i did a book called countdown to crisis. my main specialty is the middle east. i write for news max, magazines, quite a bit of television as well. >> we would like to hear from you. twitter dot com / book tv. next on book tv, why obama care is wrong for america. the code-authors present a criticism. a panel discussion at the first amendment lounge in washington d.c. for a little over an hour. >> good morning. i am president of the galen institute. i would like to welcome all of you here. i want to welcome our live web caps audience. also welcome our c-span viewers to our launch event. why of all medicare is wrong for

america. it is an important new book published by harper, and available in bookstores across the country and also order online at our dedicated website, wrong for america book got,. the book in there. it is a collaboration of me and code-authors. ..

>> it's not a collection of chapters, but each one of us will add of individual ownership. this is a seamless book. we wanted to tell the story of what obamacare 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. the book is written to really help people understand, this is not written by policy monks are really accessible book for people to understand what is coming with this law. i'll be talking about the overview and my co-authors and i will be each talking about individual parts of the bill. and to lead us off absolutely

delighted to welcome our long time friend and colleague, bill kristol, currently editor-in-chief of the weekly standard, a commentator on fox news, former chief of staff to vice president dan quayle. and a true freedom fighter who has been in the trenches with us for a long time also on health care. bill and i first really got to work together during the 1993-94 health care debate when hillary clinton was proposing probably actually at this point a much less aggressive form of health reform that has been enacted under the obama administration. bill was really remarkable. he was a master of the facts of the time which was the latest technology to help people understand what was really and the law. and it was really thrilling and pleasure to have him here today

to talk a little bad about what he sees the politics of health care today. bill, welcome and thank you so much for all you do. [applause] >> well, thanks grace-marie, and thank you for inviting me to join you. i will be here birth. i have an appointment i have to run off to but i did want to come partly because i'm such a fan of this book. it's an excellent statement i think of the case against obamacare which i think is the correct case, in understanding obamacare. i also suggested the direction once it is revealed to we publish an awful lot on obamacare in the weekly standard over the last couple of years and one publisher approached us and said why did you publish kind of a collection on obamacare. i said it's good stuff, but these dispute articles and i think people, there's a limited market for that and people probably deserve more coherent

explanation of where we stand now the last and past and is allegedly being put into effect, or playing to put into effect. the great thing about this book as grace-marie said, it is a book, not a collection of different articles stitched together. i'm amazed more people can get together and and produce such a seamless book, that attributes to them all that they did that so i want to just come here to recommend the book. obviously what's striking also about the book is the book is about a life issue. most books about public policy argued about what should be done in the future, which is fine and those are interesting, but, of course, they suffered in a sense because they have one set of proposals and our other 25 sets of proposals out there. what ends up in some combination of a bunch of ideas and you need to step back and what did happen and how does it relate to all the different articles and books and proposals that were out there ahead of time.

or wait until something is past and start analyzing it. and maybe one can tweak with the legislation later on but that sort of retrospective look at public policy. this is a very unusual moment. one reason the book is relevant and important, the legislation pass, it is there. god knows how many pages of it, the regulations that are flowing and will flow from it but it is there and also it is something real and concrete that can be analyzed. it's not speculative. and yet it is not a done deal. it is up for review and it can be rebuilt and it will be repealed i think by republicans in 2012. i think what's striking over the last year is how little there's been no increasing support for the bill. there's no been waving in the determination of the republican party. even if you democrats, the determination, no wavering.

it's going to 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, but then the issue and its they are still up for grabs. so i think this is one reason why this book is not a backward looking book, it's not here some ideas for the future's book. is an important study of something that will be at the center of our national debate for the next year and have. it's up for grabs. from there has been to national election in which health care was such an important issue. and the second case i would say this in to pitch. in first 2004 president obama defeated cindy king. -- senator mccain. they push this through any

partisanly. they became huge issue in 2010. republicans won huge victory running against obamacare. we got one election and each side. 2012 is the rubber match and probably will determine the future of health care in this country one way or the other. this is an unusual moment. american public policy develops in a much more messy and criminal sort of two steps forward one step back way. but here we have one of these rare moments where this kind of a fork in the road. a fork that sensitive is very important health care is a huge issue. 60% of gdp i think, about 30% of the federal budget. and really two different visions of how to reform it. this is not sort of one party is for doing a little more in one part is an a lot more in the same direction. this is not one of these money cases where the parties, one party has ideas.

this is too fundamentally different visions of the way we should go. very important for the future of health care, very important for the future of the size and scope of government, very important for even broader questions i'd say of citizenship and self-government the whole way we think about the relationship of individuals, private sector and to the federal government in this country. so it's an unusual moment as to how such a big issue in the balance over a year and a half now, there'll be a huge congressional and national debate about it. there's a concrete piece of legislation that people can look at and judge. it will be argued about in voted on a year and half from now. so subsidizing very important and politically very important, politically in the balance and here we have a book that helps us understand and so i just wanted to come and commend the book and thank the authors for the service they have given us.

final point, i will repeat i think people underestimate how important health care will be in 2012. it is the centerpiece of legislation. it is the one that also is most a matter of choice. the stimulus, a terrible recession, the republicans were also pricing is, a smaller one. but i think they'll be an issue in 2012 but it does have the kind of clarity health care with something we didn't have to do. no particular emergency. obviously, with the bailouts and the stimulus, and even dodd-frank where there is arguably a huge financial crisis, when you do something or people thought we had to do something about the banks and financial system. this was a matter of choice on the part of the president and the democrats in congress. opposing was a matter of choice on the part of republicans. they could have gone alone.

