i'm grace marie turner, president of the institute. i welcome you all here. thank you for joining us, and i want to welcome our live webcast audience and welcome our c-span viewers today for our launch event of why obamacare is wrong for america. it is an important new book published by harper collins available in bookstores across the country, and also you can

order online at our dedicated website, wrongfor wrongforamericabook.com. you need the word "book" in there. it's a collaboration of me and coauthors jim of the ethics and public policy center, tom miller of the american enterprise institute, and bob moffet of the enterprise. it's a great collaboration. i want to thank our editor at harper collins and our publicist as well as the terrific team and all of our think tanks that helped us so much in helping us make sure people know about this important new book. it is -- it really was a pleasure and a remarkable pleasure to work with the three coauthors and myself to put this

book together. it's not a collection of chapters we all wrote and took individual ownership of. this is a seemless book. we really wanted to tell the story of what obama care is going to mean for the american people, how it's going to affect families and young people and seniors and employers and employees and taxpayers and citizens and most importantly, doctors and patients, and the book is written to really help people to understand this is not written by policy wonks, but it's an accessible book for people to understand what is coming with this law. i'll talk a little bit about the overview, and my coauthors and i will each be talking about individual parts of the bill, and to lead us off, i'm absolutely delighted to welcome our long time friend and colleague, bill crystal, currently editor and creef of the weekly standard, a common

they tore on fox news, former chief of staff for vice president dan qail, and a true freedom fighter who has been been trenches with us for a long time also on health care. bill and i first really got to work together during the 1993-1994 health care debate when hillary clinton was proposing probably actually at this point a much less aggressive form of health reform than has been in effect now under the obama administration, and bill was really remarkable, the master of the facts at the time which was the latest technology to help people understand what was really in the law, and it is really thrilling and a pleasure to have them here today to talk a little bit about where he sees the politics of health care today. bill, welcome, and thank you so much for all you do.

[applause] >> thanks, grace-marie, and for inviting me to join you. i'll be here briefly because i have an appointment. i wanted to come because i'm a fan of the book. it's really an excellent statement in the case against obamacare which is the correct case, and understand the direction to go once it's repealed. we talk about it in the weekly standard, and one publisher approached me and said let's publish a collection on obamacare, and i said, realm, it's good stuff, jim wrote most of it actually, but, you know, these are discreet articles, and i think people -- there's a limited market for that, and people deserve a more coherent explanation with the law passed and lelgdly put into effect or planning to be put into effect, and the great thing about this book as suggested is it is a

book. it's not just different articles stitched together. i'm amazed four people could produce such a seemless whole, but it's all because of them. i wanted to come here to recommend the book. obviously, what's striking also about the book is it's a good book, but it's about a live issue. most books about public policy are about what should be done in the future which is fine and they are interesting books, but, of course, they suffer in a sense because they have one set of proposals and 25 other proposals out there and what happens in legislation is some combination of a bunch of ideas, and then you step back and ask what happened there and how does it relate to other books out there ahead of time, or one waits until something is passed, analyze, and you can tweak with legislation later on, but that's the retrospecktive look at policy. this is an unusual moment.

one of the reasons the book is so important and relative is that the legislation passed so it's concrete. it's there. you know, god knows how many pages of it and the legislations that are flowing and will flow from it, but it's there in law, and so it's something real and concrete that can be analyzed. it's not speculative or looks like they're going in this direction, and yet, it's not a done deal because it's up for repeal and it can be and will be i think if republicans win the presidency in 2012. what's striking over the last year is how little -- there's no increase for support in the bill or waiverring in the determination of the republican party and a few democrats have been waiverring and all the major presidential candidates and openness i say on the partisan democrats even to modifying it. it's going to be a central issue in 2012. it's pretty unusual when you think about it in american

politics to have a huge piece of legislation passed and then -- but then the issue and its fate are still up for grabs, so i think this is one reason why the book 1 not a back ward looking book, or here's ideas book, but it's an important study of something at the center of our national debate in the next year and a half. it's up for grabs because this passed on a purely partisan volt which is very unusual in history. there's been two national elections in which health care was an important issue in the second case, the central issue. first in 2008 when president obama defeated john mccain, and there were several reasons for that. he won, the democrats won congress, pushed this through, became a huge issue in 2010, republicans won a huge victory winning against obamacare, so there's one election on each side.

2012, you know, is the rubber match and probably will determine the future of health care in this country one way or the other so this is really, it's an unusual moment and american policy develops in a messy two steps forward one step back way. that's the history of health care legislation over the last 20-30 years, but this is a rare moment with a fork in the road, a fork that substantively is important. health care is a huge issue, 16% of gdp, i think, 30% of the federal budget, and really two different visions of how to reform it. i mean, this is not sort of one party is for doing a little more and one party is for doing a lot more. this is not one of these muddy cases where the parties -- where one party has ideas abs and g, and the other has c, i, and h. but it's very important for the

