illnesses. doesn't make sense. at. >> guest: i'm not sure about the relationship to the movie. halves an opportunity to raise consciousness about the facts there are these new viruses emerging all the time that place potentially a worldwide community at risk and something we should be working hard to anticipate, develop therapeutics and vaccines for. what we've been talking about. the two individuals that were air lifted from liberia, that was something that their organizations, samaritan's purse wanted to put in the resources to do. that was not. money that was responsible for their traveling to the u.s. and being cared for. but in fact, u.s. citizens, as they were, are entitled as they were, are entitled but in fact u.s. citizens are entitled to asked to come back into the country if they need medical care. there was no reason to refuse that.

happily both of them are covered with the care they got at emory university hospital grade of course there are now thousands of people in west africa who are infected. there's no practical way to move them out at the space where they currently are so the big effort now has to be to provide care for them they are in the country and that would apply also to health care providers many of whom sadly have also been infected and hundreds of them have died as a result of ebola. but the big push has to be to get things on the ground in liberia and sierra leone to make it possible to treat those who become infected and reduce the number of new infections. >> host: waldorf maryland job is watching as their independent caller. good morning. >> caller: good morning. what are they using to treat the people that came back and they

ran out and also the troops they are sending are they going to get the vaccine before they go? >> so the vaccine is not ready yet to be delivered to anybody. right now it's just a phase one trial in healthy volunteers to see whether it's safe and where there generates and there generates an antibody so the troops that are going up to set up these 1700 beds are not able to have access to that because it's happening right away. in terms of zmapp as i mentioned this is a biotechnology advance were these where these are antibodies directed against the ebola virus that they are generated using ever, that dna factor which in this case happens to be tobacco plants. tobacco plants have increasingly been used for that purpose because they have the machinery to turn out proteins but it

doesn't scale easily. production of zmapp was not anticipated to be needed on this kind of scale anytime this year so at the moment we are in a bit of a bind. they are trying trying to block this gobs to find other ways to scale that up or to find other ways to make zmapp antibodies in a different kind of system such as has been used in biotechnology for other purposes. all the stops are being pulled out but unfortunately there's no solution that will provide large numbers of doses in the next few months. >> host: alban saint johnstone new york democratic caller. >> caller: good morning and thank you for taking my call. dr. grady and have a few concerns because well a lot of the public has been exposed to difficulties by way of moving into fictional accounts both from what i remember when you have an outbreak like this in the city and containment

possibilities are pretty difficult at best. in addition to that it sounds to me like we have blown off a lot of our weak time because we were doing research yes but they weren't willing to expend the resources to actually develop for things like a bow and other potential viruses around the world. my question is what measures are being taken to facilitate the attainment? how much trust should have the public have in vaccines that are developed and given we have seen things go into legislation like the patriot act that protects from litigation if they fail to produce vaccinations and cures and treatments and what do we have in terms of backup to prevent this from becoming a

worldwide epidemic? some people are very worried about the avian flu and many people discussed it. >> host: thank you. all right. >> guest: lots of questions there. let me take them quickly. in terms of the confidence we ought to have a containment this is a huge challenge in the circumstances that now afflict west africa. our colleagues at cbc have a hundred people on the ground. as you have heard the department of defense is sending resources to put in place 1700 beds. the usaid teams are there as well but it is very challenging to come up with a strategy which requires both facilities and public education so people know what to do. they are critical issues about individuals that are infected and about the burial of individuals who have died whose bodies turn out to be infectious and need therefore not to be touched and not wash which is viewed against the usual cultural practices. a huge effort is underway to

achieve those strict public health measures but it's challenging indeed. in terms of what we are doing about other kinds of outbreaks i can tell you this is a huge area of priorities at nih. you mentioned the possibility of some flu outbreak. we worry about that with age five and one that's been there in southeast asia for a while and could potentially at least break out into a worldwide effort like 1918. we are working on a universal flu vaccine that would be effective against all flu strains and believe we are on a pathway to get there. frankly as i said earlier we would be further along at nih had not been there in a circumstance of losing purchasing power. this is his extensive work it takes time and effort and yet we have not been able to move up at the pace we would have liked to. this is kind of a wake-up call about the consequences of having those limitations when in fact there's a serious risk of worldwide illness. >> host: dr. collins how much of your work is focused on

preventing with vaccines, preventing illness and how much is focused on treating illnesses? >> guest: it has to be both of course. vaccines are an incredible contribution to the world and when you look at the way in which that has prevented countless deaths from childhood illnesses and for such things as influenza it is worth every penny we put into that. but people still get sick so we want to have something there to offer them whatever the illnesses. we also put a huge amount of effort into therapeutics. of course we work as part of this ecosystem. we are the basic science researchers funded by the government doing things i would not get them by the private sector because they are not that close to a product that we work with our products in the biotech industry. this vaccine for ebola and talking about gfk as her partner. we wouldn't be able to promise to get scale that up and have thousands or tens of thousands of doses without that partnership.

>> host: there's a full-page ad in the "washington times" this morning from pita with the picture here of an infant monkey in business and i ate, millions spent starring baby monkeys and making them depressed, lonely and drunk since 1983. stop it now. what is the nih's policy about using animals for research that you do? >> guest: is a good question. animals are essential for many of the things we are trying to learn about how to prevent and treat human diseases. we can't can do things with human patients ethically nor would we necessarily asked them to be involved in some of the studies that can be done on animals that have given us great insights whether diabetes or heart disease or alzheimer's. all of the things people want to see answers do we depend on animal studies to learn about that. think their particular concerns when those animals are close relatives of ours and i want to point out that we have recently made the decision pretty much to

scale back or maybe even stop altogether our research on chimpanzees after an extensive debate. we still have the potential of a small colony of chimps that could be used if there's an urgent need for the kind of research that could only be done with champs but otherwise we have put in place a circumstance where chimpanzee research is being phased out. when it comes to the pita concerns i think they are also pointing to other monkeys where they are concerned about the way in which animals are handled. i want to reassure people that this is done with intense oversight by a variety of groups that look of protocols that make decisions avoid pain and suffering. but reasonable people will still disagree about whether we have the balance right here it >> let's go to harriet, a miami beach republican caller. >> two questions. first, there was a study not the ago that showed possibility that ebola was airborne. have you done any follow-up

