from this fixation on open access and broad networks." end quote. now, let me just repeat that, mr. president, to get the full context of what he's saying here. "we have to break people away from the choice habit that everyone has." is this really what we wanted out of health care reform? wasn't that one of the good things about our health care system, the fact that people were able to, by and large, go to the doctor that they chose? that people could look around for the best doctor in a particular field or find a doctor that they felt comfortable with? do we really want a health care future where americans don't have a choice about the doctor that they see? and limited choice doesn't just mean that americans may not be able to find a doctor they like. it also means that americans may not be able to go to the doctor that they need.

a "daily caller" article from last week noted -- and i quote -- "cancer physicians with their specialty and expensive procedures have been a primarily casualty." according to an associated press, 4 of the top 19 comprehensive cancer centered by all obamacare exchange plans if their states." 4 of the 19 top cancer centers, mr. president, in the country. that's not what you want out of a health insurance plan if you have cancer. given the president's broken promises and the havoc that obamacare is wreaking on our health care system, it's no surprise that 80% of those politico sur vaifd wan surveyedy or repeal it entirely. or that it was the most cited reason for a negative experience

with the federal government. or that obamacare will be 90% how they will vote this farm. there's a lot more that could be said about obamacare, like the damage that it's doing to our economy, but i want to move on, madam president, to talk about another very serious instance of government mismanagement and that's what's going on in the veterans affairs department. madam president, almost every day a new report surfaces of mistreatment or mismanagement at v.a. facilities across the country. at least 40 veterans have reportedly died because of delayed or inadequate care. it is now clear that this is not an isolated problem at a few select locations but a system-wide crisis. and it is a national embarrassment. madam president, our contract with our servicemen and women is a sacred trust. they pledge their lives in the service of our country and take

upon themselves the burden of defending liberty for the rest of us. in return, we promise them benefits, including health care and a college education. our men and women in uniform uphold their end of the contra contract, sometimes at the cost of their own lives. for us to fail to uphold ours is a disgrace and a betrayal of their sacrifice. mr. president, every resource of this administration should be focused on discovering the full scope of this problem and immediately starting to fix it. yet this administration has shown a startling lack of concern about the widespread mistreatment of veterans in our country. when it became clear that his health care web site was a disaster, the president employed an all-hands-on-the-deck approach to fixing the problem, spending hundreds of millions of dollars in the process. in response to the v.a. disaster, on the other hand, the president has dispatched just a single staffer -- a single

staffer -- to oversee the investigation. this is not acceptable. as commander in chief of our armed forces, the president should be leading the charge to fix this problem but he hasn't even spoken publicly about it for weeks. but, madam president, regardless of the president's in, as congress -- president's inaction, congress, congress must take immediate steps to address this crisis. this week the house of representatives is taking up a version of senator rubio's bill, the department of veterans affairs management accoun accountability act, which would allow the v.a. secretary to fire oh demote senior exeb tives in n the department when warranted. private organizations can fire employees who fail to fulfill their responsibilities. we ought to be able to fire officials who fail in their obligation to our veterans. yet all we've seen from the v.a. is the resignation of the undersecretary for health, dr. petzel, who was already planning to retire, hardly the

accountability that our veterans deserve. i've introduced a bill to require the v.a.'s inspector general to conduct a national investigation of the wait times veterans face. it's essential that we get an idea of the full scope of this problem so that we can ensure that it gets fully fixed. under my bill, the inspector general would have six months to investigate and submit a report to congress. in the meantime, the v.a. would be forbidden from closing any of its medical facilities. no facility, not the hot springs facility in my state of south dakota, or any other should be closed unless we make very, very sure that veterans' care is not going to be affected. there are other bills this body should be considering as well, including senator heller's bipartisan legislation to reduce the backlog of veterans' disability claims. and i hope the senate will take them up quickly. madam president, this -- this crisis can't wait.

there is every likelihood that right now -- right now -- veterans around our country are still failing to receive the care that they need. i hope the president of the united states will come to his senses and treat this situation with the seriousness that it deserves. but, madam president, if he won't act, congress must. it is the very least that we owe our veterans. madam president, i yield the floor. a senator: madam president? the presiding officer: the senator from georgia. mr. isakson: madam president, this congress, particularly this year, has not been noted for much of an accomplishment of anything. we've been at cloture-atrophy and political-atrophy. but we're about to change that for a dayi want to pause for a moment and acknowledge the hard work of a number of members of

the house and senate on what's known as the water resources development act, which soon will be on the floor of the senate and i understand will be on the floor of the house today for its ratification. the water resources development act is "the" authority of the united states government to move forward on infrastructure across the country. i want to congratulate chairman shuster in the house and chairman boxer in the senate for their hard work on the conference committee, ranking member david vitter has been an untold hero for us working hard for the senate, as well as others who i want to give thanks to. sylvia burwell at o.m.b. has been a life saver for us on the savannah port and i appreciate her cooperation and her help. vice president biden, who did a tour of ports on the east coast of the united states to focus on the importance of improving our infrastructure. in this wrda bill are improvements across the country. but there's one i want to talk about for just a second. it's an example of why infrastructure is so important and that's the expansion of the savannah harbor and deepening project in the savannah river at the port of savannah. that was a project that was authorized 16 years ago, the

year he was elected to the u.s. house of representatives. it was authorized to be built but it hasn't been expanded for 16 years or authorized for 16 years because of environmental concerns. atmospheric concerns, sometimes funding concerns, sometimes political atrophy concerns. but finally everybody has gotten their act together. noaa has endorsed it, fish and wildlife has endorsed it, e.p.a. has endorsed it, the corps of engineers has endorsed it. and thanks to that wrda water resources development act authorization, a $706 million project will become the reality over the next five years. why is it important? it's important for this reason. as we sit here and talk today, the nation of panama and widening and deepening the panama canal. wane few months they're going to be taking through the panamex ships of the 21st century. ships that carry not 9,000, not 11,000 but 14,000 containers. and ports along the east coast of the united states, like the port of savannah, are not go to

be able to take that deep a ship. they'll have to wait until high tide to bring it in and then wait for it to come back to take the ship out. that causes money and causes people to divert to other ports and countries and it hurts us. so over the next five years as we deepen the savannah harbor and river, we improve the opportunity for the intiets southeastern united states to grow and prosper and be competitive in the 21st century. the port directly contributes to 297,000 jobs in our states. it contributes to 49 of the 50 states on the continental united states. provides jobs, economic vitality, tax revenues and prosperity for america. its time has come and i'm so delighted the water resources development act is done. i'm so delighted that chairman boxer and ranking member vitter and chairman shuster have put their teams together, have dotted the last i and cross- the last t. and i encourage everybody in the senate to ratify prosperity, employment and economic development for america. and when the bill comes before the senate, ratify the improvement of the water

resources development act and that final conference committee report. and i thank you, and i yield back the balance of my time. mr. reed: madam president? the presiding officer: the senator from rhode island. mr. reed: thank you, madam president. madam president, i rise today to again discuss the urgent need to