future of the country and size and scope of government, very important for even broader questions i'd say of citizenship and self-government and how we think about the relationship of individuals in the private sector to the federal government in this country, so it's really an unusual moment to have such a big issue in the balance over a year and a half now. there's going to be a huge congressional national debate about it. there's a concrete piece of legislation. everyone can look at it and judge. it will be argued about and voted on a year and a half from now so it's substantively very important, politically very important, politically in the balance, and here we have a book that helps us understand it, so i just wanted to come and commend the book and thank the authors for this, you know, service they've given us, and that's the time point to repeat and i think people underestimate how important health care will be in 2012. it's really the central piece of legislation in a sense of the

obama presidency. it's the one that also is most a matter of choice. i mean, the president can say the stimulus, you know, it was a terrible recession, a lot of economists say we have to do something, the republican position was for a smaller one, one targeted towards tax cuts, ect., but health care was the something you didn't have to do. there was no particular emergency. obviously, it wasn't the bailouts and stimulus, and even dodd-frank where there was arguably a huge financial crisis and people thought you had to do something about the banks and the financial system. this was a matter of choice b on the part of the president and democrats in congress proposing it was a matter of choice on the part of republicans. they could have gone along, and they have in the past with lots of liberal and democratic pieces of legislation, try to modify, but not challenge them, so this tells you more about the governing visions of the two parties of the two major

political philosophies than most other issues do. it's unusual in that respect. two, the president chose to make this his signature priority. they chose to force it throw on a matter vote even after losing in 2010 when they could have had an institution. it's there, it's law. if democrats keep control of the senate and perhaps gain seattles in the house, it will be hard to repeal it. if the president, republican or democrat, and republicans maintain control of the house or come close to winning the senate it will be easy to repeal it. unlike 1993 and 1994 in the fight against the clinton health care proposal, that failed. that was off the books by 1995, and then president clinton had movability and signed welfare reform and ran as a moderate to

save the country from the gingrich congress. president obama moved to the center on some issues and should be praised for doing so on some issues, but at the end of the day, this is a signature piece of legislation. it's on the books. he can't tinker with it too much. republicans repeal it, he'll defend it. it's a contrast, a real choice for the country you know between the parties, between the presidential candidates in 2012. again, this is pretty unusual i'd say. most the time in american politics, it's muddier, the policy consequences of an election are less clear. this is a case where it's a essential piece of domestic policy legislation, and this was their central piece of legislation. its fate is in the balance in going to the polls a year and a half from now, and this book will help voters understand what's at stake, help them think about the problems with obamacare.

you will be surprised it's not entirely dispassionate. it's not a neutral on obamacare as you are not surprised to hear about this book. they went with subtlety on the title there, but it's a truth in advertising, no point in actually being coy about this. it's a huge issue. this is an honest critique of it, a compelling critique of obamacare, and its final chapter lays out the likely, i think -- well, not likely, but very likely way in which republicans go about replacing obamacare if repealed. this gives citizens and voters a sense of what is at stake and what the real choice is in 2012. thank you for having me here. i'll run off now, but thank you and good luck with the session and good luck with the book. thanks. [applause]

>> thank you, bill. on behalf of all of us, that was a wonderful introduction. thank you for your complements on the book. again, for you who just joined us, i'm president of the institute and i'll be introducing the speakers and coauthors as they speak. i just want to reenforce bill's point. i mean, we did not take an equal stand, but a substantive well-documented well-cited stand about why obamacare is wrong for america, and the subtitle is how the new health care law -- i don't have my glasses on, how it drives up costs, puts government in charge of your choices and, and threatens your constitutional rights, so how it drives up costs, puts government in charge of your choices, and threatens your constitutional rights. in case anybody was wondering

about the title, we told you where we felt about this because we understand this law so well. we not only saw the debate leading up to it, we've seen the debate over the last several decades of this real contrast that bill was talking about between two different visions of where our health care system is going and the sector is one sixth of a capitalistic economy, and yet we are trying to put this part under a different system with a different system of rules, and i think that's really where the difference is and why we felt we needed to help people understand when you live under a set of rules in which 2800 pages of legislation and likely tens of thousands of pages of regulation that will be written to comply, it's a very different world than the rest of the economy, and we do have a

chapter in the book talking about what we should do instead. we could have written a whole book about that, but we what needed to do was help people understand first what's coming, and a lot of people have thought, you know, the house voted to repeal this, and it's been declared unconstitutional in several courts. it's being challenged by the states, 28 states are challenging it and have court cases against it, what's the big deal? especially when the president and others who talk about this legislation talk about some of the early provisions that were put into law to help people have something to talk about early, allowing 26-year-olds to be on their parents' policy, creating new risk pools with people who have preexisting conditions, some of the insurance regulations, some of the provisions that allow -- that require actually health plans to

provide preventive care with no cost to the consumer. those were designed to try to help people think about this law in a more friendly way, but it's a freight train coming at us. it's in law in 2014. most of the provisions will take effect, and we are going to see over the course of the -- if this law, obamacare is actually allowed to stand, we are going to see half a trillion dollars in cuts to medicare. we're going to see half a trillion dollars in new taxes just over the next 10 years, 20 million people will be added to the medicaid program which already is not able to sustain and take care of the people on the program today. you're going to see mandates on individuals to purchase health insurance, and this is likely to be for many people the first or second most expensive thing in

