. it's the best writer that discovers the steering wheel is no longer connected to the axle. this is our democracy because of the influence of the way that we fund the campaigns. what's the solution here? the truth is the solution is not hard to describe. if this is the picture this tweed system and the problem is the filter the solution is to find a way either to dominate the filter or to dominate the vice. that is an example of how this can be done. the number of republicans in the spirit of teddy roosevelt perhaps, began to push the ideas like vouchers as a way to solve this funding problem. vouchers where you imagine what to say that every voter gets a voucher, think of it like a target card or starbucks card, the stored value card that

allows them to allocate a certain amount of money to the candidates running for office and the candidates can take those vouchers would say a 50-dollar voucher here if they agree to limit the contribution that they take to the vouchers in a small competition, let's say $100 frankly. $50 dollars would be about $7 billion in 2014 the total amount spent by congress shall candidates was 1.5 billion. which means that this is real money to point his the voucher system would mean that money comes from many people and not just the .04% were not just a .024%. so it filters perhaps because it is not everybody that is going to participate, but it isn't biased in the way that the current system is biased by allocating the funding to the tiny tiny fraction of the 1%. democrats have been pushing this idea of matching funds john sarbanes from maryland, the

governor by the the people's act that basically takes the small contributions and multiplies them up to 9-1 to make them much more valuable. as a $100 becomes a thousand dollars because the 9-1 and encouraging the candidates to get lots of small conditions and again many many small small competition, not conjure visions coming from the .04% or above .024%. still a filter but not biased in the way that the current system is to read what these systems the thing that matters more than the current system is votes. voters. that's what matters to the democracy. equal votes from =. it isn't hard then why don't we have the solution? why do we have political movements to push the solution? the political experts tell us that the reason is most people don't care about it. most people look at the corruption and they are okay

with it or they are okay with that relative to relative to other issues they want to fight about. i don't think that's actually true. the most recent studies were december 2013 and we asked the public how important is it to you that we influence the money and politics and the answer was 96% of americans said it was important. 96%. but the next question was how likely do you think it is that we will reduce the money in politics and politics into the answer is 91% said that it was not likely. so just like most of us wish we could fly like superman at least 96% of us but because at least 91% are convinced we can't, we don't throw ourselves off a tall building regularly. we accept we are resigned to our human status and we live life the way that one would assume a new can fly from the ground or from tall buildings.

so too with this corruption. we accept it. we don't do anything about it because we belief there is nothing that can be done. we have added it to the slogan nothing is certain but death and taxes by adding the anti-corrupt government. these elements are taken for granted. that means the question here is how do we exist in this what is the strategy for fighting the resignation? the problem is not convincing people that there is a problem. the problem is convincing people that there is a solution that could actually be adopted. so what is it that we could do for that? as many of you know, because i'm sure that many of you are supporters the beginning of the year in march we announced we are going to launch something called the mayday project, made a as in distress signal.

the mayday for the democracy. the objective of this project was to be a kind of superpac to end all. the question was what would it take to run the series of campaigns that would even charlie when the congress committed to the fundamental reform. they then get as much of the match from the top down as we could. it's to run a pilot in 2014. and then a campaign to win in 2016 and push them at a station in 2017 and then 2019 to prepare to protect it by passing

whatever constitutional reforms would be needed to defend it against the supreme court. in the first stage we were able to raise $11 million from more than 57,000 contributors around the country. [applause] with the objective to elect the candidates committed to the fundamental reform. now, the truth is with that as the objective, the problem was a bust because out of the eight candidates that we supported, only one of those races was really competitive. we would've the data that we were able to pull from the surveys done before and after.

just in passing on the of the partisan election of 2014 that's enough to overcome the strong partisan division. we didn't prove at least to the skeptics the system that could scale. so there is no clear path which was the objective to get to the place in 2016 where we could elect to congress committed in the fundamental reform. when we lost in this dramatic way, the truth was one part of me was relieved because the truth about the politics as it is run today is that it is deeply satisfying and disgusting in most of how it works. and the constraints of politics constraint of politics today is almost impossible to imagine

using to educate people in a constructive way about these issues. i have likened it and trying to teach teach and algebra course by screaming out of the windows on the harvard yard the various aspect of the lesson as the students are walking through because most people don't want to hear the message that is being broadcast to them while they are trying to watch a patriots game. most people want to ignore it, so the method for communicating to them must communicate in a way that is incredibly constrained, almost impossible to move people. but the other part that echoed a kind of guilt of how it felt to the ultimate objective of this movement because the game was an insider's game to fix the problem with other insiders. the problem with that is that we americans don't be leave when we

tell them they will fix the problem. they found 80% of americans believe that the reforms that have been passed have been designed more to help the current members of congress get elected and to improve the system. we are cynical about the reformers as much as they are cynical about everything else. that means we have to find a way to stand outside the system to force the change within the system. the challenge here is to be authentically outside in the effort to force the change on the inside. that sounds like a heart problem and in some ways it is. there is something so appealing about the idea of demonstrating that throwing the message around the corruption of congress would be enough to rally the voters and then raising the hundreds of millions of dollars necessary for the something clean and simple about it even if there

was something somewhat corrupt about it. so this forces us to think what is the way to go forward that could force the change on the outside? from the outside? and i'm going to describe three elements of that strategy. one element is to make the change plausible. one element is to make the congress panic and one element is to make the issue presidential. first they originally had this idea of electing a congress. the bad was that we could demonstrate the power of the message to elect the candidates. this was a bad year to make that bet and now we have a horrible word of the valley to visit, to figure out what the work is that

can contribute to the project. so what are we doing now? the objective is to find a way to turn the army around and to focus it on a much more manageable project of recruiting incumbents to commit the reform. so if there is a majority in congress and there are those that are committed to the reform and the resulting gap, the project is to shrink the gap to shrink the gap to make it seem plausible that we could actually get the fundamental reform, not necessarily the majority connected to one of these versions but committed to the fundamental reform. so how will they actually deploy this? right now in a top-secret project that gets announced. there is a strategy for the platform to enable the tools of

this infrastructure we call the internet and incredibly powerful ability to begin to recruit targeted actions in the districts to convince the voters in the district's two get the members to connect to the reform and we be leave that it's feasible to get within striking distance gradient of 2015 and in march, the structure is announced and we launched a project to bring about the commitment on republicans and democrats both to the system of fundamental reform, to make it seem plausible. but that isn't going to be enough. it's getting close. much more interesting is creating panic. so this guy is george mason, one of the framers of the constitution. two days before the constitution was published, the draft in

philadelphia mason noticed a problem. the only way to amend the constitution at the time was the provision that gave congress the power to propose amendments. so george mason stood up and set on said on the floor of the constitutional convention what if congress is the problem? the system only congress can a man and if not they are the problem and that the first known instance that we have in the history of america is the framers recognized they have this fundamental flaw and so they created a second way to amend the constitution. article five gives the states the power to demand that congress call a convention, not a constitutional convention which has the power to amend the constitution but for a very limited purpose to propose amendments. now, what is clear is that the idea of the convention terrifies washington.