restore emergency unemployment insurance. like many americans, i am hopeful about our future but concerned about how the great recession has impacted our fellow americans, particularly those who have been hit hardest, the long-term unemployed. these are good people from all walks of life, from all 50 states. they are people who worked in a variety of fields, from high-tech to manufacturing and from cubicles in offices to plants and factory floors. many of them are older and finding themselves out of work for the first time in decades. all of them, all 2.78 million of them, lost out on december 28 of last year. while they have been out looking for jobs, congress has failed to do its job and restore unemployment insurance. previously congress had never let emergency benefits expire where the long-term unemployment rate is so high. today's long-term unemployment

rate is 2.2% and it's still well above the highest rate, 1.3%, of previous expirations. in the past, when the rate was this high for long-term unemployment, we maintained these benefits. this is still an emergency and we have to maintain these benefits. it still requires our attention and swift bipartisan action. and to the senate's credit, there has been bipartisan acti action. thanks to my republican colleague from nevada, senator dean heller, and a coalition of 10 u.s. senators -- five democrats and five republican republicans -- the senate passed a five-month extension of these vital benefits that would provide aid to job seekers that have been searching for work for more than 26 weeks. senators on both sides of the aisle recognize that this is the right thing to do for workers and the smart thing to do for our economy. and so the senate responded and

found a path forward. and it was a difficult path. majority leader harry reid dedicated a vast amount of floor time. our bipartisan coalition reached a true compromise and stuck together on vote after vote after vote. and on april 7, 43 days ago, madam president, the full senate approved the measure. unfortunately, speaker boehner and the house of representatives and the republicans in charge there have refused to take up our bipartisan legislation or pass their own extension of these emergency benefits. because of their obstruction, millions of americans are hurting. madam president, we need to get our country back to full employment. that's the fundamental answer. to place people in jobs. we have to move the country to a place where all americans have an opportunity to earn a living and build a better life for their families.

some may be tempted to look at the latest unemployment numbers and say, well, see, ending jobless benefits is -- is working because the numbers seem to be falling. but that notion is simply not supported by the facts. this long-term unemployment problem is still, as i mentioned, of significant proportions and those are precisely the people who benefit from extended unemployment benefits. a recent study by the illinois department of employment security found that 4-5 illinois workers who lost long-term unemployment benefits at the end of last year were still without work two months later. they are still struggling in a very difficult market. and i agree with the director of this state agency, who says -- quote -- "economic conditions should determine when this safety net program ends, not an arbitrary date on the calendar." and the economic conditions for the long-term unemployed are still perilous, it is still an

emergency. the peerk's refusal to re -- the speaker's refusal to renew emergency unemployment insurance makes it even harder for struggling americans to feed their families and it does nothing to improve our economic outlook. the senate-passed bill was fully offset and included, in fact, deficit reduction. so the idea it was too expensive just doesn't hold water. the fact house republicans are moving $300 billion worth of budget-busting tax breaks, many of which flow to corporations, but refuse to renew emergency benefits for job seekers strikes many people, including myself, as not just an unfair double standard but it's an -- it's out of step with what we need to do to get this economy moving forward. let me again remind everyone, we had a full-paid for unemployment extension bill on a bipartisan basis that actually resulted in some deficit reduction, and the house has

refused to take it up. but in the meantime, they have passed $300 billion worth, over several years, of tax cuts and tax breaks which flow to corporations, all of it unpaid for. so for the sake of job seekers and our economy, i hope house republicans will stop obstructing emergency aid to job seekers. they need to take up the bipartisan senate agreement to restore these benefits and work with us on strengthening our economic recovery. just give the bill an up-or-down vote. and give millions of american job seekers a chance to get back on their feet. in fact, i'm confident if there was an up-or-down vote, it would pass the house. it is fiscally responsible, fully paid for, and provides assistance to people and families who desperately need it and would help the economic climate in every state in this country. now, they can attach measures to the bill if they want,

that's their progress are tiff. but let's go ahead and get the bill passed and if we need to resolve between the house and the senate let's do so. refusing to vote is irresponsible. the american people deserve better and i hope they will see better in the coming days ahead. with that, madam president, i would yield the floor and by also note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: .

quorum call:

the presiding officer: without objection. mr. reid: madam president, on behalf of senator johnson of south dakota, i ask unanimous consent that karish nflt a patel and dan fletcher, detailees on the banking committee, be granted floor privileges for the duration of today's session. the presiding officer: without objection. mr. reid: i now ask unanimous consent that notwithstanding this previous order, today at 5:30, the senate proceed to executive session to consider calendars number 521, 622 and

765, that the senate vote on confirmation at that time on the nominations in the order listed, that there be two minutes for debate prior to each vote, equal and divided in the usual form. a roll call vote following the first in each series be ten minutes in duration. further, that if confirmed, the motion to reconsider be considered made and laid on the table with no intervening action or debate and that no further motions be in order to the nominations, that any statements related to the nominations be printed in the record and that the president be immediately notified of the senate's action following disposition of the nominations, the senate proceed underunder the previous order. the presiding officer: is there objection? without objection. mr. reid: madam president, what this means is that tonight at 5:30, we will have as many as five roll call votes. some of those votes would be confirmed by voice, so we'll wait and see about that. so there would be maybe only two roll call votes on confirmation

of jeffrey costa to be united states circuit judge for the fifth circuit and cloture on stanley fischer to be a member of the federal reserve vote. i now ask unanimous consent that notwithstanding rule 22 and the previous order, that if cloture is invoked on calendar number 768 which i have just talked about, that's fischer, on wednesday -- on wednesday at 12:15 -- that's tomorrow -- the senate proceed to executive session and all postcloture time be expired and the senate proceed to the confirmation of calendar 768, that's fischer. further, that following disposition of calendar number 768, the senate be in recess until 2:00 p.m. that at 2:00 p.m., there be ten minutes for debate equally divided between the two leaders or their designees prior to a vote on cloture on the nomination of barron, calendar number 576. further, that if cloture is invoked on thursday, at

2:00 p.m. all postcloture time be expired and the senate proceed to vote on confirmation of the barron nomination with all the remaining provisions of the previous order remaining in effect. finally, that following the cloture vote on the barron nomination, the senate proceed to consideration of calendar number 773, cook, 775, green, 774, daly and 775, martinez. that further there be two minutes for debate prior to each vote equally divided in the usual form. that any health care votes following the first in each series be ten minutes in length and motions to reconsider be considered made and laid on the table with noint intervening action or debate, that no further motion be in order to the nominations, that any statements related to the nomination be printed in the record, that president obama be immediately notified of the senate's action. the presiding officer: is there objection? without objection. mr. reid: with this agreement, madam president, on wednesday, we expect one roll call vote at 12:15 on confirmation of fischer, and as many as five roll call votes at 2:10.

we hope that all four of these votes will be by voice, but again we have to wait and see. the presiding officer: under the previous order, the senate previous order, the senate story set

the stage for november and who controls the u. sena joining us on phon joining us on the phone is saissam young men a politicalhe" reporter with the lexington herald to talk about the primary suspect the race for us today. >> guest: sure. well i think it is sort of anti-climactianti-climactic afte solvafter what we sawthis fall. we were sort of expecting the businessmen who was challenging the senate minority leader mitch mcconnell. it was more of a heavyweight challenge for him which might have been a fair expectation given that he is a first-time candidate. mitch mcconnell made the decision after watching the first tea party of 2010 when rand paul picked the successor.