their family budgets, about 110 million people may think that they are eligible for subsidies. when the congressional budget office scored this, they said only a fraction of that number are actually going to get subsidies. employers already started having second thoughts. they were told, you know, if you just support this health legislation, then you will be more competitive internationally because you won't have this burden of health costs. we all knew that there was no place else. they were not going to get off the hook, and, in fact, they will be paying more, and the rules and regulations are going to have to follow in order to provide that health insurance are going to be even more rigorous and more strict than the flexibility that they have now to figure out how to balance their resources with their costs, and, of course, we see the states absolutely crushed under the budget demands they have now, and our recent study,

but i believe the senate finance committee and the energy in commerce committee in the house showed states are facing more than $100 billion in additional costs as a result of this law. they can't afford it, so the country can't afford it, businesses can't afford it, individuals can't afford it, and here we are talking about entitlement reform while we're creating two massive new entitlement programs. jim is going to talk with us about the budget impact and why it is that this law stretched the rules so far to try to get this through, but the reality of what's coming is really on a noncontroversial that is really going to happen and jim having now currently a scholar and expert at the public policy center and director of obamacare

watch is an expert on budget issues. he worked at the office of my management budget handling entitlement policy, health policy in the first bush two term, and half that, worked with the senate committee. he really understands what the impact of the law will be not from a political standpoint, but a budgetary stand point, it's going to affect all of us. jim, i welcome you to the podium to talk to people about your per perspective on what's coming. thank you, all. [applause] >> well, thank you, grace-marie, and i want to say to my fellow coauthors it's been a real pleasure working with all of you. i was very pleased to join this project when it was proposed to me some months ago because i saw a real need to do as bill said which was to inject into the

conversation an accessible book that explains the new law in ways that the engaged citizen can find out what they need to know, and there's chapters in here on a number of different groups of our country, young people, senior citizens, taxpayers, employers, doctors, vulnerable people with health conditions, and so all of these things are impacted by the new law and by reading this book, you can find out why it was the wrong approach and why we need to go in a different direction, so when i heard that this was what this book would be about, i was really, really pleased to be a part of it. let me just talk for a minute about two groups that are discussed in the book, taxpayers and senior citizens. one of the main talking points used by the president and still used by the advocates of the new law to sell it was we'll cover

everybody in the country with insurance, and you're not going to believe it, but we'll cut the deficit too. it was going to be a two-fer. what's not o like? you know, everybody gets coverage, no middle class people pay anymore, and the -- [inaudible] if it's great all the way around until you dig into it which we do in the book to try to figure out and explain is that really going to be the case, and when you start to dig a little bit, you realize that, no, it won't be the case, and actually this new law exposes taxpayers to substantial new risks in terms of financing just at a time when the conversation is getting around to how do we deal with the entitlement problems we haven't funded yet and there's a bunch of new wops who can want be paid for either. now, where to begin. first let's talk about the class act. this was a provision that

hitched a ride on to the new law, and it was sold as a long term care insurance program for people with disabilities. the problem is that -- and they claim that it would generate $70 billion in deficit reduction. now, just in the last two months, secretary has brought into question whether or not it produces anything at all because you've gone to the hill a couple of times and basically said, you know what? we discovered the program is flawed after the fact, after it was enacted, and that it's financially unstable, and we're not going to let it go into effect until we can figure out how to make it workable, okay? well, there's a couple things about this. first of all, it was known all along that it would have this effect, okay? they jammed it through anyway because it created the perception of deficit reduction. now, why is this program so flawed? it's flawed because it creates the perception of deficit reduction because you don't --

you collect premiums for 10 years, but nobody is eligible for benefits until at least five. there's a period of time where nobody gets benefits, but you pay premiums creating the illusion of a surplus in the near term. the problem is it's a program that suffers from adverse selection meaning that because it's voluntary, more likely high risk people sign up for it rather than people with low risks. the premiums will be very high, and within 15-20 years, it itself runs short of money and we'll need -- either we need new premiums to cover the cost or the benefits will have to be cut to keep the program in line with the premiums that are collected. instead of this improving the situation for the country, it actually is the exact opposite. it's something that will expose future taxpayers to the potential of another bailout because you have these vulnerable citizens signed up for a program that wasn't financed properly, and, of course, the political response

in a couple decades time would be, hey, we should take care of them, let's have taxpayers pay for it so they created a new program here that is very likely to fall into the same trap as many other programs have in the past. it will not be something that will improve the outlook for the federal budget. secondly, let e me just -- let me just mention that this new law has in it already very large tax increases that most centss i don't think understand are there. according to the congressional budget office, between now and 2035, the total tax increase from this is going to be about 1.2% of gdp. now, that's an abstract national term, but that's another at least 5%-10% increase in taxes associated with this now law. it brought back something we got rid of with president reagan was

bracket creep. you might recall in the 70s inflation was high and people were automatically pushed into higher tax brackets because their wages went up. that new law -- this new law does the same thing. there's a new payroll tax that supposedly applies to people with $500,000 -- $200,000 a year. as time goes on, more and more people reach that. by 2030, the thresholds are the equivalent of $130,000 today, so the fact that the president says only rich people pay for the bill is simply not true. excuse me. finally, there's the impact on senior citizens. the remarkable thing that occurred last august didn't get enough tapings which was that the president -- attention which was the president's medicare trustees made a report on the medicare

