms in medicare and medicaid. more than twice as much as we're calling for in medicare. 2.5 times as much. douglas holtz de can who worked for the senator for arizona, said that the savings from medicare and medicaid. the idea of saving money in medicare is certainly not something he's unfamiliar with. we all understand that there are responsibilities for savings that don't jeopardize basic services for seniors. we also understand that left untouched, medicare is going broke. ignoring the problem will take it worst. if we want to put medicare on sound footing, have to tackle this issue four square. we can't afford the subsidies

for medicare advantage. and we can't afford the waste that's going on in the system today. i might also tell you that the increase in payroll taxes for those individuals making over $200,000 a year, and families over $250,000 a year, that's the increase in the medicare tax, it's going to be buying five years of solvency for medicare. so when they talk about our raising taxes, true, at the highest income levels. what they don't tell you is the other side of the coin. the money goes into the trust fund to keep it have solid for medicare. what else does this bill do? it starts filling the donut hole. you may not know what it means, unless you're a senior, but medicare prescription drugs stop paying at a certain point. this bill starts coverage in the donut hole, in the gap of coverage that currently exist in medicare prescription part d?

what is the republican bill to fill the donut hole? it doesn't exist. at least, it's not on their web site. here's ours. that's why aarp endorsed the bill. they know this bill is a good bill for seniors. i urge my colleagues to oppose the mccain motion to commit. first, if we take this bill off the floor, which many republicans want us to do, it will take us theys, maybe a week to bring it back to the floor. they want to delay this as long as possible. they want us to fail. they want us to stop. they want us to adopt the senate approach, which is do nothing. leave the system the way it is. we cannot continue the system with the way it is. this is a responsible bill. it makes health insurance affordable. it reduces the deficit according to the congressional budget

office, it covered 94% of americans, finally tack manies the health insurance companies for the first time in a long time. and it buys at least five years more for the medicare program. i wish i could compare it to the senate republican approach. but that doesn't exist. any mule can kick down a barn door. it takes a carpenter to build one. i yield the floor. >> senator from arizona. >> mr. president, i reyet that he does not obscure the courtesy of the senate. especially as he continued to mention my name throughout. and totally falsifying my position both in the presidential campaign and the position that we have on this side and this amendment. i've always extended the courtesy to senator of illinois. i deeply regret that that the comedy is no longer reserved.

i regret that you did not respond to a question that i had hosed, and you had said, i will respond in a minute. so i, again -- >> senator -- >> comedy is not observed here. >> if the senator would yield for a second. >> i will go ahead with the -- >> the senator did not provide me with the courtesy of allowing me to respond to a question. now you want me to respond to a question from you? i will display a more courtesy than you displayed to me. >> go ahead. >> i apologize. i planned on yielding to you. i'd be happy to yield to you. i always do. and i failed to. i apologize. >> well, senator, i guess my questions were one, the senator who claimed to we have not -- no republican hat done anything to curve the health care industry insurance. was the senate in the senate when senator kennedy and i fought for weeks and months

forecast patients bill of rights? was he here then? senator kennedy and i fought for the patient bill of rights. and a majority on that side of the aisle opposed it. there have been efforts on my part to curb the abuses of the health insurance industry by sponsorship with the patients bill of rights. second of all, during the campaign, yes, i said i said because of the patients choice act which could save $1 trillion from the states in medicaid save welcome $400 billion over the next ten years in medicare savings. i wish that the senator from illinois would examine the patients choice act as proposed by the senator from oklahoma. maybe we would learn something.

the senator from oklahoma wants to reserve the best quality of health care in measuring, and now eliminate $120 billion to the medicare advantage program, which $330,000 of my citizens are enrollees in, and like and want to keep. $150 billion to house piece and nursing homes, $23 million to be determined by independent medicare advisory board, as well as billions of additional cuts to the medicare program. there is no rescission between what i try to do in my campaign, and what is being done in this willing. -- legislation. i tell my friend from illinois, i'll be glad to hear the senator from illinois response. i'd like to extent him that courtesy. >> i thank you, senator from arizona. i joined in those bill of

rights. i and i would do it again. >> your stance was that no republican had done anything. you just said no republican had done to curb the health care industry. patients bill of rights certainly wouldn't have done that. >> my point was there are provisions in this bill which i have not heard the senator or others -- >> that's not what you said. >> well, i would just ask you do you support the health insurance reforms in this bill that give patients the right to -- against health insurance companies on preexisting conditions, for example? >> my record is very clear of advocating for patients and against the abuses of insurance ai companies aa cross the board. >> we thank you for that. >> mr. president, i ask consent to yield from the senator from oklahoma to describe the patients choice act. and the way we could truly save money and reduce the fraud abuse and waste in this system and the at the same time preserve quality health care.

>> mr. president -- >> senator from oklahoma. >> thank you. >> you know, there these to be some clarification. medicare doesn't cover everything. 84% of all medicare patients have to buy a supplemental policy now. you know what medicare advantage is about? who set the prices on medicare advantage. the government set the prices on medicare advantage. the very same people that you want to run it now created the 14% premium. the insurance industry didn't set the prices. the medicaid services set the price. the government is responsible for that. now why is medicare advantage important? because the vast majority of the people in my state and every state who have medicare advantage can't afford to buy a supplemental policy to make them whole on medicare because medicare won't cover it. so medicare advantage for 89,000 oklahomans is the only way they get equality with the rest of their peer group that can afford

to buy a supplemental policies. now we're going to take that away from the seniors in oklahoma, illinois, iowa, and say you don't what everybody else. because you are economic challenged. we're going to give you substandard care and take more of your income. they offer the things with the supplemental policy when you can't afford to buy it. the very idea to say we're going to take that away, when you take that away, you are taking it away from the cheapest program that we have in terms of performance. because what medicare advantage does, which their bill and this bill proported do is recommends and encourages and incentivizing prevention. like the senator from iowa wants to do for everybody. it incentivizing. doesn't cost to have a

prevention exam understand medicare advantage. there's no out-of-pocket cost. you are going to take that away. you're going to destroy it for 11 million seen nors. the ability to get a preclear, a screening exam, without them having to spend money on it. is there a way to get money out of medicare? yeah, there's $100 billion worth of fraud a year. and according to harvard, there's $150 billion worth of year of fraud in medicare. there's $2 billion worth of fraud. i want to address -- >> before the senator continues, i'd be. >> i'd be happy to yield. >> i ask unanimous consent to regain the floor. >> without objection. >> i consent to engage in colloquy for the senator from oklahoma. >> any objection?

>> mr. president -- >> without objection. >> mr. president, i have to address the situation since i have been accused by the majority leader of changing my position. in 2005 the senate considered the deficit reduction act of 2005 which called for approximately $10 billion in reduction in medicare cost. approximately $10 billion. senator harry reid, democrat from nevada said, quote, unfortunately the republican budget an immoral document. let's look at what is in the bill before us. the budget increasing burdens on america's seniors by increasing medicare premiums. we have not seen what the house is going to give us. it's cuts medicare and medicaid by a total of $27 billion. the majority leader was outraged in 2005 that there should be

reductioned in medicaid and medicare spenting were $27 billion. now the distinguished majority leader with the white smoke coming out of his office now says that he's for $483 billion in cuts and medicare. that my friends is a remarkable flip-flop. and by the way, i might add that senator dodd who's here on the floor said of concerning this reduction, this deficit reduction act of 2005, senator dodd said, for example, this bill cuts funding from medicare and medicaid. which provide health care to poor working men and women, the disabled, and the elderly. what a plea. senator barbara boxer saying, mr. president, i oppose the bill before the senate. it would cut vital programs for the middle-class, elderly, and poor. that's why i cannot believe only two months after katrina that we

have a bill that would cut medicaid by $27 billion. and the list goes on and on. and now before us, we have cuts of $483 billion, including hospice, including other vital programs for our seniors. we're going to go ahead and talk about flip-flops, let's look at the rhetoric. that accompanied my colleagues on the other side. which by the way, it only saved $2 billion over five years. i would ask my friend from oklahoma, does he believe that it is possible to make these cuts, including from the medicare advantage program, and

establish a medicare commission that would not over time cut benefits that exist today for medicare and medicaid patients? >> mr. president, i would answer my colleague by saying, this bill is a government-centered approach. not a patient-centered approach. this is the very reason that we're in the trouble that we're in today. it's that we've had the government making the decision rather than the patients and the physicians. and we will in fact lessen the care for seniors. i gave a speech earlier this morning on the floor that if you are a senior, you should be worried. because the medicare advisory commission and the cost comparative effectiveness commission will now decide ultimately what you got. and we have an amendment on the floor which in many ways, i support, i would like to nod if

i. about reinstituting what should be the farm for mammography for women. -- standard for mammography for women. how'd we get there? we have a commission that looks at cost, and not patient. from a cost standard point, the task force on screening is absolutely right. but from patient standard point, it's absolutely wrong. how do we decide the difference? did we make the difference based on what something cost, or cowe make it on what my wife, who will soon be a medicare patient, receives? so the question is will the cuts that are manifested by this bill, impact seniors care? and as somebody who's practices medicare for 25 years and cared for seniors for longer than that, i will tell you undoubtedly they will have delay, they will have denied care, and they will -- 80% of them will be just fine.