he watched firsthand and prepare accordingly. so, when he got in the race at the end of last summer, he was prepared and i think what we are seeing today are the fruits of that preparation paying off. >> the polls show that senator mcconnell has a 20-point advantage heading into today's primary. >> what it really comes down to tonight, and i guess at this point i would sort of cover my bases and say that you can ask the president if that has happened but every poll that we have seen shows senator mcconnell the request now what becomes the margin. he is walked in a dead heat with the nominee. so we will be looking close to see if he has a problem and whether or not the republicans how many of them are and how big of a problem that is going into

the fall. >> host: how do you decipher that information what you are looking for? >> guest: i've heard numbers ranging from 33% to 40% but put mcconnell in a danger zone aiming that he would really struggle to win back the disaffected republicans and he needs them all because she really is running in the wave i don't know if it is enthusiasm for the campaign or if it is the discontent for a five term incumbent. so we will be while chained to margins closely. the one thing i would point out is after that primary, which was very contentious i believe it was 41 per cent of republican os said immediately after the primary there is no way they would vote for rand paul ultimately 91% voted for him, so it is going to take some work on his part but i'm not sure that

it's a mountain that he can't climb. >> host: what about the outside groups in the primary but as a general election a lot of people are already looking to november. >> guest: i was with senator mcconnell over the weekend and he kept saying this will be the most watched race in the country and he seems to be right. outside groups think it could be between 75 to $100 million making it the most expensive race in the country and, you know, i broke the news yesterday that the two groups, the 501 c-4 and the super pack that are aligned with senator mcconnell are putting $5.2 billion starting tomorrow, so i think what you are going to see is the race is going to accelerate starting tomorrow. the fall campaign will start monday. >> host: what does mcconnell look like as well as his

opponent? >> guest: he has a reputation and this has been no exception. he's raised over $22 million as the last report we got in april fundraising report he had a little over $10 million left in cash on hand so this primary has cost him considerably though they would say they've been able to put in a lot of infrastructure that's going to pay off in november. alison grimes has also proven to be a fantastic fundraiser. she has raised close to 8 million )-right-paren $5 million cash on hand. it's unlikely whether she is ever going to catch the advantage that she has certainly proven she can write enough to hang in there. matt really struggled from the beginning to raise money. he put initially $650,000 of his own honey in wheeler and he putt another 350,000 in april and we will find out after if he ended up putting him anymore.

he was very much overwhelmed by the cash advantage at the same time he was a better funded challenger. if you go back to 2012, richard murdoch at the primary spent about 2.3 million. so, this p. bevin hasn't had enough attraction to go with it. >> host: appreciate your time. >> guest: thanks. >> again we will have the primary results from kentucky and other states in the races today as well as victory and concession speeches later today on c-span. >> what i'm trying to say is fraud tools and it is nonpartisan and we've got to do something about it. we do not have unlimited budgets

into the money gets wasted on a building that is never going to be used. it could have helped some people here in the united states and you keep seeing this again and again and again. i am very proud to work for this administration, and i think it's important that people realize is appointed by the president and the inspector generals are independent. it's important that the people see that the government does care and there are a lot of people in the adb and the state and the pentagon that care about wasting money. at the national press club in dc on friday the american legion announced a military

workforce partnership that will help returning servicemembers find private-sector jobs by turning military training into professional certification licenses. stephen from the american legion explained how difficult it is for servicemembers to transition to the jobs because of translation issues when it comes to describing the skill set from the military to private-sector employers. this lasts for about an hour. >> ladies and gentlemen, welcome to this sponsored by the national press club on finding employment for returning veterans. this is one issue that all americans agree upon. usually we speak on subjects in which there is a great divisiveness. finding employment for anyone especially returning veterans is one that we agree on. we have two gentlemen

who will discuss this issu issud are very credentialed. we have steven gonzales and the american region and he is the deputy director for the legions veteran employment and education division. he's worked with members of congress and the executive branch. he's worked on very positive legislation such as the veterans opportunity to work, the veteran bills skills to jobs at, military commercial drivers license act and executive order 13607 establishing principles of education for educational institution servicing serving veterans, spouses and other family members.

bill is a former marine, formerly with the air force, a retired air force colonel who spent much of his life on the very subject of which he is discussing today, credentialing. bill is worth solid llc. i turn the program over to you. thank you. >> thank you for the opportunity to actually speak to such an issue that has been in the works since 1996. it's something that the american legion has actually been working on for quite some time and trying to assess individuals

experience his expertise, skill sets, education and how do you transition those particular portable skill sets to allow the individuals to find employment. let me give you some quickly numbers on fy 12 on the unemployed benefits as some people believe it does not impact multiple or broad spectrum's of what's going on. i know a lot of people talk about the military readiness and how do we improve the readiness and one of the things i want to highlight is the 2012 a total of $6.5 million of unemployment insurance benefits are paid at e individuals based on the military records. this was done through the state submitting the amount of compensation what is considered

by the department of defense paid by the state to the federal government and the former employee military service purdy much pays this particular amount of money through its operating budget which as we all know operating budget affects the readiness of the respective service branch. according to the recent report from the center of the naval analysis and veterans on employment, transitioning marines in fy 11 to give you a small spectrum of what is being paid this is prior to the big drawdown that we are expecting in the society as a community the army had 102 applicants into these 10 102 applicants that are inflated, it costs $515 million in unemployment benefits. the navy had 31,000 plus applicants at the cost of 174 million. the marine corps had 29,000 of course being the smallest branch

of applicants unemployed and it was a cost of up to $185 million. unfortunately in the air force they did not release the numbers prior to the report being released so the numbers for the air force were not available at the present moment in time. let me also give you a couple of initiatives where again, once again, some people believe that it is undermining and it is not their and pretty much want to let the waistline but the stakeholders have come together because again this particular importance of not just having the impact of how do you help decrease unemployment find veteran employment but also how do you increase the workforce and allow for companies and industries to access a lot of these skilled workers who can help with our economy and help our economy not take away from that economy which none of us have served wants to do that.