program. it's a 300 page document, and it was only in the last two or three pages that you really got to the punch line which was the person most responsible for producing this particular document wrote a statement, an opinion, as he does every year, and he basically said in so many words don't believe all the numbers that preceded this statement in the prior 290 pages because they are based on a premise that this new law, this new health care law, will make permanent perpetual cuts in payments to institutional providers such that they fall well, well below what medicaid pays. now, if anybody knows about medicaid, medicaid's rates are so low that the availability of services to those who are oned medicaid program is extremely constrained. you can't get access to care easily in many places if you are on medicaid, and the notion that you take medicare's payments

down to such a low level they are well below what medicaid is paying even by this coming decade strikes a lot of people as being not plausible. it's a very fundamental aspect of the law is we're paying for the bill by cutting medicare in a prearbitrary way. we need to reform medicare, but this is not the way. they are doing arbitrary price controls, and from that, you get the -- you can already see that it's political pressure will certainly build to say we can't do this because seniors need access to care, and so the presumed spending reduction coming from the large cut in medicare is not going to materialize and that's what the medicare program said. the end result will be a new entitlement program pressured in medicare spending and the deficit reduction promised goes away. timely, this is my second finally, but really my last

point. [laughter] the -- the debt limit is coming up for a vote again. there's lots of concern that the nation is piling up debts at a very rapid rate, and we have to raise the amount on the subject debt limit croording to pressure -- according to treasury estimates. now, what did the new law do to debt subject to limit? it was promised that this law would actually, you know, improve the deficit outlook for taxpayers and not add on to the cost, but when you dig into this, you realize that, in fact, the new law even according to the very optimistic projections that the administration cites will actually speed up the raising of the debt limit because what it does is it piles a bunch of new iou's into the trust fund with phony cuts and paying into the new entitlement program. the limit goes up under this

bill, and that's an indicators for taxpayers that this is not a winner, but a loser. thank you. [applause] . .

>> adds the cato institute and chief economist with the competitive enterprise institute and serves on the national advisory panel. we are pleased to welcome tom miller who was a former broadcast -- broadcaster with the wildcat days about cats? [applause]

>> thank you very much to all those from harpercollins to make this wonderful book project possible. thank you for the obama administration for making this necessary but i do not want to. so let's in dislodge what is stuck in our throats. [laughter] our book is written to understand the serious consequences of the unaffordable care act or aka aca. we do that with the clear manner at least my co-authors did but there is the biggest of the bill murray groundhog day experience how we keep repeating the experience of the same policy mistakes year after year although this lot has tried hard to expand the scope of failures to come although the better

benefits -- metaphor is december 1997 episode of seinfeld with the celebration of the hall holiday alternative to the christmas season. it is highlighted by the airing of grievances which each person tells everybody else the way they had disappointed him or her over the last year. you can review our book chapter to look with president obama who promises great gifts and product defects or the proverbial lumps of coal so much for clean energy now to be fair the broader airing of the health care grievances is rather inconsistent and contradictory with the common denominator the condition being it is always somebody else's fault we do keep stepping on the gas pedal then hitting the brakes and wondering why

they're so many commission despite the air bags on board and the important part of what we see we have to shift gears and move in another direction. the final tradition is it cannot conclude is out the head of the house will be pinned to the mat to buy another challenger we move to the direction of the 2012 campaign season within the appropriate limits of secret service protection looking back on the enactment of this public nuisance we see various tax and a five ring circus with clowns, a contortionist, ed their doubles and a lion tamer is. in the political arena public opinion has remained skeptical about the overall virtues and benefits with the plurality and maturity and refusing but though

whole is a some of its parts and it is said the poll. in the legislative bring we have seen many of those from the previous majority given the puck the reviews are not in yet to be funded lowered disemboweled but it will hopefully sooner rather than later. lowered economic bring with the slow job growth and massive government debt they fight from double entry bookkeeping and assumptions and incentives leaves more americans anxious and insecure than it offers any feasible path toward more productive health care. we are running just little bit short of resources for other priorities, more health care spending and the new health care law as a temporary truce is

contradicted by a steady drip by drip of political water torture of plan sponsors and disincentives to job growth and disruption of unpredictable regulatory schemes the only certainty is what the ec a staged 86 has that delays important business decisions in the next reagan we find promises of amazing feats of the implementation many of which have never been witness before when first unwrapped initiative carried the warning some assembly is required the law did seemed to rely heavily that had tried to put ground paid into square holes. you know, what i meant.

a lot of pounding from those when they hit their fingers remember items like the medical loss ratio rules phasing out annual limits to protect the existing employer plans those are supposed to be the early easy path not only do the wires not connect with the t's aca but a more explosive fireball with the health care system with the budgets and the economy and it seems federal planners assume state governments fall into line without a whimper as a junior associates are assigned the messier jobs to make health exchanges and dual insurance regulation and coverage mandates work better and local practice than they were designed. we may have a show stopper

almost the entire constitutional law dismissed any basis for a challenge of the new health cotte -- care when you go they have dusted off the older vintage that has been in exile the last half a century. to declare the powers of the mandate under the commerce clause, the constitution, don't leave home without it. we're in the first amendment that begins congress shom make no law that is a good start. [laughter] the final opinions i have mentioned from judge hudson and $0.7 respectively are serious substantive a carefully well written. there are a their rounds of appeals we may see another far-reaching decision. but we may not.