they certainly have gone along in the past. so there's any sense really tells you more about the governing visions of the two parties and of the two ages you could say, than most other issues do. it's an unusual in that respect. the president chose to make this his signature priority. they chose to force it through on a party vote even after losing the scott brown election in january 2010 when he could've had an excuse to back off. it is there, it is law. if the president is reelected in 2012, the democrats will keep control of the senate, it will be awful hard to repeal it or if the president, a new president or republican president and republicans maintain control of the house and come close with the senate, i think it's easy to repeal it. so unlike in 93-94 which we mentioned, we put together in the fight of the clinton health care proposal, that failed.

that was all the books by 95 and president clinton had a huge amount of maneuverability in 95-96. he signed health fair reform. president obama can move to the center on some issues and has on some issues. and he should be praised for doing so. so at the end of the day this is his signature piece of legislation. it's on the books. you can't tinker with it too much. republicans would repeal it. he is going to defend. again, this is pretty unusual i would say, most the time in politics it's muddier. the policy consequences of any election are less clear. this is the case we are on a centerpiece of legislation what the president and speaker pelosi said was a centerpiece of legislation, it is faded now as

we go to the polls, you now from now and this book i think will help voters understand what's at stake him help them think about the problems. obamacare, it's not surprising how entirely dispassionate or -- it is objective, but it is not neutral on obamacare because you might not be surprised in the book of why obamacare is wrong for america. they went for subtlety on the title there. but is truth in advertising. actually been going about this, a huge issue. this is an honest critique of it. i think a compelling critique of obamacare and its final chapter lays out the likely i think more than likely the very likely way in which republicans would go about replacing obamacare if it weren't repeal. it gives people a sense, give citizens and voters a sense i think of what's at stake in what the real choice is. in 2012. so thank you for having me here. i have to run off to my

appointment, but good luck with the rest of the session and good luck with the book. thanks. [applause] >> thank you, bill. on behalf of all of us that was a wonderful introduction, and thank you very much for your compliments about the book. for those of you who just joined us, i'm grace-marie turner, president of the get institute. i will be introducing each one of our speakers and co-authors as they speak. and i just want to reinforce bill's point. we did not take an equivocal stand but yet a really substantive and i think well documented and well cited stand about why obamacare is wrong for america. in case anybody was confused about that, subtle title is how the new health care law drives up cost, discover in charge of your choices and to ensure constitutional rights.

-new health care law drives up costs, puts them in charge of your choices and threatens our special rights, so case anybody stood, we have now made in felt this. it's because we understood this -- we understand this 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. that the health center is one-sixth of the capitalistic economy. and yet we are trying to put this one sticks of our economy under a different system, what the different system of rules. and i think that's really where the differences and where, 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 would be written, is a very different world than the rest of the economy. we do have a chapter in the book talking about what we should do instead. we could've been a whole book about that. but what we needed to do was help people understand first what's coming. and a lot of people have thought, you know, thousands go to repeal this and it's been declared unconstitutional in several courts. is being challenged by the states, 26 days, 28 states are challenging it. 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, of creating new risk pools for

people with preexisting conditions. some of the insurance regulations, some of the provisions that allow or require actually health plans to provide preventive care with no cost to consumer. those were designed to kind of help people think about this law and a more friendly way. but is a freight train coming at it. it is in law into a 14 this law, those provisions are going to take effect. and we are going to see over the course if this law and obamacare is actually allowed to stand, we are going to see half a trillion dollars of cuts and medicare. we'll see how that join dollars in new taxes just over the next 10 years, you're going to see 20 million people added to the medicaid program, which already is not able to 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 on second most expensive thing in the family budgets. about 110 million people may think they're eligible for subsidies. when the congressional budget office forwarded this they said only a fraction of that number actually will get subsidies. employers already started to have second thought. they were told, you know, to support his health legislation and you be more competitive internationally because you won't have this burden of health loss. we all knew that there was no place else that they were going to get off the hook. and effect they will be paying more, and the rules and regulations are going to have to follow in order to provide 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

the costs. and, of course, they see the states absolutely crushed under the budget demands they have now, any recent study i believe the senate finance committee and energy and commerce committee in the house showed that things -- states are facing more than $100 million in additional costs as a result of this law. they can't afford it. so country can't afford it, citizens can't afford, individuals can't afford. and here we are talking about entitlement reform while we are creating two massive new entitlement programs. so jim capretta will 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 is coming is really, is really unknown controversial. it is really going to happen and

gym having now currently a scholar and expert as a public policy center and director of obamacare watch, is an expert on budget issues. he worked at the office of management and budget handling and climate policy, health policy in the first, the first bush to turn. and before that he spent many years with the senate budget committee. so he really understands what the impact of this law will be. not from a political standpoint, but from a budgetary standpoint, it's going to thank all of us. and jim, i welcome you to the podium to talk to people about your perspective on what's coming. thank you all. [applause] >> thank you, grace-marie, and i want to say to my fellow co-authors, it's been a real pleasure working with all of you. i was very pleased to join this