there was an initiative taken upon the american legion and collaboration in the u.s. chamber of commerce which is a company that bill works for that as well as the standards institute were better known and has ansi. we took the initiative of bringing state coders together we had a 250 people. having this in particular allows for individuals to no longer have their silos in initiatives. having individuals come together to figure out what was the initiative and what were the barriers and the solutions and what were some of the best practices whether you are private or public partnership actually coming together to figure this out how to move together moving forward. now i will take a step forward on the initiatives that have been undertaken post the summit in 2012 working at the

department of transportation, what is the particular omnibus bill moving ahead with progress in the 21st century or the map 21 includes the federal railroad administration federal highway administration has come together with the department of trade petition to conduct the study and report to congress the differences between military and civilian licensing. to fill the gaps but also to ensure that the department of transportation who has a big jurisdiction over transportation logistics to work with the department of defense to figure out whether or not how you bridge the gaps, how do you work together for the end goal of finding employment in strengthening the workforce. you have also initiatives in the department of energy and the national institute of the building sciences. they are convening industry subject matter experts to come

together to develop outline for how to acquire energy efficiency workforce certification programs and i would like to bill discuss that more since he is heavily involved through this particular initiative and the department of energy. the military assistance program is meant to help map out the credentialing programs to help identify the gaps and fill the gaps with the training needed in the proper credential. you have also senator mccain who yesterday introduced working with many other members in congress who see this as a bipartisan issue worked together to introduce the improvement of the troop or the credit act of 2014 in which this particular act would allow the facility to service members to transition into the civilian workforce by

allowing the members in the armed forces to obtain the credentials while active-duty service is expanding the tuition allowing them to use the tuition assistance for those who are looking for the credentials but also that would allow for the military as a force enhancer to allow them to increase the job performance in th and the workfe and also increase and improve the readiness within the actual military workforce and of course as we know we can buy weapons and all the fancy new toys for the military but if you don't have an educated workforce demand the systems they are just as good sitting in some block off of the east coast if you talk about the navy. this particular piece of legislation improves and of course the other component is making sure that the quality of that credential is not compromised and ensuring that the credential is meeting some type of standard comment meeting the standards that pretty much

industry needs but also that those particular skill sets have the demand for it but also the industries recognize them and od of course it ensures the industry has a say in this that we do accept this and it's not a fly-by-night credential that was just developed out of the blue because of access of certain types of funding. last i would touch on working with solid and the national governing associations the center for best practices who november 2013 convened the officials from the six states in illinois, iowa, minnesota, nevada, virginia and wisconsin who were selected as a part of a pilot program to participate in what they consider to be veteran licensing certification academy and to assess and look at the actual industries within their

respective states and figure out what are those gaps and how can the states but also a particular stakeholder how do you actually help with that and fill in those gaps and of course by doing so that would allow them to transition out of it again as a pilot program in the different states with different needs it also allows us to look at what are the best practices, what are we still missing, what are the components they might be missing to give to the states and by doing that allows us to take the particular program and make them sustainable and put them on a scale so all 50 states can actually run and operate some of the particular programs in general. i won't let go discuss the other key talking points. >> thanks to the press club for allowing us to come and talk about this topic. it something that the legion has

been very engaged in and we appreciate them taking a leadership role and including us in the discussion. in talking about credentialing and earning justifications for military members at kind of a new topic. the general discussion that has happened going all the way back to world war ii is always more education focused and certainly a great education target. military members and the g.i. bill and the tuition assistance which is fantastic programs for military members and steve took advantage while inactive duty to help her formal education through the higher education institutions. credentialing cells and other role in what we are trying to do is open the other pathways and create another direction for

those. not everyone is going to choose that path would we do have is a lot of soldiers, sailors, and then and marines. it's really a state-of-the-art and it doesn't matter. if you look at some of the multitudes of job titles that are contained and obtained by military members comments you see that it's an expertise that fits into every city in the state and community around the country. they are certainly the most captivating up front and those army of one type of folks we talk about the incredible skill sets beyond the beyond of their

operational nature. we try to create a pathway for the servicemembers to urban. the department of defense and labor. we are skiing for the first time a lot of inertia gain from all of these coming together through some of the legislative initiatives that are being talked about. it's pushing the department of defense and the department of labor. we have this pathway. it serves a couple of important roles. it is difficult for the servicemembers particularly the junior servicemembers over the past few years in the difficult economy.

they were talking about the folks that are due the fourth to seven year group that have their technical training and to do their fantastic work in the military. this has come out and suffered some high numbers of unemployment in the past years. 22 to 24% by some estimates. the department of defense has an interest on this as steve was talking about some of the numbers are numbers referring to the pershing and aggregate in a billion dollars even in the dod terms that is big money. the data being the case if we could create a pathway through all of these efforts in the state, local, federal government as well as the industry creating these quick entries recognizing

the training for the credential through the certification and the license and the military members to be able to jump into, we might be able to make the bird in a little bit less. men and women have families by the time they get out of the first to her. sitting on unemployment for an extended period of time isn't a drain on the budget but on the morale and misuse of the federal workforce. our general american population workforce. how can we get them more engaged when they want to go home and find a job? of these translator translatorse found is the certification and licenses are a language that everyone in the human resource officers industry in this. they understand what the certification means. what often happens with that era man and sailor folks after 20 plus years i was indoctrinated into the military culture an in

speaking thus speak that we had within the uniformed community translating that become difficult. what we were talking about even before the briefing this morning we don't have a high number in the country anymore. fewer than 1% of the population, much less than 1% of the population is actually wearing a uniform. it is a big shift from what we saw in the vietnam generation certainly back to the world war ii generation. we have 7% of all americans that are veterans. that is a very small number as well. where we used to have people very familiar either they served in the unit for or their brother, sister, mother, father someone served they were familiar now we do not have that

exact and direct linkage. so when they go in and they talk about what they've done and they have a hard time in that first term of understanding what the business model might be for the experience in the training that they have, they are not able to maybe articulate it as well. everybody wants to hire veterans into there is a lot of will. there is a lot of companies that won't hire. what we have seen is a communication gap so by helping the servicemembers earn a certification in the very thing they have been trained on and have gone through incredible technical training they carry with them the experience that is the hiring authority that the certification kind of validates their technical capability. they say okay i don't understand what you're saying that you did but i know what that's certification means. i know what that license means

and you are bringing something to the table that will help our country. so that as a translator and the dod is interested in doing this to save the unemployment part as well as doing the right thing for all of us at some point. i see folks in here that i know that served previously at some point we changed our uniform from blue or green and moved into a coat and tie in hard hats to work in a different capacity so that translation helps. this helps more than just the transition point. steve made reference to it in his talking points about the fact that we see this enhancing and professionalizing the military workforce as well taking these best practices and ideas about what is going on in the industry can do nothing except enhance the workforce while the service member is in

uniform bringing these new ideas into couple and link with the very things they are learning as a technical expert for the military operations with course there are things the military does and there are things the civilian military does and doesn't do however, that middle portion can link together through the certifications and we can bring both sets of experiences to the military and into the civilian world when the member leads into separate. so, the congress has taken notice of these as steve made reference to the authorization act over the past two years included language that inspires the services to take a look at the credentialing potential to implement these programs. is it something that is obtainable and they've been investigating these and taking the steps into the credentialing business to see if it is something that can be rolled out into the services. the good news is that there's

already been a lot of talk. at the army into the navy for a decade have been discussing credentialing and do so has the air force in certain ways, not in a broad way, but the arm thed navy established programs that can be found and i will give you some links to see them. they are called navy cool the stands for credentialing online. maybe cool is the same thing, this deal by www.cool.navy.com. those are first and foremost informational sites for the service member to be able to go in and look at what is content online that the army and of any beast that up over the past few years as a way for the service