but the initial the litigation is fleshed out on how the aca reseller principles of fundamental government and the constitution. so to learn more read the book and since we're working on sales frailties with part-time writers, by one if you can. the message is not just how it is helpful but ms not be implemented as a whole but yes we have overloaded the circuits of our political system and misdirected the future of health care decision making but with the future implementation of obamacare is inevitable with said discourse and still a bit confused but repeal is not enough but will provide

a mighty good start. those before moving in a manner so it is long overdue solutions the clock is running we can and will do this much better. we have to. thank you. [applause] >> he does not disappoint for our final co-author and speaker robert moffit is a current fellow with health policy with the heritage foundation with policy innovation and was there for many years and before that served in the reagan and mr. scherer part of health and human services and also at the office of personnel management that shows the program that we applauded as a model of consumer choice

to purchase health insurance. i welcome mule again as one of our valued co-authors we started off very much in the same place am proud to have worked with all of view. >> thank you very much. i'd like to think my colleagues for this wonderful collaboration and the wonderful staff in new york of harper collins publishing team. they did a truly great job. i would be remiss if i did not extend my deep appreciation for house speaker nancy pelosi. she told us it is important to pass a law to find out what was in it and was one of the most profoundly prophetic declarations where we find out a great deal.

and the book what we decide to do is look at a number of different things but one of the claims that were made on behalf of the new law, from the beginning of the health care debate back in 2009, president obama repeatedly made a series of high-profile prompt -- promises that turned out to me rather extraordinary claims. i think it is fair because in the book we go in detail the evidence behind the claims, that it is fair to repeat some of those for you this morning. what we looked at when we examined the debate. you will recall the president said if you like your health care plan you can keep it and repeated this constantly december 2009 address to the congress and the president declared nothing in our plan requires you to change. extraordinary.

the mandates and regulations and economic incentives are hard wired and require literally millions of your fellow citizens whether they like it or not to provoke 2010 the obama administration on field rules of those that were to be grandfathered but it requires one half of all the plans change. beyond that to when you look at the impact of the incentives medicare richard foster estimated 40 million americans would lose our be transitioned out of employer based health insurance reform director, looking at the economic incentives to project 35 million americans would be transitioned out of their existing coverage. that could be much higher

and the disruptions to employer based health coverage could be massive. remember the president said at the beginning that americans would see an annual decline in their health insurance premiums for 25 angrily i don't think that is any further discussion in. we will see an increase between 10 and 13 percent of your premiums and with the taxes and drugs and medical devices all we'll result of higher premiums. the president said and with the famous spending curve downward promising that would have been then new law will do exactly the opposite.

and reactionary says over the law enforcement united states will spend an estimated $311 billion more than we would have if the law was never enacted. you will see a decrease in taxation with middle-class americans will not see a tax increase. promising no family making less than $250,000 annually will see a tax increase. most of the tax increases are those that will directly affect middle-class. medical goods and services and all of these are passed on deal with the middle-class tax increase but even the 40% excise tax

and largely a middle-class tax increase. eight out of 10 that would be affected by that are those making less than $200,000 annually. he would recall during the debate one of the big concerns with how this will affect senior citizens. its allies in congress promise to make bets to benefits for anybody not remember that? this is a key point*. largely because the senior population is so critical. with what the president said i want to assure you we're not talking about cutting medicare benefits but making medicare more e efficient to eliminate insurance subsidies and working with hospitals so they change some of the reimbursement policies. in december 2009 the cbo

director told the united states senate finance committee that the medicaid payment cuts would result in cuts of medicare benefits. later the heckscher reported after the law had passed the medicare provider payments would result of payment cuts of 15% reduction of hospitals to see reductions and make them unprofitable and jeopardize senior access to care. subsequent analysis by independent analysts have indicated the medicare advantage cuts will result not only in a massive the settlement of people in medicare advantage but also cut the benefits available to people in the medicare advantage program. harry did test and the independent analysis the medicare advantage will result in $3,700.