it terrifies dc to imagine this entity being created because the power to propose amendments even though those amendments amendments required a 35 require the 35 states to ratify the idea of the alternative power emerging or being called into being by this process terrifies them. and the closer we get to the magic number of the constitution specified, 34 states calling for a convention the more the panic grows. what is and recognized is that right now there are between 24 and 28 states passed resolutions calling on congress to call in article five convention. and vermont and california and illinois have last year passed proposals to call for the convention specifically related to the corrupt influence of money and politics. and as more of these organizations push for more states to join legal in the we

will in the next two years get incredibly close to the magic number. i think that we will probably get over the magic number. and as that happens, the congress will respond because historically, it has always responded to cut off the convention movement by getting people who are pushing for the convention that they want. and we may made for this process get what we want from them even before the convention. the best example of this is the amendment that gave us an elected senate. the constitution had to the senate picks by the state legislatures. people didn't like that. they thought that it would be filled with rich people that were selected. [laughter] so they said we should change that and have a directly elected senate but they were not going to have anything to do with it. there was a process going for the article five convention but then when they got within the

states to call for the article convention that congress simply sent out this amendment that created the elected senate so that panic produced reform, and the reform was central to bringing about what was perceived to be a solution to the problem and that is the same dynamic that we should expect here. the closer we get the closer we get to achieving something from a congress and finally, maybe most importantly, immediately as presidential. this issue has to be made presidential because in the modern american political system it only comes when the president is pushing its not just the president pushing it. some people might remember there was this guy that talked about the problem precisely and promised to address it precisely that once he walked into 1600

pennsylvania avenue and looked around, he realized that there was no chance that congress would ever address this problem, so he just dropped the issue completely. so we need to get the congress close to being able to pass it and then a president that wants to pick it out and make this issue presidential. it's not their natural wish to talk about this issue. if you look at the gallup poll politics related to the corruption in government in 2000 it wasn't even an issue in the top ten list. in 2008, it was number four on the top ten list of issues they thought that america should address. in 2012, it was number two. number two, second only to jobs. corruption in the way the government functions. and by corruption, thinking about rob at that time they were talking about and thinking about extraordinary money from the brothers or whatever favorite

person you want to point to. but if you looked at the site of romney and obama nowhere in the discussion of the issues did they even mentioned the problems and indeed i had a researcher look at it and it is the first time in as far as we can see when an issue on the top ten wasn't even mentioned by either candidate in the address of the policy issues that they promised to pick up. they don't want to talk about this issue. it's too embarrassing to talk about this issue. it's hypocritical to talk about the issues that they will avoid it as much as they can. it's to figure out how to get them to talk about this issue as they go around and engage in the rain dance to convince people to support them about whatever issue they want to get people to support them for.

it's not what they would rather consider. how do we get them to address a topic should they would rather not have to address. and that is the objective of this organization in new hampshire called the new hampshire rebellion. and by rebellion that doesn't mean against the government, it is to do though rebel against the agenda they will bring the presidential candidates to not talk about the issue. it's by recruiting people to ask this question again and again in new hampshire. it's also in the president related to this issue.

the focus led to him winning the primary in new hampshire. but just before he finished, new hampshire had a tidy to this issue that was much more powerful for many of the people that continue to talk about it. january 1, 1999 they started to walk in los angeles to cross the country to washington d.c. 3200 miles. she began at the age of 88 and arrived at the age of 90. there were hundreds of people following her including a bunch of congressmen who got in their cars and driven out. she focused on addressing what was then porter fundamental

issue into the corruption of the system of campaign finance reform and what they seek to do is revise this by remixing it a bit nobody has the time for 3200 miles up last year they did the first instance of the block across new hampshire. they walked 190 miles in new hampshire and did i mention in january? it's totaled about 200 people across the course of the block reaching tens of thousands of new recruits in new hampshire that signed up to join the candidates to talk about this issue in the primary and reaching a million people in the state and around the state of new hampshire talking about and focus on this issue.

there will be a four routes. it's to the citizens united. the objective here is to recruit 50,000 committed voters in new hampshire to ask this one question how are you going to end the system after option in washington and the theory is if enough ask that question and if the race is sufficiently competitive it creates an incentive and opportunity on the republican side and certainly and maybe too on the democratic side for the candidates to pick this issue up and if they take this issue up and make it an issue there is a chance that it becomes an issue in the presidential election. would that be enough?

in my book the public lost i was skeptical that would be enough. i also described what you think of as the region and the idea of this was if it's impossible for people to believe that ordinary politicians would really take this issue upcoming may be what we need is something that is not an ordinary politician. so imagine somebody like don gaetz or david souter or christie whitman or my favorite, just imagine the voice. it would be fantastic. a non- politician. with one promise that it would do one thing to pass whatever the reform is that that person thought was essential and that promise to resign. that's it. one thing.

the regions is there when the children grow up so washington is filled with lots of children so we are going to force you to grow up by taking away this corrupt influence and step aside and then the ordinary politician becomes president. [is that there is no ambiguity of the person is elected and why that person was elected. barack obama can say that i was elected for 34,000 different reasons but this person would be elected for one reason and there is no ability for the congress to push back against it if the congress wants to survive because it is pretty clear what the american people have said and there would be plenty of incentives by ordinary politicians to give that person with a person wants because it is the easiest way to get rid of that person. once you give them the bill they have to go home and go back to the ordinary politics as usual. this system, this region president system if we could find such a leader to step up and take the challenge i think would do it and would actually

bring about the kind of reform that we need. maybe it's possible to do it without but i think the key is to recognize that we needed a president in the mix. we need to move the congress, we need to scare the congress. we need a president to be three parts, to make it possible in this change. because the change is possible. it takes one statute. i think that we need 15 senators and 45 representatives to switch area that's possible. it's possible if we come if you come if people like you stand up and focus not just on the simple injustice, the injustice of the corrupt criminal, but the real justice that we have to bring back to the system, to the equality of citizens which the system has lost.

it's my view it's my life on it is the passion that started behind that we can get it back. it's possible. but the key here is an old harvey milk strategy. it's possible if we give people hope that there is something that can be done and not in the sense that our friend obama has abused the term but maybe in the sense that it was described. here's what he said about hope. hope is a state of mind, not of the world. it is a dimension of the soul. it is and prognostication. isn't prognostication. it's an orientation of the spirit and orientation of the heart. hope isn't the same thing as joy that things are going well. the willingness to invest in the enterprises that are obviously heading for success but rather

an ability inability to work for something because it is good. hope is definitely not the same thing as optimism. it is not the conviction that something will turn out well, but it's the certainty that something makes sense. if something does make sense here. it's my view that this republic makes sense, the ideal that the 225 years of struggling has evolved and it makes sense. there's something to hope for and something even to be optimistic about that if we organize in the way that we have now the capacity to organize there is a chance, not a certainty but a chance that we could restore this a quality of citizenship and. for once, maybe, maybe it's

never been here before once but for all of us that is our obligation. a moral obligation that can inspire all if it is understood to be something that speaks to the best of our tradition which is including an expanding and building a democracy that expands the capacity that we have. thank you very much. [applause] [applause]

>> thank you. i'm happy to take questions which i understand there are microphones on both sides. >> please come to the idol. thank you. >> question over here. >> thanks for a great talk. my question is related to how you get everybody in their individual issues to align with this greater issue. whether it's like you said healthcare environment, the list goes on. it seems to me that there is an emotional piece and, you know how do i take my english all fervor around a solar and climate change and even intellectually even though i

know that this bigger issue is the first issue it hard for me to get emotional about this and to take the same emotion and pour it into this underlining piece. so that is my discussion on the question. >> right. so this is a general problem that people described around this reform movement for many years. and i think the first step is to recognize something about how you can't get what you want. but i don't think it's enough to think about how i can't get what i want. i don't think the personal selfish perspective is sufficient even if you are a selfish perspective of the body public policy issue that you think is great for the world. i think the other part about it is to recognize why it is wrong. and when you see why it is wrong is because it is disenfranchised us. it's taken from ordinary americans a fundamental part of

what a democracy is equal representation. it's taken that away. there is a certain anger that goes with that. ..

and if we can find the way to link the recognition i'm not going to get anything anyway and they're is something than they're is the chance to begin to coordinate. i don't want to convince you to give up work on solar climate change. those are incredibly important issues regardless. i don't want to convince you to give it up but i want to convince you to tie give 10 percent to this cause cause, and if we can get everyone to tie to give 10% of his cause, then they're then there is enough to imagine this cause taking on the fight that it has to take on. and this fight in the end is actually not as hard as other fights we have taken on an want.