project that was posted me some months ago because i saw a real need to do as bill said, which was inject into the conversation and accessible book that explains the new law in ways that engaged citizen can find out what they need to know. so we have chapters in your as grace-marie has noted on a number of different groups of our country, young people, senior citizens, taxpayers, employers, doctors, people with health conditions, and to all of these things are impacted by those, am i 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 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 present and still used by the advocates of the new law to try to sell it was booker we're going to cover everyone in the country with insurance and you not going to believe that we will cut the deficit, also. so we will be a twofer. so what's not to like? everybody gets covered, no middle class will pay any more, and the deficit will come out as well. it's seems like great all the way around. well, it's great all the way around and tell you started into that which we did in the book. and i had to try to do anything isn't 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. that acts a new law exposes taxpayers to substantial new rift in terms of financing, just at a time when the conversation is getting around to how do we deal with the atomic problems that we haven't funded yet. this new law will power on top

of the existing entitlement promises a bunch of new ones that can't be paid for either. we are doing we begin? let's talk about the class act. this was a provision that hitched a ride on the new law, and it was an sold as a long-term care insurance program for people with disabilities. the problem is that, and they claimed that it would get, generate $70 billion in deficit reduction. now, just in the last two months secretary sebelius has brought into question whether not it will produce anything at all. because she is gone to the hill a couple times and basically said, we discovered that this program is flawed. after the fact that after god enacted. and that is financially unstable and would not go to let it go into effect until we can figure out how to make it work, okay? there's a couple of things about this. first of all, it was known all along that it would have this effect. but agenda to anyway because

they create the perception of deficit reduction. what passionate why is this program so flawed? it is flawed because it creates the perception of deficit reduction because you collect premiums for 10 years but no one becomes eligible for benefits for at least five. so you. so jim capretta time where no one can get any benefits but they have to pay premiums that greets the illusion of a surplus in the near term. the problem is that it's a program that will suffer from very severe adverse selection. that's an insurance companies more high-risk people be signing up for it than people with low risk. the premium will be very high. and within 15 or 20 years it itself will run short of money and will need either need new primus to cover the costs, or the benefits will have to be cut to keep the program in line with premiums that are collected. so instead of this being something that will improve the system for the country, it is the exact opposite, and

something that will expose future taxpayers to the potential of another bill because you have these very vulnerable citizens signed up for a program that wasn't financed properly and, of course, the local response and a couple decades time would be 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 of many other programs have in the past but it will not be something that will improve the outlook for the federal budget. secondly, let me just mention that this new law has already in a very large tax increases that i don't think most citizens 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. that's an abstract national term but it's roughly another five to 10% increase in taxes as those they with this new law.

it's already great a very large tax hike it has brought back something we thought we got rid of with president reagan in 1981 which was bracket. you might recall inflation was very high, people were automatically pushed into higher tax brackets because their wages went up. that new law, this new law does the same thing to do is a new payroll tax into that supposedly applies to people with just income above $200,000 a year. for individuals, 250 or a couple. but those income specials are not indexed to inflation so that as time goes on, more and more people profit in fact by 2030, those thresholds will be equal that of about $130,000 a day. so the fact that the presence is only rich people be paying for this bill is simply not true. finally, there's the impact on senior citizens.

the remarkable thing that occurred last august didn't get enough attention which was the president's medicare trustees made report on the medicare program and it's about a 300 page document and is on in the last two or three pages you got to the punchline which was the person most responsible for producing this particular document wrote a statement about your opinion as he does every year, and in this particular statement he basically said in so many words don't believe all the numbers that preceded the statement in the prior 290 pages. because they're based on the premise that this new law, this new health care law will make permanent perpetual cuts in payments to institutional providers such that they would fall well well below what medicaid pays. now, everybody knows about medicaid, medicaid rates are so low that the availability of

service to those who are on the medicaid program our restraint. you can't get access to carry easily in many places if you're on medicaid. so the notion that you'll take medicare's payments down to such a low level they will be well below what medicaid is paying them in by the end of this coming decades strikes a lot of people as being not plausible. so a very fundamental aspect of this law is we will pay for all his income and spending by cutting medicare in a pretty arbitrary way. we need to reform medicare, but this is not the way to do. and from that you get how you can already see that its political pressure will certainly build to think we can't do this because seniors need access to care and so the presumed spending reduction coming from large cut in medicare is not going to materialize. that's what the chief actuary of the medicare program said. the end result will be will have a new endowment program. there will be pressure for even

more medicare spending and deficit reduction promised will go away. finally, this is my second finally, but really is my last point. the debt limit is coming up for a vote again. there's lots of concern that the nation is piling up debt at a very rapid rate. they had to raise the amount on the subject at limit, according to treasury estimates. now, what does the new law deal to debt subject to limit? it was promise that this law would actually improve our deficit outlook for taxpayers and not add on to the cause. but when you dig into this you realize that, in fact, a new law even according to the very optimistic projections of the administration sides, will actually speed up the raising of the debt limit because what it does is it a bunch of new

ious, and it pays for the new endowment program. so debt subject to limit will go up under this bill again i think think that's an actual indicator that for taxpayers this is not a winner but a loser. thank you. [applause] >> many thanks, jim. i know some people were laid. apparently there's a very big traffic jan in virginia so thank you all for still continue to come. i just want to emphasize that all of us have been working for much of our career on positive solutions for health reform. so the fact that we are criticizing this law is not because we don't think we need health reform. we do, but we just don't think

