people keep saying people don't read, and they -- their proof of that is that book sales have gone down, but e-book sales are up. amazon is one the biggest per veighers of anything. book clubs have flourished. men are starting to form book clubs which was never true. book clubs are as old as the first book clubs in america was formed by black slaves who secretly got together to teach each other to read. it's a very old tradition in america to get together and read books, and i just don't think that's dead. i really think that when you look at this, you're looking at it through the object of the publishing industry which is -- is hoping around for its beat like the newspaper industry. they are in trouble, but i don't think they are in trouble because people stopped reading. i don't believe that.

>> what do you think the future holds for books? >> well, i think as i said, they have to adapt. i do think that what the industry's are going to do best are the industries that tap into the community needs that just don't get sort of obsessed with the latest books. i think that's why used books are popular. ..

>> they invited me back. how do you self-publish? once you self-publish, how do you deliver and distribute the book? that used to be something that was set up by these traditional publishers. you had to beg them to publish you. that's all changed. and you have people concern the book that i saw published, which was a collection of my mother's writing, she was 86 when she first wrote a column for the st. petersburg times. she wrote from age 86 to 93 when she died. i wrote -- i put together a collection of her work and published it under amazon. it sold better than the book i published, my own published book. because people really related to the topic.

i sold it in odd venues. i went to art gallery, i went to a visit in the nearby gulfport, they are walk every month. i sat in front of a used bookstore. i sold $100 worth of this book. because people stopped by and they were drawn by the story of this woman who had had success, creative success late in life. so it's the topic now that draws people. and with the internet one don't have to rely on publishers. you can figure out ways -- i'm not clever enough -- to create a video of your book, get on all of the social networks to tell people about your people. people are bypassing the traditional publishers. in other words, stories are still being told. people are still reading those stories. that is what books are. they are stories and the people are telling other people. either fiction or nonfiction. that's still happening. and it's actually happening win

think, at a greater level than ever. >> this june on "in depth" the balance between security and liberty. the difficulties of a climate change treaty and the limits of international law. your questions for author and university of chicago law professor eric posner. his books include "law and social norms" and the perils of globalism." >> where she discussed her book "the truth about obamacare" and took book tv viewer phone calls. this is about 30 minutes. >> and our impromptu set here on the ucs campus. this is sally pipes, sally has written her third book about health care. this one is called "the truth about obamacare." how long have you been

interested in health care as a professional interest? >> probably, susan, for about 25 years. i grew up in canada, and in the late '80s, we started lookinging at the growing waiting list. then i came to the canada and got the opportunity to get involved in hillarycare, and then, of course, following what's been going on in particular with president obama and obamacare, just totally involved in it. >> host: in the book, you acknowledge that the american health care system was in need of reform. in 2009 when this began to take up the scene. what do you see as the major problem with american health care? >> guest: everyone wanting affordable, accessible, quality health care. that's the goal. and universal coverage. the president wanted universal coverage and to bend the cost curve down. we spend about 17% of the gross domestic product on health care. i would like to see the health care system reformed, my vision

though, is not increasing the role in government in health care. we have about 50% of health care in the hands of government today. i would like to see that reduced and to empower doctors and patients. get away from increasing government, and, of course, under the affordable care act, this legislation is really growing the role of government in our health care system. it's not going to achieve universal coverage. it's not going to bend the cost curve down as the president said he wanted to do. >> sally pipes here to interact with you about health care and particularly about this book, one included miracle cure and the top myths of american health care. >> guest: yes. >> host: this was published in 2008. you can send us your questions by e-mail. that is about booktv@c-span.org. we'll put the phone numbers on the screen. twitter handle at booktv. lots of ways to get involved.

we look forward toker why -- forward to your discussion on this. one the thingies learned in the course of reading your book is some of the interesting cross roads for the development of american health care. just as a way of teaching people about how our system changes over time. i'd like to go over them and have you talk about them. one was as you point out in october 26th, 1943 irs ruling. i was wondering if you could talk about how that reinforced the current health care system. >> guest: well, you know, during world war ii, when wage and price controls were in, employees were having a new time attracting employee. they couldn't give them wage increases. the government decided they would give employers benefit if they offered health care and employees would get their health care with pretaxed. the government got us into the mess in the first place. now they are getting more and more into it. i would like to see that changed, we don't get our