for example, racism which we have not one but spent a long time making extraordinary progress with a really hard problem. you it takes generations to pull that out. but but this issue is just a problem of incentives the incentives for running a campaign. there is know candidate running for office today who would lament giving up the world where they set like a pigeon in a cage and peck on the phone to get the person at the other end to give them the money that they need. it is about creating incentives where they see that they can win it a different way. this is not as hard problem and if we can get recognition beyond the simple injustice that i started with something beyond i hope i think that

is the way that we will make progress. >> i don't have any additional questions. thank you. i am convinced. i have been convinced for some time. it was just hard to not do both, but they're is an emotional piece they are and i think they're is something great about everyone working together. thank you. >> last question on the side >> high. i cannot think historically of any government that is not built to protect the interest of the elite and even in the graph whether is better income distribution so i am wondering if you could address that and whether in fact some of the people in this country

not a more effective way of skewering politicians. >> so i don't think they're is a a golden history. they're are particular times which work better but did not work better for all issues. even in a time when i think congress was not as captured by money as i think it is now it certainly was incapable of dealing with civil rights because of the veto power of democrats in the senate from the south. there is never a time in history when you can look back and say things were just grand. what do we want to think follows from that? because i i do think that we can see in our history ideals which still resonate with us, many that we have discarded unfortunately like disenfranchisement of women with a failure to recognize equality of race. but the ideal of this

equality of citizenship was from the founding an idea which we can still collect and use. madison, when he described our democracy said democracy, said we would have a branch that would be dependent on the people alone. we don't have that now. but then he went on to be clear about what he meant. meant. by the people he meant not the rich more than the poor. that is an ideal that we can use to.to the democracy we should be pushing for. now you ask if there are questions are more radical revolutionary changes more effective? and so far i don't think so not that anything has been, but so far we will we see is that when pushed at the extreme like that this enormously powerful system response in an incredibly

brutal way. you know, we can can look at what happened and occupy. or forget occupy, think about the brutality of the response. the system is enormously powerful for dealing with what they view as deviations. that deviations. that is what commits me to the idea that somehow inside norm the morals of the system we have to use the system to change it. i'm happy to be proven wrong i am not saying people should give up on the more radical but we need to recognize a path that does not require tearing down everything. there is the path. it is possible and does not require or even invite people to give up fundamental commitment.

i can't give a version of this talk to a group of republican conservative republicans and find a way to show them as much a commitment to ending the corruption of the system as people care about climate change or whatever. i do not think that it is necessary. i don't think extreme has done in the current brutality of our system as much as could be done if we found a way to speak across the divisions and push in a way that united in the way that i'm trying to describe. >> question over here. >> okay. i want to go back to the article five convention that you were talking about earlier. what i get from a lot of the political changes that were promised like financial reform, campaign-finance reform is we get promised one thing and it works its

way through and by the time it's done its gutted of power meaning. my question is, what does this amendment you envision look like? how do we get the change we are demanding? >> you are describing the product of a a system where money has an enormous influence because it is learned how to exercise its influence over the system. the thing the thing that they are afraid of when they talk about the convention is that no one quite knows how to control that. that is not to say they're is any good reason to believe that entity would produce fantastic ideas. in fact there are a lot of reasons to worry about that entity producing terrible ideas, but what i described here was not the product that great ideas would come out of that process but instead that of that process puts enormous pressure on congress to try to stop that

process and does that by giving the political movement what they want. the want. the last time we came close was a balanced-budget convention in the 1970s and 1980s. we came very close but then congress adopted a series of reforms that responded to that push and stop the push by the response. all that i am saying right now is we should recognize this as another tool to create the kind of pressure for reform that right now does not seem to exist because they are happy to run the system the way that the system has been run for the last 20 years. we have an election. the 1st thing that happens after the election is the passage of a bill that basically undoes the financial reform that the dollar frank critical part the derivative store raises the raises the contribution by campaigns, the

contribution that you can make to parties giving billions of dollars to parties or you could not before, and all of it is done by democrats and republicans recognizing that they need to do this. that can that can change unless they are terrified about the consequences. one dimension comes from this unspecified power from the article five convention. >> on the side. >> thank you so much for your time and all your work on this issue. you said we need 15 senators and 45 representatives. i think that is feasible and tough polarized, vicious political environment. two questions off the bat. bat. tactically do you think it is better to try to insulate this issue? or try and channel those forces behind the issue? secondly, more importantly

to build trust between members of congress to try to bridge that gap what sort of them formal informal mechanisms or institutions do you think we can establish? exchanging constituent letters to the editor might be to california for you a group meditation session. [laughter] >> i was here for nine years this is the really critical. it is hard especially for progressives to embrace that we need more than progressives to win. and that is not to say we have to compromise anything but to say that we need to recognize that fundamental reform only ever happens at the constitutional level if it is cross partisan and that is to say, i want to get these 15 senators that by saying we are going to kick out 15 republicans against 15 democrats. we only get 15 senators or ten maybe if we can get

republicans to begin to talk about the issue. what we no is if you get republicans in the context they are not worried about losing his seat to a democrat to choose between a republican candidate who cares about reform and what it is not, the reform candidate does better. better. a strategy that suggests is to begin to think about safe republican seats where they're is a chance to talk about republicans who care about reform. one example is a brat who beat eric cantor. a completely safe republican seat, i guy who spent almost no money came in and call them a crony a crony capitalist. those are fighting words for a right-wing republican. it's the evil, but that is exactly what this corruption is, the production of crony capitalism. that is how the right thinks about it.

and that credible fight which was complicated by other issues like immigration that people on the left are upset about but that way of framing it makes it a credible republican concern as well. the only way we win is if eight to ten republican victories happen around this not because democrats have beaten them that because republicans have begun to generate there own version. this election cycle support of the only republican candidate in the nation to make the way elections are funded a a fundamental issue and to propose public funding of elections. that was a central part of what jim rubens campaign in new hampshire was about and that influence has now begun to spread. spread. republicans talking about introducing a very large voucher bill which would radically change the way the campaigns are funded.

this is the slow progress that has to happen on the right and if a slice of republicans, not 50% not 40% maybe even 10% where to begin to open up were to begin to open up the possibility of that as a feature of the platform and the coalition necessary to win is possible. and that is exactly the way it has always been. teddy roosevelt's republican upon the following is a republican tapped as a republican. they work with reform democrats to produce the progressive movement but the progressive movement is democrats and republicans, not just a bunch of democrats. democrats have conservative southern democrats. so that recognition of the need to find a way to knit together political perspectives focused on this fundamental issue is what we have to discover and is so counterintuitive to us and

is not even clear organizationally that it is possible. the business model of progressive organizations is inconsistent with the business model of winning because the way we want to talk about this issue is designed to make the other side haters. we want to talk about how terrible corporations are and how evil it is to have money in the system which might be true, but if you talk like that you are certain to turn off 40 percent of america. is they're an authentic entryway to talk about this that does not necessarily turn them off? and the parallel that just becomes more and more compelling to me is to think about the civil rights movement. in the late 50s and early 60s the fundamental divide in the civil rights movement one part that we associate now with malcolm x. thinks the way to win is to build as much fury among african-americans for there cause is possible. and if that includes

violence that includes violence. god knows they're has been violence for hundreds of years. that is what it takes, that's what it takes. the other part of the movement which we now associate with martin luther king is the part that says, look, we have to speak so the other side can hear us. if we go out their and engage in violence the other side doesn't listen. they they say let's deal with the violence. if we go with nonviolence and engage in a way that celebrates the best of our traditions they have to listen to us. when you watch parents and grandparents watched african-americans being housed in bowling with dogs and beaten on the bridge they responded by recognizing this was inconsistent with the values that they had. they were speaking in a way so the other side had to hear, here and i think that

is what we have to do here find a way to talk so the other side has to listen and here in the greek and greek command as i have done this spoken to people the right there is a recognition that this common problem a common a common enemy even if we don't have confidence. we have to find a way to organize and that objective includes recognizing it is not about being republicans but bringing them to recognize the corruption of the system. >> a question over here on the right. >> i love your speech. been with you for eight months. i have a question because the 1st explained that i i have absolutely know chance of making any change. and the top .02 percent can veto any issue that they want. the 2nd half you explain to me that we could probably