member wherever they might be. either deployed overseas, shipped to back out of the home station, to be able to walk on o aan old in internet connectivity and get to the site and search the military occupational area maybe it is the air force special code army and marine corps specialty. they can loo can work for the specialties and find it and then they can look at what through the database is linked directly to the skill related industries that are out there for them to pursue that today might be part in the service. even bigger then towards the credential certification licenses that are related to this the entry criteria to get in is closely paired up with the department of labor system where

you can see the linkages for hiring ability and what is predicted. so these are great information services. it's also for those i was talking about earlier. they can go and look through this information that's starting to come forward where they can say okay i run an engineering firm. what's military occupational areas are related to what we do. they can search and put in the industry and look and see what military occupational codes are available and have some linkages. so it is a great information or both servicemembers into the civilian population to look at. as i said that the navy and the army armatures during the program and the marine corps soon will be doing the same thing trying to provide this information. the navy has been able to take

the next step and that is actually to find funding sources to help. over the past six to eight years they've been in the range of the 40,000 that they've been able to help with some sort. again this gives them something in their back pocket for the transition as well as it brings the wealth of the information to the navy to the folks that are the certification. so it is a good push and a positive thing for both the military service into the individual member into the industry. we see this all kind of wrapping together. if an industry leader and official were going to go and look for their particular area. when they look for the titles that is for the enlisted personnel. the navy has over 420. the range is amazing. it's things people don't look like associating in the army or

the navy. the army alone in the 400 you have the air traffic controller equipment repair took clarinet player to the combat engineer to the drillers and working dog handlers. a pretty wide spectrum and that is just grabbing a few out of their. of the navy again has aircraft catapult technicians, underwater construction technicians. again, you are talking about so many skills, technical skills that can be brought to bear. linking them up and pairing them in the credentials and certifications in the related industries would provide a great benefit coming back to the navy or the army as well as tw to the member. so that is where we see them standing and we are quite optimistic about the future because of the discussions. i will turn the microphone back

over to him, bu that he talks at some of the protections and i think that he was going to expand a little bit more about those two make sure that we are protecting the credentials and the servicemembers while they pursue them. so i think i see a very positive momentum moving behind this and a lot of great talk and good work being done by the services that going to do the return and good things to help clear up the pathway for the credentials and employment. i will turn it back to steve to talk about these other pieces. >> as though he limited to, all of the efforts that have occurred in the initiatives through the stakeholders whether we talk about the states, national industries, academic or academia in general, when you talk about the different stakeholders if you ever get a chance i don't know if we have some representatives here if

they have it on the site it creates an interesting flowchart. and within the chart that shows you all of the different stakeholders who have a piece of the action when you're talking about some type of credential and when i talk about the credential, it is irrespective of the credential when you talk about it you talk about the certification. it's all considered a form of a credential. and you can see who has some type of involvement whether it is a small piece or whether it is a large piece who is involved in this whole complex conversation issue. now, they're moving forward. we are helping the economy into the workforce into the industry, but the other component of the

piecepeace, and again going baco what bill said how do you ensure that even though you are expanding, whether you are putting more funding and shoring that the quality of the credential team by the servicemembers is accredited irrespective of the credential that again goes back to the certification degrees and diplomas that is offered with certain core elements of the quality. you talk about the competency and the base process. you talk about the credentialing that should be based and dave are dead from the industry needs and should include the structure process to identify the knowledge of the skills and attributes from the specific job function, competency in the building blocks into developing the training certifications. so you want to make sure again that the industry is working

with the bodies and ensuring that they are meeting some standards. we are not creating something that you created and we are not creating something to fill up the bottom line as we see in the past where we see the individual institutions create something not because it wasn't the best interest of the workforce or because of the bottom line. and that is something that as we move forward whether through the legislation or policy making or to just looking at what is the best interest again in the national veteran servicemembers but again as for the industry workforce. it is for the best interest of the economy. that is the picture that we have to never forget is how do we improve our economy. and i see this very, very honestly. we encountered this in world war ii, 1942, 1945 where the g.i. bill was created for a certain reason for the readjustment of

the servicemembers coming back and 32% of our population was serving at the time, but again, you encountered which the world war i veterans i think had a good understanding of the will never make sure that what happened with world war i veterans happened in the world war ii veterans, but you have had a fragile economy that if we have done 13% of the servicemembers who would've transition to become veterans to the fragile economy, we could have broken that economy. in turn we actually helped create a middle class and what we do not want to do now 70 years later would be the largest time that we have seen in history that we will be the match saying to the society here you go, society, here is a veteran after 14 years of fighting in the war in a fragile economy that is something that we don't want to do and again it goes back to the whole concept of what happens now will impact of the department of defense and as you know, the economic

environment, the department of defense is pretty much worried about the readiness. we are all worried about the readiness, not the defense and this can either help or break that as well. so i will make this really short with added that as we move forward we want to make sure the quality of the credentials being obtained are meeting the standards necessary to allow for those individuals to find employment, find the right and claim it and find the right skill set for them to be able to get employed. and i will let bill close out pretty much ende and then we cao to the q-and-a. >> i want to say thank you for your interest and in the topic. it's something that kind of flies under the radar of little did we see the unemployment numbers for the veterans into the conference to hear about offers for work trying to draw that bridge and pathway into this is what it is all about the just developing some interest in

general discussions in the public information and awareness of this i think is worth the time. so, thank you for coming out and for paying attention to it. it. >> thank you very much both of you. with that. >> i am a freelance journalist and i'm a member of the press club. you mentioned the term fragile economy. obviously it includes that was not only veterans that everybody. what steps would you like to see to improve the overall economy class. even though the economy does get an improved you have to remember to take this into the servicemembers in general that are transitioning their our

particular jobs and occupations. it doesn't matter how much the economy improves if they do not have the right skill sets when they transition it will still be difficult for those individuals to find jobs with a case in point. if i am in the air force and i put the bombs, i put the bombs on 13 i don't know where you are going to find that job. if you are a sniper and i would say that because i was in the infantry in the marine corps and it was not an easy transition for me. what do you put on your job resume? for me the economy can get better but if i do not have the right skill set that is portable enough that would allow me to find employment when i transition out, the job search would still be difficult for individuals. when you talk about the army and the marine corps, double of what makes up the two services are combat arms and the individuals who have a harder time finding employment, and i will say the

reports that i named earlier in ththe center for naval analysis which did a survey mostly about the marine corps found that those who served in combat arms have a harder time finding employment because of the less portable skills that allowed them to have the more seamless transition into the workforce where those that have a certification credential for example in the license were easier and employment or any other airlines in the world so that economy can improve but again the concern is for those that do not have the right skill sets and have the portable skill set how do you still ensure that they can have the right skills to have the opportunity to be just as successful for those that are already arguing the

skills. hopefully that answers your question. >> one thing i want to follow up on you can see in the job that he manages for the area can be jammed his significant education and employment programs, comprehending the legislation and i don't think it is absent and awareness of the skill sets that he obtained during his time in the marine corps. the combat arms and military occupations that we are talking about are more difficult because there is not a direct linkage. what we talk about in the program i was referring to earlier had been enabled of the certification discussions are skilled linkage is not just direct job to job because sometimes as the earning license is to be able to work on the