>> caller: there was an animal study that showed the possibility that ebola was airborne. have you done any follow-up research to see whether that's true and my other question is, there's a magazine that has put out and i send a delete to everybody about the nih. i wonder how much money the taxpayers are paying for the nih pr magazine. >> so taking a second question i'm not familiar with any magazine that goes to every household that is pr for nih. there is a small publication published by the national library of medicine which basically highlights things that are happening in research that you might find in a doctor's office. it's an opportunity to inform people about what's happening

that they might want to know about in terms of medical research and their implications for health. as far as your first question about the bowl i think there has been a lot of discussion about is it possible that this virus could become transmissible by the airborne route which was obviously be a dangerous development. there was one animal study that was actually quite different than anything you could imagine happening with humans has suggested the possibility of that. frankly i think the experts looking at that say that's not something that's likely to happen in the current circumstance for humans at any serious possibility. the other concern is the ebola virus is mutating as viruses will do especially now with so many people infected. there are a lot of copies of this virus that have a chance to change their properties but we think it's very unlikely those mutations would make a complete difference in the transmissibility. there's no real precedence for that so while it deserves close watching and the best solution to the risk is taken the

outbreak at the present time we think airborne transmission is extremely unlikely to develop and that's a good thing. you don't want it to happen. >> dr. sought collins a lot of questions about ebola but before we let you go remind our viewers the role that nih plays in the medical research community. >> guest: at nih is the largest supporter of biomedical research in the world. the research that is funded through grants that we give to institutions all over the country as well as what's done here on the bethesda campus including the largest research hospital in the world has been over the course of many decades the reason why life spans have been increasing for things like heart attack and stroke on the wane and why we are making great strides against cancer, alzheimer's disease and other conditions. i believe this is a noble institution with a noble enterprise. it's a great privilege for me to serve as its director. i wish nih was more widely known about in the public because i

think anybody who looks at the mission and accomplishments in the dreams and the vision of what could happen next if we pulled out all the stops and applied all the resources it would be truly excited about the promise we have here for dealing with a whole host of diseases that currently cause a great deal of suffering. >> host: dr. up next we are talking to patricia grady who's the head of the national institute of nursing research there. what role -- wise is important to focus on nursing and having research there? >> guest: patricia grady is the rector of the national institute of research can no doubt tell you a lot of exciting work that they are supporting. we have 27 institutes and centers at nih. we are trying to cover the landscape of biomedical research needs and certainly nurses is a critical part of our health care health care system also have great ideas about ways the system can work better. she will tell you more about that but that is part of the integrated hole called nih that

covers the waterfront of the basic science and what we call transition -- translational science to clinical trials and everything in between. we are trying to do everything we can to make the world safer against disease to come up with strategies for prevention and treatment that people desperately need. >> host: dr. francis collins we want to thank you for your time in a big thanks to you and your team for letting "washington journal" come out to the nih. we appreciate it. >> guest: is it's a privilege to be on c-span. thank you. thank you. i will come anytime. >> host: we are going to be talking with patricia grady who heads up the national institute of nursing research. we will talk about what a team does and what sort of research they are doing in the role of nurses and later we will be talking with dr. griffin rodgers of the national institute of diabetes digestive and kidney diseases. that will be our conversation coming up. we will keep taking your calls until we get to patricia grady. kimberly in washington and

pennsylvania republican caller. kimberly we don't have a guess right now but what are your thoughts on the nih and specifically what they do there? >> caller: i was thinking a lot of these vaccinations they do our greed driven. they take care of a lot of cedar cindy's -- citizen brand 75 plus and despite the fact that they have never had chickenpox or whatever i have noticed they are pushing the shingles vaccine which out-of-pocket is over $200. even though they are telling the doctor i don't want it when they get their blood drawn they still try to get the shingles vaccine. to me that's crazy and also the fact that i myself have taken my daughter to the doctors who had a respiratory problem they wanted to give her vaccine while she was sick. being a "cnn" i'm like you are not supposed to do that.

if you tell these people anything different than what they want they take an attitude. you are not as smart as they are but the truth of it is is when someone is already sick you are not supposed to give them any vaccine. i'm wondering how much of this is money driven. >> host: wondering about the profits of vaccines and industry. >> caller: the physicians and nurses are pushing even though they aren't qualified at the time that they are sick or are they never had chickenpox to to justify why would they push it? >> host: next to westbury new york, democratic caller. help me with your name caller. westbury new york, call or go ahead. one last call for westbury new york democratic caller. let me move on. sorry about that. kurt and clifton new jersey democratic caller.

go ahead. >> caller: i'm in new jersey and when the ebola comes up and everything i have to wonder who's doing the research and what's happening in new jersey with the biotechnology and pharmaceutical research has been decimated. what i mean is all the biologists don't have anywhere to work. what i'm saying is brunswick fired everybody and marc came into conor werth and bought schering-plough. roche went to genetic biotech and changed -- close the site at roche. i don't know where the people at seton hall princeton and are going to find jobs and no one will do the research after them. >> host: back to the national institutes of health were patricia grady is joining us and she is the director of the national institute of nursing

research. patricia grady what is this institute institute? what do you do? >> guest: our institute provides information for improving clinical practice and also for promoting wellness and health across the nation or individuals regardless of age or stage of life. because of nursing research teams are better able to manage their diabetes in young minority women are able to increase their risk of acquiring hiv/aids. we have a better understanding of how men and women respond differently to certain pain medications and we also have provided tools for helping clinicians discuss end-of-life and palliative care with family members and patients and also to try to approach the issues regarding a difficult time of life. >> host: why is that? what contribution is nursing research making? >> guest: nursing research

does studies that address management of chronic ailments to help us identify what the issues are and how better to identify interventions to help make that better. we also engage in studies to determine how to change behaviors related to health so we can increase the health and behaviors of individuals and prevent some of these illnesses. and we also do studies to determine what are the important things that patients want to know and their families at around the time of end-of-life end of life. we spend a fair amount of our effort on the patience and what their symptoms are and how to make their conditions better. we also focus on families of those individuals because we know the caregivers who engage in helping their loved ones cope with illness have important health issues and require assistance from us as well. >> host: what if you found out about end-of-life care are? >> guest: the area of end-of-life this particular

importance are population ages and people develop more chronic illnesses and also develop serious illnesses. we know that it is really important to focus on the patient symptoms, pain and suffering. what we found out as there is a great deal that we don't know about pain management. communication among the health providers and also for patients and families so that we have identified ways to strategize communications systems to improve that so we can better address what patients need at that serious time of illness. another area is that of advance directives and incorporating the patient and planning their own care. they get the type of care that they want and do not get the type of care they don't want. we also have an studies have shown that that's very important to the patients but also to families.

if the condition has a negative serious negative outcome and if the person does die the period after of bereavement is improved somewhat by the family members understanding that they did with their loved one wanted and can rest assured of that. >> host: we are talking with patricia grady the director at the national institute of nursing research at nih. she's a trained nurse and masters in nursing and doctorate in physiology from georgetown university. our topic this morning is research, nursing research and the role that nurses play in health care. we have a fourth line set aside this morning for nurses. (202)585-3883. let's get to joshua in rockville maryland independent caller. good morning joshua. we lost joshua. let me go on to joy in st. louis missouri independent caller. >> caller: hello greta. i would like to see a program on exactly what the nih does to monkeys and other animals.

i'll bet the average person would be shocked at the cruelty involved. >> host: all right. patricia grady, our use of animals and monkeys part of your institute? >> guest: actually we do a small amount of research on animals but we do not do any research on monkeys. research. >> christine, buffalo, new york, democratic caller and a nurse. caller: good morning. i have been a nurse for 48 years and have seen tremendous from the old to the new. i stted out in the dip >> caller: good morning greta. good morning dr. grady. it's a tremendous opportunity from the old to the new. i started out in a former program and got my ds and agreed when i could afford it. i'm just wondering have you done any research on the impact of the 2020 resolution before a lot

of the nursing boards as to having the bsm for all degrees and what impact will that have on obamacare? >> guest: we have not done any research in that area. we have done studies that do show that more education and a background experience that nurses have is associated with better outcomes for patients with serious illness but we have not done studies on specifically the 2020 proposition. >> host: souzan this next a republican caller and waldorf maryland. >> caller: yes i have been an outpatient of nih for the past six years after having brain cancer. i'm currently an inpatient sitting right here watching my tv in the neurological research division and i cannot say enough about nih, the nursing staff, the doctors, everybody. i have been so impressed and just in love with the nih.

