overrun and all the things that you mention. >> to be very clear there was gross mismanagement in denver it had to do with a 2.5 billion dollar. >> but there's still that much money missing. >> no. it is not missing. it is money going to pay for veteran care in the community. >> that is what we're talking about with a cost overrun that money has been spent on all kinds of stuff but it all this appears it hasn't been updated and disappears with figures system and that is what i mean about having more control with what is happening with the many. >> we would love to brief you on my v.a. so long term

plan for the transformation of the department with the cultural changes said of the staffing. >> have a bite to see something dramatic to change the status so it is much better than the bureaucracy that we have now. . . secretary mcdonald said ten months. that doesn't mean we don't need to be getting things done. we do. but i think we have to take into account the fact that changing an organization as large as va in less than a year i am not sure who would be able to do that inside the federal government no less. >> i have another question about the choice act.

i think part of it is the problem with getting a provider list up there. and my understanding is that we were going to be paying medicare rates for care. but it is always my understanding that the third party providers are getting medicare rates but the people doing the care are not getting medicare rates. they are getting a less than medicare rate. and some of the providers said the rates are 30% less. so they are not signing up for it because you know they are loosing money.

>> >> we would be glad to share with you the letter going now to providers but you

recognized. >> thank you for being here. i now the v.a. has been overwhelmed for problems of the past with the old id system is a lack of a planning system with treating hepatitis and the medical technology is changing so rapidly that we did not plan for this backlog for the appeals process and as you mention

and andrew have a good way to plan for a demographic shift i worry about places like las vegas where demand is increasing. but to give or take a few going through money quicker will we run not moved money sooner? how do you make up for that kind of money? >> that is the great question. recently giving the budget guidance when i got to that recommendation page to

mention the number down or another up but that is not the way we will do this. the requirement starts with what we expect to deliver to the veteran. so i will take appeals. to give the veteran and appeal decision now it is like four years or five years obviously we cannot beat that standard immediately to decide how long it would take and that conversation we have is the only resources even hepatitis c. the last time i was here i propose the idea to take the hepc prevalence at a functional o that we all agree to that to understand what it would

cost and executes to that that starts with the veteran experience you try to deliver. >> just for the record and for that era hospital it was the patch from other projects but i cannot vote 1% across-the-board cut it is a bad way to do budgeting airways voting against amendments not just where you don't but i hope you come with another proposal but i cannot cut veterans' benefits across the board to

bail out a bad construction project in denver. >> mr. secretary of one to follow-up with what we discussed with the opening questions from the chairman of the committee. i didn't hear exactly the answer of a 40% cost overrun >> it became clear there was of very large variants into late may or mid may to live cattle whole series of alternatives with different solutions that fund may or may not have had direct control. >> where are we at today with the choice fund?

i know the president submitted a of budget. >> is a little over $1 billion? >> 402,000,940,000,000 i was close what is it? >> back when we did our first estimates on tories will look dash utilization of $3 billion the first year. so it is interesting as we look at what we have done to decelerate care what we originally forecasted. >> but to propose to raid that choice find it sounds like what you are doing today is a rare you predicted it was?

>> i don't understand the question. >> in the president's budget you propose to raise a choice find -- fund including v.a. care the you said we ran short even though we did not know about it and tell day even through the 2016 budget proposal so where are you back today? what did you project you would spend. >> between now and the end of the year? to be optimistic is a total of billion and a half dollars. id if we can spend that that reduces the 2.5 billion dollar shortfall. >> when you knew about the shortfall with new told

congress do you wait until the end of the fiscal year then add up the bills it looks like we were 40 percent over. , often do you figure out your budget? >> looking inside the financial management system to provide reports to appropriators. >> at least on a monthly basis but the point i made earlier but we are under obligating and we have people to do manual reconcile with millions of transactions for what is obligated. >> but what happened? so that march memo was

falsified as inaccurate? >> there reported the financial management system did not take into account the specific details of every authorization. >> they give you reports. >> historically it would have been done at the medical center level where we kept the budget but congress passed the choice act to require less to consolidate into the chief business office. >> you do that in march. so how do have the 40% cost overrun and kong to congress in june and say we have a couple months left in don't forget it's? i am concerned about the implementation. >> dilution is the secretary

that has said repeatedly give us the flexibility to use money to follow the veterans. veterans make decisions faster than the budget cycle. quite frankly we cannot change as fast as we need to change. >> to fire understand correctly you hire 12,000 individuals. >> net increase. >> county direct care providers? >> more than 1,000 our physicians 2700 verses i cannot tell how many were psychiatrist. >> i would like to know that based on the figures only one-third of what you hired we could render carry a two-thirds. >> the biggest challenge is to don't leverage providers with sufficient support staff so that means they cannot be as productive as they need to me.