this is it. and from a perspective of someone who doesn't ever hold anything back, tom miller, i think it's because in his original training, tom, he was a trial attribute want of a trial attorney on your site. he is currently director, he's the resident fellow at the american enterprise institute. dealing with health policy issues. he previously was the senior health economist for the joint economic committee. he was director of health policy studies at the cato institute, and chief economist with the competitive enterprise institute, and also served on the national advisory council for the agency for health care research and quality so we are very glad to welcome tom miller, who also was a former broadcast sports broadcaster with a wildcats, jamison college

wildcats. welcome, tom. [applause] >> thank you very much, grace-marie, jim, bob and all the other folks for making this book, project possible. i'd like to thank the obama administration and the last congress for making this necessary, but i don't want to. so let's just continue our collective rights to maneuver to dislodge what is stuck in our throats. our books are written to give you a firm understanding of the serious consequences of the unaffordable care act, a.k.a. aca for americans. i think we did it in a clear and accessible manner at least my co-authors did. but there's always a bit of a bill murray groundhog day experience in one county keeps repeating the experience of many of the same basic health policy

mistakes year after year. although this law has tried hard to expand, however i think the better metaphor of the moment comes from december 1997 episode of a seinfeld show involving the celebration of festivus. the holiday alternative to the over commercialized high pressure christmas season, festivus for the rest of us was that phrase. it was highlighted important by the airing of grievances in which each person tells everyone else the way they disappoint him or her over the past year. now, you can review our book chapters and categories and find her favorite ones involving president obama that promise great gifts and delivered either empty boxes, product defects or the peru lumps of coal. so much for clean energy in this new health care law. to be fair the broader airing of health policy and health care grievances in this nation's local discourse is rather inconsistent, contradictory with the common denominator

consistent being it is always someone else's fault. we do keep stepping on the gas pedal and then hitting the brakes. despite the airbags onboard and a high political office. an important part of what we're seeing in this book is we have to shift gears and move in another direction. the final tradition of festivus is a cannot conclude without the head of the household being pinned to the mat by another challenger in a wrestling match. we're moving in that direction on capitol hill in the 2012 campaign season ahead within the appropriate limits of secret service protection of federal law. i don't want to get arrested you begin looking back over the last year, some of what preceded in final enactment of this, we see various acts in a five ring circus including political clowns, contortions, daredevils and aspiring lion tamer stood in the political arena, public opinion has remained skeptical about the overall virtue the

benefits of this law, sometimes majority has refused to buy what the laws try to sell for many months. the whole has been much less some of its ports and it's a pretty deep hole when you stare down into the abyss. in the legislative ring we have seen many of those in the previous majority in congress given the hook, next cast please do. the reviews are not in yet on whether repeal or defined or disemboweled will get to the final act, but it will. hopefully sooner rather than later. over in the cloudy economic rain, the aca continues to flounder in the face of slow job growth and massive government debt. the health laws flight from double entry bookkeeping, evidence-based assumptions and effective incentives leads even more americans anxious, insecure and uncertain it offers any feasible path towards higher value. meanwhile, we are running just a little bit short of resources

with it, other important priorities, not all, more health care spending. on the new health care laws temporary truce with employer-based war of private insurance, is contradicted by its steady drip by drip of political water torture of plan sponsors, distances to job growth and wage growth and job creation, destruction and turning of arrangements and unpredictable predatory schemes. the only certainty is the aca has and will continue to produce massive uncertainty of firms which delays important decision. we find amazing feats of administration implementation. many of which have never been witnessed before. we first unwrapped and congress of the aca gives, should have carried the warning some assembly is required. the law did seem to rely too heavily on a toolbox full of

hammers. a lot of panic and a lot of yelping from some of those in the innovation when they hit their fingers. remember that items like the medical loss ratio rules, facing an annual limits on insurance plans that would protect the existing employer plans, those were supposed to be the easy early tasks. the wires not like don't connect to the aca's overly ambitious, welfare state report and real-time data flows, they create a more explosive fireball that spreads throughout the health care system of government budgets and the economy. and it seems that federal planners assume that state governments would fall into line without a whimper. as junior associates and branch office aside to mr. jobs of making health exchanges, insurance regulation and

carriage mandates work better in local practice than they were designed in washington three. in the last circus ring of course, we might have a real showstopper, although almost all the entire constitutional law condescending reflectively dismissed any basis for a challenge to new health law a year ago. federal district court judges have dusted off an old advantage of the u.s. constitution's that's been in exile for the last few century. the constitution, don't leave home without it your we're in the first amendment lounge that begins congress shall make the law because a good start as a presumption. the final opinions in the court cases i mentioned that judge hudson and judge vinson respectively which we discuss in a book, there are serious and carefully written. lower courts have disagreed in

another round of appeals after another round of the. and we may see a far-reaching final decision by the supreme court nearly somewhat in 20 '04 may not. let's see what justice kennedy has her breakfast that day. but initial litigation is fleshed out important insight on how the aca reach far beyond fundamental american principles and limited government and the federalist structure of the constitution. so to learn more, read the book, and since we're working on sales royalties as part-time writers, buy one if you can. the big message is not just how bad this health law is why it can't work it must be a limited in full, it's hard to do in part, yes we've overload the server torp legal system, stretch our struggling economy and destroyed the future of health care decision-making, but what really is a longer believable that the future implementation of obamacare and aca is inevitable. instead our political discourse and health policies has been