jim is already talking about the fact the law does add to the deficit it was worth reporting that he would not sign a lot that to do the deficits either now or through the first-- future for you can bet the farm the cost estimates of the cbo will continue to increase of what this will cost and since the enactment the cbo revise the initial tenure cost estimate to add another $115 billion and that is just the beginning. under any scenario the $1 trillion addition plus the creation of two new entitlement programs was

hardly a reduction there is one other item a very important drivers of this debate is the question of how we are to be governed. is the underlying source of a great deal of discontent in this country. the president and his academic allies have insisted they are not proposing a federal takeover of health care because providers will still exist. but where would anybody get the idea this is a federal takeover of health care? under the law officials will make the key decisions of health care and decide whether they will require you or your employer to buy a federal it approved health care plan or pay a penalty and define the content of your health care benefit

package including the medical treatments and procedures you must have been those services that you must have and low-level of coverage you must have and cost sharing the co-payments that are permissible you will get to what the federal officials say you will get or you will be penalized. beyond that not simply a question of the law the law's language is so vague the transfers enormous regulatory authority to the secretary of hhs to make all kinds of decisions such as defining quality of care and securing value with provider purchasing so and retain their rule that will directly affect your life federal officials especially the secretary of hhs will fill and finish the gritty details on the issues the decisions that congress could not or would not make

the broad discretionary authority enables these officials to make exceptions to the rules that the issue and grant waivers or apply them differently. this is very sobering. not just a matter of cost or quality, that is important but the great part of the national debate is how we will be governed. when americans are treated differently with a large and growing administrative state, manned by those who they will never know and not accountable to them we live in a different world. with such a process you can expect her arbitrary and highly politicized decision-making. the problem is the decisions and the bureaucratic politics that drive those will profoundly affect your

personal life we are in the first amendment lounge. i doubt the founding fathers had in this kind of thing in mind. certainly they did not want this to be the job of government we're not to be governed like this. they did not want that and neither should we. thank you very much. [applause] >> thank you. you can see from these talks that each of the off what -- authors brings knowledge to what we have done and written in the book but also of great passion because this is about freedom and the future of the country and hugely consequential lot and absolutely has said in the beginning will bleak days be a defining issue this is not

settled policy. and as the previous speaker of the house and maybe useful to quote the current speaker john boehner here wrote the endorsement for the book that sen while obamacare is wrong for america is perfect a carefully researched and a must read for anyone concerned of the future of health care. it proves without a doubt this law will bank of termination and hurt economic growth again, the book is available bookstores, and we have a dedicated website wrong for america book.com and i now welcome your questions. we have several people with microphones because this is being recorded we need to wait for you to get the microphone.

please identify yourself have we answered all of your questions? >> in a preliminary discussions it says that 10 of the book there are the recommendations for what you would do. can you outline briefly? >> in the book we've talked about a different perspective and a fork and the road that crystle described is accurate that you can start from the premise that the government will allocate resources and the health sector than what obamacare does the way to make the health sector more equitable to cover more

people and more efficient and bending the cost curve is have the federal government managing every aspect of resource allocations the benefit package, premiums, which insurance companies are allowed in the marketplace and which aren't. to put the government in charge of all of that. we come from exactly the opposite the way to put the patient at the center of everything and that gives control over resources that once you put them in charge of two major races for themselves the system will orient itself for pleasing them much more than they do today. higher-quality and more productivity and cost is an issue people look for value with limited resources so

they make of recommendation that says you need to change existing public policy to put the consumer at the center of the marketplace providing oversight and something's to aid of their traces but consumer choice based on limited contributions from the federal government. >> negative sheet music of what you should hear and do your choice of competition accountable health care delivery and know what they are doing but at the core we have written about this separately you have to change the mistake and signals starting with the

financing of the subsidies. it is not going to be the same flat for everybody. and then the public resources are not limited that is the start of getting the system reoriented. not only medicare but medicaid. but our boats count the most. >> where is the republican plan if they come up with the 20 underplays plan to get it right and we don't think that. we believe with the way to change the health structure interchange canada -- the

big changes are 2014 the individual mandate, the mandate on the state's and massive expansion of medicaid. they take place much later

that means the president and his team have invited a long long political battle over health care which will have flashpoints that will be very intense of the next few years you administration's allies have done is guarantee we will have a major battle on health care as a titanic struggle. we are a federal republic. power in the system is widely divided to handle general concerns. most of us liberals and conservatives to look at this very carefully to make a fundamental point* there is no such thing as the american health care system. it doesn't exist.

we have a complex system of third-party payment arrangements and is also point* out going from one state to another finding that the market conditions on the ground the practice of medicine vary from state to state but the congress should do what is in the proper constitutional jurisdiction to areas where it can make policy article one section 8 two raise revenue and to make tax policy that is fair and equitable and expansive to enable americans to get the health insurance they want at the prices they want to pay. congress can do that but recanted have competitive market unless we address the tax treatment. we have states to regulate the job market.

congress could encourage that the state level. i don't know anybody who thinks we ought not to help low income people that is not on the table. but who at the end of the day will make the key decisions? our approach is as my colleagues have pointed out to put them at the center of the process the. >> i wonder what you think about what is the best plan for undoing obamacare? going after particular error class tax with a 1099 or full repeal or many

victories which is the most likely to be successful? to make this will be fought on all of those levels. it is for a major friends which is certainly the legislative challenge of the house of the voting to repeal the law by taking a series of votes on individual provision by the dreaded 1099 paperwork the studies and asking the administration for more information how it implemented the law that is important the regulatory front continues 6500 pages of regulation that were written and many thousands more congress will see oversight of that and the political front this will continue to be an issue with the election 2012 and beyond and of course, the legal front the law being