>> host: specifically souzan what is it about the care you are receiving? >> caller: i am receiving such excellent attention and care. i don't have to push the call button more than once. i can't give enough love to this place. i wish i could give some way back to it. >> host: patricia grady that's a picture right there at nih right now. are you watching nursing, nurses interacting with patients or best practices? >> guest: yes, we are in most of the research we do in fact is directed toward improving best practices for the over 3 million nurses across the country. i would also like to thank the color for her contributions to nursing over her 40 year career and am pleased that as a practitioner and as someone who has been a part of the health care system that she is feeling

very positive about nursing in its contribution. i think the clinical center is a specific example of nursing at its best because the nurses there are involved in the research protocols and really state-of-the-art care being given. it's good to hear that you are there and it's good to know that you are watching this morning from your bedside. >> host: the budget for the national institute for nursing research, the request for $2,015,140.5 million. it was established in 1986 as the national center for nursing research elevated to an institute in 1993 and more than 80% of the budget goes to researchers and trainees. registered nurses in the united states, in 2012 there were nearly 3 million registered nurses. the estimate for 2022, 3.24 million, and 19% increase. patricia grady what is the health care system need to do to prepare for that increase?

>> guest: the health care system desperately needs additional nurses and i think because of that the nurses who are graduating the environments will be prepared to take them in and to make certain they become part of the new system seamlessly. our graduates are very well prepared and very excited to be part of the new health care system as the nih nsr country moves into the 21st century. we have so many more opportunities for taking care of people well and also for helping them keep healthier. we spend a lot of time in different settings and so we have a number of studies were example that help teenagers manage their diabetes. we address public health problems across the spectrum of life from helping infants and the weepy video nail care

earlier and teens managing their diet and illnesses they may have and also the older population who are living with chronic illnesses to help them manage those illnesses and to help them be part of their own management of care. most people now are living older and healthier at that age so they be part of their health and part of their care. we have a number of studies that are helping us assess that and develop strategies for helping people participated in their own health. we are working with technology that helps people aged home, as it were. we also -- it also allows them to be active while monitoring their situation. if their activity level decreases or increases according to whatever chronic illness they are managing, that will be noted and if help is needed it will be sent. all of these technologies are now becoming much more available

for people to help monitor their own health and also to be able to be as active as possible for as long as possible. >> host: we will go to george next, joseph and independent caller. >> caller: yes, thank you so much patricia. i was there for the ebola situation and my question is we as a medical community have been trying to reach out to nih, cdc trying to help the situation right now and we haven't had success with regards to being involved in trying to help. my question is we know that there are programs by cdc in alabama and we know you can send

in your resumes which all of us have done that we are finding it extremely difficult to be contacted back with regards to helping. for me i'm a research associate and i believe that we can help directly being that way are from the area and they are willing to do that. so if there's a way may be a link to directly contact cdc are nih so we can have a direct impact. >> guest: i don't have a specific contact information for you on the ground in africa but i do know that we are excited that people are wanting to help in trying to help. we have -- we are going to the process of trying to get back to people. there's a great deal of preparation that does take place even for people who are are

involved in clinical care and clinical research so that the process of going through the numbers of people in identifying and advising the training programs to help people when they are on the ground is in process. i would suggest that you check our web site. we have a special link on the nih web site that is related to ebola and will help you get from there hopefully to wherever it is you need to be. >> host: at nih.gov is the web site. vicki is a nurse democratic caller in oregon. go ahead vicki. >> caller: good morning. i'm a registered nurse since 1966. i was wondering, i'm still working because i was called back by my organization today teaching and i'm wondering about the trend for the 12 hour shif shifts, across the country where

nurses worked 12 hour shifts and they're actually at the workplace 12.5 hours then and i care in many situations they don't have breaks for lunch and rest breaks and things like that. how does that impact our 100,000 lives campaign and is there any association with increased errors in medications or other errors? when somebody is working maybe three, 12 hour shifts in a row and they are commuting and have a 14 hour day and maybe they are sleep-deprived of not getting the rest that they need at work. any research been done on that or has there have been any research in the past? >> guest: we are actually funding a fair amount of research on sleep and sleep disturbances and sleep patterns and it has been shown that's decreased sleep is associated with impaired thinking and the ability to function. we particularly have noted that in soldiers and shift workers. it is important that everyone needs a rest but it's

particularly important to have proper sleep and rest so you were -- people are better able to function and think objectively. >> host: cap the democratic caller, or when illinois. >> caller: yes patricia i have a question for you. how do you determine your criteria when you are given money to these medical students in the university's? what is the criteria that is required for giving money for research and how do you know if they are being upfront and telling the truth actually and not just getting money for kickback money? because i'm actually a victim of that. having seniors as a human guinea pig some in the university in

the chicagoland area. the money, i'm not sure for if it was funded by government or the nih but i contacted nih and they would not help me with that. they were very rude to me. i had a procedure done that was -- in the journal. i'm disabled now and when i spoke to somebody at the nih they could not answer any questions. >> host: patricia grady can you answer the criteria question? >> guest: that's a very difficult story and i'm just sorry to hear you have that unfortunate outcome. the research, the money that we have for research, 80% of our budget goes out to research for research studies and training across the country. we keep very close monitoring of those funds. they are given to the university on behalf of researchers to do

the studies were trainees. there is fairly brisk surveillance for how that money is spent and to make certain the goals of the research projects are mad as outlined. we also have very strict oversight for human subjects. anyone that participates in a clinical study because we understand how important that is and how they are helping us to make lives better for future generations. so they are are very strict oversights for inclusion of patients and studies. i would think, and that's at a local site as well. so those are usually our oversight plus the institutional oversight tends to be very strict. >> host: we will go poll in hollywood florida, independent caller. hi paul. >> caller: hi patricia how are you? the research and in the area pain management in the emergency

room for patients with sickle cell disease. has the institute, the health institute done any particular research in this area and have you dispersed information out to state and local regions so the local hospitals can make use of back? i have seen some research in this area at duke university. that seems to be pretty successful. north carolina as well and chicago. it doesn't seem to be reaching the rest of the nation. >> host: paul what is your experience with sickle cell? >> caller: my experience as a survivor, i'm 65 years old now, has been that the treatment is very slow. as the patient come in, they area of fluids being administered right away can decrease some of the stress that a patient will have to wait for