push through the one issue that most want to veto. you left out what the top 2% was going to do to stop us which is also what got left out before the last election i did not hear much about it. i it. i we will ask you to fill in the blank. you don't remove the filter between the top of made a in the bottom because i cannot find out what your discussion intellectually up top and how you make your decisions you cannot contribute to it. there is a real strong block just like in democracy. >> well let's separate the issues for a 2nd and talk about how it is feasible 1st that the group that is

disadvantaged out the bottom 90 whatever percent you want to call it can mobilize enough power to destroy the thing which the top might care most to preserve. let me let me start by reinforcing the intuition that it is a really hard problem. my friend jim cooper, democrat from tennessee describes capitol hill as a farm league for k street. what he means is a common business model now all my members of congress and staffers to go become lobbyists. represent that. 1,452 percent. so if you're on the inside and imagine your future that someone comes along

lobbyists can't possibly be paid that much, you much you are not likely to be encouraged to support that reform. it might well be that they're is nothing to be done. it might well be. so what do you do in the face of what might well be? i get from many people all the time the argument can't be done so don't do anything about it. and that is a really tempting tempting idea because it is really costly to do something about it. you know young kids are not happy than trying to do something about it. when i look at the temperature in new hampshire next week this is a nice idea.

but some of you might know when i was a kid i was republican. i grew up, but i was a republican when i was a kid. here's over public and republican say all the time, we love our country. as i have grown up and become a liberal i here liberals say it, to. we used to chant that. and as i have become a law professor and looked at the great parts of our tradition standing next to the terrible parts i feel that love. and what i no about love and you know what love is what love means is you never give up regardless of what you face. i wrote this at the end of my book as a woman standing before me.

you have convinced me, professor. there is nothing that can be done. done. it is hopeless. there is know change we could ever achieve. and as i said in the book i was terrified because i don't want to produce the reaction and people. the the image that came to me was of my son milo and imagine a dr. saying to you your son as terminal brain cancer and there's nothing you can do. what would you do? >> you have avoided my question entirely. >> have taken the 1st part what do we do it all me to continue the story. [laughter] so quid pro quo. great.

so the.to this is a should be obvious, if you feel this you are going to do it regardless and we we will work and you said you we will work, to. the 2nd part, you want to talk about how we organize and regulate this one entity i totally agree. and so what i described was a process that we will invite exactly this project to figure out how we recruit but you need to -- the only -- they're is know justification. the only explanation that i i would offer is just understanding the incredible constraints of ginning up and executing in a month the project that

try to take him what we try to take on. and they're are a million mistakes to learn from. we are trying to learn from half of those mistakes as quickly as we can. i eagerly want to find a way to bring as many as possible but i also know from the staff that were there there are only so many hours that we have so much that we could not get done. i take your question and insistence that i answer it as a pledge from you that you step forward and be part of that but that is exactly what i confessed the shift is got to be how to recruit people to do the work person to person as opposed to how we recruit television stations to do the work i agree. thank you. >> we have time for one last question. i just want to invite everybody to join us for a

reception and book signing. we have time for one last brief question. >> in 2,008 getting marijuana legalized was basically a sideshow ignored the presidential candidates never talked about it and today because of the ballot proposition we have five states in which is now legal i'm curious about how a similar strategy isn't being used for campaign finance reform to make it so that the state has a real campaign finance reform system and people say while. we can emulate this and get something on the ground immediately instead of waiting for congress. >> this is a a great strategy and it is being pursued to push at the state level and the local level to create these anticorruption ordinances. they just succeeded in tallahassee and they are

pushing ones in montana. i totally support this idea and believe we don't have time. we don't have time for states to come around to get there local house in order before we take on the challenge of congress. we don't have time because we don't have the opportunity to way to address the issues that motivate everyone to turn out and want to do something like climate change your healthcare will be quality or some way of finding a common purpose. these are not things that can wait. as much as i am eager to see those things succeed i would not say that means we shift our focus and not also try to pursue those and recognize that that might mean those don't move as quickly but i think as they move together they feed on each other. what we saw half of the victory in tallahassee was an extraordinary revival of the belief that they're was change possible plan that

helps us to work at the national level. it's a great strategy. it is just one more we have to be able to adopt. i adopt. i am incredibly grateful you would to spend time with us and then hopefully you will carry this forward to others enjoyed at least one of these maybe two. yes, there are some left in new hampshire waiting for people to fill the. come join us. thank you. [applause] >> thank you. >> washington journal program has been touring the nation's historically black colleges and and universities. earlier today we visited florida a&m. we we will begin today at 6:40 p.m. eastern with a look at howard university. later a tour of hampton university of virginia. tonight the 1st of three

days of tech related programming >> here is the idea you push a button, a car comes in picks you up like normal and while you're on your way to your destination somebody else is going along the same route at the same time and with two minutes or less deviation from iraq you're in picks someone else up along the way. >> and they get in my car with me. >> they get in the same car as you, that's correct. what happens is -- >> it sounds a lot like a bus. >> understood.

the differences of buses you go to a quarter that's half a mile away from you and wait 15 minutes and sometimes it's on time and sometimes it's not. this one comes. it's they're when you want it. that is the magic. you still get the benefit of the bus to the benefit of carpooling by literally taking cars off the road. significant deficiencies in doing this. >> that was a small portion of the recent technocrats disrupt conference. more tonight wednesday thursday

>> book tv and american history tv on the road you. this weekend we partnered with time warner cable for a visit a visit to greensboro, north carolina. >> after months and months of cleaning the house charles halpern was making one more walk-through and he looked over and saw an envelope with a kind of green seal on it and walked over and noticed the date was in 1832 document. he removed a single mail a single mail from a panel in an upstairs attic room and discovered a trunk and book and portrait. this was this treasure of dolly madison.

we have had this story available to the public from displaying different items time to time and trying to include her life story from her book to her death in 1849. some of the items we currently have on display a card, i've recalling card case that has a card enclosed with her signature as well as that of her niece, some small cut glass perfume bottles and a pair of silk slippers that have tiny little ribbons that tie across the arch of her foot. the two the two dresses other reproductions of a silk peach silk gown and a red velvet gown which has intrigued but that it has lasted and is part of the collection

joining us on the phone is bart janssen. >> here to talk about faa unveiling over the weekend knew rules for drones. what what did they put out they're? >> they put out a proposal for how they would like to regulate commercial jones. the drones people might want to use for wedding photography and for real estate to show houses. all states of commercial uses. they are asking for comment and

they will be chewing over those comments. it runs for 60 days and they will be analyzing those comments before coming up with a final rule. host: who does this impact? caller: all sorts of folks would like to use commercial drones for bridge inspections or moviemaking, realtors, anybody that might want to see things from the sky but is cheaper and less dangerous by drones them by helicopters or by regular aircraft. it is a cheaper a more safe way to do aerial views of things then standard aircraft. host: what is the faa saying about how they are flown? guest: the big concerns, how do

you prevent them from colliding with other aircraft and hurting anybody on the ground. the proposal is to say you can fly the drone, but you have to keep the aircraft within sight of the pilot on the ground , you can only fly during daylight hours, you have to avoid flying over people who are not associated with you. if everybody in a wedding knows there is going to be a drone flying overhead, that is ok, but they do not want you flying over a sporting event. those are the most important parameters of what they have proposed. host: what about the high lives flying the drones? do they have to go through any

sort of certification to be able to fly these commercial drones? guest: yes, they do. they would create, people who have flown recreationally, that is still allowed they do not have to have licenses, but for commercial off raiders, people using drugs for businesses, they would have to get a new certificate, that shows they know stuff about aeronautics how you need to avoid other planes, and they would have to go through a setting by the transportation security administration to check their criminal background and there is a certificate required. it would not require a full pilots license, like the folks

who fly a says. -- who fly a cessna. host: what is next from the faa? are they going to way into these other areas of drone use? guest: congress ordered them three years ago this month, to try to come up with rules so drones could fly in the same skies with all other aircraft. they were supposed to come up with all of the rules by this september. only coming up with this proposal for drones that way up to 55 pounds, they have a ways to go. they have not even begun to deal with larger drones. these are the ones you are

familiar with, the smaller ones, flying around with hobbyists today. they have to develop and analyze the comments about this proposal . it beyond that, they will have to come up with the rules for bigger drones. drones can be as big as regular aircraft. a drone just means it is flown by somebody not aboard the aircraft. another aspect is delivery folks, such as amazon, they would like to fly drones to deliver their books and there is concern about having drones fly the faa would like to have one pilots were ever drone. you watch it is flying safely. in order to do deliveries, they have to fly automatic flight paths. that is not part of this proposal.

the amazons of the world may ask congress to say you should let us to deliveries. >> providing allied nations with weapons and become a cornerstone of us counterterrorism strategy. intensely controversial. the knew policy to be announced today is a significant step for us arms policy as allied nations from italy to turkey to the persian gulf region clamor for the aircraft. it is also a nod to us defense firms scrambling to secure a greater share. that from the "washington

post" today. >> washington journal has been touring the nation's historically black colleges and universities. we reenters segments. we we will start today at 640 eastern with a look at howard university and later we we will tour hampton university of virginia.