long-term care, house insurance through our employer. 60% of americans get their health care through their employer. we need to change that to build a market-based health care system. because if you lose your health insurance, if you lose your job, your health insurance, you go into individual market and have to buy your health care with after-tax dollars. we don't have a level plays field. >> host: people that support look at the fact. it's employer based. that leaves us out if we lose our jobs or aren't employs or other reasons. you see the same set of circumstances and come at a solution from a different perspective. >> guest: i think it's ultimately, i would like to see us move away from employer-based coverage. i think what we should do, we have to change the tax code so that individuals can get their health care with pre-taxed dollars as well. we need to build up a competitive market in health care. there are a lot of people. i think the president himself really wants a single payer

medicare. which is the system that i grew up in canada under. of course, you know, when the government controls it, you have government saying we're only going to spend 10%, and you get long waiting lists. i think very few people in america realize today that in canada, the average wait for seeing a primary care doctor to getting treatment by a specialist is 18.2 weeks. that's over four months. that's going to happen. care is rationed. and the older that you are in canada, the more your care is rationed. our seniors are going to be rationed under obamacare because the president, of course, wants to cut out $575 billion out of medicare to finance the people that are going to move on to medicaid, the program for low-income americans. >> host: another historical point that you talk about in your book was that legislation signed by harry truman in 1946. the hospital construction act, how did that change the health care system? >> guest: well, i think, you know, the health care system

changed a lot. you know, in california, for example, doctors cannot be employed by hospitals. we built community hospitals, we built private hospitals. but under obamacare today, we -- private hospitals can no longer, you know, be built. and they -- doctors won't be able -- hospitals won't be able to deduct if they don't take medicare patients. so there's a lot going on in the whole system. that was harry truman. you know, it was one the people that also got us into this mess. now, of course, we are in it in a much greater extent. >> host: we got calls. let's begin with the viewer in rochester, new york. >> caller: yes, i just wanted to ask a question that you posed to her when she sat down initially. which was what does she think is actually wrong with health care? what can she do? come up with that answer, not so much dispatch what the health care reform act is saying.

>> guest: well, i mean, you know, as i said, we want affordable, accessible, quality care. how do we get there? instead of increasing the role of government on taxes and insurance companies, need to do a few things, such as changing the tax code that we talked about, empowering doctors and patients. we need to get stating to do medical malpractice reform, the cost of defensive medicine in this country today is about $210 billion according to price water housecooper. they said doctors are doing all of the tests because they want to line their pockets with money. that is not the case. they are afraid of being sued. we need state to do medical malpractice reform. we need to reduce costly mandates. all of these things that add 20 to 50% to the cost of insurance. you know, i think, health

savings accounts where you do empower, they do empower doctors and patients. we need to remove the regulations and controls. under obamacare, what's happening is the -- the more regulations on hsas, you are not going to be able to year to deduct the cost of over count meds, and they are reduced from five to 2500 dollars. those are some of the things that i would like to see building on empowering doctors and patients rather than government. >> host: by extrapolation, then the diagnosis of what's wrong, if you think it should be affordable and accessible, our health care costs too much and not enough people can access it. is that some of the systemic problems that you see right now? >> guest: right. 64% of americans get their health care through employer. 60% of people on medicare, medicaid, s-chip, and va. the census says there are 57

million americans uninsured. when you break that number down, there are only about 9 million americans who are chronically ill without health care insurance for two years or more. those are the people that we need to help. one the things is about 14 million are eligible for medicaid and haven't signed up. the president wants to add 18 million. and the people on medicaid find they can't get a doctor because the doctors are reimbursed. that is going to become an increasing problem under this system. and we know the congressional budget office has shown that about 23 million people will still be uninsured in 2019 when, you know, obamacare really becomes effect i have -- effective in 2014, that's when the state based exchanges come into being. >> host: questions from san antonio. caller you are on the air.

go ahead please. >> caller: hello, ma'am. you already talked about the one thing that i was going to bring up about bringing back half a trillion dollars and eventually enforcing rationing. i wanted to ask if you thought the intention of the obamacare program was to eventually so straddle the insurance companies they can no longer make a profit and were forced into single payer. also if we are portioned into rationing, do you think it'll be something like the british program, the n.i.c.e. program where they determine your care based on the age, productivity, your ability to contribute to society. >> guest: right. those are two very, very good questions. i think, you know, because of the controls put on insurance companies already such as children being able to stay on their parents plans until age 26, the beginning of the end of the annual limits, there's a lifetime cap, free preventive