as the doctors and emergency rooms are very crowded. doctors can't always get to you right away but there is very little protocol like immediately giving fluids as opposed to saying we will get to you and that type of thing. there's this triage when the patient remains in pain. >> host: paul, describe the pain. >> caller: sickle-cell is rated in the emergency room from one to 10, anything from eight to 10 is considered to be crucial. the pain is in the joints and many times in the chest in the head as well and it says though if i could describe it, it's as though somebody is squeezing your joints were squeezing your chest. your breathing is restricted and the pain can be very excruciating as a result of oxygen being denied or the blood

cells tickling and clogging arteries and joints. blood is not being supplied to the areas of the body especially the organs. blood is not reaching the organs. this is producing pain and it can affect organs within the body. >> guest: poll is a very good example of someone who knows a great deal about his condition, sickle cell and is able to describe it to us and also to his care providers if you do go to the emergency room. as it turns out in our institute we do not focus on specific diseases that we do focus on symptoms. so we do have eight fair amount of research that is directed toward the pain related to sickle cell because it is acute and serious. part of what we do in addition

to getting information is develop strategies for how to improve it some of which, some of the once appalled as mentioned our caller are some of the ones we have been able to identify. we also and his question about getting information out, we also have verse possibility to get the information that we generate, the new information from the research out to patients and their families. we to make a concerted effort to do that for her our web site and through messaging as well as publishing not just in scientific journals but also lay journals and publications that are more available to the general public. that's an important part of what we do. we have for example at end-of-life would have a brochure on the web site is available both in spanish and english and we also have written a chapter on the senior health for how to stay healthy and related to end-of-life issues.

we have a campaign in pediatric palliative care that discusses issues related to conversations. it's called conversations matter. those are very important because they have information about how to manage symptoms, how to communicate with the health care system and in general are intended to help health care providers work more effectively with the patient populations and also for the patients and families. >> host: we will go to our line for republicans, naomi and a nurse. hi mail me, go ahead. >> caller: how many of the 2.7 are actually active nurses? i and retired after 45 years and they keep my nursing license current because i am with the american red cross now.

they really make it hard for you to keep your nursing license up because you have to attend so many classes for so many credits. i was just wondering what is your comment on that? >> host: okay. you. >> guest: we do recognize as the population is aging that the nursing population is also aging and we are facing a serious issue of retirement in the upcoming years. but part of me licensure and a requirement for continuing education classes is important because there is so much new information, much of it we are generating pure research so there's so much new information that does affect the clinical practice for nurses and other health team members. so it really is important in the interest -- i notes inconvenient

for the person sometimes but it's very important for the patients and their safety that the people who are providing that clinical care are up to date on the latest research and the latest findings to improve clinical care. those requirements for continuing education are likely to continue. >> host: we are talking about nursing with the director of the national institute of nursing research at the nih in bethesda maryland. patricia grady we have a couple of minutes left. our last call is with christopher who is in garden alla bouma -- alabama and the democratic caller. >> caller: hello greta and ms. grady. have a general comment on nursing. i pay out-of-pocket. i have a great doctor. he referred me to a clinic for things like blood test. i have diabetes and i'm treated for anxiety. what i found was that the nurse, because we have more time to

talk if i'm at the doctor it costs more the longer i'm with him. i found in talking with the nurse i actually have found i have gotten more information of how to treat my medical problems. >> host: chrism going to leave it there and have patricia grady jump in. >> caller: so much that is related to having a condition or an illness are the symptoms that bother us and really that's the focus of our research is on symptoms and symptom management, determining what causes the symptoms and how to intervene and how to create comfort and relieve the symptoms. a great deal about we do in research and a great deal of what nurses do and practices related to that so it does make sense that the nurse would be able to help anyone whatever setting whether emergency room or a clinic and even in the community since we have so many people who are very mobile

dealing with chronic illnesses. it does make sense. i would say talk to the nurses, find out the variety of approaches that can be used to relieve symptoms and to make you feel better so that you can feel as healthy as possible. our goal is about wellness and preventing illness and increasing quality of life so every individual regardless of their stage or age or background will have, be able to have as high a quality of life as possible. that is our goal and we want to work with you the public to make that happen. >> host: for more information you can go to ni and r.nih.gov the national institute of nursing research web site. patricia grady thank you very much for it -- your time could our conversation continues about the role that the nih plays in

medical research and we will be focusing on diabetes, digestive and kidney diseases with dr. griffin rodgers and later c-span buses big-ten tour continues with a stop at northwestern university and we will talk to the president there morton shapiro. we will keep taking your calls until we are joined by our next doctor could let me go to marjorie who is a nurse and independent in missouri. marjorie what are your thoughts on the nursing field? >> caller: well i am also retired but some things i dealt with, i was a missionary nurse. i have a masters also. in 1989 i encountered the ebola virus in south sudan and we dealt with it impermanent ways. we were able to do some things that contain it a little without any technology.

we had to cordon off people an and -- give the ashes away. i did want to ask a question about the epidemic. someone may wonder why they send out the american missionaries from america and that's common. you always take the people who can save others first. you want those being alive to be able to help more people. the other question that i think was didn't, but perhaps is relevant, we dealt with in iran where he taught in 74 and 78 and many of the epidemics and sudan were totally in denial. it could be people dying everywhere but you can admit it. the health service cannot admit it. we had a huge cholera epidemic

when i taught there. students were losing family members. we weren't allowed to call it that. it might be relevant to mention. i have always wanted to bring it up. we did research project because we always taught at home so they were 10 times as many physical and medical problems among underage mothers. infants would have lower mental status and things but you can't adjust for the social convictions but in iran you could. many early marriages among women came to the clinic. we did a research study and four years later before the children and mothers under 16 were still four years below in doing the

tests you can give children. it is a problem in america and i think we need to do some research here. >> host: on that i will jump in because we want to go back to the national institutes of health in bethesda maryland, a sprawling campus close to the capital and bethesda maryland. it's a budget overall for 2013 was $29.2 billion. in 2014 they got about $30.2 billion in the white house request is $30.4 billion. the institute founded in 1887 comprised of 27 separate institutes and centers. one of those institutes is the national institute of diabetes and digestive and kidney diseases. we are joined by its director dr. griffin rodgers. dr. rodgers teleour our viewers was sort of research you do. >> guest: the national

institute of diabetes and digestive and kidney institute are have research in diabetes and related endocrine disorders thyroid disease and other metabolic conditions. we fund studies and digestive diseases, nutrition, liver disease as well as in kidney disease, benign neurologic diseases and hematologic diseases so you can see that the vast spectrum of disorders we are responsible for. >> host: your budget, $1.7 million. how is that money allocated out and for what? >> guest: there are two components to our funding stream. we have an intramural program here in bethesda that funds a number of laboratories and branches. we have also had an intramural laboratory in phoenix, arizona

near the healer river reservation where we study diabetes among the pima indians who have the highest prevalence of diabetes of any population in the world. roughly 10% or slightly less than 10% of our budget goes to our intramural program. about 85% of our budget funds research at universities, medical schools, hospitals around the united states into a limited extent internationally. >> host: lets us focus on diabetes for us. in 2012 according to nih in affected about 30 million people. seventh leading cause of death, 86 million aged 20 and older have prediabetes and 208,000 under the age of 20 estimated to have diagnosed diabetes. how bigger problem is this? >> guest: this is a huge problem. the fact that there are 29 million americans with diabetes, perhaps a quarter of them are unaware that they have

diabetes but that's just the tip of the iceberg. the 89 million that you describe that have prediabetes a condition in which blood charters are high but not quite high enough to designate them as frank diabetes is a major problem. we know these patients however are at high-risk for developing diabetes sometimes within the next one to five years. i think we all agree that prevention of diabetes is certainly a goal that's critical. we want to prevent that high-risk group from developing or preventing the development of diabetes as long as possible. >> host: "the wall street journal" this morning has this headline. easing of diabetes rates seen as a sign of progress. >> guest: certainly that is some positive news. i would say though that is not seen in all populations.