by 20% of the seniors in this country will be markedly hurt by this bill. because the bureaucracy looking at numbers, not patients, never putting a hand on the patient will make a decision about what is good for them and what is not. and everything we know about medicine is that's exactly the wrong way to practice it. because every patient is different. every patient's family history is different. and so when we talk about taking $120 billion out of the medicare advantage program, what's you're talking about is decreasing access to some of the most important screening capabilities that many of these people have. and making them unfordable because they can't afford a supplemental medicare policy. they can accomplish it. now i want to address one other question. the majority whip said the republicans haven't had a bill.

during the mark up in the health committee, i went through point by point on the patient's choice act. the patients' choice act puts doctors and government in charge, it neutralizing the tax effect to make everybody treated the same as far as the irs. right now if you get insurance through your insurance, you get $2700. if you don't, you get $100. that's really fair. that's one of the reason that people who don't get insurance through their employ can't afford health insurance. americans plus help them pay their share. the patients' choice act incentivizes states to have reform in terms of the tort problem that we have that we know costs at least 6% to 7% more than we've spent on health care than we would if we had a

realistic health system. we go after health insurance companies because we do risk readjustment. if you're dumping patients or cherry-picking, you have to pay extra. you have to pay to the very insurance companies that are covering those sick people. so we change the incentive to where aen insurance company is incentivized -- to where an insurance company is incentivized to care for somebody rather than to dump@@@t 13 voted against the common sense bill that did not increase taxes, didn't increase premiums, covered more people than this bill will cover by 4 million, put everybody in medicaid and private insurance policies all nolan crear where they discriminated against the

doctors who won't take medicaid, taking the medicaid stamp of the four had been giving them the same access to health care we have. >> ethos my colleagues find it entertaining that's my friends and colleagues on the other side of the aisle who in 2005 as part of the deficit reduction act, we have to bring in the vice president from the white think was overseas in order to break the tie because they were worried about what senator reid called immoral republican budget and in moral document and by the way, is the center aware that the citizens against government waste our, have come out in favor of this amendment and mr. president i ask unanimous consent that a letter from the citizens against-- against her government waste be included in the record and also mitt the seniors in my state and i would ask my colleague, have been very puzzled at a aarp endorsement of a proposal that would cut their

medicare, that has already been made clear that medic aired fanning gen there is 330,000 of them senior citizens in my state that earned medicare advantage that it has been announced that it will be celestin some how aarp is now supporting. all i can say is my friend were there is in the organization called 60 plus, an organization that is working very hard on behalf of seniors to make sure that they don't lose these benefits? >> i am and i would tell the senator again, how are we where we are? how are we clear we are when we are going to take programs that are working. granted the think medicare advantage could be decreased by two competitive bidding but cms did not do that. we could bring the cost of and still have the same benefits but this bill just cut the benefits and half. the extra benefits that medicare patients have by being signed up on medicare advantage that

everybody has to penafort a supplemental policy. i want to address one other thing of the senator would allow me. the majority whip said the only want to get rid of conflict of interest? yes, but his argument was speeches because the prices set for an x-ray or a or azt, or a blood test. they are set by medicare now. there is no differential and the prices other than what medicare says the differential will be. there's no arbitrariness. the government sets the price for every medicare test out their so there is no way to gain it as the senator from illinois said it was games. the best reason to have a lab in a doctor's office is so you don't have to wait and come back for another visit to the doctor that charges medicare another $60 because you get the answer

right then. we want to eliminate that. so what will we do? there is no cost savings in the. there's a cost increase because now instead of giving an answer to a patient you are going to wait until you send it off to the lab and it comes back and. >> can i ask the senator a fundamental question here? how does the senator and vision that we can eliminate the fraud, abuse and waste and institute significant savings, one of the ways is retain the provisions in this amendment, this motion to commit the uses the savings from fraud, abuse and waste elimination to make the trust fund strong ear bud at the same time preserves the benefits that our senior citizens have earned. how many times have you heard from senior citizens in your state saying i paid into this trust fund. i paid for my medicare all my

life. now is going to be cut. how was that fair to my generation, the greatest generation? >> if you take $100 billion a year when that is not an exaggeration, even hhs this last week said improper payments were $92 billion. the inspector general and the gao votes sade is higher than that. that is on medicare alone. if we just captures 70 billion of that, how do you do that? do you know how medicare pays them? they pay and then shays the use of madden in voice and they don't know if it is accurate or not and a payette. they payette and then they go try to get the money back afterwards. please certification of the payment like everybody else does and that has anything to do with the volume that medicare has. the other way you do it is under cover patients, where you put people actively defrauding medicare in jail.

less than $2 billion in this whole bill goes after fraud. that is 10% of the fraud per year. we could cover everybody in the country or extend the life of medicare 20 years by eliminating the fraud that is in medicare today. what are we going to do? we are not. we are going to create more government programs and more agencies that are going to be designed to be defrauded so therefore the fraud will go up and not down. and we are also going to limit the availability of prevention to seniors. i have read the propension text in this bill. their parts of it i absolutely agree with. we know that if we manage propension and we manage chronic disease we are going to save a lot of money but we are not going to save any of that by building jungle gyms. what we have to do is incentivize people both

positions and patience to get in the preventive mode. we need accountable care organization for colbert lots of things we can do and lots of things we agree on. i know the senator from iowa and i agree on a lot in propension but we ought to be sitting out money and we ought to eliminate the fraud. if we did nothing in this body except eliminate fraud in medicare, of he think what we would have done. king what we would have done. think wet we would have done ago $447 billion spent on medicare, $100 billion on fraud. wheeled chairs that had been built up so many times that they collect over $5 million on them. doctors to submit false invoices , suppliers to submit invoices or people who were deceased and we try to go get that after the fact.

there is lots of things we can do. this bill is short on that. you all recognize it is short. it is the biggest savings out there. the reason there is not more in it is because cbo once corrette. because we have never demonstrated the capability and one final point. this bill only scores the way cbo scores because it says you intend to do what no congress has ever done. it says you intend to cut medicare. $462,480,000,000,000. if you intend to cut medicare the american people like to nowhere you are going to do it in how it's going to affect them but if he were just doing it for a scoring point, the young people in this country ought to know that too. because where you say you are claiming $460 billion you are really just getting to the deficit if in fact we don't cut medicare that much and is it

fair, is it fair to the medicare advantage patients who are poor, who don't qualify for renewal coverage with medicaid, can't afford a supplemental policy. is it fair to take away the benefits that they have today that we have given them and it was not price by the insurance industry, it was priced by sea mfn say because the government agencies didn't private we are going to take away half of your benefits. if there is anything immoral, that is the moral and with that i yield the floor. >> the senator from montana. >> mr. president i would like to once and for all laid to rest this false claim that the up-ending bill is going to "hurt seniors and it is going to hurt

providers and is going to bead this long parade of horribles that the other side like to mention. it is totally patently untrue, the claims that they are making. number one, you are all crying allegations on the other side. if the underlying legislation cuts medicare, it cuts medicare, that is what they say. what they don't say is that it does not cut medicare guaranteed benefits. it doesn't cut benefits. it does reduce the rate that hospitals would receive. it does reduce the rate of growth that medical device manufacturers might receive. all that is true so it is true it is cutting their rates of the role of medicare providers. it is not true that this

legislation cuts medicare benefits. that is not true. the other side would like you to believe that is true by using the words they choose, by saying cutting medicare. they want you to believe that is cutting medicare benefits but it is not cutting medicare benefits. rather, the underlying bill reduces the rate of growth of government spending on providers, on hospitals, home health, hospice, lots of other providers. that is really what is going on here. don't let anybody fool you. this bill does not cut medicare benefits. it does not. but it does reduce the rate of growth of providers. now, why are we doing that? first of all, most of these providers, virtually all the providers say we don't like their rate of growth of federal

dollars coming to us being cut but we will go along with that. they are okay. they are ok with that. wirer they okay with it? why is the american hospital association of k with reducing the rate of growth of hospital payments by $155 billion? why are they okay with that? they are okay with that because they are going to make it up on volume because this legislation provides coverage for many, many more americans who will have health insurance. americans who do not have health insurance now often have to go to the emergency room in the hospital. the hospital has to provide them care. it is uncompensated care because no one has paid for the hospital benefits and that cost is transferred off on to private health insurance premium holders. they have got to pick it up. on average that is about $1,000 per family per year so number one, i repeat there are no cuts