aircraft and air force or the navy is a direct translation to a job in the civilian world and there are certainly a lot of members in uniform that can do that but there are a lot of skills and every different occupation including those in the combat arms over the seas that we know many of them to leadership and the teamwork, the dedication duty there are certifications that come with the managerial focuses that can attest to the skills, exam, awareness that can bridge the gap again for the truth to be able to say i bring the skill sets. the army had a great advertising campaign and still does and if you look at that independent soldier and marine that is out in the field, they have incredible skills to go along

with putting their weapons together and doing their operational needs. but they bring these other skill sets such as those to bear that they might be able to earn a certification without too much training to help and your question specifically about what would i see the changing economy and the fact a lot of people have that silver bullet today would be able to offer i'm focused on a small subset of that economy, so i do not feel qualified to answer that one but what i would like to see is this marriage between the industry and the skill set of the members finding easier ways to bridge the gap so we don't have the long-term unemployment. we know the industry has gaps and we are hearing from the groups in the energy trade for instance where they cannot find enough people and we know that skill sets are there within the military organizations that if

we could get these out of the way they would be able to fill those pretty easily so that's something that we are targeting our work on and i thought there was another question back there. >> kind of along the same wine in the marine corps and more specifically the skills are not translated in fact you can't do that if it is in iraq and afghanistan and translate that back for good measure. and i'm just wondering what is the light at the end of the total or that 10% of the marine corps or even more for the army particularly in the infantry the folks that are more likely to have the injury is associated in the service and more likely to

have mental health service rated disabilities that are higher, what is the light at the end of the tunnel and what are you all looking at with regard to the population as opposed to say the core of it becomes that ent were things like that. >> i will say from the american legion we work in collaboration with all stakeholders. again, the national governors association and the department of transportation we would take that to consideration so that when we do the mapping and as you say i am pretty sure that bill can talk about that because he's more of an expert of the whole aspect of it but when you do the mapping is in many cases a lot of the collaborations are linked when you talk about the department of transportation issues you try to have a public

private partnership where for those individuals that need to be retrained or given an additional skill set, then those programs are in place to help those who maybe might want to go into the energy sector or manufacturing. even though you might not have all of those skill sets do you have the aptitude to get into the programs and of course while they help you train and acquire those skill sets so we look at it from both and again we are looking at it from trying to be very proactive so prior to even transitioning can we help you in the military and that is why senator mccain and our organization introduces legislation to help expand and how to assist in supply. how can an individual take advantage and how can an individual go from their benefits because it has to be to benefit kind of the services have to get something out of it and what they get out of it is

up performance and an enhanced readiness in the service. what th the service member deats is access to media right now i'm not ready for college but what i am ready for is a credential. i'm ready to get my license and to get a certificate. whether it is it or something in that field where i am able to get something now because right now i don't think that i'm ready you were in the combat arms as you do know as well as i do when you are at a higher temple of deployment or i don't have time to go to college, i don't have time to go to school. that isn't a part of my daily agenda where someone that might not be as high in the deployment especially when you are not in any type of the regiment you might have time to go to the community college on that military and it's a perfect example where we are stationed. they do have campuses, but guess what i wasn't able to go because

when you are in the deployment in the field of two weeks out of the month. it's doing something other than having the opportunity to get that additional skill set to have a skill set at a quicker pace so that when you do transition you have the g.i. bill or hopefully the g.i. bill was created to help you readjust to society so we are looking at that again and those that may be nice not have the skill set that if they do have the aptitude to at least learn the skill set than those initiatives will help those transition to the new profession if they choose. >> i would just add to that certainly is a bigger question compared to the other multitude of occupational areas. the bigger question is how do you draw those skills. there were other things he was

doing in the preparation as you probably did and you certainly did there's other things you are doing in preparation that developed the skill sets that allow you to eventually where you have to find your own path. i think it is a less defined path for the infantrymen unless they have to do a little bit more searching of what am i doing. it's something when last year the department of defense did a report for congress on the feasibility of aligning with credentials and certifications for all the military personnel. it's something that they said okay we see where we can do alignment with these directly linked and correlated jobs and funding sources were always difficult. the dod budgets get cut and these are the kind of things that are hard to pay for for the department of defense. they have to choose the operation. it is a tough call but they are

trying to find ways and they have circled. let's really dig in and look at what the skill sets are that these men and women mostly primarily men but soon-to-be women it looks like in the future have that we can bring to look and marry. there are industry leadership groups. the constructs in focused jobs. there are a lot of state focused initiatives and industry focused initiatives saying we see the valuable attributes that these combat arms former members are bringing and we now need to look at how we can map out. ..

. >> you might be, you know, you might be qualified to be an lpn, you might be qualified to do something else in the medical field where it's not just let me stamp you with an emt and send you on your merry way. this is how in many cases institutions of higher learning have become involved with the whole mapping process from a academic or institution of higher learning. and, again, this all goes back to how institutions of higher learning and not just community colleges, but overall, how they also have a role in why they're considered a stakeholder, because they do play a role in many cases where you have to have a degree before you can sit for your nursing license. and that's one of the prerequisites. and i will assume many states or in all states, so they do play a role, and what they're doing is

helping us and helping dod or helping all the other stakeholders, how do you map that. and also how do you interpret what you've learned. and how do you apply that to what you want to become when you get older or when you grow up. >> just to follow up with steve's comments, there are -- i was mentioning the cool database. in that database, we have collected over 4,000 certifications, licenses that are out there. about 1600, i think, are mapped to navy or army occupations. what's great is when you go in and look at these, it'll lay out what the certification requirements are. what are the eligibility factors, what are the exam to cover the certification gonna, you know, be tested on. so the soldier, sailor can look at that, look at their own program instruction to their technical training and assess

where there is a delta, where there is a gap that they need to -- a lot of times the community colleges are filling the role of providing that gap training, and there are a lot of them where they can earn an associate's degree. we're working with the air force now. the air force has the community college of the air force which is a degree granting community college. and it actually is an accredited degree-granting institution that every airman when they finish their tech school, their tech training -- just about all of them earn an associate's degree. so they have that to help apply towards if there is an education, associate's-level education requirement, they'll have that attained. they'll have that in their pocket. the other services are looking to do the same types of things, to make sure working with the community colleges they can pair with them and get the necessary education to do it. and just one example among many

that comes to mind right away is at the u.s. army military police school in fort leavenworth, kansas. they've been working a pilot study. every state has its own licensing requirements for peace officers. there's a natural transition there that you would see. military members going into being police officers. a lot of community and state, local, federal police agencies would like to have military members. what they're finding is that, of course, every state has its own jurisdictional issues. you have a range from some states only requiring 300 hours of training to some states that have 1200 hours of training required. and then, so what the army military police school has been doing a pilot study saying, okay, let's shoot for the key requirements that are necessary to earn, they're located in missouri, how can we get our soldiers in this schoolhouse licensed to be reciprocal