overall numbers may be trending to flattening out. certain groups have the higher proportion. a certain ethnic groups and of course people over the age of 60 so as we age and particularly with the baby boomers increasing the numbers of our population, this is a risk factor for diabetes. anyone who has a family history certainly is another risk factor so putting all that together, while it is somewhat comforting that the levels may -- the numbers may be leveling off the trend is not at all populations. >> host: dr. rodgers where reagan the treatment of diabetes? >> guest: there are two major forms of diabetes that i should mention. first there's type one diabetes which were used to refer to as juvenile diabetes. this exists in individuals who have a genetic predisposition to

form antibodies and destroy the cells in their pancreas that are producing the insulin. in these individuals, which represent 5% of that 29 million that you cite they are unable to produce sufficient insulin and insulin is required to sustain life. the vast majority, about 95% of individuals have type ii diabetes were what we previously called adult onset diabetes. and then their body produces a sufficient amount of insulin. it just doesn't work very well and a condition called insulin resistance exists which is really driving this epidemic we are seeing type ii diabetes is that it's directly related to the obesity epidemic we have seen in this country. >> host: nexa the headline i just read is this headline in "the wall street journal." soda firms pledged 20% calorie cut by 2025.

coca-cola pepsi company dr. pepper snapple will work to cut beverage calories in american diet 20% by 2025 by promoting bottled water low-calorie drinks and smaller portions. dr. rodgers the treatment is one thing the treatment combined with the bad diet does what? >> guest: well you offset the positive effects that one receives and i have to say that we are gratified that a number of these companies are taking the effort to actually reduce the calorie count. one of the things that we know is that in those individuals who are at high-risk for developing diabetes those with prediabetes r. and h. -- and nights funded research the diabetes prevention program show showing that high-risk group losing five or 7% of the body weight through exercise and calorie restriction

can greatly reduce the risk of going on to develop type ii diabetes. the fact that you are seeing companies now making this effort really is gratifying. >> host: jersey girl in pa tweets in why can a public ad campaign against obesity be done as was so successful in reducing smoking? >> guest: well that's the a frequently asked question. of course no one needs to smoke to live but you certainly have to eat to live so the types of strategies that were so effective in antismoking campaign don't exactly match or can be utilized in the obesity campaign. these really require important efforts and behavioral research and usually people respond in different ways to rewards.

so a lot of the research that we are funding now is efforts and behavioral research or the science of behavioral research to try to understand why people do certain things and not others and how one can best and more effectively explain or make certain that the recommendations that are given are carried out. >> host: according to your institute of the city united states approximately one third of u.s. adults in nearly 17% of children and teens. let's get to calls. conrad is up in richmond virginia, an independent. hi conrad. cocoa good morning. i have recently had a kidney transplant after two years of being on dialysis here and one of my biggest concerns is a set of bills a bicameral bipartisan bill with a beautiful name, the

comprehensive immunosuppressant drug coverage for kidney transplantation act of 2013. it was 2011 in 2009 in 2007 going back about a decade. it has bipartisan support, bipartisan co-sponsors in both houses and yet after a decade it has never even gotten out of committee. i'm just wondering if you knew about this bill dr. rodgers and if so if your organization has any public support for its? >> guest: well i am not certain of the details. what i suspect the caller is referring to is an effort to make certain that after patients who have end-stage kidney disease who either require dialysis or a kidney transplant and a situation which individuals receive a kidney transplant of course they are receiving an organ from

generally a close relative or other donor. of course one has to take immunosuppression regiment or drugs to make certain that the body doesn't reject that transplanted organ. i suspect and again i'm not certain but the bill you are referring to allows for ongoing coverage for those medications and that is an area in which we really provide the research to understand what drugs might be more effective than not and how long one needs to be on the drugs that specifically for the legislation we aren't a part of that area of governance. >> host: kidney disease impacts 20 million americans. what are you doing on the research fight and where are you with treatment? >> guest: we have a number of things that we are undergoing.

again, just like with diabetes what's driving the diabetes epidemic in this country is obesity. in turn the leading cause of chronic kidney disease in this country are diabetes and secondly hypertension. so if one can effectively mitigate or prevent people from developing diabetes which is our effort, then in turn what could prevent the complications associated with diabetes such as chronic kidney disease. we have really a host of efforts underway to see whether in fact one can first identify people at high-risk for developing chronic kidney disease. again bear genetics associated with this. people with kidney disease runs in families. we want to make sure that people who have a family history or a history of high blood pressure or diabetes are aware of that so they can go to their doctors to be tested because if one is

found to have early kidney disease one can introduce therapies that can gradually slow down the rate at which it progresses to end-stage renal disease requiring a kidney transplant or dialysis. we are currently involved in a number of studies to understand what it is about the kidney that could potentially lead to this damage either acutely or chronically and whether some of those -- that damage can be reversed. for people who already have end-stage kidney disease there are number of efforts that are underway. for example what we typically do in a clinical trial it involves recruiting individual patients to trust -- test one treatment versus the other a standard treatment for example and oftentimes those are costly and it takes a long time before one

can obtain the results of those trials. we are trying in addition to that effort, we are trying or pragmatic trials. for example one trial that is currently underway is called a time trial. in this case instead of the patient being a unit of randomization is the location of the center that's providing care. .. are talking about 4000 or 40,0 patients. you get a result much more rapidly. if that result is positive, that can gradually improve the standard of care. leslie will go to michael in massachusetts, democratic caller. thank you for hanging on the line. >> good morning. i am a type one diabetic dr.. i am 43 years old.

i've had diabetes since i was four. apparently, according to my mom and dad, i did not really have a chance against it. i had gotten sick with a virus that happened to a pack -- to attack my pancreas. i was four, i was fine. after, i was always a type one diabetic. my mom is in her late 60's, and i'm getting concerned because she is on the line of diabetes type two. an excellent group of physicians, i am pleased with the care i get and i'm pleased with everything that has been going on with my care, except for the fact that our stem search -- stem cell research development got stopped when our last president was in office. i want to know if we can do anything to bring that back in what we need to do to bring that back. --t is very them written

very important for the cure of this disease. host: dr. rogers, do you believe it is important for the care of this disease? guest: i think we need to examine all areas of research, including stem cells, both in humans and also other models. one introduction of a new , which we fund this type of research, is giving us clues to how one could actually take an individual with type one diabetes, take their skin cells, and then put them in a test tube with a combination of agents, reprogram those cells back to pancreatic cells reducing insulin. in this regard, one can begin to test a variety of therapies that might be more effective in making certain those cells survive for much longer times.