-- there are benefits and reductions in the rate of growth to medicare providers, which the providers agree with by and large. i won't say totally. i won't say they are totally jumping up and down and enthusiastic about it but they realize they are not really getting heard. they are going to do okay. they are going to do okay because their corn to make up on volume what they might otherwise lose. that is a very important point for people to understand. second, but if you will listen to the other side, they would have us do is virtually do nothing. and when-- what is doing nothing mean? doing nothing means the solvency of the medicare trust fund is just open the horizon. this legislation extends the solvency of the medicare trust fund and another 45 years.

man, oh man if i am a senior and about to be a senior i would sure like the medicare trust fund to be solvent. i would like that very much. this legislation extends the solvency of the medicare trust fund by another 45 years to about the year 2017 so without this legislation the actuaries say that medicare trust funds can become insolvent five years earlier, 2012, that is not very many years from now mr. president, not many years that all so it is very important we extend this alfonsi to the medicare trust fund. you might ask, why is the medicare trust fund in a little bit of jeopardy? why is that? why is that? the very basic reason is because health care costs are going up that such a rapid rate in america. adi very rapid rate in america. our health care costs are going up 50% more quickly than the next most expensive country, per

capita 50 to 60% more than the most expensive countries so there are a whole host of things we are doing in this legislation, a whole host of this legislation to make sure that we have some limit of our health care costs. mr. president i realize i misspoke earlier. currently medicare trust funds are due to be insolvent in the year 2017. this legislation extends the solvency of the medicare trust fund to the year 2022, so the principle with the same, it is just that five years is tacked on a little bit different, a later period of time rather than up front so early. were doing a whole list of things in this legislation to reduce the rate of health care costs to people in this country and health care costs which are driving up the cost of medicare trust fund so we are doing all we can to extend the solvency of the medicare trust fund.

someone might say, it the medicare trust fund is this all because of baby boomers, that will add to the pressure on medicare. that is somewhat true but the congressional budget office did a study six or eight months ago that showed it is about 70% of the additional cost of medicare trust fund is due to cost increases, not due to more baby boomers retiring when they reach the age of 65. now, what are some of the groups that say about this legislation? let me say what aarp says. they have a chart here which indicates what the american association of retired people says about the underlying bill. now, they were cutting medicare like the other side says you think they would not like this bill. you would think they would have problems with it. aarp has not totally endorse this bill but they don't have problems with that because they know we are doing the right thing but what did they say?

proponents of health care reform will not rest. they are using misinformation to distort the truth and wrongly suggesting medicare be harmed after a lifetime of hard work, don't seniors deserve better? that is what are says, referring to the distortions and misrepresentations and untruths, trying to scare seniors mentioned by opponents of this legislation. here is another aarp quote. this is just this month the new senate bill makes improvements to the medicare program by creating a new annual wellness benefits, providing free preventive benefits and most notably for aarp members reducing drug costs for seniors involved in the dreaded medicare doughnut hole. that is a very important point mr. president. this bill not only does not cut benefits, it increases benefits for seniors and the big one referred to right there, that is the so-called doughnut hole, the

gap in coverage under the prescription drug program. this legislation in effect says seniors now you have $500 of their drug benefit prescription drug benefits paid for when they are in the doughnut hole period end after that this bill also says that is paid for a lease for one year. we have to worry about that and subsequent years but this bill improves the benefits that seniors will get, not take away benefits as the other side would imply. now, it is true that private programs like medicare advantage are reduced from what the otherwise would be, just as hospitals are reduced in payments from what they otherwise would get. let me just, i have a chart here. let me point out the next chart here if i could which shows that the provider groups, hospitals etc. are actually going to do

okay under this legislation. what does this chart shows? this charges medicare spending will continue to grow under this legislation. it will grow and grow by a lot. in 2010, $446 billion a steady growth through the ten years of this bill. in the mite say that just parenthetically, one of the previous speaker said rural health care, rural hospitals will be heard with this legislation. mr. president i don't think that is entirely true. i've got a lot of hospitals in my home state of montana, they say it is okay, they approve it and in addition to that there are no critical access of access in rural america and most of those are critical excess hospital so they are going to be okay. basically, if we did not pass this legislation, these provider groups, hospitals, nursing

homes, home health, hospice, medicare advantage, even part-b and medicare improvement would all increased by about 6.5% over the decade, they will decrease by 6.5% under the decade. under this legislation that will all increased by about 5% over this decade with a 1.5% cut which they basically agreed to. so i want to make that point very clearly mr. president that we are not cutting medicare here. not cutting medicare benefits, but we are reducing the rate of growth of medicare spending. now another point i want to make here if i could mr. president is that there is nothing new here. many of the senators advocating killing this bill made the opposite statement not 20 years ago. what did they say? they said we have to reduce the

rate of growth of medicare spending in order to save medicare benefits. that is what they said a few years ago. exactly what they said. let me read some. we proposed a slower growth in medicare. becker will otherwise go bankrupt. there are standards in making the opposite statement today, exact opposite statement where they tried to scare people to kill the bill. i am not going to give their names of their senators who currently serve in this body. we do heed the warning of the medicare board of trustees and limit growth to more sustainable levels to prevent medicare from going bankrupt in 2002. that is what is necessary to ensure seniors to not lose their benefits altogether as the result. they said that. won senator said that. i thought-- 14 years ago. the exact same thing is going on

today. we no, the experts know if we are going to save medicare benefits, we have got to stop over paying some of the providers, hospitals and were overpaying them. let me tell you one how-- example. you know the updates, the mansing form for paying hospitals, do you know they don't take productivity into account when they make these recommendations? the recommendation is basically made by an organization and is the president, the presiding officer knows it is a bipartisan organization. in is a nonpartisan organization composed of doctors and experts that advises congress on what, updates and what the payment increases should be for different groups over the years ago we in congress basically look at it in we tried to decide what makes sense and what doesn't make sense and so forth but the the medpac is said mr. president that this is what we have to do. with to slow the rate of growth

in some of these providers because they are getting paid too much. with and i just repeat myself, we will allow a 5% growth over the next ten years, and none of them are crying wolf i might say. that is the main point i want to make mr. president. i've mentioned what aarp is saying and i mentioned in the american medical association. we are working to put the scare tactics to bed once and for all and inform patients of the benefits of health reform. that is the american medical association. south arb and the american medical association and others no senior will see a single reduction in their guaranteed medical benefits under this bill, not a single one.

i might also say that this bill would reduce premiums that seniors may have otherwise stayed. much of the savings to seniors comes from limiting massive over payments to private insurers as private companies like medicare advantage. small pointier, seniors to the word mccarrick antigen they tend to think it is medicare. it is not. those are private companies. their private companies and they are basically enhanced under the 2003 medicare part d legislation, they are given a lot more money and encouraged to less competition rural areas. it turned out that we gave them way to much additional money and they know it. and this legislation is trying to cut back on the access that they are provided back in your 2003. i would say the cut is about $118 billion over ten years. i don't have with me how much is remaining but at 5% figure i gave you for growth, that

includes medicare advantage plans. i mentioned already that this legislation would reduce prescription drug costs. that does not sound like a benefit cut to me. it sounds like an additional benefit for seniors, and we also provide for new prevention and wellness benefits the medicare. that is in addition. that is not like that. we are also helping seniors they in their homes and their own homes, not nursing homes. that is the benefit. i think it is important to point out here the opponents of health care reform did not have a plan to protect seniors and strengthen the medicare program. they say don't do what they said a few years ago. they say we commit the bill and do nothing. they say go back and start from scratch again. if you listen closely to the music as well as the words and read between the lines basically they are saying kellett, don't do it. the islamic sense. that is what they are saying and i hate to say this because i

tend to be a non-partisan kind of guy but these are scare tactics. they are not truths from the other side. sometimes you just have to call a spade a spade and that is exactly what is happening here. i might say that the medpac the out-- they think that medicare advantage plans are overpaid by 14% and in addition a typical couple that days, typical couple will pay $90 more per year for part b premiums to pay for medicare advantage even if they are not even enrolled in the plants and that is not right. medicare home health providers, i gave you that list on the earlier chart, one small part of that is medicare home health providers. they have an average margin of 17% for home health. that is a lie. if we are trying to protect medicare benefits we have got to make sure we are not overpaying