licensed by the state of missouri? and they found pathways to do that. some of it required working with a local community college and developing a curriculum that taught to specific use of force things that were missouri-specific. and that's where each state can help develop that kind of bridge program so that the service member doesn't have to complete the whole thing. they have, you know, 80% of the work already studied through their technical training. but that limited scope can be awarded through, additional training can be done through the community colleges. so they can be a gap filler in a lot of ways. >> thank you. >> yes. >> i have a question. after your presentation, do we have any barometer or actual statistical data? i doubt that we do, but do we have anything to show the effects of these programs and how many personnel have actually

been able to place? [inaudible conversations] >> i'm looking out in the audience because we have a subject matter expert, a couple of them. i don't think that we have any real hard data on that. lisa, did you know of anything? >> [inaudible] in the process of doing exactly that for the navy's credentialing program. >> right. you mentioned 40,000. >> yeah. and, actually, a bit different than the study that steve was talking about, but this is going to look at, it's going to track sailors who have gone through, gotten their credentials and see what it's done for them both while they're in the military and after they've left the service. that'll be the first of its kind, and it's be very interesting. >> it'll be a first aggregate study kind of looking at this. we have many anecdotal examples of success, but this'll be the first comprehensive kind of look. it's navy-specific. i think they're looking at just those sailors who have been able to participate in some of these credentialing programs.

so there's not a lot of evidence right now that's established other than anecdotal. there's a lot of confidence that it works. now we're going to see. >> yeah -- [inaudible] >> okay. with that, do we have any other questions? if not, we very much want to thank you for coming. i think we've learned a lot today, and good luck. right on. thank you. [inaudible conversations] >> well, senate democrats are meeting for their weekly party caucus lunch. republicans will host their weekly gathering tomorrow. senators expected to return at 2:15 eastern for more speeches and votes expected around 5:30 on judicial and executive nominations. we'll join the senate when they gavel back in here on c-span2 and, again, that'll be at 2:15

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>> c-span2, providing live coverage of the u.s. senate floor proceedings and key public policy events. and every weekend, booktv. now for 15 years the only television network devoted to nonfiction books and authors. c-span2, created by the cable tv industry and brought to you as a public service by your local cable or satellite provider. watch us in hd, like us on facebook and follow us on twitter. >> and once again the senate set to gavel back in at 2:15 eastern for more general speeches, votes on judicial and executive nominations coming up at 5:30. we will have live coverage. right now, though, a discussion on the concerns over middle east respiratory system or mers and whether it's a threat to the u.s. from today's "washingtonntin journal."

>> host: michael bell is joining us to talk about the mers virus. dr. bell, what is mers? >> guest: mers is related to the sars virus that spread throughout the world several years back. it's a virus that is normally an animal virus that can spread to human beings, and when it does, it can cause in some people a severe respiratory infection. >> host: what does it stand for? where did the name come from? >> guest: mers stands for middle eastern respiratory syndrome. the arabian peninsula is significantly affected by the virus. we've seen a lot of cases throughout the region. there seems to be a link with camels, although that's not completely pinned down at this point. that is an early clue that might be part of the animal pathway. >> host: why would that be the source? is where else could the source come from? >> guest: you know, it's interesting, when viruses get into the human world from an an

maul reservoir -- animal reservoir, the path can be mixed. we saw with sars that it seemed to be the original source that was getting into human beings that way. with other infections we've seen bats be a source, an original source, but not necessarily the direct source. we've seen bats transmit the infection to pigs or horses, and this is not mers, but with other viruses. animals in between the original source and humans can be part of the pathway. so it can be very difficult to pin down. >> host: dr. bell, how is it spread? >> guest: well, what we know so far is based on early and limited information, but what we can say for sure is that it doesn't seem to spread from person to person very efficiently. in other words, it doesn't spread across a group of people like chickenpox in a summer camp. it's not like that. instead, it seems to be related to really close contact with somebody who's actively sick. so people who have taken care of

a sick family member, people working in health care settings. those are the folks that we've seen have secondary cases. >> what are the symptoms? >> guest: mers causes a very generic-looking respiratory infection for the most part. so cough and fever are the top of the list. other people will have, some people will have a bit of a runny nose, some belly complaints, headache, that kind of thing. but nothing that would distinguish it just based on symptoms alone. >> host: if you get it, is it fatal? >> guest: no. a few people have died. well, more than a few, actually. the people who have died tend to be older with other diseases, whether it's diabetes or heart disease. these are people who for any infection are at somewhat greater risk of having a bad outcome. the majority of people have a mild or moderate respiratory infection, and they get over it. but we are concerned about the fact that some people have died, and those people are certainly

at risk. >> host: this is a headline in "usa today": mysterious mers third case brings more questions. where is, where has it been found in the united states and why? >> guest: so there are two cases that were imported directly from the middle east, and those individuals arrived home in florida and in indiana. the third case is actually somebody who had face-to-face contact -- a business deal, actually -- with the indiana patient right after they arrived back in the country. that person just had a mild cold, but because we've been very, very careful about tracing everyone who might have been exposed, this is behind the scenes that no one ever really gets to hear about. but when something like this happens, cdc mobilizes a tremendous amount of personnel resources and communications resources to make sure that every last person who is sharing

a flight or, in the case of the indiana patient, a bus gets identified and tracked down and alerted so that they know that if they start to feel ill, they need to take it very seriously. and then if they'll allow us, we also do some testing. and in the case of the business colleague, we did an early test, and it was negative. but then a follow-up test ended up turning positive. so it look like he was exposed to the indiana patient, became mildly ill and is now doing fine. tracing him after he turned positive was yet another piece of that work. >> host: so for this illinois man that had just a cold, is he a carrier now? does he have it in his system? and could other people contract it from him? >> guest: so that's why we're so careful about tracking everybody down. what we don't want is multiple people to start new chains of transmission. while you're sick, it's obviously possible to spread the infection to other people just like with a lot of other

respiratory viruses. but again, like other respiratory viruses, once you're better, you're not a carrier anymore. >> host: so talk about the cdc mobilizing your resources. have you been able to track down everybody on the flight or on the bus? what kind of reaction do you get from people when they hear from you? >> guest: so the impressive thing really is not only that we track down everyone -- and we don't do this alone, we work in partnership with airlines, other health authorities in other countries. there's a lot of cross-communication that takes place. but it happens amazingly quickly. this is the investment that we make in our major airports, our system for tracking travelers and so on when it comes to outbreaks. these are hinges that we -- things that we maintain because when push comes to shove, you really do need them very quickly. so over the course of a day or

two, the vast majority of people receive some outreach. the reaction is mixed. some people are ho-hum about it, others are quite concerned, and part of the value of being able to speak with them directly is that we can guide them to information, we can answer their questions up front be, and we can connect them with their state and local public health resources which is another very important part of the response. >> host: you've seen the headlines about mers, the outbreak and the cases in this country. if you have questions or comments about that, dr. michael bell is our guest. he's the associate director for infection control at the centers for disease control and prevention. he'll take your questions and your comments, so start dialing in now. democrats, 202-585-3880. republicans, 202-585-3881. and independents, 202-585-3882. dr. bell, is this preventable? >> guest: so that's a broad and mixed question. yes, in a way it is.