that research is very important. we funded studies to really understand everything that is necessary in terms of the development and progression of cells that we funded. now the knowledge learned from that has really developed in number of tools that might be applied in the future to expand, even in people who have only a relatively small pancreatic functioning this type of research is an area that we are actively involved in. your color really highlighted a very important point. these individuals live with type one diabetes for over 30 years. he mentioned he was doing fine until the age of four and then he developed a virus. something about that virus that

.riggered his immune system more --ally became much ultimately required insulin because he had type one diabetes b. because we no so much about the genetic predisposition of diabetes, 85% of the genetic risk factors are understood. we think it's time to now study patients at high genetic risk and understand what in the environment is triggering this. it could be a virus. there are camps that believe that it's something in the night. we have a study just an ambitious study looking at the environmental triggers of diabetes in youth. we screened half a million individuals to find 8000 at were

following-- we are from the time of birth to 15 years of age. we are doing very careful follow-ups with them and their positions. we are collecting samples of stool and saliva and blood and other factors. we are determining what types of vaccines they are receiving care be collected millions of samples so far. what we will learn from this study is what are those triggers to people with high genetic risk for developing diabetes. if it turns out to be a virus, a vaccine can be developed to soat this successfully patients never develop. ,f it's something in the diet some sort of dietary restriction will be important. this is a bold effort and we really think that because of this combination of a genetic risk and and environmental interaction, this study will set

a gold standard for understanding other diseases and which genes and environments come and apply. host: canton, georgia. don, republican. caller: my mother had triggered diabetes. i don't recall what type it was. i have a brother and sister that are 10 years older than i am. shots andtake insulin have had difficulties with this disease. life, am so far in my i've been disease-free of sugar diabetes. -- if theyc makeup have the gene and i don't, i would like to know why i succeeded in life without becoming a victim of that illness. our genetic makeup says a

lot about what we are likely to become. you may or may not have the same risk because we have two parents and you inherit half of your genes from one parent and half from the other. , thatld be that susceptibility gene, you may have been lucky to not inherit. a lot has to do with our environment. how much we are exposed to, what we eat. as it turns out, and diabetes, our environment begins even earlier. bothtudies we have funded, in our phoenix branch and other sites nationally, determines that our environment begins in utero. a mother who develops type 2 diabetes or who has diabetes , theg pregnancy

infant born to that mother when they have diabetes is more likely to develop diabetes later on in life then an infant born to that same mother who was not affected with just a small diabetes -- gestational diabetes. there is something in our environment we are trying to understand. that's another factor to be considered. of course, if it runs in your family, that does put you at higher risk. it sounds like you're doing the right thing and you are being checked periodically to determine whether you have any signs of it. good prescription, however, is exercise and maintaining your weight at a level that your doctor recommends. we are talkingt: with dr. griffin rodgers. dk.nih.gov.

you can follow nih on twitter. they are like tweeting right now. a conversation we've been having here with several doctors at nih. to see if you qualify for a clinical trial, go to clinical trials.gov. steve in manchester, new hampshire. democratic caller. caller: hi. rogers, i have a brother who worked in the diabetes research project. a prominent diabetes research clinic. .e was laid off some time back they told him the project had come to an end. it coincided directly with the , what theion government did.

how much of this research has been affected by the sequestration and other types of budget cuts? the sequestration you are referring to is something that occurred back in fiscal year 2012. that had a direct effect on funding in that year until 13. or fiscal year 14 and 15, the funding is at a level approaching where we were back in 12. obviously, the more funds we have to fund research, the more research we can fund. it is axiomatic. i understand the concern the caller has and i've heard from -- had important

projects moving on when they had to cut their budget by a certain amount. they have very little choice. i'm hopeful that some of those positions are now opening up because this research is so vital. especially given the numbers that were cited early on in this program. host: jacksonville, florida. jack. independent caller. caller: my wife was diagnosed disease thatmmune attacks your lungs and kidneys. i would like the doctor, if he the lungs andts the kidneys. she's been on dialysis since 2007. right now, she's in a nursing home getting good care. , nobody was diagnosed

had ever heard of this syndrome. when she was in the hospital, the doctor took an educated guess and he diagnosed her right. guest: i'm really sorry to hear that your wife suffered from goodpasture's disease. that is an area that we actively are involved in researching. this is a disease that can affect both the lungs and the kidney. like type one diabetes in which the body is producing antibodies directed at the pancreatic cells . here's a condition in which the body is producing antibodies directed at the cells within the kidney. cause scar tissue to the kidney and overtime, as the kidney loses its function, patients will require dialysis. we are making a substantial benefit to understanding the

underlying cause of this. people in the pharmaceutical company are looking at potential a conditionreat such as goodpasture's disease. you were seeing drugs in the pharmaceutical companies which are called biologics. rather than a pill, these are treatment center directed at antibodies or neutralizing in the interaction that are occurring. goodpasture will be an example in which there are better therapies that will become available. host: edgewater, maryland. angelica is watching us there. republican. caller: good morning. i wanted to thank you for your important work and all the good that you do. have a question for you. i feel the root of the problem

is not being addressed by the fda. see and hear is that there are so many things now in the food, especially processed food, from sugar to antibiotics to chemicals from gmo produced food that are having all kinds of impacts on the human body. i feel there is a failure on the de of the government because the sugar, in particular, is a huge issue. i used to buy organic orange juice. i don't do it anymore. i was not aware that 24 grams of sugar per cup meant six teaspoons of sugar. guest: i think the caller raises an important point. we are beginning to understand causeme of these products

disease or contribute to health. for example, the food labeling suggests it's better to have more fruits and vegetables, more grains, lessre sugar. chemicals that she is suggesting may have direct negative effects. what we're learning now is that a number of these sub lenses me,ually affect the microbio a combination of bacteria and viruses that live within us. variousocesses these nutrients or additives, it changes our own chemistry in a actuallyit can contribute to the number of conditions. this is an area of active

research by investigators that we fund. basis or some of these adverse effects that we are seeing with the specific nutrients that we are ingesting? host: silver spring, maryland. independent caller. acua, cohead could -- go ahead. caller: i've heard you on our local radio stations providing really great information about combating diabetes and related diseases. thinkman's terms that i are very effective. i only hear it periodically. i'm wondering if there is any major campaign to get that information out on multiple radio stations into the schools. the way you say it makes so much sense. people will understand how to address the issue. guest: thank you for giving a

plug to our radio stations. you can go on our website. 85 series archived and readily available for your listeners. this on a daily basis in the baltimore-washington area and richmond and chicago and norfolk, virginia. four times during the year, we air this nationwide on about 50 stations. coming up on the first of december, this national airing in observance of world aids day in which we are talking about the importance of aids is an issue -- as an issue.