the medicare providers. it is just common sense. it is the right thing to do. so many seniors that just need help with their medicare benefits and i might say nursing homes are making profits of 15% off of medicare. in my judgment that too is unacceptable. we have an obligation. this is a government program. we have an obligation to where taxpayers to make sure we are not overpaying hospitals and providers. we have to do right by them and make sure they are doing okay, but just not overpay them. that is a tough line to draw sometimes and is a judgment call but that is what we are doing here. in addition the office of the inspector general has found rampant fraud and waste and abuse in the medicare programs. there's lots of fraud and waste in the medicare program, lots. the last figure i saw is about $60 billion in fraud in medicare. that is the providers ripping off taxpayers in seniors. we have added additional

provisions to allow lovette fraud some additional screening and certification, ways to make sure that medicare does a better job, hhs or cms does a better job in knowing which payments to providers are right in which are not right. what is the real impact of the medicare policies here? let's be clear. the real impact of these policies even with the medicare changes in the bill overall provider payments will still go up. i don't want to be that horse too much but i want to make it clear that we are not cutting benefits folks. we are reducing the rate of growth of spending for health care providers as hospitals and nursing homes but reducing it in a moderate way and not reducing it by too much. as this chart shows those providers to get at least a 5% net increase in payments over the years and what the groups

themselves of not really complain about them. take the pharmaceutical companies, hospitals, nursing homes, home health, hospice. they are not crying crocodile tears. mr. president remember the famous meeting at the white house not too long ago, the embassy came and talked to the president? remember they pledged the providers of how much they could cut reimbursement to them. this included insurance companies, insurance companies and hospitals. $2 trillion over ten years the said they would cut, 2 trillion, $2 trillion. this does not come close to cutting $2 trillion. it does not come close to cutting $2 trillion. i think the figure is about $400 billion. that is not to trillion dollars. that is $400 billion though we are not hurting them that much. we are not hurting them,

frankly. they are doing okay. i have got quotes from hospital association. the catholic health insurers the asian, clearly catholic health thinks the possibility that medicare who-- very unfounded. leavitt hurtig claim that this legislation is going to cost providers, it's totally untrue. i have so many kozier people in the hospital industry who believe that this is okay. they are not going to. hospitals will stand by senior citizens, the president of american sr. hospitals. some providers can do it really well, really well under this reform legislation. wall street analysts have suggested many providers including hospitals will be "net winners." hospitals will be net winners according to the basic feeling on wall street analysts because under erbil diesta mate hospital profitability will increase with

reform because more and more hospital patients that have private health insurance. so nobody is going to pull up. there are not cuts in medicare benefits. it is true there is a reduction in some of the private plan non-guaranteed benefits, plans the companies would give to seniors at the expense of private paid to seniors. that is true. wit medpac it is said it should be cut. medpac is even said it should be cut more. we are giving these plans a break. again, the reductions in this bill for the providers, not the beneficiaries of the providers are far less than the health care industry itself over the next decade and they pledged to save $2 trillion. right now it is over ten years and this legislation-- i

mentioned reform. the other side has often said and they say no, no, i'm not quite sure what the difference is between a few years ago when they said this is what we should do. perhaps they should explain that and i might mention too, and this is very important. we tend to lose sight of the delivery system reform. one of the reasons why there's so much waste in our health care system and there is a lot of ways, the estimates are 15, 20, 30% least in the american system. wise there's so much waste? which means the seniors and not given the benefits they should receive and which means that private paid patients generally aren't getting the benefits they receive is all the ways. the always is basically because of the way we pay for health care in our country. we pay on the basis of quantity.

we pay on the basis of volume. we do not pay on the basis of quality. or to stated differently the hospital, and they try to do the right thing, hospitals or doctors try to do the right thing. they are paid on the basis of how many procedures they provide, not outcomes, not quality and that is the basic judgment that is causing a lot of the waste and the american system. you know, health care is provided for differently in different parts of the country. the fancy term is called geographic disparity. health enmund communities practice one way, health care in another communities practice another way. they are very different. many of us are-- read the "new yorker" article, the june 1 article written by dr. gawande comparing el paso, texas with mccollum texas. ict texas centers on the floor here.

perhaps they can help us elucidate what is going on but basically in el paso texas the cost of health care is about half per person. that is the border town. about half. spending for a person in el paso texas is about half what it is in mcallen, texas and yet the outcomes that his help patients do is a little bit better and el paso then it is then mckellan. why? according to the article, it is because the of, what is this sense in el paso regarding health care in what is it in mckellan regarding health care? it may be dangerous for me to say so but according to the author his conclusion is in el paso it is because the care is more patient-centered, is coordinated care. it is less on making a buck

where is and mckellan it is less coordinated care, more special the hospitals and a little bit more providers wanting to make a buck. the main point is this common medicine is practiced of differently oliver the country, geographic disparities. some states in northern high plains states, it is less spending per person. the outcome is direct again some of the sun belt states, much more spending outcome is worse. just because it is based on volume in quantity and not based on quality. this legislation stars to put in place ways to move toward reversing-- reimbursing based on quality, not volume and that paradoxically is going to result in lower costs and higher quality. lower costs but higher-quality. virtually all folks in the health care community, doctors,

hospitals, administrators i talked to, the doctors i talked to come of virtually all agree, i would say, i will be very conservative, 80% agree, 85% agreed this is the direction in which we have to go. this legislation goes in that direction. failure to pass this legislation, which the other side wants, and that is not to pass it, means we don't do any of that. means we don't start putting in place ways to more properly reimbursed doctors and hospitals and other health care providers. this bill includes those patient's centered reforms that i just mentioned. they include accountable care organizations, bundling is another concept, reducing unnecessary hospital readmissions come mccreedy innovation centers. this bill starts to do that. there's something else this bill

does, but which i know some on the other side all exercised over and i think exercised over it improperly and that is ways to start to compare one drug versus another, compare one procedure versus another, one medical device versus another and we just got started doing more of that with the nongovernment agency, with a private and public agency that works together so that it gives good solid information. so we have more evidence-based medicine in america. riedel lot of docks want to do the right thing but what they do depends on the drug representative the comes into their office and starts peddling is certain drug. doc skeel unease the bout that and they don't like it but they are so busy and they see so many patients it is hard to keep up

the date so we are trying to help them keep up-to-date with the evidence-based medicine and with a lot more health i.t., helped information technologies of a can get access to the best evidence for these various organizations here. there are just so many reasons why this legislation is so important and i personally believe we have to move a bit toward what is called integrated systems. we hear about gice singer, mail cleveland clinic, intermountain health care and there's some home health in seattle where doctors and hospitals and nursing homes and pharmacists are more integrated together and therefore it cuts down on costs, increases quality. it is mayor patient's centered and this legislation help says manatt direction. you know, we are just trying to get started here with this legislation, get started on doing some of the right things that we know we should do. we don't have all the answers

here. nobody has all the answers but if we get this legislation passed in the next couple, three, for five years we work with the basic underpinnings of this legislation we are going to help correct some of these mistakes. we are going to be working on getting health care costs down which we have to begin doing to help our people, help our companies. we are going to work to get more covered so more people have health coverage. it is an absolute embarrassment that the united states of america does not provide health insurance for its people. it is more than an embarrassment, it is a travesty. it is morally wrong so this legislation gets us moving. it helps medicare beneficiaries, not hurting them as either side would like you to believe. it does not necessarily harm doctors and hospitals. they kind of notice the right thing to do. they are still getting big increases in payments and there

are other forms here which i attempt to mention but i strongly urge us to say hey this is the right thing to do. let's get started, let's pass this legislation and certainly trounce this week amid a motion to stop what we are doing. we are getting started here. let's keep going. i yield the floor. >> as the focus on health care continues, c-span's health care hub can be a key resource. you will find congressional hearings and the fence, speeches by the president and town hall meetings. also video at scumbling sandra health care comments via twitter. the c-span health care hub at c-span.org/health care. senators return tomorrow morning for more debate on their health care bill. live coverage of the u.s. senate is on c-span2 at 9:30 eastern.

secretary state hillary clinton, secretary of defense robert gates and the chairman of the joint chiefs of staff admiral my molin will be on capitol hill tomorrow to answer questions about the president's afghanistan strategy. you can see their testimony before the senate armed services committee live on c-span3 at