we're investing heavily in several ways to make sure that we can control this, and part of that control is preventing its, preventing the problem abroad before it gets imported. cdc has been working night and day since this began to devise tests so we now have a very effective way of testing for this particular infection. if you can't test for something, if you can't detect it, there's no way to control it or even track where it's going. so having that test and then being able to distribute it through all of our state health departments and to international partners, that's one of the major activities that takes place. again, behind the scenes. you never think about it. but there is no off-the-shelf commercial test for a newly-e emerging virus, and that's something that cdc is able to do, again, very quickly because we have that base of capability. so one thing we do is makethinge

that everyone can detect it. you can imagine that if a health department in a state is able to quickly identify a case, we can surround that case and make sure that it does not spread to other people very effectively. if it takes weeks and weeks to get a result tom a there is more possibility it will spread. in the middle east, working with the partners there, we can improve infection control practices where the disease is originating and make it less likely that the infected will carry it around the country. host: in what about vaccination? guest: there is not a vaccine right now. i know they are thinking about the potential vaccine that might work for this. we don't have one to rely on. it would be wonderful if we had one. this is the most impactful public health item you can imagine.

host: is this an issue for the whole world? guest: when you think about what happened with sars, a similar virus that caused very severe illness and killed a good number of people spread very effectively through air travel. instances, in canada, it caused chaos at a major hospital. if you think about what that does if you think about what that does to the business world in terms of travel, in terms of international locations, the ability to do business is significantly compromised when there's a risk of that kind of severe illness. whether it means that you can't have meetings, whether it means that your in-country staff are incapacitated or if there's simply logistical chaos because of the attempts to control the infection, all of this impacts the bottom line and makes it very difficult for american interests to do business. >> host: we'll go to idaho,

bonnie is watching us, republican caller. you're on the air. >> caller: good morning. i have a question about the test that you do to identify mers. is it like a nasal swab? and then also is during the course of the illness, is it during the fever stage that this is identified? i know you mentioned one person that was negative and then it was positive, because i know what -- i know with the pertussis, when they were testing for that, they were doing slides. but some of them were negative but, actually, a person was into the stage of illness later on. those are my questions. >> host: bonnie, are you in the health field? >> caller: i worked at the health d. here years ago -- health department years ago, and i've been in the medical field for, like, 40 years. >> host: okay. dr. bell? >> guest: those are great questions. this is early in the learning phase about this virus, so we're collecting specimens not only from the nose and throat, but we're taking blood specimens,

stool specimens and so on because we want to know how the virus is likely to spread. so with sars, for example, we found that it was actually being released in the stool, and that changes how we try to control the spread. whereas in this case so far it seems to be hostly respiratory, and it is found in the bloodstream. all of these things allow us to refine the testing and better understand transmission. as you point out, during different parts of the infection the virus may not be detectable, so immediately after an infection the virus needs to build up in your body before we can detect it either directly or detect the normal antibody response that your immune system makes. both of those are targets of tests, and it usually takes a few days for those things to become positive. generally speaking, these respiratory viruses tend to have

detectable virus during the fever stage, and then that tends to go away slowly. but it's different from virus to virus, and so with each new challenge that we see, we spend a good bit of time describing really that new pattern so that we can understand the period of risk and the best time to test. >> host: kimberly's next in sterling, new jersey, independent caller. hi, kimberly. >> caller: hi. thank you for taking my call. i was, a few weeks ago, i was in new york city, and i came home that night, and i started coughing, and i didn't want stop coughing for -- i didn't stop coughing for days and days, and it did turn into a fever and then the mucus and my respiratory system, i never had anything like this in my life. i'm 58 years old, and i, and it turned into this thing where i couldn't get out of bed. and i finally took a zpac, and

then i flew to florida, you know, to try to feel better, and i went to a doctor down here, and he never mentioned anything about mers. and i was wondering do, you know, because this has been going on, shouldn't these doctors, you know, have a notice go out to them by, in their, by checking them? and i am not able to be checked now because i am feeling better. but it seems to be, you know, rearing its ugly head again today, and i'm feeling a little achy and stuff -- >> host: okay, kimberly, i'll have dr. michael bell give a response. >> guest: so you've got a couple of great questions mixed in there. i'm glad you're feeling more or less better. first, i wouldn't blame new york, but i will say this: it's a great reminder that when you're traveling or when you're in crowded places, you need to take some precautions to keep yourself healthy. there are any number of viruses

out there that can give you a respiratory syndrome exactly like you described, and those things are transmitted either by close contact with other people, so, you know, face-to-face kind of contact, or by touching your eyes, nose or mouth with hands that might have touched, oh, a handrail or something like that. i can tell you i am personally neurotic about not touching things. i'm able to make it through airports without ever touching anything. and, you know, that's probably overkill, but it's, it's a reflection of how i think when it comes to transmission of infection. the most common thing that's going to deliver anything to your eyes, nose or mouth are your own fingers in which you have a toddler, in which case it's probably your toddler's fingers. if you have to touch your face, make sure you wash your hands first. i'm constantly hand washing. and then finally, you know, i do keep a fairly large social distance. again, i am neurotic, but i don't get up in someone's face very often because i like to

keep my space sort of clear. that all said, you can't avoid some contact with crowds, and that's why we promote it's called cough etiquette. if you have a cough, we recommend not only that you cover your cough when you're coughing, but even think about wearing a dispose able mask just to make sure that you're not spreading things to other people. obviously, if everyone does that, then our personal risk goes down as well. now, the question about should doctors be testing for mers routinely, the answer's no. you're extremely, extremely unlikely to have been exposed to mers traveling through new york. there is clear recommendation right now for somebody who's been in the middle east, especially somebody who's had contact with somebody with mers or something like mers in the middle east where it's likely, those people need to be tested. if somebody had contact with a known or suspected mers case, again, like the man who had

face-to-face contact with the indiana person, those people need to be tested. but there's absolutely no need to test everybody with a rest pa pa -- respiratory syndrome. >> host: bill beatty agrees with you, people touch their faces on average 1500 times daily. stop touching your face. dr. bell, is that something that you guys look into, research, how many times people touch their faces and how that contributes to the spread of viruses? >> guest: well, what we know is that people do it, and i don't think there's a need for more specificity in the data. i think what we need is better and better ways to keep our hands clean. again, not touching your face is great. touching them with clean hands is necessary. >> host: here's a tweet from the las vegas review who tweeted this out, that the biggest risk that mers will become a global epidemic, ironically, may lie with globetrotting health care workers. dr. bell? >> guest: that is a great point. so we've seen that both of the people who came back to the

united states with the infection had contact in the health care system. they were health care professionals. we use in this country and many parts of the world strategies to protect health care personnel. we've got infectious diseases in all of our hospitals every single day, and back in the day 150 years ago, we actually built separate infectious disease hospitals because we needed to contain these, but we can't think we could prevent the spread to other patients. what we know now is by sticking to some pretty straightforward practices, we call them standard precautions, we can, we cannot only prevent the spread from, you know, one patient to the next, but we can protect our health care personnel. we don't want doctors, nurses and students, volunteers becoming ill just because they take care of patients. so these practices are used uniformly for all care. that is something that is built into our medical system, and i think we see the benefit of that in the fact that we't