>> for months and months charles halpern was making one small walk-through, and in the attic he looked over and saw an envoy kind of a green seal on it and walked over. the date was in 1832 document. he removes a single mail from a piano a piano and discovered a trunk and books and portraits. we had the story available to the public, displaying different items from time to time but trying to include her life story from her book to her death.

some of the items we currently have on display i've recalling card that have a card enclosed. that attorneys. some small cut glass perfume bottles and a pair of silk slippers that have tiny little ribbons that tie across the arch of her foot. the reproductions of a peach silk gown that she wore early in life and a red velvet gown which is part of the collection. >> watch all of our events saturday at noon eastern on c-span2 book tv and sunday afternoon at 2:00 o'clock on

american history tv. >> a hearing now on vaccines and vaccine treatable diseases. it it was stressed on the hill that vaccines are safe. there is no scientific evidence that they cause autism. comments before the senate health committee earlier this month as washington dc california and several other states are dealing with measles outbreaks which is part increased debate over making vaccinees it -- vaccines mandatory. this is about two hours.

>> the senate committee on health education labor and pensions we will please come to order. we we are holding a hearing about the reemergence of vaccine preventable diseases senator murray and i we will each have an opening statement and then introduce our opening witnesses. --'s we will have five minutes of questions. two panels and two hours of hearing. he we will have an hour for each panel and i we will end the 1st panel 11:00 o'clock. from smallpox to polio we have learned that vaccines save lives. a troubling a troubling number of parents are not vaccinating her children. last september this committee held a hearing about the ebola virus who worked in liberia and who contractible you. a father

in sierra leone came to warn us about how rapidly the virus is spreading. the number of people being infected _-dash three weeks and many of the infected were dying because for a bowl of they're was and is know cure and there was and is know vaccine. this produced a near panic in the united states. it changed procedures in nearly every hospital and clinic. i remember one chattanooga public health officer saying it is all the ball all the time everyday. in response congress appropriated more than $5 billion to fight the spread of the virus. the impact of efforts to fight ebola is that the number of cases is declining. at the same time hear in the united states we are experiencing a large a large outbreak of the disease for which we do have a vaccine.

measles used to sicken up to 4 million americans each year, many believing he was in on preventable childhood illness. the introduction of of a vaccine in 1963 changed everything. measles was declared eliminating any absence of continuous disease transmission for greater than 12 months from the united states in 2,000. then from 2001 to 2012 to 2012 the median yearly number of cases reported was about 60. today is february 102015 the 41st day of the year and already we have seen more cases of measles that we would in a typical year. one outbreak in illinois a suburb about a half-hour from chicago has affected at least five babies come all less than one -year-old. infants and individuals who are immunocompromised are traditionally protected by what is called herd immunity

meaning when more than nine out of ten of the people around them are vaccinated so they don't get sick which keeps the babies and others who cannot get vaccinated from getting sick. that herd immunity is incredibly important. measles can cause life-threatening complications and children such as pneumonia or swelling of the brain. our witnesses we will talk more not just about what is causing this outbreak but why some parents are choosing not to vaccinate they're children. measles is only one example. this hearing which was planned before the outbreak reminds us of the importance of vaccines. an analysis of immunization rates across 14 states performed by "usa today" found the following hundreds of thousands of students attend schools ranging from small private academies in

new york city to large public elementary schools outside boston to native american reservation schools in idaho where vaccination rates have dropped precipitously low, sometimes under 50 percent. california is one of the 20 states that allow parents to claim personal belief exemptions from vaccination requirements. in some areas of los angeles 60 to 70 percent of parents at certain schools have filed a personal belief exemption. vaccination rates are as low as those in chad or in south sudan. the purpose of this hearing is to examine what is standing between healthy children and deadly diseases it ought to be vaccinations but vaccinations but too many parents are turning away from sound science. vaccines save lives. they save the lives of people who are vaccinated protect the lives of the vulnerable around them like infants and those who are ill. vaccines save lives. they protect us us from the ravages of awful diseases

like polio which invades the nervous system and can cause paralysis. paralysis. i can remember how parents were frightened by the prospect of polio for they're child. i had classmates who lived in iron lines. our majority leader contracted polio as a child or whooping cough is another example which causes the mucus to accumulate in the airways and can make it difficult for babies to breathe or diphtheria, a bacterial infection that affects the mucous membranes of your nose and throat and can damage your heart kidney, and nervous system. we have learned that vaccines save lives. they lives. they take deadly, awful ravaging diseases report a history, so it is troubling to hear that before we have even reached valentine's day this year 121 americans are sick with measles a disease eliminated in the united states 15 years ago.

it is troubling that a growing number of parents are not following the recommendations of dollars to five doctors and public health professionals who have been making those recommendations for decades. at a time and we are standing on the cusp of medical breakthroughs never imagined,, cutting edge personalized medicine tailored to an individual's genome we find ourselves retreading old ground. i now turn to sen. murray for her opening statement. >> thank you very much. thanks to all of our witnesses for coming in sharing your expertise with us today. keeping our children and families healthy could not be more important, so i'm glad to have the opportunity to hear from all of you about the threat vaccine preventable diseases still pose in the united states and discuss what we should be doing to take these threats of the table. there is no question we have come a long way when it comes to what was once

widespread and extremely dangerous illnesses. vaccines vaccines are one of our country's greatest public health successes. thanks to them we know how to prevent illnesses that struck so many children as recently as a generation or two ago like polio and whooping cough and measles. recent news made clear that vaccine preventable diseases are still threat and that we can afford to become complacent about protecting the progress that we have made. this means children across the country need to be vaccinated. it also means we need to be vigilant about breaking down barriers that families may face when it comes to accessing certain vaccines, and we need to ensure that in any cases where take-up rates are low we are providing information and spreading awareness so that more people can be protected. the hpv vaccine is a great example. it prevents life-threatening cancers.

despite that cdc reports that take-up rates for the vaccine are still unacceptably low meaning people continue to be exposed to deeply harmful illnesses that could've been prevented. i no several of our witnesses have done a lot of work on this issue and i have questions about what we can do to encourage broader use of vaccines. looking forward to an update about the recent measles outbreaks in the work that the cdc is doing to continue to encourage vaccines. i am eager to hear from doctor kelly more about the role of states in preventing and responding to outbreaks like this one and i no dr. sawyer and jacks we will be able to provide valuable insight into ongoing nationwide efforts to increase immunization rates and keep children and families healthy. i want to thank all of our witnesses for the important work you are doing and

taking the time to be with us today. >> thank you, sen. murray and thank you to you and your staff are working together so that we jointly invite the witnesses today. it always it always produces a better hearing and good variety of views. i we will ask if you we will summarize your views in five minutes so that the senators can have a chance to give they're questions i said before some of the senators came in to my we will have to end the 1st panel and 11 so we can get the 2nd panel. i hope all of us can get questions and. the dir. of national center for immunization and respiratory diseases at the centers for disease control and prevention. prevention. she has worked at cdc since 1998 on immunization respiratory, and other infectious diseases and rear

admiral of the public health service commissioned corps and was named assistant surgeon general of the united states public health service in 2,006. welcome. >> good morning, mr. chairman, members of the committee, thank you for the opportunity to speak with you today. our nations immunization system is strong. this year's outbreak demonstrates how interconnected we are. many threats are just an airplane ride away. despite high national immunization coverage last year we had more cases of measles in the us then we have since 1994. since january 1 we have already had more measles cases this year than we have in most -- most full year since 2,000 when homegrown measles was eliminated. from january to february 6 of this year 121 people from