9:00 a.m. eastern. later the house foreign affairs committee is live at 1:30 also one c-span3. >> now, a confirmation hearing for intelligence officials that the homeland security and state departments. dianne feinstein of california chairs this hour-long session of the senate intelligence

committee. >> the meeting will come to order. the committee meets today to consider to nominations to the intelligence community. in positions that require senate confirmation. they are ambassador philip goldberg nominated to be the assistant secretary of state for the bureau of intelligence and research, which we finally know as inr and this is ms. caryn wagner nominated to be undersecretary of homeland security for intelligence and analysis for aye and a. i would like to welcome both of you and say congratulations. both individuals were nominated by president obama on october 26. they have since met with me and other members of the committee and have responded to numerous

pre-hearing questions. the responses are now posted on the intelligence committee's web site for public view. interestingly enough most nominees come from different backgrounds, and that are nominated to lead to very different intelligence organizations. ambassador goldberg is nominated to lead an organization with a very distinguished and respected history. the state department's bureau of intelligence and research in ducks all source intelligence analysis to and buys the secretary of state and other senior department officials and serves as an active participant in intelligence community wide analytics products. its analysts while far fewer in number than the old source analysis organizations at the cia and dia, are highly expert in their fields and have no qualms about dissenting from

judgments they believe to be incorrect or unsubstantiated and that is very much appreciated. one example of the importance to me was ina's dew in the 2002 nit on my rack that iraq was not reconstituting nuclear weapons and especially her due to the different view on the use of aluminum tubes and centrifuges. that obviously proved to be correct. and bester goldberg himself has been long in fault the national security issues and has received intelligence throughout his career but has no past experience inside the intelligence community. we will be very interested in hearing ambassador goldberg's use on his preparations to assume the responsibility. ambassador goldberg is a career foreign service officer. he is distinguished himself over a 20 year period including

charge that there's and deputy chief of mission and santiago, chile, cheap admission in kosovo and united states ambassador to bolivia. since june he has served as the coordinator for the implementation of the united nations resolution on north korea. earlier in his career he served in bogota, colombia and pretoria south africa. particular note is is being declared persona non grata bipa live cam presidents morales in september of 2,008. the committee has looked at this incident and members may have a few questions, but it is pretty clear to me that ambassador goldberg had no blame in this matter. mr. wagner by contrast as a career intelligence professional beginning as an army officer in rising to the level of captain. after three years on the house intelligence committee she

joined the senior ranks of the dia before becoming director of intelligence community management staff and subsequently the assistant deputy the and i and chief financial officer. she returned to the house intelligence committee as budget director and is now a faculty member of the intelligence and security academy llc. she is being nominated to head the office of intelligence and analysis at the department of homeland security which unlike inr is the young intelligence agency and one that has struggled to identify a clear mission and bring together and a appropriate workforce. we have discussed that earlier. the committee's report accompanying the fy2010 intelligence authorization bill noted some of these concerns. they include that as of this summer, contract personnel make

up a staggering 63% of the workforce of the office of intelligence and analysis, including a large percentage of its intelligence analyst. in my view this is an inherently governmental function and should be done by the government and not by contractors. the office says written analysis that inappropriately analyze the legitimate activities of u.s. persons based in part on highly questionable and noncredit cybil open source information. in addition, the office as numerous and unclear missions, some of which overlap with work being done by other departments. according to the homeland security institute the offices on stable and lack structures for budget and management accountability. i discussed that this morning with mrs. wagner and i actually

believe she is up to it so we will see what comes. i am told that the office. of intelligence and analysis has been drafting a plan to restructure and refine its mission but the plan won't be finalized until a new undersecretary is confirmed so that will be clearly ms. wagner your first big job, and i think this committee will be very interested in your views as a professional on what the office should be doing and how it should be structured or restructured. again i welcome both witnesses and i will turn to the vice chairman for any opening comments he might have. >> thank you very much madam chair. you have played down a tough call let. we welcome both of the nominees and ask do you have family members here or close members

who are supporting you today? ms. wagner? >> thank you senator bond. my husband is here with me and i have numerous friends which i will not name because i will know that thou. them. >> ambassador. >> i have my colleague from the state. >> thank you very much. well the public often hears about other elements of the intelligence community, the office each of you was nominated to head, inr and the department homeland security can and should be making valuable contributions to the community and to our national security. as the chairman said, and the chair said i also have had conversations with you and pointed out some things where we think you could enhance and improve the operations of intelligence.

mr. goldberg that chairs told one of my best lines but i can save a few can be expelled by the likes of the emerald morale so it is clear you have already chopped up a major accomplishment at least in my book and i congratulate you on that. be i am interested to hear how you expect your experiences and bolivia and other diplomatic posts will help you head and analytic shop. i've had the pleasure of sitting next to a former mi5 official who shared insights on the importance in this war on terror of forging selig and productive relationships among federal, state and local law enforcement agencies. his point to me was that what the brits do and we do not do is use the contacts we have, the continuing contacts we have come up with state and local officials to task them to bring information up the chain of

command. weiss then information down but local police department or a local sheriff's office is far more likely to know when the board here when something is amiss going on in their community, and report that back up the chain, so we have talked about that, and i think that while it is very important, not enough intelligence is being pushed downstream, there may not be enough intelligence coming upstream from thousands of communities and we hope that he will pursue that. we can make fusion centers were but there's a lot of intelligence i believe can be best gathered at the local level. on the federal level we need to make a further commitment to training these authorities to identify and collect-- ms. wagner if you are confirmed i expect you will leslie with director mueller and the attorney general in the coming months to make better training

programs in reality. they can be done without additional cost and the benefits will more than compensate for any price of the cost. madam chair i'm sure both of these nominees are anxiously awaiting their questions and even more importantly their exit strategy, so with that i congratulate them on their nominations and look forward to hearing from them today. >> thank you very much senator. ms. wagner, why don't we begin with you with that as of right. >> thank you very much with. i am honored to appear before you today is the nominee for undersecretary for intelligence analysis of the department homeland security. i believe this position occupies a unique space between the national intelligence and law-enforcement communities and the state, local and private sector entities that there the from whence it, and security. there is nothing more important than forging and fostering those connections. with confirm the believe i have the right skills to continue building on the foundation laid

by pat cues, charlie allen and the undersecretary mark johnson. i began my career is as a intelligence officer in the united states army serving eight years on active duty in the years since i have spent seven and a half years that dia, five years on the staff intelligence and for years with the odni. i've had a mixture of staff and line management jobs including leading a 2,000 person analytic organization within the defense intelligence agency. i've also had a great deal of experience in the interagency in parliament in familiar with all facets of the intelligence community. my experience with law enforcement has been more limited i have had a significant exposure while working at dni to the capabilities and contributions of law enforcement and homeland security agencies. i know i have much to learn about state and local and tribal law enforcement which is why if confirmed i'm eager to get started with the help of deputy and the undersecretary for intelligence and an analysis of

our johnson who is a highly respected and decorated veteran of the new york state police force and has done an outstanding job as undersecretary for the past six months. i had the opportunity to observe the office of intelligence analysis from the outside wall eye served in the office of the dni and i am aware of the many challenges the organization faces. since my nomination i have learned more about ina's the activities and the secretaries vision about where she would like to take the department. i form preliminary cues on what needs to be done to enhance support its customers and the department to improve its standing within the intelligence community and with its congressional overseers. it confirm the plan to focus my initial efforts in three main areas, first creating a chernin homeland security information sharing enterprise to a greater focus on the state and local fusion centers. tsypkin creating a dhs intelligence enterprise as the chief intelligence officer for the department and third putting in place the management

processes necessary to improve the morale efficiency and professionalism of ina as an organization. the nake nedge is best defined by its responsibility to share information with state local and tribal authorities in the private sector on the full range of fritz to homeland, often referred to as all fritz kemal passage. kurds responders at the state and local levels of the nation's first line of defense. they are able to identify anomalies or criminal behavior that could-- it is critical to educate them on terrorist indicators as they are identified, to capture information that is lawfully obtained will strictly adhering to privacy civil rights and civil liberties regulations and share it with a wider enterprise. this is a multifaceted challenges that requires adopting analytic methodology and product lines, a great deal of training at all levels of the enterprise and itn information sharing solutions. it also requires an approach

that is tailored to a different thread and operational reality of the individual fusion centers. if confirmed i intend to develop a comprehensive multi-year strategic plan for supporting the state and local fusion centers that can be used to guide analytic planning. the role of the chief intelligence officer from the diprovan was created by secretary chertoff to empower the undersecretary to create a dhs intelligence enterprise that is more than some of its parts. the operational components have elements that support their individual missions and they also have stayed and expertise that can be leveraged by ina or national state local and tribal clans will strictly adhering to privacy civil rights and civil liberties regulations. in addition the components may have the intelligence or information requirements that are not adequately being met. ina can meet these requirements by leveraging the intelligence community on their behalf, producing keillor products or with them providing analytic training and mentoring in serving as an advocate for