challenged a number of cards and cannot help but go to the supreme court very likely that decision of 2012 so the american people still have the opportunity to be heard on many friends but i don't think there is any one that is more important than another. >> reit kid try a the death of a thousand cuts with no blood clotting factors but to overturn this in whole will not happen every effort should be made to pick out whatever you should do there is so much there there is more things there to get rid of. not polite to be optimistic we should never totally invested nine elected judges who have a long body of bad precedent to get over to transform and regard to that

clause. of the district's did a good job with the supreme court you don't know what will happen. we are hopeful but i don't think that will save us from anything else prevent it is a political battle and win its old school you have to vote and throw people out and i think we know who needs to be taking care of and this will happen 2012 and we will repeal 2013. >> we do have a chapter of what you can do to put the brakes on obamacare. we have a lot lovely ford buy congressmen paul ryan and we are delighted to have the current chairman and has a provision how to put consumers back in charge i think we have a question? >> tell us your name. >> i hate to be negative but

the title is unfortunate because so many people who learn about this look at the title and go no further. i wish something about putting the patients in the center of that but we cannot fix that. how will you address the masses to persuade them you have something else to offer? because also in regard to putting patients first, the response the most often i hear for those in favor of obamacare is i think everybody should get health care and go no further. how will you address those people if you say it is wrong you don't want people to have health care? >> there is a real misunderstanding about what this proposal would do versus the alternative in

that regard. frankly the mainstream precedent is very well back when senator mccain opposed his health care program it was widely reported at that time and obama was against the individual mandate by the way. it was widely reported on speculative estimates that obama would cover everybody and mccain would not. that is completely erroneous. what senator mccain proposed was to give every household minimum of $5,000 tax credit only to be used to get health coverage and health services and definition it was universal coverage if you do not use it to buy health coverage to lost $5,000 you could always come back the next year to get it.

the it was a universal coverage program that got everybody into some type of assessed -- system of insurance. meanwhile the president's proposal passed use a series of mandates and coercion to get people to buy private insurance otherwise they would not want to get. because all of these coercive tactics will be enforced the irs will find everybody and this will work to get 50 million people into something they don't want. >> a 23 million are still on insurance to mike that is a rounding error. [laughter] >> my point* is the alternative can cover everybody to make sure they are in good health care. >> i hear what you say about the title.

there are a lot of people out there who are of sets and we are among them and want to tell people where we come from. the next book is how do we get to to patient centered health care? thank you for suggesting that to our editor. [laughter] >> when you have a tumor you have to stop it from growing and cut it out. >> i would just add that i think part of the agenda with us is to explain in playmate would do very complex piece of legislation that has a president in american history. i do not recall any piece of legislation affecting all americans dealing with one particular set of the economy that has ever been like this where congress passes 2800 page bill. i don't recall anything like that nor do i have a situation where 28 states in court fighting the federal government regionally

diverse states. we live in a historic time with the health care debate. but i think what we have to do to broaden the conversation is more open air public debates. i am talking about the stuff , and it would fuel political discussion at another time and place and a better time and place when we had real debates between proponents of legislation in. my view this town hall meetings should not be simply town hall meetings of members of congress want to sponsor public debates we ought to have and people should hear both sides equally but as far as the media is concerned, for the most part it has done a pretty good job. i don't want to single

anybody out in particular but some of the columns that have been written are absolutely tremendous. but there's something pointed out the was interesting having to do with section 1312 which requires members of congress and their personal staff to go into the health insurance exchange. what that means despite the argument to keep your own health care plan, but what is interesting is that the parent leave the leadership of this is not covered by the provision. don't you think that is interesting? and a professional committee staffer not covered by the provision. for the members of the press and the first amendment blount i'd like them to find

out a simple question. i would like to know the name of the congress man who drafted section 1312? that would be nice to know what congressional staffers were involved. because you have a law that is consequential and affecting so many people and they insist, the previous leaders insist this is in the best interest of america. so they should be able to defend it in broad daylight. >> >> win in hezbollah that is one of the most interesting aspects of the society that was managed to create. i like to say the women are

really the cornerstone to the movement and it is turning into some thain that have such an enduring and resilient bedrock. each time there is a war of 1993 and 1996, there are massive amounts of destruction and people's homes are destroyed every time. people's kids get killed. for it to happen wants, anything can happen wants but for people to be willing with good cheer and high energy to volunteer again and again requires to buy yen at the level at home at the women in the household that hezbollah has worked hard to teach and indicate into their view and they are the bedrock of the

etfs and the willingness to fight for them. i write about this a fair amount in the book. the murders have a very different flavor or psychological profile. these people from lebanon were grieving their dead children. nobody has said it i am happy that my child died but they did say i am proud. and i will send another kid to do it. but they work quite well with the surviving children to instill a sense of pride with the martyrs of the family and it is the thing that makes hezbollah people willing to die such a stable part of the movement that they can count on.