there is a wealth of information that we did not have time to cover that if you visit our you can not only get reference to that healthy moments, but also things for kidney education, diabetes education, weight control and a host of other things that are extremely important. support andte this come up with observations on publicly funded research, we have to make this available to both patients, families and the providers. host: dr. griffin rodgers, we want to thank you. everybody over at nih for talking to our viewers and letting

>> [applause])/

date you very match. good to see you again john foust and an opportunity to meet you also. we will begin with opening statements each candidate will have five minutes. the timekeepers in front shows how we will do this. i will let you finish the sentence because that serves the audience. there is no complaints afterwards i favor one side$>ñ( or the other. >> of one of the references your opponent that is an

obvious opportunity for me to give that person to speak. because of the coin toss barbara comstock goes first. >> good afternoon. today is not about left verses right but the past verses' the future or status quo verses moving forward. when i love about this district is the opportunity to work for the people who were inventing the future. understand invexq%=9 on cliffs people out of poverty and would get its back on the path to prosperity. the virginia general assembly of the science and technology committee have worked with you to get us on that path to get the job done. my priorities will be to get people back to work to grow

the economy with 21st century jobs. to repeal and replace obamacare with reforms in control of your health care. and reinvesting in military to stop sequester cuts that threaten not only jobs but our national security. my opponent and i have different visions for the future he thinks the answer is to raise taxes. he has voted property-tax is 20% sales tax increase. medical device taxes. and the purchase of a car or this day in the hotel but now he says no. we need to ease the burden of taxpayers.

i have bipartisan success. the legislation that i know that in virginia and to provide mom and dad's was workplace flexibility and also the credit we passed this year that so many of you have worked on that was si1jed this year. and read the 21st century tax reforms in washington. and to go so far to attack me personally to said never had a real job for i don't know about real jobs. but now they have endorsed me with u.s. chamber of commerce, national

association of women business owners and realtors in credit union and former chairs of the technology council court former chairman of the chamber. also to pash reform legislation on infrastructure projects already saving as hundreds of millions of dollars. legislation my opponent opposed. also to experience in energy development. with today's increasingly volatile trial situation and our economy is not only about jobs. not only dedicated money for education but to crack down on human trafficking and

this year i have legislation for testinga÷ newborns for congenital heart defects so we can save those babies lives early on. coming from a family of educators to hear about george washington everything they are doing their windows previous democratic governor made to the schools. and then to% rebalance the budget together we balance the budget every year without raising taxes and also support a balanced budget amendment. our best-- are ahead. and everything here in the tenth district allows us to grow on that.

in one of the most diverse districts in the country we know if you get back on the path i can hit the ground they number one to continue the tradition of my mentor congressman frank wolf i ask for your approach to work with you and for you. thank you very much. [applause] >> this brings me to something it should have said earlier. please hold your applause. it is an important voice that you have is the voice you cast on election day. applies takes away from our ability to question the candidates. so we asked politely do not applied.

after the you will will not but moving forward. thank you in advance. five minutes for opening statements. >> thinks. good afternoon. it is a real pleasure to be here i have enjoyed working with you in the business community in the past couple years as a board of supervisors. before that as an active member of the business community for many years. i'll look forward to working with you and continuing to work with you. i have to tell you a little story. a story about my background. basically i was born in johnstown pennsylvania. for a working-class familyl9

we cannot pay for that so i had to do it myself. i got an mba in the finance economy department and go to school full-time. i tell you that story so i can answer the question why a guy running for congress? because i have tremendous opportunity a good education to old men the in my opinion work the american dream. because there is not enough opportunity, education is too expensive. and we have to change that. the way to do that is to deal with the congress that is broken, far too partisan

partisan, all holding our country back. we have to make a change. the way is to spend -- send it to people to washington. we do things differently and not been a government and i hope you recognize that. when iran for reelection 2011, i was the first one ever reelected in my district. i carried every single one in over 60 percent of the vote. i hope you agree i work with both parties to get things done. as a board supervisor to serve as the vice-chairman#f vice-chairman, a balanced seven budgets by working with my fellow board members

and the community. we set priorities and have tens of millions of dollars of wasteful spending. i say taxpayers millions of dollars by cutting waste and efficiency and on the economic abies three commission is spent the past six years working with dozens of business leaders in the community to expand and improve our economic environment. we make the county more attractive for business in that economy. we do this by supporting public schools and infrastructure investments like in tyson. select the regulatory

process.m said to get past the partisanship. said to make washington work again. made a functioning congress to create jobs and opportunities to invest in education and research and development in the infrastructure and improve educational levels to put more of the sissonne stem cell in making college more affordable. so we can take advantage to make it easier for foreigners to stay in our country.

and will certainly disagree and others. think you very much. [applause] >> taliban ask many questions i will start with the virginia congressional delegation will take a senior democrat is retiring and frank wolf is retiring.] they go have proven ability to get things done. and eric cantor was defeated in the primaries so a lot of seniority arguably is going out the door. one of you will be a freshman member of the house.

which view is better equipped to a least help to offset some of leverage it is missing? >> as the senior aide with the justice department and being in the private sector of a law firm may have worked extensively and obviously so many issues and federal employee issues. and it was important for there to be a republican voice in the majority. for the defense industry in northern virginia to have that bipartisan support it

is clear that republicans will be in the majority and i am a strong voice and experienced voiceuvp3p also legislator who has worked with colleagues here but we don't have the expertise. but i know the experts and all the areas in defense in the house communities. for 25 years since i have been in congress i have four to a fall of youjb with that bipartisan success to hit the ground route running monday never one to work with my colleagues across the aisle. and that is what people want with the allied bipartisan bills we have people on one side or the other never

worked together of the human trafficing bill.[ we put together a coalition. i want you to be our advocates to help me to take the expertise to make sure we do everything right in northern virginia. >> supervisor john foust? >> thank you. think about washington right now. almost nothing is happening. because we get things done. it is hard working problem-solving to demonstrate i can get more done. was also 2.0 to a said junior senators that support my campaign.

and i also want 2.0 as the history of extreme partisanship that is a problem in washington. by investigating the clintons' as the investigator for the house reform committee. she has been a lobbyist for the coke brothers. these and not the people that will go to washington and choose all our problems. >> you may respond. >> my opponent did not notice any accomplishments that he has done and a bipartisan basis it reminds reid you want something said

ask my colleagues if you want something done ask me. it is done on a bipartisan basis. for my work with congressman frank wolf it was reported of this we had some constituents and i and very proud we went to bat for. in the investigation that we started[v in then i was very proud to exonerate him. in than eyes turn to tell congressman frank wolf. >>.