increasing their capabilities. by leveraging but the components and capabilities we can build on recent progress to create a true intelligence enterprise that enables ina and the department to achieve their full potential. if confirmed by will view the role of chief intelligence officer as one of the most important of all emissions and put in place the staff structure to manage it. finally in the management of pranab ina is still a young organizations in several recent studies have suggested it suffers from a lack of processes and poor morale. one of my biggest prairies will be developing in formalizing internal processes for planning programming and budgeting, the performance measurement and human capital management and mostly i will be taking a look at contractors. i believe communicating clear mission guidance implementing ferren transparence processes for hiring promoting and rewarding people in developing a structured includes the process of building the budget will go long way towards improving

morale. have confirmed dials the plan to make training a centerpiece of my agenda. i have party mentioned the importance of training to build an information sharing and intelligence in a prizes bud is he pull in porton for professional development within ina. if confirmed i will focus on ensuring ellis received the training that they need. finally if confirmed that will work hard to establish and maintain constructive partnerships particularly with the office of the dni, the national counter-terrorism system, the fbi in congress. if confirmed the pledge to keep you fully improve-- informed of the activities. thank you very much. >> thank you very much. mr. goldberg. ambassador should say. >> madam chairman mr. vice chairman it is a great honor to appear before you today as president obama's dominque for secretary of state for the bureau of intelligence and research. i'm grateful to the president and secretary of state clinton for their confidence in nominated me for this position

as well as to the director of national intelligence, dennis blair for his support in my nomination. if confirmed by the senate i pledge to work closely with this committee has a plays a vital role in the oversight of the intelligence community. madam chairman, ina is and it treasures source of information and analysis for policymakers for more than 60 years. inr is also a deeply respected voice within the intelligence community. inr's excesses not been based on its size or budget. rather has been based on the extraordinary experience, judgement and analytical skill of its personnel. inr has earned a reputation for be professionalism based on a mix of civil and foreign personnel. the combination of those who spend years and often decades on an issue buttressed by those with reason experience in our embassies overseas. jobs through training, academic

opportunities and service overseas. and i will work to recruit the finest people available. i will also defend the process of independent and unbiased analysis as well as the people who produce it. as you point out, madam chairman, the people of inr have in recent times won praise for the quality of their work as well as sticking to their analytic con clueses when necessary. inr has another essential role. assuring that intelligence activities are consistent with and in support of our foreign policy and national security objectives. in this area, too, inr is fortunate to have a staff of professionals who have special expertise and years of experience and often very technical areas. if confirmed i look forward to working with these professionals to support the secretary and department in assuring that foreign policy concerns are a central consideration in the

intelligence community decisions and activities. i will also work with the relative committees of congress as they carry out their essential oversight rules. madam chairman, i believe if confirmed i would bring a set of skills and experience to the job of assistant secretary for intelligence and research that will add to the value of the bureau. while i have not previously served in a position in the >> i have worked closely with analysts in the intelligence committee as political and an officer overseas helping to produce analytical product prior have produce products for policy makers as well as in washington. this experience is giving me a strong appreciation of the independents and intellectual rigor and it experience and personal integrity -- integrity that applies to the products. having were caught in policy

matters, seventh floor of the department i have a strong appreciation house intelligence can best support diplomacy and its practitioners. this is inr primary mission. from the affair and two-time chief i assure intelligence and law-enforcement facilities were carried out and support of national security objectives and four policy provide service implement your of the security council resolutions one north korea per great job requires analysis of intelligence information and close coordination with other intelligence community members. my experience leading large and complex missions overseas as well as managerial assignments have prepared me to leave the large bureau. madam chairman relive and a time of enormous foreign policy on issues of "war and

peace", a change in the economic situation around the globe, our leaders to serve the best information and analysis before making a difficult decision. if confirmed by a book forward to working with you and your colleagues to make sure that happens. thank you. >> thank you very much for i have a list of four questions we ask all nominees. please respond yes or no. do you agree to appear before the committee when invited? >> yes. >> i wonder what we would do if somebody said no. [laughter] do you agree to send officials from your organizations to appear before the committee and doesn't a staff when requested? >> do agree to provide documents and any other material requested by the

committee to carry out oversight and legislative responsibilities? >> to the best of my ability, yes. >> to the best of my ability, i guess. >> what does that mean? >> if it ever became as far as the inr bureau goes i will share whatever we can. there are some issues from time to time might come up about the documents or executive privilege and of the rest that might to be beyond my control spread this is the first time anybody has qualified their answer and that will have to be looked into more deeply because of this committee expects to get documents that their requests. we are the oversight committee to have agencies without the ability to conduct oversight is not acceptable.

>> i might add that the president has the right to declare things of higher security level. before we would except that we would need to know from the white house that this was something over which there exercise a national security. >> that is right. >> we would carry our argument at 16 kendra's to make that is right executive privilege cannot be the driftnet to pick up everything that people do not want oversight that is where we become the guardian angel. >> absolutely provided not mean to say, from our point* of view what i would share all information requested by the committee. that it really is not a qualification it is just something that would be beyond my control. >> i want everybody to know

if we ask for it we expect to get it unless there is not a good reason or you will have to tangle with us and you don't want to do that. last question. will you ensure your respective offices provide such material when requested? >> yes. >> i have one question for each of you. ms. wagner in testimony before the homeland security and government affairs committee on september 38, this year secretary napolitano and noted that ina quote matt currently undergoing an important to realize it to strengthen the delivery of useful actionable intelligence to state and local law-enforcement based on their particular needs. here is the question. have you been briefed on this realignment and do you support? >> yes. roi have been briefed.

at it has not been finalized by half and briefed on what's he is proposing to do. of the top-level it makes sense but i would like to reserve the right if confirmed to make adjustments sorrow prefer to come up and brief you after i am confirmed if i am on where that is. >> if i understand you correctly, you were saying you will have some input into the right -- realignment and it is not finalized? >> we will take you at your word because i think it is fair to say there is some weaknesses in your area and we would like to see them corrected. so any correction you could bring about could we very important and we would like to have you discussed that

with us the fed is agreeable. >> yes. >> thank you very much. mr. goldberg? we talked this morning about the fact to have not previously worked in a intelligence agency are produced analysis. you do have significant experience in a lot of different areas and in receiving it in particular. in my view you are clearly qualified for this work. >> that runs counter to policy preferences? >> a think the kinds of

policy analysis with the analytical work i have done in particular in the balkans in the 1990's in a difficult atmosphere when we were debating within the united states government about whether to intervene first is in bosnia and later it in the kosovo? those issues were one that i was fortunate enough to be a will to weigh in on and give my unvarnished view. i think in part because of the people that i worked for and also because i felt it was important to do so. >> i will not ask you what your views were but it is very important. one of the things we want to see are independent intelligence agencies to give the policy makers what they perceive it or what

they might want too. >> of some of the. >> following up on the questions from the chair what should be the primary focus of ina? the infusion centers? disseminating intelligence products of the un classified information? or some other things? what is your priority? >> i think the primary mission of ina is spelled out in the legislation and what congress expects is to share information with state and local and private sector entities. as far as i can tell ina is the only committee using those people as the primary customers that. also as a departmental

intelligence element have the responsibility to report -- supports the other elements of the department and orchestrate the seven days the 70 within the various components. they're key but also goes back to where you say in the opening statements that sharing goes both ways. we need to make sure they're the clients and how their wealth of information. that needs to be analyzed and shared with the support of national intelligence. >> can he provide trade -- trains for representatives of local law-enforcement like agencies so they can carry back to their teams what informational what activities may be useful?

i think the department can do a lot by providing training. of the secretary once to support analytic excellence and that is where i can help with training and the department is already helping to develop trading on ensuring negative rights and civil liberties are protected. there is a great deal of that can be done and that is a key element. >> ambassador you said issues of "war and peace" come mike climate change and our leaders need and deserve the best information before making decisions for could you believe that climate change is the best use of limited resources? >> i believe it is one area.