17 states have been reported to have measles. most are links to an ongoing outbreak that originated the disney parks in california during december. most cases were not vaccinated or did not know if they had been vaccinated. recent patients have exposed others in a variety of settings including at school, child care emergency departments outpatient clinics and airplanes. these episodes require a rapid response coordinated across local, state and federal jurisdictions to read the backbone for such a response a response comes from the public health immunization infrastructure. the systems and people that protect our communities from vaccine preventable diseases today we are talking about measles but we could just as easily be talking about a resurgence of whooping cough, meningitis or adapting to a shortage of a popular combination vaccine. we need a strong immunization system that

takes care of the everyday prevention and assures the quality of clinical practice but is also robust enough to respond to emergencies and ready to launch mass vaccination for the next pandemic. whether a vaccine is given in a private doctor's office or at a committee clinic the public health system plays a critical role in making sure vaccination is accessible safe, and effective and used in the best way to protect all americans and that immunization policies are based on a strong scientific foundation. our priorities for maintaining a strong program we will include preserving core public health infrastructure at the local state, and federal level maintaining adequate vaccine purchased and for responding

to outbreaks and other urgent vaccine needs and making strategic investments to enhance the immunization infrastructure and evidence-based and improve efficiency. efficiency. coverage for many childhood vaccines is above 90 percent and reported cases for most vaccine preventable diseases are down by more than 90 percent and most parents are vaccinating children with most of the vac -- recommended vaccines. vaccines. less than 1 percent of thomas received no vaccine. immunization continues immunization continues to be one of the most cost-effective public health prevention for each dollar invested they're are $10 $10 of societal savings and $3 in direct medical savings. the past 20 years of us childhood immunization is prevented over 300 million illnesses, 732,000 deaths and resulted in $1.4 trillion in cost. in many ways -- cost savings. in many ways ways we are victim of our own success.

fewer and fewer doctors, nurses and parents have witnessed the series and sometimes life-threatening consequences of these diseases. parents may parents may wonder if vaccines are necessary and worry that the risks are a temporary discomfort that may outweigh the benefits of protecting families. the increase in measles cases should be seen as a wake-up call. measles measles is contagious and quickly uncovered pockets of under vaccination. in the in the 1980s and early 90s measles outbreaks uncovered systemic problems with poor children having access to vaccines the into the creation of a vaccine for children program today measles in the us is an indicator of how globally interconnected we are. and we see outbreaks measles uncovers those people and areas in the us that are

opting out of immunization command we have indications that some of those unvaccinated micro- communities may be getting larger. our immunization system has risen to challenges in the past. the cdc we will work with partners to keep measles from regaining a foothold. we can keep these numbers down, keep measles from returning and threatening the health of communities and sustain the enormous health and societal benefits that our immunization partnership is achieved. thank you. >> thank you, dr.. about ten years ago a group of us were led to south africa where we found the president of south africa had rejected the science on hiv-aids, decided it was not caused by a virus and that the cure was elimination of poverty setting back south africa for years in terms of

its ability to deal with hiv-aids. .. >> according to this medical journal, there is a relationship between this measles and mumps vaccine and the possibility of my child being autistic. what would you say to that parent? >> autism is a terrible condition. that paper that you're mentioning has been totally

discredited. it was found to be fraudulent and is not the case. there have been dozens of studies of vaccines and the question of autisming. vaccines don't cause autism. they are highly effective and safe and are a good way to protect your children from advantage soon-preevent bl diseases. >> when you say "totally discredited," what do you mean by that? >> the information in that particular report was found to be um, fraudulent by a british investigator. some of the information wasn't correct in terms of the notes that were submitted. but there have been dozens of studies that were better to try to understand whether there is a link between vaccines and autism. it was sort of a natural question some parents had because of the onset age for autism. but thoses have been incredibly reassuring -- those studies have been incredibly reassuring. when i talk to parents i like to explain as a physician and a public health expert i can tell you vaccines are very safe and effective. and while autism is a terrible

condition, one thing we know is vaccines don't cause autism. >> so you would say to the parent that that article was flat wrong. >> that's right. >> and that numerous studies have shown that it was wrong. >> that's right. >> and what happened to the author of the article? >> he lost his medical license. >> because why? >> because of the fraudulent behavior. >> because of the fraudulent behavior. we've been talking about a variety of vaccines. it struck me as we were so worried about ebola in the fall last fall -- we're still worried about it -- that many of the public health people would point out to me from tennessee that we have the flu season coming up. we lose -- is the number -- how many americans die each year from the flu from flu? >> you know, flu is very variable but it can be between 3,000 in a good year to 50,000 in a severe year. this is a quite severe year for flu. >> so 3000 to 50,000 could die

from flu. is this a vaccine from flu? >> that's right. several different vaccines for influenza. right now about 46% of americans get a flu vaccine every year. we'd like that to be much higher so we do recommend everybody six months and over get a flu vaccine every year. >> let's go back to the measles for a minute. measles is not just a runny nose, is it? it's a serious disease. what would you say to a parent who comes in and says i'm going to opt not to get the measles vaccine? what are the risks of that? how many children who contract the measles die? >> you know before there was a measles vaccine in the u.s., 400-500 children in this country died. the risk of dying is much higher in countries that are poorer where malnutrition is a problem. so we have about 150,000 deaths from measles around the world each year. used to be millions and that's actually an improvement because of high uptake of measles

vaccine. >> but would it be accurate to say if your child contracted measles in the united states, the chances of a death would be about 3 in 1,000? -- 1 in 1,000? >> that's right. but remember, there are other problems with measles, not just that rare risk of dying. even a mild case of measles is a really scary thing for a parent. my mom told me i -- when i had measles, she was scared to take my temperature. measles can be scary for parents, even the mild cases. there are other complications besides death. children can get pneumonia, they can get dehydration, they can get a neurologic problem encephalitis, which can be quite scary and severe. >> thank you. senator murray. >> doctor, thank you for being here and really thank you for all the work you do to protect our families and chirp across the country -- and children across the country. there is no doubt that challenges remain with regards to immunization rates and

american families' broad access to no-cost vaccines is clearly a key factor in maintaining and improving our vaccination rates. in my home state of washington, we have a universal childhood vaccine program which provides recommended vaccines for all children. but i know there are a number of important federal programs that insure access to free vaccines in our country. can you describe cdc's effort to insure all americans do have access to the vaccines they need without cost sharing including through vaccines for children program? and particular lu why that's so important -- particularly why that's so important. >> the cdc administers the vaccines for children program and we just celebrated 20 years of that program. it's been extraordinarily effective. it provides free sack seens -- vaccines to children who are uninsured, medicaid-eligible american indian and alaska native true truly to financially vulnerable children in the

country. it provides vaccines for almost 50% of children in the united states. this program has greatly overcome racial, ethnic and financial barriers to vaccination, and we see much higher coverage now in the era of the vfc program. as i mentioned, we think it's saved over 300 million ill 'ems, prevented those illnesses in the past 20 years and saved $1.4 trillion. cdc also support the states in a program to try to bridge some of the gaps that are not addressed through the vfc program. in particular, supporting the public health infrastructure for immunization. so state and local health departments have the immunization programs that work with clinicians in those areas. they don't just investigate outbreaks like the measles outbreak but they workday in and day out in supporting provider education in dealing with vaccine shortages, in distributing vaccines so that they get to the providers' offices. and your own state of washington