>>. >> has confusion and complexity. please tell us if you believe health care reform law has been a success or a failure? and what you could do to improve it? >> i believe that is separate enough. particularlyrz concerned about obamacare and the cost. so to create jobs and opportunities. one of which we look at is

the cadillac plan. we have higher health care costs in northern virginia than other areas of the united states. and then to negotiate with medicare. and we can do that right now. in those that have lower costs deductibles and plans. what i will not to -- do is allow health care to return to the insurance companies so they can decide

pre-existing condition can disqualify from coverage. to youths and too much health care so they can reprice. and we have to remember how bad the mess was the for obamacare. we have to major insurance companies, do not make those decisions. >> obamacare has been a failure even the president knows going forward it will be that bad. maya opponents acknowledge that the which is why the economy has such a tough time. bay he says clearly not.

that the premiums would go down but they have gone up. the deductibles have also gone up. i talk to businesses they tell me not given the plants they used to have. we can buy across state lines and affordability with deductibility in health savings accounts we need to start over with the of one size fits all plan but the deductibility-5 for other pre-existing conditions. we king keeps the good things about destroying the system. >> america's growing deficit has hampered the ability to

of economic growth and competitiveness. waste and fraud is not enough to solve the problem. what federal programs would we live in a to balance the federal budget? >> it is because the tax business is so much to put some much regulation on them then we have fewer jobs. right now since the '70s we have not had such low participation rate without people in the workplace there is less money creating money for taxpayers so first we need to have a growth economy. but they don't get that is the number-one priority.

but in virginia is so is better for their priority why we need to do things like pass legislation. to get into the private sector to get those people on food stamps back to work then they save money on food stamps.xbq÷q. then you have money coming in so we said you find savings in your budget and the only found enough with the bonus because federal employees are our best experts to find those a one them to work with us. to get people back to work hand in the '90s we balance

the budget in the '90s we want to take the $1,000 per child tax credit and make it $2,000 so families can see more money to raise their kids with more flexibility. >> supervisor? >> i have been here seven years it is hard to tell you seven years ago by in fairfax county where the budget is 3.$5 billion we went into a deficit in one year. we're not allowed to have a deficit so we have to balance the budget. and we prioritize.

but what we can do is allow the republicans to choose to cut infrastructure and education to take away the medicare for seniors. they are approaching the of fiscal challenges. we need to focus to make government more efficient. >> supervisor foust come after a lengthy debate congress added $11 million to the highway trust fund which is expected to only last until next month. should it go insolvent?

and then what about raising the federal gas tax for the trust fund and if so how way to fund the trust fund? >> transportation obviously is important but the state delegation but unfortunately my opponent voted against the transportation bill. but they are increasing the infrastructure.

these i the opportunities we have to focus on infrastructure investment to oppose the increase of the gas tax. these challenges will be behind us. >> we also need said davis bacon repeal or reform. and to stretch the transportation dollars further i do support offshore drilling that was in the bill for projected now we have bipartisan support now most of our delegation supports offshore drilling because that would be dedicated stream of money for llord transportation so

i strongly support that. also it is good with the international situation also the competitive bidding bill that saved $400 million that my opponent opposed. he opposed saving hundreds of millions of the competitive bidding bill. we took that to washington and i know the unions oppose it but with competitive bidding we would have more money on all at the structure projects other than what this administration in president do to put the project you give mandates on all projects that are run up the cost that is why the leadership will work with us on the competitive bidding. and i will have great help to get that bill passed. >> barbara comstock, returning to regulation you have a significant economic burden that regulations imposed on

businesses estimated at $2 trillion a new lee had to ensure federal agencies use the best available practices to a fight with the cost of regulation? would you support that congress must approve all regulation expected to cost more than $100 million a newly? >> yes. i do support that requirement. the administration has put all kinds of regulations on businesses that hurts our economy and making job creation difficult every day. so of a book to federal employees and their expertise and you and your business expertise. people tell me what problems they have with the government and their business you work with you to try to solve the problem. no matter what coalition we can put together that is what i have done to work

with people like we did with the competitive bidding bill. and we need to do that on regulation in washington because this president keeps going to agencies to put in the regulations and kills of paul industry and has held up the keystone pipeline. so every turn this administration supports kills our economy to stop in its tracks and what frustrates me is it doesn't have to be this way. we have seen a different way in virginia. some of you we're doing a groundbreaking a couple weeks ago. instead of maryland where they don't the us do anything. if you have the business friendly environment people

come from all over the country coming here from california they would not call the ' they said they were beating. they came here. it was up right to workload tax day we need to build low regulation right to work country to compete internationally. [applause] >> my opponent wants to talk about regulation but with the revised three commission we do that we meet with industry groups and staff working with industry groups all the time looking at the regulation that is in place to make it less costly and more business friendly.

i guarantee in northern virginia we have the good business climate environment. but they say that kills the economy but the challenges of northern virginia the reason we attract business is because we have an excellent educational system. mile boat -- supported coded two / $620 million to support the schools but the biggest problem is congestion my a opponent voted against the transportation spending bill but wants to create jobs. >> supervisor foust, the nlrb rules as the objective arbiter between business and labor is called into question.

looking at the lamar alexander's bill that would restructure the nlrb tour equally balanced between democrats and republicans would you support this bill or do you feel it is unnecessary? why? >> i am not familiar with the bill. i think that nlrb plays the important role and i would be supportive if it continues to play that role obviously in a fair and reasonable way. but i am afraid i cannot comment on specifics. >> i strongly support that bill. and also would support others. the nlrb is out of control. anybody in business knows

that and you see that every day they tried to shut down businesses there on the side of unions they have just become an advocate for the unions. the supreme court overturned their actions unanimously that means even free single supreme court judge said you are out of control that is the nlrb that needs to be reformed. you in business know how important that is to have somebody in the stands when an out-of-control agency. they tried to make card checks through regulation i oppose that and have worked against that i am a person of virginia who passed the right to this secret ballot that the nlrb members do not like but i will fight to make sure we have secret ballot elections not just in virginia but the entire country. [applause] >> i will ask the question

next. barbara comstock can you explain why you voted against the governor's transportation implant that was hailed by some of as once in a generation infusion of money for transportation in the state or a region where problems are a significanti%? why gave you vote against the bill? >> i would note that it was bipartisan opposition as well as support. it is a difficult issue. we did work civilly. in the business community i did discuss this but i was concerned about disproportionate taxes on northern virginia. we have a higher tax plus

additional taxes put on businesses. i knew it was a tough call but that was the call i made. now that is passed the night in washington we need to immediately come together to say how do we make that bill look? the important part is previous legislation to focus on congestion relief. monte arlington trolly colleague getting tens of millions of dollars. i was told that would never have been ben now you see that going for word. we need to prioritize that to make sure the money does not go tousing is like that. but where we get shortchanged i will fight every day. that is why those that support the transportation bill still supported me

because they know i am the person who works to get things done. >> one minute supervisor foust. >> it doeslx cost more in northern virginia. but my opponent is now currently is voting against it and thinks that somehow she makes this work. but let me tell you but of course, be uploaded showed up to the ribbon cutting and did not as shows support. this is the type of thing you have to work for. are you there to take on the challenge or meet the challenge heard you just show up and take the credit?

transportation is too important to play political games. and we are solving a significant challenge. and through our ability to retract business. >> a think it is a characterization not the attack. [laughter] >> supervisor foust being stalled the past three years of changes made in the number of destination of flights around airports called the perimeter rules. faa authorization is expected to come up during the next congress. what would you do to keep more flights in order to