it is largely a scientific issue and probably not necessarily the inr is competent to judge we are involved in negotiations and of the britney the positions of others and how they would appreciate -- pushed the issue so it is in line with said diplomatic role. >> guy eight assume you might be looking into the process of some of the analysis that came out to from the scientific institutions. but that may be beyond years ago. the wind to mention to you that inr has developed a reputation for being a dissenting voice in the

intelligence community projects. summit inr believe it is positive and others believe it may be a negative because continuing descent will make those views ignored. what is your view about this type? isn't a problem? and what could you do to help? at the reputation of inr that is feistiness and independence which is to be encouraged. actually i took your statement when we had a chance to meet and then went back to look at estimates without going into the

details i think there was less than three and 13 and new-line was more or less general. i do not know if it is a huge issue blair 128 incurred to that is my responsibility to put the best foot forward. >> finally, one of the responses you made to the committee's questions, u.s said the rules of the assistant secretary to share the diplomatic and four policy positions represented in the formulation of intelligence policy. can you explain what that means. >> mr. vice chairman we have a responsibility to assure that is at least one

consideration and the region no secretaries they have they've voice but that is not enough to as we have a responsibility to the intelligence community and we want to make sure that the intelligence flow but there is one consideration but it is in within the councils and one of many factors taken into account with the ic. >> policy positions would affect intelligence operations? >> no sir. i did not express it well. it is a risk/reward issue. to point* out the possible downside that is known up

front before something could occur before it would be taken into account at that time. >> eight use mr. vice chairman. senator white house? >> think you. could i ask you about that and it is a matter of concern and i am interested to know briefly what type of a parody you think it is a and whether additional efforts on the part of your agency should be required? >> thank you senator. i will take that. it is obviously a critical issue and something i have

already looked into as a limited time as a nominee i know there ongoing analytic efforts part of the analysis effort at the department. i don't know yet to if i am confirmed i suspect one of the first thing said flinch you do is talk to amy to talk about how ina can team with him to get the analytic support that he needs. but as it continues to revolve that it continues to sort out who will do what but i was a cyber security coordinator so i am very familiar with some of those issues. >> ambassador goldberg? >> i agree it is a critical issue and one that inr has

taken the lead role in the state department to deal with a critical issue. we are and a state of flux on the cyber issues with the organization because inr has a very large role but some of the issues that may be coming up in the years to come will be diplomatic as well and that is not a traditional inr role. we are organized to deal with thought internal issues in terms of the cyber issues. i have already had a discussion with general alexander about the larger issues involved. it is a very important foreign policy issue as well.

we just need to monitor closely and we will. >> on that the second point*, there is a strong bipartisan consensus on the disk committee that we your sick to death of leaks from the executive branch of government. not only is it a bipartisan concern leaking like a sieve and the bush administration does not seem to have stopped with the change and over and over we're subjected to the unhealthful spectacle of having our staff cleared out of the room for a secure briefing that we read about one day later and the "new york times." leaking is politics the way people expand turf and make their moves.

the tolerance has developed but i think it frankly needs to be adjusted and i would like to put that ford on this subject of leaks with you engage in them yourselves and how you consider that a problem? ms. wagner can go first. >> i share your concern about leaks. and your perspective way they have been part of i am confirmed it and i believe anyone in my organization is leaking i will do that with management accountability but it rises to the level a crimes report needs to be submitted i would do that. we'll take every action i can to insure the leaks will not come from ina if i am confirmed. >> a-share and her statement

and i would add the personnel at inr are not involved in politics and it shouldn't be prove they have no business involved and if they leak seem to be coming from our general direction the retake it very seriously. >> he to view may be called upon with the witnesses or make your staff available in the investigation that may go through and then to provide your full cooperation. >> yes. >> thank you very much before recognizing senator wyden i have appointed a task force on and a a very serious concern to this committee senator white

house heads the task force and senator snowe is a member and they will be speaking with you anymore serious nature at a later time but it is of major importance to this community i want to say that. senator biden? >> welcome to both of nominee is. ms. wagner, it seems there are various -- very serious problems facing homeland security intelligence unit and your response to several of them i will ask specifically but i will start reading it excerpt from the report that the committee approved unanimously earlier "the committee has raised a number of concerns with reports issued by the department of homeland security office of intelligence and analysis that inappropriate analyze

the legitimate activities of u.s. persons part of a repair it -- raise fundamental questions about the mission of the office of intelligence and analysis and use to search and questionable open source information as a basis of their conclusions. that committee is not talking about one instance but a pattern enlists report was approved unanimously by the entire committee. my first question, if you are approved what specific takes -- steps to make sure the office stops the inappropriate analysis of legitimate activities of law-abiding americans? >> senator wyden i am aware of some of the

troubling -- troubling products released in the past and if confirmed i intend to attack that several different ways there a couple of issues reflected a basic leave poor trade craft india there is the problem with the failure to take into proper account privacy civil-rights and first amendment protection of speech the problem with the definition was it did not draw a sufficient distinction between beliefs and actions. i would put to a very strict training program to include mentoring and also be assured there is training for everyone on the guidelines year to follow that flow from the anchor nablus the justice department to make sure all concerns are built into the

product early on. as the insurance measure, i will make sure there is in place a very thorough vetting process for review before the products are actually released. >> host: do you ever believe it is appropriate for your office to be analyzed legitimate activities of law-abiding americans? >> no. i do not. >> the homeland security institute federally funded is a research center with independent evaluation of the office, they gave the overall ranking of 1.5 out of five with regard to general functionality and in particular noted "back off this process is inconsistent, ad hoc and planning programming and budget process is

ill-defined and a lack manager involvement. you are a former for the house intelligence committee i assume you're up on the general issues. do you agree with the independent evaluation? >> i have not had an opportunity to be briefed but as far as i know it is accurate. i expect to make them management issues if i am confirm. >> i am almost at a time. based on what you know, what specific steps would you take to address the concerns from the independent analysis? >> it seems to me that the primary problem is a lack thereof transparent process that gives people trust in

the organization and their leadership. i think al would take steps to put the process in place and i have done that before as we do the larger political organization and i have the ability to address some of these issues. it will take time but i will make it a priority. >> senator fine gold? >> i want to think the nominees of your willingness to serve in these positions. last month by a chaired for the senate foreign relations committee so i will address my questions to ms. wagner as undersecretary you have responsibility for setting policies fleeing to connection and analysis including open source information. i know you are aware this is important responsibility but also fraught with privacy and so will the world stage civil liberties implications

and going to the maryland this date police of local and anti-war groups. i express concern earlier this year. what is concerned of open source of information on americans and what is the policy how the information can be used? >> senator fine gold i believe they have well-established guidelines in place that just need to be followed and the analysts need to be trained. the language separate tax u.s. persons data has not changed since 1981 and there are guidelines that ina should be using that flow from that an accord native with the department of justice. i believe training, oversight, and review and release mechanisms are critical to

ensure we're only using data that is appropriate and laws with rules and regulations. >> is one thing for a private company but another for the u.s. government with power and authority to have this information so when is it appropriate for the government to purchase data on americans? should that be considered open source? >> i don't believe so i think for us to have information 1/2 to be a item that is consistent with legal authorities and consistent with privacy guidelines laid out in the documents i mentioned earlier. >> would be fair to say that there's a lot of information on the internet to re-read is there fair to say how

much of that can be to dana borat -- today are subjected to data mining? >> there are some very crucial legal test that need to be met to deal with that information. >> americans is subject to statutes the attorney general's guidelines of former cia the debate whether those authorities are broad or checks or balances are adequate but members of congress know where to go for the framework. but ina is a new institution with a big impact on americans. where should the guidance come from? is there a role from the department of justice have view resolved other questions are gaps in the legal guidance and did you identify those how would you go about solving them?