has an absolutely fantastic program. >> okay, thank you. you know, for me and for a lot of my colleagues disease prevention was a key priority when we wrote the affordable care act and i'm very proud of the fact that health plans now do have to cover recommended vaccines without cost sharing. as health insurance coverage now is increasing, can you tell me what cdc is doing to help health departments bill insurance providers for vaccines provided to cover individuals? >> that's right. the affordable care act means that more people have insurance and more insurance is excellent for vaccines because the aca requires that insurers provide all recommended vaccines with no co-pays or deductibles when they're given in an in-n provider. so cdc's been supporting, i believe, 35 states to set up billing practices so that if insured people need to get vaccinated, for instance, in a public health clinic that public health clinic will be

able to bill the insurer and recoup some money. we're really trying to make sure the scarce federal dollars that are discretionary really go to protect the infrastructure and that the insurers pay their way. >> okay good. and i just wanted to mention i'm really proud of the number of organizations in my home state where they're really, truly global leaders in promoting vaccinations worldwide. we have the gates foundation and the reality is we're incredibly lucky in this country to have people who have witnessed death by diseases like measles, polio or whooping cough. i know you've worked with these issues across the globe. can you tell us what you perceive are the key challenges to achieving optimal immunization rates here as opposed to developing countries? >> you know, we're so fortunate here to have a strong health system and access to vaccines. in many countries even with the alliance that provides vaccines for free for some of the poorest

countries, the infrastructure is very weak. so strengthening health systems overseas so that they really can deliver vaccines is vitally important. there are a number of public/private partnerships that have been helping in that arena and i just want to mention the measles/rubella initiative. they've been responsible for more than a billion children getting measles vaccines through campaigns and other areas. and we think that about 15 million children have been prevented from dying from measles in the last 15 years through the measles/rubella initiative working with governments around the world. >> so the public health infrastructure that we have here is critical for issues like this. >> absolutely. even if every single american were with insured, we still need public health to make sure that we are addressing the needs of the communities. >> thank you. thank you, mr. chairman. >> thanks, senator murray. we'll now move to five minute rounds of questions. senator collins senator mikulski, senator cassidy senator warren will be the first

four. senators who just arrived at 11, we're going to move to the second panel even if we haven't finished the senators' questions. that'll take 15 minutes, and then we'll pick up where we left off with the senators who are next in line. so, senator collins. >> thank you, mr. chairman. dr. schuchat, the president's budget request includes a $50 million cut to the centers for disease control and prevention section 317 immunization program. you've just responded to a question from senator murray about the importance of the state and local public health infrastructure. and more than just paying for vaccines the section 317 immunization program supports outreach awareness, surveillance efforts by the

state and local public health agencies. it's puzzling to me that the administration would propose to cut this program when we're in the midst of a measles outbreak when you would think that you would want increased public outreach awareness and surveillance. you've just talked about the importance of the state and local roles. could you explain to us why this cut has been proposed? >> the public health infrastructure at the state, local and federal level is vitally important to protecting americans. as i mentioned earlier, these threats like measles are an airplane ride away. the reduction in resources requested through the president's budget will be accounted for through a reduction in vaccine purchase and the idea is that instead of paying for vaccines for insured people the health departments will be able to bill the

insurers so that they will pay their way. but, absolutely, protecting the public health infrastructure at that state and local level is critically important as is the communication outreach and the provider work that we do. >> well it just seems to me that this is exactly the wrong time for us to be reducing funding in this area given the importance that you've just outlined. historically, access to health care and the cost of vaccines had been the major barriers to achieving high vaccination rates. but increasingly it's clear that other factors have come to bear. as we're seeing declining vaccination rates in some extremely wealthy areas of our country. for example, there was a recent article in "the atlantic" magazine that recently compared

unfavorably the vaccination rates in wealthy areas of los angeles to the higher rates in the south sudan. how should our public health strategy change to reach those parents? you would not think that would be the area since they obviously, can afford the cost of the vaccines and have amples is the to health care. -- ample access to health care. certainly better than those in the south sudan. >> yeah. 25 years ago we were dealing with a problem of children not having access to vaccines, and what we're seeing more and more these days is parents opting out of the system and not wanting their kids to be vaccinated. i'd like to start with the premise that every parent wants their child to be healthy and safe, and that's number one. i think that for a number of parents, especially in some of these communities where opting out is common, they really don't realize that the diseases are still around.

and as we're seeing this year, when measles virus comes into a community, it's those communities where lots of people aren't vaccinated that are at higher risk. so i hope parents in those communities are recognizing that the threat is actually real. another factor is misinformation. and, of course, in today's world it's really easy to get information of all types, much of it isn't very good. and so we at the cdc try to have the best information possible available and to make sure people see the sources of the information and really check facts themselves. we also work closely with clinician groups like the american academy of pediatrics because what our research suggests is parents want to hear about these things from their own doctor who knows them, their family and their unique circumstances. so i think a lot of the attitudes out there may be from complacency that these diseases haven't been visible. but, unfortunately, this year the disease is getting more visible. >> thank you.

i think that the lancet study also played a huge role. unfortunately, i think that there are a lot of people who still mistakenly believe there is a link to autism and are unaware that that study has been thoroughly discredited. thank you, mr. chairman. finish. >> thank you senator collins. senator mikulski. >> thank you, mr. chairman. doctor, my question was going to be fatherly identical to senator collins -- fairly identical to senate collins' question on the reduction of $50 million in the 317 grant program which is to take care of the uninsured as well as vaccine safety outreach and education. now, you're saying that that reduction of $50 million will have no impact on those services related to vaccine safety outreach and education? >> no, i can't say that those

reductions will have no impact. what i'd actually tried to say is that the way that we would address those changes would be to reduce the discretionary vaccine purchase and try to really increase the billing of insurance. so it's, of course, vital that the public health infrastructure be protected. >> well, we feel the same way and particularly in the issues related to outreach ask education. i'd like to join with the gentlelady from maine, because this is not an appropriations hearing. but when we do move to hhs i think this is a valid area of inquiry and bipartisan cooperation. this then takes me to science and to misinformation. does cdc track the correlation between vaccine compliance and rates of autism? and specifically mississippi that has almost virtually a 100% compliance rate.

what is the autism rates in mississippi? >> i don't have that information, but there are a number of ways that we've tried to understand trends in autism and vaccine expose yours. a number of different -- exposures. a number of study designs have discredited -- >> here's my question i believe the dissolution to -- is more information. exactly your whole professional career doctor. so my question though is do you track that? do you track the correlation? >> we track the trends going on in autism and the trends going on in vaccination around the country. the trends in vaccination are that almost everybody's getting vaccinated with most of vaccines state by state there are differences in particular vaccines. mississippi has a, today not allow personal -- does not allow personal belief exemptions and

many people feel that the only exemptions that ought to be allowed are medical ones because, of course some children can't get vaccines because of -- >> and i'm not here trying to get into it. what i'm trying to get into is the epidemiology -- >> right. >> that where there are high rates of compliance, how does that correlate? >> there's no correlation between vaccination uptake and autism. >> and you have the epidemiology to support that. >> right. >> which then goes exactly to outreach and education. now, i'm going to go to a different -- because i really think, and i think the committee ought to really think about our efforts in the area of awe touch. i -- autism. i know we've been very focused on issues related to alzheimer's and other issues, but it really is an epidemic in our country. and mothers will to anything -- and fathers as well -- to mr. speaker their children. to protect their children. they need good information, they need real science, and for families facing these challenges, they need to have answers. and it's another area i think we should take a look at on a

bipartisan basis. but i want to the shift gears to immigrant children and their vaccinations. and i know this can get controversial. but what are the outreach efforts, and how do we deal with this? because, for example 60,000 children came to america last year. many of them are in maryland. and, hopefully they're in the sunshine going to schools and so on. but are you -- has cdc in effort with states where there's high rates of new immigrants both legal and illegal, where the immunizations of the children are addressed because there's this whole attitude they shouldn't be in our school they shouldn't get our public health infrastructure, and this is exactly what we're talking about. in my own hometown of america central american kids are going to school side by side with the gentry kids. is so how do we insure that those, the needs of those children are addressed and, therefore, the needs of american