care. all of these things are going to -- adding already to the cost of insurance. i think, you know, kathleen sebeilus, the secretary of hhs has said she's going to keep a list. if she thinks any insurer is increasing by 10%, she may not allow them to be part of the exchanges. there's not a public option or government insurance program in the affordable care act. what will happen win think, is private ensurer are going to be crowded out of the insurance market. then it will be the goal of getting a public insurance plan and then leaving it all in a medicare for all or single payer health care system. which is like canada. we have long waits, rationed care, and lack of access to the latest technology. on the issue that you talked about, comparative effectively research which is patterned after n.i.c.e. in the uk, and

the administrator, he loves n.i.c.e., he call it is -- calls it a national treasure. the government determines what health treatments are cost effective as compared to medically effective. i think the 15 panel group of bureaucrats who will be part of the comparative effectiveness board, they are also going to determine what is cost effective as opposed to medically effective. that is going to end in ration care. they will be decided what kind of health care, not the private sector. >> host: we have a tweet. this viewer tweets texas has regulated medical malpractice and has seen the same increase as state that is have not done so. >> guest: well, i guess i would disagree. in texas in 2003, the state capped not economic damages and punitive damages at $500 and $250,000.

we have seen in texas because of the change 16,000 new doctors going into the state of texas, doctors premiums have fallen in that state, and it is the way to go. california has a microlaw, we also have had lower premiums, doctors, neurosurgeons, and ob/gyns around the country, particularly in states with high med rates, west virginia, nevada, pennsylvania, what's happened is ob/gyn and neurosurgeon got out of the practice. who does that hurt? it hurts the patient that needs a neurosurgeon and ob/gyn. it's the way to go. >> host: next phone call from las vegas. you are on for sally pipes. go ahead please. >> caller: well, hi. richard is my name. i'm calling because it's easy to sit there, but i was permanently disabled from the earthquake, i lived in california for over 40

years. and i was in three earthquakes. the last one permanently disabled me. if it wasn't that i was with motion picture and had a pension, i'd be out in the cold. and what do you suggest we do about people? i have two questions. the first question is i think government should be more involved in health care. because i see what these doctors can and will try to get away with. and the second question they is how -- what do you propose? you are talking about after -- you are talking about prior to medical trauma or something happening with taxes and medical taxes and things like that, and insurance, but what do you do if a person is in the midst of his life like i was at 44 years old, and all of the sudden i was struck down permanently?

>> host: caller, let me jump in. we understand where your question is going? >> guest: yes, well, you know, everybody in this considerate is entitled to health care under a federal law. so nobody can be denied access at an emergency room, community hospital, or community clinic. going back to your point win mean if insurance were not tied to an employer, but it were your insurance, you would be covered, you know, over the course of illnesses, as we get older, certain things happen. we need health care. in the meantime, i think if the federal government wanted to do something, one the things they could have done was to beef up the high risk tools by $55 to $1 billion. people that are not insured, such as yourself, and have a catastrophic event, you would be insured.

i understand that certain people are having trouble getting health insurance. this way we would be able to get insurance. of course, insurance through your own, it would go with you in a country like switzerland. >> related question by a tweet. howard frost says health care is rationed now in the u.s. by how much we can afford. how is that a good system? >> guest: well, health care is rationed. do you wanted to be rationed by the private sector, market, or rationed by government? in a country like canada where the government took over the health care system in the '70s, they determined what percentage of gross domestic product. so the demand for health care in a country like canada is much greater or even in britain. so people because that's all that is spend, the budget could be afforded. people have to go on a waiting list. and government determines, you know, how long your wait will be, whether you can get access

to care. i think america is a country based on entrepreneurship. we want the private sector to be determining how we get our health care, what level of health care that we get, and if government gets involved in it, it's going to be long waiting list rationed care and lack of access to, you know, the new equipment, the new mission, and all of the new treatments and things, medical devices are developed in america. they are not developed in canada, they are not developed in europe. you have to have a market. we want research and development to happen. you have to be able to have a profit motive. >> host: we have about 15 minutes left in the half hour. we should tell the viewers, being in the middle of the festival, all kinds of sights and sounds and planes going over head and carts going by. now at midday we have a group of muslims and midday prayers. if you hearing sounds, that's all part of the texture of los angeles festival of books. welcome to the experience with

us here. next is a telephone from pueblo, colorado. you are on the air. >> caller: yes, ma'am. couple of things. first a comment. i deal with canadians all the time. for years. i still have not found that canadian that would trade their system for our system. >> guest: caller, you can criticize, but you don't need to be insulting. not found the canadian yet that would trade in their system. two things, when you poll canadians in general, they like their health care system. when you poll canadians who had to get treatment, the poll numbers are very, very bad. do you know there's 17% of canadians today are just waiting to get a primary care doctor. so when the president says we need more doctors to go into primary care, canada, you know, has the huge waiting list for