in some ways it is breathtaking the sophistication of the social network that has built up around the idea. when a young fighter dies and becomes a martyr, the party says psychologist and social workers around to the family to work with them to make sure they do with their depression, the kids are doing okay and adjusting and succeeding in school. two reasons. line because they care about the members but also because they want people and the society of resistance to see the families are the ones who thrive the most. if you have a martyr the foundation will make sure that they go to the best schools, encourage the widowed to rebury and to

someone of a high status within the party or often another fighter and the result is at the core of the real need to are the widows of the murders who exemplify the most successful medicis station and people say this is the way to climb to the pinnacle of my society and if i am chosen to die then my family will be more blessed and me incredibly effective. >> we have the author of courage to descend. what is the importance of

atlanta with the civil-rights movement? >> that has not been discussed very often although it was the home to several national organizations the place i wanted to explore because i thought it would be a success story is usually considered of interest on a because it is the home of the mill cajun year. but i want to explore atlanta because i knew it was african-american in middle-class main black colleges and the fathers considered it a replace of a place to study the dynamics. >> host: wasn't a success

story? >> in some ways. including those for these people who came after legislation of the sixties but it is a little more complicated but in me and the won would be a perfect place to tell a story of civil-rights success it was not all successful for everyone there was a lot of failure for the welfare rights activist and the third part of the book but the black leadership in the '70s said they had been left out. >> host: when you use the

word dissent who is dissenting? >> great. i talk about three ways had three different historical moments part of a first wave are pragmatist lowe's from members of the african-american middle-class who was interested in challenging jim-crow but not giving up the capital that the black middle crowd last -- but this meant they were interested in preserving their economic status and their educational equality but not so interested in other segregation many black teachers could lose their jobs. >> host: was there a fear by the black middle-class? >> absolutely. to some extent that fear was

well-founded bed to the last third of my book that explores the dissenters whom i talk about as welfare rights activists and i discuss the black middle-class pushing back because of employment discrimination or the fear with black teachers and principals. >> host: what was the relationship between march and a 13, jr. and thurgood marshall? >> it was complicated it is a story that i tell the middle third of my book and those who represent the fed and it turns out thurgood marshall was not enamored student protesters and told

students at the beginning that they should not engage in a street protest that it would get people killed and they are invading the property of whites and he believes that margin is 13, jr. had inspired to protest for a very good reason because of the leadership from 195527 were you surprised with the civil rights movement is look negative as monolithic and an agreement reuse surprise the level of disagreement within that? >> the most surprising thing

that i saw in my research so much we don't know about the movement that there was so much conflict talk about the three historical moments about whether to desegregate the schools, and whether to desegregate housing and st. protests and this is what historians had been written about because we want to tell stories that are simple that our progress and for so many years those stories have turned over brown v. board of education and the legislation of the

1960's and with the movement to ask us to go out talk about the 30's and 40's sonat to stop that those points in the story. >> host: if you had to pick a date when it started what would it be? historians these days are very skeptical of taking a starting point* but i can tell you my book begins in the 1940's. postwar era after world war ii provided a point* including their wrists such a conflict of pursuing democracy abroad were

african americans found themselves with jim-crow but i talk about the forties. >> host: published by oxford tell us about the cover. >> and love these photographs. the first is of wall then who is the first african-american lawyer, little known today, but what i show him doing is that the white primary convention that excluded african-americans from voting in the democratic primary in georgia and throughout the south. he is here. >> host: what year is that? >> 1944. as you can see in the photograph he is scaring off

against this gentleman who is the registrar and a lot of people are gathered around looking at this dramatic moment in the history of the atlanta. the lower photograph points us to the 1970's where i show a woman who was the leader of the local groups of the national welfare rights organization who was a strong dissenter in the african-american issue and was involved with the protest and what she is saying is the civil-rights movement has not worked equally well for all blacks. she demands it adequate income, integrated schools, affordable housing, the cover is meant to depict the nuances of the book. >> host: professor is ethel matthews still alive?

>> she is not. she died 2005. >> host: could you chat with her relatives? >> not with her relatives but with her which was such a joy. >> host: you did? you have been working on this book several years. >> guest: absence of a. and i started as a dissertation and worked on it four many years and the result is a 500 page. >> host: dissertation. [laughter] so talking to apple matthews during your research, what was she like 40 years later? >> she was a remarkably strong woman and very passionate and very clear

that politicians of all its ideological strife with and races have not been attentive enough to the poor and that what she says to me in no uncertain terms. that was quite surprising to me. she really opened up to me more than anybody else who might interviewed and i conducted about 30 interviews for the book that the civil-rights movement was much more complicated than even the stories that i have heard from a graduate school or law school to seven of somebody said to you the civil-rights movement was a middle-class movement what is your response? >> i would say is an apt

description in many ways in terms of the impact. i don't think leaders of the civil-rights movement like thurgood marshall, certainly not dr. martin the third came brothers said out for it to be that way. but former litigation to have a wider impact for a number of reasons the it did endeavor to be most beneficial to members of the middle-class. those were the people who were in the best position to take advantage of the opening up of the workplace to african americans or of schools to african americans. but for those like ms. matthews who was a child

of alabama sharecroppers who was not very well educated. she was very smart but not very well educated, it was harder to do to interview for jobs and be successful even after employment discrimination and legislation was enacted. i talk about those things in the book korea was so difficult to have a successful movement that brings in benefits for a greater number of people. >> host: we're talking with the professor here at the virginia festival of the book. march 2011. what is your day job? >> a law professor at the university of virginia. a job that i enjoy very