revitalized. more engage and inform, still confused than ever before. repeal is not enough. but it will provide a mighty good start. we have to clear a heaping pile of recent and old health policy degree before moving any careful manner so the replay site is long overdue solutions, chronic resisting health care conditions, the clock is running. we can and we will do this much better and we have to. thank you. [applause] >> our final co-author, speaker is bob moffit who is the current fellow in health policy with the heritage foundation, the center for policy innovation. he was director of heritage health policy center for many years. before that he served in the reagan administration both in

the apartment of health and human services, and also at the office at the office of personnel management where he really had a good close look at a program that we all have thought actually a model that is as consumer choice. and purchasing their health insurance. bob moffit, i welcome you as one of our again, valued co-office. the fact that we are also speaking to each other shows we start a very much in the same place and really proud to have worked with all of you. >> thank you very much, grace-marie. i, too, would like to thank my colleagues for this wonderful collaboration and the wonderful staff in new york, the harpercollins publishing team. they did a truly great job. but i would be remiss if i would not extend my deep appreciation, sincere appreciation for house speaker nancy pelosi. she told us that it was important to pass the law so we could find out what was in it, hence the book.

it was one of the most profoundly prophetic declarations in american political history. we are finding out a great deal. in the book what we decided to do was look at a number of different things, but one of the items that we focused on was the claims that were being 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 very high profile promises which turned out to be rather extortionate claims. i think it's fair because in the book we go into detail, some of the evidence behind these claims, it's fair to repeat some of them for you this morning. it's a kind of things we look at when we examined the debate. you will recall the president said if you like your health care plan you can keep it. he repeated this constantly in his september 2009 address to

the congress. the president declared nothing in our plan requires you to change what you have. it's extraordinary. in fact, mandates, regulation, the economic incentives are hardwired into the law, will require literally millions of your fellow citizens to change or lose what they have today whether they like it or not. in 2010 the obama administration unveiled draft, health insurance rules that were to be grandfathered, but the draft rules would require about one half of all the plans to change. beyond those rule changes, when you look at the impact of the incentives on the law of the actuary at medicare richard foster estimated that literally 14 million americans would lose or be transition out of their employer based health insurance. the former director of the congressional budget office, our friend doug holtz-eakin, look at the economic incentives behind the bill projected 35 million

americans would be transition out of their existing coverage. now, that number ladies and gentlemen, could impact be much higher and the destruction to employer based health insurance coverage could really turn out to be massive. you will remember that the president said at the very beginning of the health care debate that americans would see an annual decline in the health insurance premiums. he had said early on it would amount to $2500 annually for the typical family at the end of his first term. i don't think this needs any further discussion. the congressional budget office said if you buy individual health insurance in the market you increases between 10 and 13% in your premium. the actuary at cms is attacks on drugs, medical devices, health insurance, all of which will result in higher premiums. the president you recall said the purpose of health care reform was to bend the famous spending curve downward.

he promised that would happen if we did the right thing. the new law will do exactly the opposite. it within the health care spending curve, but it will bend upwards. cms actuaries estimates over the initial 10 years of the loss enforcement, the united states will spend an estimated $311 billion more than we would have spent if the law had never been enacted. the president said that you see an increase, you will see a decrease in taxation or the middle-class americans will not see a tax increase. he promised that no family making less than $250,000 annually would see a tax increase. well, most of the tax increases that my friend jim capretta sites in the book are tax increases that would directly affect the middle class. in fact, increases for medical goods and services and drugs, insurance, all of these things

passed on to you. these are middle-class tax increases. even 40% excise tax on high by the health care plans, the so-called cadillac coverage, is largely a middle-class tax increase. more than eight out of 10 persons that would be affected by the tax would be persons making less than $200,000 annually. you'll recall that during the debate one of the big concerns was how is this going to affect senior citizens. the administration and its allies in congress promised that they would be no cuts to medicare benefits. anybody not remember that christ this was a very, very key point. largely because of the senior population was so critical and the politics of the debate. in his reports, the president said i want to assure you we're not talking about cutting medicare benefits. we are talking about making medicare more efficient.

intimating insurance subsidy, working with hospitals so that they are changing some of the reimbursement policies. well, in the summer of 2009 the cbo director doug elmendorf told the united states senate finance committee that indeed the medicare payment cuts would, in fact, result in cuts in medicare benefits. later on the actuary reported after the law had passed that the medicare provider payments would result to payment cuts would result in a 15% reduction in hospitals, in other words, would risk see reductions that would make them unprofitable and jeopardize seniors access to care. subsequent analysis by independent analysts have indicated that medicare advantage cuts are going to result in not only in a massive disenrollment of people in medicare advantage but it will also cut the benefits that are visible to people in the medicare advantage program. heritage has been an independent analysis of that which indicates

by 2017 medicare payments -- medicare advantage reductions will result in a reduction of $3700, the value of benefits. jim has talked about the fact that the law that actually does in fact at deficit. the present says however we are reporting, we are recording that he would not sign a law that quote at one time to our deficit. either now or in the future. well, and you can bet the proverbial farm that the cost estimates, including the official cost estimates of the congressional budget office will continue to increase in terms of what this law will actually cost. since its enactment and very shortly after its enactment cbo revise its initial 10 year cost estimate to add another $115 billion. that's just the beginning. in any event under any scenario,