getting primary care doctors. a lot of canadians come to the united states, they pay out of pocket for treatments that they find they are on a waiting list for too long in canada. look at the chat in ontario who had terrible headache, went to the primary care doctor, he was told it would take within you know, eight to ten weeks to get an mri, four months. he went to the state, paid out of pocket, found out he had a brain tumor, went back to canada, and was told it would take another four months. he came back to the state, buffalo, new york, paid out of pocket and is suing the canadian government. i am alive because there was an escape. i came to the united states. the woman in calvary expecting quad tup lets.

she said thanks heavens i would come and my quads for delivered. danny williams, when he was told he needed heart valve, he couldn't get it where he was the premiere, he was going to be on a huge waiting list. he then found that when he came, it's my heart, health, and choice. americans wanted choice in how they are going to get their health care. they don't want to wait as people do in canada. >> this is critique from someone called citizen of the world who writes sally pipes loses the argument. medicare advantage, private insurance, it's a failure. >> guest: i guess i would disagree. we have about a quarter of seniors who are on medicare advantage. they like it.

the results have been very high. the president has said we wants to eliminate ultimately medicare advantage, starting off with $202 billion in cuts to medicare advantage. it's the private program where seniors get their hmo, their insurance, through the private sector. very, very popular. so i disagree. seniors are becoming very concerned about the fact that as i said earlier, $575 billion is going to be cut out of medicare over ten years. this mean that is care is going to be rationed. and it'll be rationed first by the seniors. of course in canada, that's one the ways they cut cost. my mother passed away in canada because of her age as a senior, she could not get a come on os coby. ultimately when he was hemorrhaging in november. she went to the hospital in an ambulance, spent two days in the emergency room, two days waiting for a bed and ward, she got the

colonoscopy. she passed away two months later. it's cheaper to deny care where government controls the dollars. we do not want that in america. it's not the american way. >> host: sally pipes, we're talking about the truth about obamacare. in it you are critical of the democratic party. you call expansion of health care a democratic obsession. what is your view of the republican increase in medicare prescription drug program? >> the -- of course, right now paul ryan has his budget plan, republican plan, and president obama spoke a couple of wednesdays ago about his way to cut health care. he wants to expand the independent payment advisory over what doctors and hospitals are paid. he wants to bring in price controls on pharmaceuticals to reduce the cost under medicare part d the plan. i think that, you know, seniors need access to drugs and i think, you know, the private market is the way to go.

by putting price controls, it's going to a) reduce the ability of drug companies to research and develop and produce any drugs. it cost about $1.3 billion from when you have an idea until a drug or biological make it is through the process. so very, very expensive. but it's done in america. i think we don't want more and more government control over what drugs our seniors can get. medicare part d has been working. it's less costly. it was brought into being by president george w. bush in 2004. >> connecticut, you are on. good afternoon. >> good afternoon. quick comment and then a question. i think, you know, americans and the things i believe it's made our country great is the feedback, the consumer behavior creates. it rewards good service, punishes bad service. it seems obvious to me that through employers, fee for

service on the government, we deprive ourselves of the feedback. i guess, you know what, i look at future. my question is where is the natural advocacy for consumer driven health care. who were the constituents that you are seeing signs of advocating for that? thank you. >> guest: right, well, consumer-driven health care, there are about 11 million americans who have health savings. you put your money away in an account, it accumulates tax free, and then you use it when you need to for your health care. and it has to be, of course, combined with a high deductible insurance plan. it's very popular. more popular among young people. more and more companies with the cost of health insurance going up are offering consumer directed plans, hsa, i myself have a health savings account with anthem blue cross. i think we need to educate people on, you know, health care is -- should not be first dollar coverage.

people who have employer-based coverage have no idea what the cost of health care really is. if you pay part of the premium, if you pay a co-pay of $20-30 when you go to doctor. that's not what health care cost. when people think manage is inexpensive or free, they use more. when you put consumers and doctors in charge, they are much more careful about how they spend their money. doctors are -- a lot of doctors in favor of consumer driven plans. the tea party movement which has been terrific in america. they -- these are average american people who do not want the government making decisions about their health care. they don't want the post office being the way. >> host: another tweet. people can pay out of pocket even with a nationalized system. there's still a private market liar. >> guest: that's not true in a country like canada. the canadian government and