>> i have not identify any gaps but if i am confirmed confirmed, i intend to rely heavily on the department's office of civil rights and celebrities. ina is in the process of hiring its own officer of first look for guidance for the appropriate informational programs then i would expect we will do with the department of justice it required and the of the guidelines which we did negotiate. >> the lack of of the seizure of the laptop computers? can you tell me to access seizing laptops? >> we actually do nazis the laptops but if it is the

data that is in their own and it was provided to ina we would treated in accordance with all rules and regulations to analyze and store the data. >> where do start a policy where dhs must have a warrant before it can seize a laptop for more than 24 hours? >> i don't feel i am in a position to answer that right now. i do not know enough but i would be happy to come back and discuss that with you further. >> could you get back to me as soon as you can with your response? >> i think my colleague senator risch. additional questions? >> ambassador goldberg what role in your view, do believe the assistant secretary should play to

insure intelligence sharing relationships support broader diplomatic relationships and obviously vice versa? >> senator, intelligence relationships, among others that take place and foreign governments, are very important and strong contributors to our national security. they have to be done obviously with great care per car particular interest at inr is the chief with his or her authority which has delegated by the president they're respective as the oversight for the executive branch at the embassy. that is a particular state department interest. >> i thank you for that. my colleagues if you don't have anymore questions we

don't have anything for there is anything else you would like to ask? >> the committee will have additional questions for the record so it is clear to all senators and staff we asked members submit questions by 2:00 on friday to send them to the nominees and it is the committee's intent to review your responses and our desire to vote this month. with that, we are returned. [inaudible conversations] oúoúoúoúoúoúoúoúoúoúoúoúoúoúoúoó

[inaudible conversations] and. >> good afternoon welcome to the national press club for a hour speaker lunch and i am a reporter for "usa today" i am donna leinwand and president of the press club and we are committed to the future of journalism by providing informative programming and education by

fostering and interest worldwide please visit our website at. on behalf of our members worldwide double-a-2 welcome our speaker and guest today. also those of you who were watching on c-span. room looking forward to today's speech will ask as many questions from the audience as time permits. please hold your applause so we have times for as many questions as possible for that go for the broadcast audience if you do your applause it may be looking for a big guests and members of the general public to attend luncheons and not necessarily from the working press. [laughter] i like to introduce a hour head table guest and ask them to stand briefly. from your right, andrea's

don't come as senior washington correspondent correspondent, bradley kagan snowshoer producer "national geographic" television, raymond komen news director and a new national press club member, john kelly iii from prince albert ii monaco foundation and the washington editor of "glamour" magazine, josh right part managing director from the environmental group and a guest of the speaker and and gillette is a reporter from bloomberg news and a chair of the speakers' committee. melissa, vice chair of the speakers' committee and the person who organized today's events. thank you very much. his excellency tammet ceo of

the prince albert monaco foundation kelly rate in a cure for the fox news channel and press secretary for the national resources defense council and finally the national editor of "vanity fair" magazine. [applause] our guest today is the ruler of the world's second smallest country vatican city being the smallest jet this roi is among the most globally recognized headstay and her serene highness prince albert ii heads the house of grimaldi and brother to princess caroline and princess stephanie the only prints from prince

rainier and princess grace and rules on the principality he is boys as blanketed the airwaves and his highness the prince moonlights as a narrator in a biography about his movie star mother the late academy award winning actress grace kelly but it is his work as a champion of the environment that brings him to the national press club podium prince albert albert, straight from the smithsonian's summit where he delivered the keynote speech for the 50th anniversary for the antarctic treaty signing. his timing is impeccable especially for the journalists today. his visit comes in advance of the copenhagen climate change a summit next month both prince albert and obama's are schedule to attend. but as they prepared to lobby for lower greenhouse gas emissions but it questions of the legitimacy

of the science continues to grab headlines. from the t-bills one u.s. senator has called for the inquiry into un climate change research. brands albert ii has investigated the impact of global warming with personal expeditions to the north and south and took a monthlong tour of the antarctic that and he made a four day trek to the arctic north pole and in 2006 he also founded the prince albert ii foundation to support system will projects on climate change and renewable energies contacting these come at a loss of biodiversity and improving universal access but don't among the many honors prince albert has won the teddy roosevelt battle for his work on environmental conservation action. a passion for nature runs through their grimaldi family. according to our archives his great great grandfather

spoke here nearly one century ago in 1913 about his oceanography studies for "the washington post" reported prince albert i it was the first ruler to deliver a message to the press of the united states 34 miss -- fema's organization and also wrote prince albert i demi's poor's scientists can reach that years in the brains of the public and we continue the royal tradition and please help the wellcome his serene prance nine s albert ii of monaco. [applause] >> thank you. thank you very much.

madam president and senator warner your excellencies, angela and melissa and ladies and gentlemen, and friends i would like to tell you how pleased and moved i am to be with you here today. pleased because i know our exchanges will be friendly and fruitful. i appreciate it is just valuing the possibility we have to meet around these a genuine issues. peake says this is a special and it remained -- reminds me to this country that i have strong family and friendly ties. i am moved to be here today in front of the national press club. 96 years after my great great grandfather who you

just alluded to that who first spoke not in this very place, and a stand that the willard end of october 9113. he was curious about his times and a traveler who helped to spread his fame beyond the shores of the mediterranean to this continent. it was also a model of openness. and a man with a thirst for knowledge but with president theodore roosevelt he was one of the first heads of state to understand the importance of large areas and species. this planet nobody imagined at the time it would be in danger. we weren't able to perceive

the vulnerability on with this that empower but those had many maritime expeditions including to the arctic region but the first was the man whose message continues to vex stations buyer matches. who is also someone with a deep concern for his people and greatly contributed to reinforcing monaco prosperity and independence and making it a constitutional state with the month -- modern institutions. maybe it is the poor reality of my country. monaco is aa prada of its traditions, culture and shared values, although the population and is not

exceeding 3,000 makes the next team 45,000 which made the labor market. they bring france and italy the economy is sound. revenue made up mainly of tax resources it reflects the economic activity. this economy is highly diversified with tourism and real estate as well as the banking sector would we primarily dedicated to wealth management. at the same time the gambling sector well remaining important for tourism represents no longer a substantial part of the revenue, only 3%.

all of this comes to a from the financial institutions the principal holiday has been able to have new clients with international standards. when all european countries agreed to implement in the fiscal area of for cooperation and compliance i did not even asked and whose importance i have emphasized comment to implement the negotiations for the signature bilateral agreements over a dozen which have been signed and in particular with this country and the united states which unable monaco to be removed from his greatest threat of this recognition occurred last september.

in compliance with the orientation i set for my government monaco is waning toward compliance with international standards not only regarding money laundering but monaco was also pursuing its efforts to take our assets and safety and quality of life and intense cultural activity and medical establishment's and a user friendly and efficient administration and a network of proactive professionals. the ethical concern inspire my actions with respect to financial life also affect my commitment to the protection of this planet. having adopted a policy in

defining it will have. >> it is based on public transport to respect high-quality and environmental structure and-- construction standards. also the implementation of building the environment around monaco and other countries. all of these actions contribute to respecting my country's -- boys commitment to become carbon neutral. the actions states must be reinforced to confront the great challenge of our time and protection of our plan it. this is why when we moved over three years ago i created a foundation with a three fuld mission for 18

the effects of climate change and straining to promote diversity and preserving more resources. the creation of this foundation was in large part from the expedition i lead with a 700 people to the arctic i have a couple of ideas. >> those 150 kilometers on my dog sled to the north pole what was decisive. but not so much for the threats to reporters in the future of our plan that i am sure that has been a concern for me for quite a long time. but what was revealed through the vast syrians is.

>> it is to explore all possible forces. such an adventure week exceed one self not only in the face of momentary difficulties, but in the face of the meaning of existence. a a few months ago when relent to enter to cut we need to move this. we were dedicated to man the meeting the scientist to were working there. i was able to visit 26 different research stations all over antarctica and have the opportunity to cross pass which truly exceptional people come in men and women, apparently dedicated to try to understand complex

mechanisms os of this i also say space because a lot of scientist are studying space-bar crow they are well beyond the polls. global warming and rising sea levels of pollution threats and threats it is acceptable on a human scale. my foundation location reaches far beyond the polar regions. one nation is present today but from all continents with other eric -- institutions.

there at the capacity to take action. i am proud of the many projects conducted by my foundation with partners present in the united states. the klan tin the global initiative, aspen institute, conservation international, the earth's institute, chicago museum. the scripps institute the paraguay's side and what will you be sending in a few minutes of a memorandum of understanding. faced with the challenge of this nature all determination and energy must be mobilized. states ngos come of businesses and international

institutions will be closed. this is how we can take effective action. thinks to these partners my foundation already supports over 120 projects all over the world. some of them are directly operational while others aim to raise awareness and among the populations for scientific reasons for all of the respect not to give up in the face of daunting talent is of which we cannot escape. through the wound inflicted on our planet. >> you're right. by climate change, a species threatened or extinct, it is our survival alternately that is at stake our efforts expected of us will be tremendous.

in particular we have to proceed with the in depth revision of the principles of which we are built or held to prosperity will have to travel and consume and work and live in a slightly different way. we will have to get the four countries so they can also advanced by our side. they have less responsibility than others but today, it the first victims. we will need them to restore balance on our planet. the ecological balance, economical balance, sanitation come up migration, so on. all of this requires greater solidarity for those who are suffering today for those who will suffer tomorrow.

if we do little or nothing at all. indeed, there is no more room for doubt. scientific data come i think, although it is now under review, for me is on the questionable. challenging the data means agreeing to the sacrifice of future generations. the only alternative available at this to except except -- except or change if you ever have its perch are not everything but if we suffer and the next 50 years and a coffee blends we cannot even fathom. . . thrst-case scenarios.