a trillion dollars addition in federal spending plus the creation of two new entitlement programs is hardly a form for deficit reduction. ladies and gentlemen, that there is one other item that is, in fact, i think a very important driver in this debate. and that is the question about how we are to be governed. it is actually and underlying source of a great deal of discontent in this country. the president and his academic allies have long insisted that they are not proposing federal takeover of health care. because private plans providers will still exist. well, where would anybody get the idea that this is a federal takeover of health care? under the law the federal officials, not your employer, not you, not the insurance company will make the key decision in health care. they will decide whether they will require you and your

employer to buy a federally improved health care plan to buy a federal fine or penalty if you don't. they will define and redefine the content of your health care benefit package, including the medical treatments and procedures you must have. the kind of level of prevent health care services that you must have. the level of coverage that you must have. the level of cost sharing, the deductible, coping with their legally permissible. in other words, you're going to get what the federal officials say you get what you will be penalized. beyond that, it's not just simply a question of the law. the law's language is so that they it transfers enormous predatory authority to the secretary of hhs to make all kinds of decisions with regard to such goals as defining quality of care, securing value in hospital provider purchases. so in writing the rules, that will directly affect your life, federal officials, especially the secretary of hhs, they're going to fill in all the new

degree details on the issues, the interval decisions that congress either could not or would not make. this broad discretionary authority enables these decisions to make exceptions to the rules that the issue and grant waivers or apply them very differently. this is very sobering. very sobering. not just a matter of cost, quality and access to care, that's all vital import and. but a great part of the national debate is how we're going, winsomely situated americans are treated very differently in a large and growing administrative state, manned by large number of persons that they do not know and will never know, and who are not a candle to them and never will be, we are living in a different world. with such a process you can expect more arbitrary the highly politicized decision-making by these officials. your problem is that their

decisions and the bureaucratic politics that drive those decisions will profoundly affect your personal life. we're in the first amendment lounge. i doubt that the founding fathers really had 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 certainly didn't want it, neither should we. thank you very much. [applause] >> thank you, bob. i think you can see from these talks not only that really each of the authors brings really substantive knowledge to what we have done and what we have written in the book, but also great passion. because this is really about freedom. this is really about the future of our country. this is a hugely consequential law. it will absolutely as bill

kristol said at the beginning of the program, will be a defining issue is not the defining issue in the 2012 presidential election. this is not settle policy. and since bob quoted the previous speaker of the house, i think it might be useful to quote the current speaker of the house, john boehner, who actually wrote an endorsement for the book, who said while why obamacare is wrong for america, it is well written a must-read for anyone concerned about the future of health care in our nation. it proves without a doubt that this law will bankrupt our nation and hurt economic growth. again, the book is available on websites everywhere. bookstores every place. we have a dedicated website at wrong for america book, cingular,.com. and i now welcome your question. we have several people with microphones because this is

being recorded and broadcast. we do need to wait for you to get the microphone. so if anybody wanted to be brave and ask the first question that i do ask you to please identify yourself and tell us who you are with. so do we have -- have answered all your questions? yes or. >> -- we have a question over here. >> i michael. in the primaries discussions you said at the end of the book is recommendations for what you would do. can you outline embracing? >> well, in the book we talk about a different perspective, and i think the fork in the road that bill kristol described is really, you know, accurate. that you can start from a premise that the government is going to allocate resources in

health sector. and that's what obamacare does. it started from the premise that the way to make the health sector more equitable, covering more people, and more efficient and, therefore, bend the cost curve, had the federal government really managing every aspect of resource allocation, the benefit package, premiums, how the insurance can which insurance companies are allowed in the marketplace and which are not, okay? it really put the government in charge of all of that. our recommendation comes after exactly the opposite, 180-degree perspective, which is the way to improve our health, put the patient at the center of everything. the consumer at the center of everything. the way to do that is to give them control over their resources. that once you put them in charge of making some choices for themselves, then the system will orient itself towards pleasing them much more than they do

today. you could get higher quality, more productivity, costs would be an issue because people would have looked for a value with limited resources. so we make a recommendation in the final chapter here that says you need to change existing public policy to put the consumer at the center of the marketplace, that can provide oversight of the marketplace, and there needs to be some things to aid in her choices. but really the key is consumer choice based on some limited but equitable contributions from the federal government. >> that's the sheet music and the broader mood. we all support the basic, schematic you get right in terms of choice and competition that you reopened mean something. at capital health care delivery. you know what they're doing and you pay attention to the value of the. those are all kind of broad categories.

but we talk about the separate as well. and that is change the mistaken signals you're sending in the system, and that starts with the financing of attacks subject. not into the. we talked about more of a defined cogitation structure. it's not going to be the same flat dollar for everyone regardless. but if you start there and make it pretty clear that the public resources are not unlimited, private resources you can upgrade into all kinds of wonderful things because you're spending your own money. that's the start of getting the system reoriented. that's not for private health insurance. it for medicare, medicaid. we all need to be put together an attraction which we pay attention to what matters, and our voice counts the most. >> there's been a lot of talk about what is the republican plan, where is the conservative plan? republicans can come up with a 2801 page plan that would somehow get it right, we don't think that. we really believe the way to change the health sector and to change the incentives.