children to be protected are also addressed? >> vaccine-preventable diseases don't respect borders, and it's critically important for individuals to be vaccinated for their own health, but also to protect the people around them. so the state and local health departments work very hard to make sure that people are immunized regardless of their country of origin. it's very important in an era where measles has been eliminated from north and south america for us to continue to make sure that there's strong immunization efforts in other parts of the world where measles is still circulating. so for vaccine-preventable diseases, it is important to make sure people have access to vaccines regardless of where they're from. >> thank you. >> thank you, senator mikulski. senator cassidy. >> dr. schuchat, tell me, of those folks infected in the california epidemic, how many were native-born americans, and

how many had emigrated here? >> i don't have that information, but what i can say is that most of the importations that we have of measles each year are in americans who are traveling abroad. >> now when you say "an american," though -- >> american born -- >> u.s.-born. >> u.s.-born american, gotcha. so we've heard a lot about how the families from the wealthy communities of santa monica and the west side of los angeles are not vaccinating their children. but is that where we are seeing these cases? do you follow what i'm saying? i did my residency in los angeles, and there are a lot of immigrants, and a lot of those immigrants may have fallen between the cracks. so again, do we have any sense of who is contracting this? >> right. for the measles outbreak, we are seeing spread pa in some of the -- spread in some of the wealthier communities in california, for instance. years ago we had a lot of importations of measles from latin america which is where we have a lot of immigrants. but the americas really took on

the elimination of measles and did major campaigns around all of the countries and had great success -- >> i ask then, i'm sorry, just because time's limited when someone immigrates, what is their requirement in terms of immunization? if somebody's coming from the philippines, what is the requirement now? >> there's a requirement for documentation of vaccination against the vaccine-preventable diseases. and for chirp, the vaccines for children program actually makes sure the refugeeses, for instance, would have access to -- >> now, that would be for vfc, that's for children by definition less than 18. what if an adult immigrates from a country like the philippines? >> right. that's not, um, the case there. but most of the spread is coming from -- most of the risk is in children. if you survive to adulthood in most countries you've actually already been exposed to measles. >> so of those adults going to the philippines and coming back -- and they are the ones

bringing the cases -- is there any, i assume there's a travel advisory if you go to the philippines, get immunized. is there any effort in the philippines? you've mentioned how the americas have kind of bucked up their immunization efforts. what about the philippines? >> yes, there is -- there are efforts there. unfortunately, the philippines suffered that horrible hurricane and after the weather problem much of their immunization infrastructure was destroyed. and so they have had a really bad measles outbreak in response and are actually, cdc and others have helped respond to help them work on their immunization campaigns. you know the biggest outbreak we had last year from -- of measles was in travelers a couple amish adults who traveled to the philippines who'd never been vaccinated and brought the virus back to ohio. it turned out the amish community really stepped up to be vaccinated, but that was a large community where very few people had been immunized. fortunately, in the u.s. most

communities have high immunization rates and it's just these newer communities where parents are opting out that we're quite worried about. >> when we travel overseas, often times we need an immunization record. so a fellow from my church just went to a mission conference in the philippines -- i should ask him -- but was he required to show his vaccination record to go, and was it a required mmr? >> he wasn't. but we hope we're reaching him through our outreach efforts. we were concerned that with the ohio outbreak we hadn't razed those travelers -- reached those travelers -- >> that sounds like an easy thing to do if you apply for a visa to put in a note saying, listen, you're traveling to a place with endemic measles. >> yeah. there are a lot of electronic prompts and so forth now that do alert you but with our alerts they're not 100% in terms of people following them. >> but is that something that when we approve a visa, it seems like there should be some process by which somebody is

traveling to an endemic cup that we would remind them of the risk. >> yeah. i definitely think we could look into that. >> what about immunization rates since 2009 have they risen or stayed the same? >> they're risen for some of the newer vaccines and stable for the others. we track very closely the children who have received no immunization at all by age 2 and that's stayed low. >> i'm worried about senator murray's statement, and you seemed to concur but i think we know with the chip program and the vaccines for children's program, i've done a lot of immunization work among children that cost has not been a barrier for immunization for children for some time again, because of vfc as well as public health units. would you accept that? >> that's right. it's adults where the vaccination record rates are very low and we have some lagging coverage in teenagers -- >> but vfc, for example, would not require coverage in an adult, i would assume. >> no just through age 18.

>> and the aca would not either. >> the aca would cover vaccination of an adult with hepatitis b if they were in a recommended -- >> if they're at risk. a gay man or something -- >> uh-huh. >> i do think it's important for the record that the affordable care act has certainly not augmented that which was previously there. >> the vaccines for children program has had -- whether the vfc but not the aca. >> we need to keep moving. >> i yield back, i'm sorry. >> thank you senator cassidy. senator warren. >> thank you, mr. chairman. when the polio and measles vaccine became available for the first time, parents lined up to make sure their kids would be protected. they'd lived in a world of infectious diseases that destroyed children's futures and they desperately wanted to leave that world behind. these vaccines worked so well that the memory of these diseases has faded, and the importance of vaccination has become less obvious. last month the pew research center reports found that while

nearly 80% of baby boomers and seniors believe vaccines should be mandatory only 59 percent of people under 30 hold that belief. and now measles is back. dr. schuchat, you are the top immunization official in the united states. i just want to walk the science on this -- walk through the science with -- on this with you. is there any scientific evidence that vaccines cause autism? >> no. >> is there any scientific evidence that sack seens cause profound mental disorders? >> no, but some of the diseases can. >> the diseases can but not the vaccines s. there any scientific evidence that vaccines have contributed to the rise in allergies or autoimmune disorders among kids? >> no. >> there additives or preservatives in vaccines that can be toxic to kids? >> no, not in the amounts that they're in vaccines. >> is there any scientific

evidence that giving kids their vaccines further apart or spacing them differently is healthier for kids? >> >> no. it actually increases the risk period for children. >> so it adds to the danger. >> right. >> is there any scientific evidence that kids can develop immunity to these diseases on their own simply by eating nutritious foods or being active? >> no. >> how do the risks of a child responding negatively to a vaccination compare with the risks of skipping vaccinations and risking exposure to a deadly disease? >> vaccines are safe and highly effective, and it's important for parents to know they're best way to protect their kids. >> so i think every parent wants to protect their children. parents should know that all of the credible scientific evidence suggests that modern vaccines are safe, modern vaccines are effective, and modern vaccines are our best chance of

protecting our children from diseases that can kill them, is that right? >> that's right. >> thank you. thank you, mr. chairman. >> thank you, senator warren. senator roberts. >> thank you, mr. chairman. i appreciate you holding this hearing. in kansas we had 19 cases of vaccine-preventable diseases last year the most prevalent was measles. we have not had any new measles cases reported yet this year. our public health workers are concerned, our parents are concerned, however, i'm concerned. problem is that our immune sawtion rates are down -- immunization rates are down. for the 2013-2014 school year, the percentage of youngsters that have received vaccinations is now below 90. that's not good. for the record, i had measles. and chickenpox and mumps and everything else that people had back in the day.

but what i'm asking, if i can get to it here very quickly, if immunization rates continue to decline, what advice do you give to these youngsters' parents who have to rely on others in their community to choose vaccination to help protect their own? >> the lower the rates are the more your children are at risk. so you want to be making sure your own children are vaccinated, but also it's important to have those around them vaccinated. some kids can't get vaccines because they have leukemia, for instance they can't get live viral vaccines, so our best protection is that community-level of vaccination. >> well, you highlight the three reasons parents don't vaccinate, the fear of side effects, religious or philosophical okays, and there's a whole bunch of paragraphs in the background information on which states are easier to get a religious exemption and which are easier to get