right now bureaucrats are making choices for people and they don't like that. medicare brought by federal washington bureaucrats, medicaid by state and federal bureaucrats. employee health benefits when most people get their private insurance, but human resources director, their bosses. people want this choices themselves. especially in information age economy. what you need to do is move power and control back to the consumer so that day, the market reorganizes itself around them and change in the incentives means changing the resource allocation instead of moving power to washington, it moves it as jim and tom and bomb have written in the past is welcome moves it to the consumer so that doctors and patients are in charge of decision and not washington bureaucrats. that's a resource allocation and in changing the incentives. i hope the republicans in congress don't come up with her

own 2800 page bill. we need a step-by-step approach to reform that does this right, allows the market to work and forces the market to reorganize itself around. >> this is a huge and growing sector of the economy right now. one out of every $6 of your while is spent on health care. very soon ill be one out of every $5 spent in your what will be spent on health care. it is absolutely incredible that congress could think that it could literally overhaul that sector of the economy with one single bill. what's happening now is what i basically wrestling with a consequence of that hubris and the president said he does not want to relitigate this issue. the problem is a law that he passed has an implementation schedule of eight years. other minor things things have taken place however you feel about them are minor. that big changes take place in

2014. the individual mandate, the employer mandate, demanding on the state. a massive expansion of medicaid. all of these things are taking place much later which means that the president and his team have invited a long, long political battle over health care which is going to have flashpoints that will be very intense over the next few years. what i'm saying to you is that what the white house and the administration allies on capitol hill have done is guaranteed that we are going to have a major battle over health care when a titanic struggle, it'll be a titanic struggle over the next few years. there's something else or that is crucially important. we're a federal republic. power in this system is wisely divided between a national government to handle general concerns and particular governments to handle particular concerns. ..

>> the congress should do what is within its proper constitutional jurisdiction. it has two areas where it can make policy under article i, section 8. one is to raise revenue and, transfer, make tax policy that is -- and, therefore, make tax policy to enable americans to get the health insurance they want at the price they want to pay in a competitive market. congress can do that, but they can't -- we cannot have competitive markets unless we address the tax treatment of health insurance. the other factor to remember is that we've got states who

largely right now regulate health insurance markets. some of them do a very good job, some of them do not do a good job. but congress could encourage that innovation and experimentation at the state level. then we would start to see some progress. i don't know of anybody, you know, right, left, centrist who think, for example, we ought not to help people who cannot afford to get health insurance. the question is, who at the end of the day is going to make the key decisions on the table? our approach is to put the patient, really, at the center of the decision-making process. >> another question. yes, ma'am. >> please tell us who you are. >> hi. i'm kirby thomas with the charles echo foundation, i'm an intern. i was wondering what you thought was the best hope for going after obamacare, maybe going

after the class act like we've seen with the 1099 full reporting or full repeal or victory in the courts which is most likely to be more successful? >> you know, this battle is going to be fought on all those levels. this is now four major different ones. there's certainly the legislative challenge with the house not only having voted to repeal the law, but taking a series of votes on individual provisions like the dreaded 1099 paperwork provision. the hearings and the studies and asking the administration for more information about how it actually wrote and is implementing the law. so the legislative front is important. the regulatory front continues with, as we said, 6500 pages already written and many thousands more to come. the american people have an opportunity to comment. the political front will continue, as we've said. we think this is going to continue to be an issue in the elections in 2012 and even,

perhaps, beyond. and then, of course, the legal front where you have the law being challenged in a number of courts, and it certainly cannot help but go to the supreme court, very likely a decision in the summer of 2012. so the american people still have an opportunity for their voice to be heard on many fronts, but i don't think there's any one that's more important than the other. >> we can try the death of a thousand cuts without blood clotting factors, and certainly that's a good way to nibble away at this. a legislative turning on the whole by the end of 2012 isn't going to happen. don't worry about taking out the ugly eyesores, there's so much there that you could remove half, and you'd still have more things to get rid of. on the court probability, i'd like -- front, i'd like to be optimistic. we should never totally invested in nine unelected judges who make all kinds of decisions,

have a long body of bad precedent to get over to fundamentally transform what's a terrible line of precedent in regard to the commerce clause. the district court did great job. when you go to the supreme court, you don't know what's going to happen. we can be hopeful, but i wouldn't think that's going to save us from everything else. we're going to win this old school. you have to go ahead and vote and throw some people out and put some people in. and i think we know who needs to be taken care of in this regard, and this'll happen in 2012, and we'll be repealing this in 2013. >> we do have a chapter in the book, what you can do to help put the brakes on obamacare. we have a wonderful forward by congressman paul ryan, and i neglected to mention that early and really delighted to have the current chairman of the house budget committee who has prosaided a vision for -- provided a vision for how to put consumers back in charge of choices in health programs of all sorts. i think we had a question up here.

yes. tell us, again, your name. >> i'm martha lewis, bethesda, maryland. i think -- and i hate to be negative, but i think the title is unfortunate because so many of the people who should be learning about this will simply look at the title and go no further. i wish it had been something that you mentioned putting the patient in the center of it. however, we can't fix that. how are you going to address the masses and persuade them that you have something else to offer? because they won't read to the back chapter. and, also, in regard to putting patients first. the response which most often i hear from those in favor of obamacare is i think everyone should get health care. and they go no farther. so how are you going to address those people who think that if you say it's wrong, that means you don't want people to have health care? >> really good question. >> you know, there's a real

misunderstanding about what this kind of proposal would do versus the alternative in that regard. and i think the, frankly, the mainstream press doesn't report on this very well. back when senator mccain proposed his health care program back in the 2008 campaign, it was widely reported at that time -- and at that time president obama was against the individual mandate, by the way. it was widely reported at that time based on very speculative estimates that president obama would cover everybody, and senator mccain would not, okay? and that is completely an erroneous way to report on this. remember, what senator mccain proposed was to give every household in america a minimum of a $5,000 tax credit that could only be used to get health coverage and used for health services, okay? by definition -- in effect, it was a universal coverage plan. if you didn't use it to buy

health insurance, you lost the $5,000. and you could always come back the next year and get it. so by definition it was a universal coverage program that got everybody into some kind of a system of insurance. meanwhile, the president's proposal -- the one that's been enacted -- has to use a series of mandates and coercion and fines to try to get people to buy private insurance that they otherwise probably wouldn't want to get, okay? and the speculation is it's going to work. yeah, we're going to end up with all these people getting insurance because these coercive tactics will be in force, and the irs is going to fine everybody, and this'll really work to get the 50 million people into something they don't want, okay? is. >> but at least 23 million -- >> there still leaves 23 million uninsured -- >> and that's just a rounding error. [laughter] >> my point is, my point is that the alternative to this can cover everybody, can make sure that everybody's in good health care, and it can do so in a way

that's better than what was passed. >> i hear what you say about the title, you know? we -- there are a lot of people out there who are really upset about this law, and we are among them, and we just wanted to tell people where we were coming from. the next book we write will be how do we get to patient-centered health care? so thank you for suggesting that to our editor. [laughter] >> when you've got a tumor, you've got to stop it from growing, and you have to cut it out. >> i would just add that i think that part of this agenda here with us is to explain in plain language a very, very complex piece of legislation which really has no precedent in american history. i do not recall any piece of legislation affecting all 300 million americans dealing with one particular set of the economy that has ever been like this where congress, basically, passed a 2800-page bill. i don't ever recall anything like that, nor do i ever recall

a situation where you had 28 states in court fighting the federal government. regionally diverse states. i think we're living in a, we're live anything a historic time here in this health care debate. this is one of the great debates in american political history. but i think what we have to do to broaden this conversation is, i think, what we need is more open-air, public debates. i'm talking about the stuff that used to fuel political discussion in this country at another time and another place and, in this some cases, a better time and place when we had real debates, awkward-style debates or open-air debates between opponents and proponents of the legislation. so, you know, my view is that town hall meetings should not be simply just town hall meetings. if members of congress want to sponsor public debates, we ought to have it. and people should be able to hear both sides equally. as far as the media is concerned, i think the media has done a, for the most part, a

pretty good job in this area in reporting things. i don't want to single anybody else, anybody out in particular, but some of the columns that have been written by robert pare are absolutely tremendous in this area. but pare pointed out something that i think is really interesting. it has to do with section 1312 of the bill which requires members of congress and their personal staffs, right, to go into the health insurance exchanges on january 1, 2014. now, what that means is despite this argument about being able to keep your own health care plan, at least perm staffs of members of congress -- personal staffs of members of congress are not going to be able to do that. but what was interesting about this, as pare pointed out, is that it is, apparently, the leadership offices of the house and senate are, apparently, not covered by the provision. don't you think that's interesting? and the professional committee staff are, apparently, not covered by that provision.

now, for the members of the press in the first amendment lounge here, i would like them to try to find out a simple question. i would like to know the name of the congressman who drafted section 1312. i think that would be nice to know. it'd be nice to know what congressional staffers were involved in that. i think we ought to know these things. because the fact of the matter is you have a law here that is consequential, it's affecting so many people, and they insist -- i'm talking about the leadership, congress, the previous leadership -- that this is in the best interests of america. well, if it is, they should be able to defend it in broad daylight. >> thank you, tom, thank you, bob. >> for more information visit the book's web site, wrong for america book.com. >> peter, first, i'd like to congratulate you on another important and terrific book. this is the third one you've gone done on the history of

al-qaeda and osama bin laden, and i think it's fair to say you've established yourself as the preeminent historian, and i think this book shows why. it's concise, it's witty, it's fair, it's dispassionate. i think it's really the wes summary of what's happened since 9/11. let me start by asking you a very basic and yet hard to answer question which is, what should we be calling the conflict about which you write? the subtitle says the enduring conflict, but what do we call it? >> max, first of all, thank you for those comments. i'm very happy that you, i mean, such a really well qualified author like yourself has read the book and that we're having this constitution. discussion. what we should call it is a good question. i don't think we've come up with the language about this conflict. you know, as i say in the book, you know, president obama had a pretty interesting question when he came into office which was how to twine the war formerly --

define the war formerly defined the war on terror. i think a lot of europeans would have liked him to redefine it as a global police action against terrorists, and i think that would have been naive on multiple levels. al-qaeda's been at war with us since 1998, certainly when they blew up our embassies in africa. they've declared war on us, they've done war-like things. for us to pretend it isn't a war would be wrong. on the other hand, president bush also overestimated the problem. al-qaeda's a serious problem, but it's not marxism or communism. i don't think we've had the language to explain it exactly. because it is a form of warfare, but the nearest form of war far in terms of american historical terms is, perhaps, the war against the barb ri pirates in the late 18th century which was certainly a war, but it wasn't, you know, it wasn't an