>> dr. reese you are recognized. >> thank you for holding this hearing into our guest for being here but my question is with the implementation of the choice program so we have some money you want to take from that program into other non v.a. care and i am always in the view we have to take care of our patients so you need to take care of them by purchasing more medications for certain illnesses bin that is what we have to do. however when i am concerned about is why is there money not utilized with the choice program when i know in my district after speaking with 70 specialist in high demand

special days -- specialties there is not a clear understanding of the process or implementation there is no efforts by the v.a. as much as we would like to see? so the actual implementation is slow and not very efficient so why is there money left over from that choice program? and could that be used with the implementation of the choice program? >> we're on the same wavelength. first of all, we're not looking to move money out of choice but to use the choice funds to pay for care in the community we just want to access to pay for care in the community. and the opening statement went through a litany of

seven or eight different factors that have gotten in the way and many have to do directly with the implementation of choice. i was surprised the other day with our daily stand at a meeting when folks were describing the five-year process under way to put in place the procedures to utilize care in the community the old traditional program and they're still working on it after five years. we rolled out choice in 90 days and i reminded one refers went to the industry for third-party administrators they said it would take 80 months. the idea to do with in 90 days they said it would never happen and eight months into this we are learning the time required to recruit providers and change the internal process that every process has a different payment mechanisms are different reimbursement

rates and with every issue has gotten in the way to run out of the characters' stories. -- choice but day-by-day that is improving. >> what about the idea to consolidate. >> yes. yes. yes. yes. that is exactly what i described and i referred to in the opening statement. we want to do precisely that but we need congress's help to do that. >> so we actually have informed the field we want choice to be the number one mechanism by which we send people into the community for care. we have work to do to streamline the process. we are treating our staff to day and we will do more coordination of that care with the purchase care

program but that movement to streamline those channels is already under way. >> whenever a system was to change they have coaches that go into a hospital. there should be some coaches that go into a community to help set it up for the providers to set up training for the veterans to work with members of congress so we can help others do the same thing. >> you are correct. for example, tri-west goes around the country to meet with providers to get them to sign up to be choice providers. that has been pretty successful effort because they work very hard.

>> we will take a short recess. we have two votes we will resume a the hearing immediately following the last vote. [inaudible conversations] [inaudible conversations]

we will resume the hearing some members are making their way back from the last series of votes. thank you for your indulgence. are you prepared to begin with your line of questions? you are recognize. >> thank you for being here i was looking through emails that i just received from new hampshire. it is some good news. we have signed up an important partner of ours from the north country that is in a sparsely populated area to be part of the tories programmer want to

reference that because we have talked a bit about the transition and how long it takes and vital part of that is to line up the private community partners and health care providers and in particular care for seniors and adults day care and home care. but looking forward we can all agree there is bipartisan concern about this transition, but some colleagues may not be familiar with the notion of the other six types of programs. as i have sat down with my v.a. we have talked about when the choice program is applicable or when are the others. through a multitude of dimensions one is the

availability of services whether a network or a local provider willing and able and available. the other is cost to the taxpayer to provide the service but also he made an important point about the out-of-pocket cost to the veterans because until we have an understanding of these decisions being made, we will my grasp the dimension to open access. we had a note that said previously that v.a. has controlled access through distance and delay and that is the reality. we made this promise to our veterans then the space lid on the cost for either was

too far away or too long to get the service. so going forward with the change that you bring to this organization what would be the path forward to streamline these programs and provide direction in each of these different communities to get access to the veteran is no way that is timely, high-quality, and cost-effective and efficient for the taxpayer. >> if he could start off in this area he has done a lot of working in this area. >> and what do you need from

us? is a day congressional changing and how do we get together with you in a bipartisan way to make that happen? >> we have been spending almost fell last year since the legislation was put in place in november. we ask them to bring the commercial side of the business to look at our business office and how we managed care in the community against best practices of private sector health insurance industry. we have identified core competencies and they did a maturity assessment against the best practices in the private sector. we have taken at hand are developing a plan to make sure we can build those

competencies using the current business office function with the foundation on which we will build over the next year some of those competencies' we will have to make decisions and to rebuild tattersalls or buy back? because the expertise is out there and it is more cost-effective and efficient to buy it. we have a group right now with our process to say going for word what it does look like? what do we want to point to into the tpa contract for the future with the much more robust program. we will need help to rationalize these programs. ultimately we would want the project folded into the choice program so we can get

rid of the multiple channels. and we need some changes to the choice act itself the way it is structured. we have alluded to those several times like the medicare providers verses those we believe are qualified to deliver that k. witte -- care with the 60 day authorization period. second pair is problematic it is very problematic in places where i was like alaska talking with the folks with dod it is really problematic if we want dod to be providers to read my eighth time is up if we can get everything going for word. >> i apologize. >> you are recognize.

>> secretary gibson, in march what we talk about is the shortfall of the budget available for health care. but if we look at the v.a. historically initially it was service connected issues for military personnel. then we expanded at at some point to the low in, the veterans on a means tested basis. then we expanded again at some point to give automatic eligibility for returning active duty for civilian life that is not means tested that is four or five

years to have eligibility but march of this your v.a. announced it would no longer used the asset tests to determine v.a. eligibility expanding again. but you did it at a time and i guess you have the statutory authority to do that, but you have to make an assessment if you have those resources available to read that expansion clearly you don't have that. so what you do about this? >> i will have to follow-up on this but maya understanding is we were able to substitute another means test we could get directly from the irs or social security in place of the annual requirement on the part of the veteran to file about net worth.

we will validate and come back for the record but it was not a move to open the aperture by read the favored and administratively. >> we need to find that out because i got this information through veterans magazine touting it as an expansion of eligibility by relaxing asset requirement to make more individuals eligible they would be any way but there would have to pay for a portion this would relax the requirement so it is an expansion of care sorry think more people would go through. look at that and get back to the committee on that because it is a concern three don't have the resources to meet current obligations we cannot spare expand eligibility. >> you are absolutely right.

i agree and we will follow up for the record. >> thanks for bringing this to light. given that the cost overruns are a problem to you feel the va could benefit from expanded use of public-private partnerships the major construction projects that allows nonfederal stakeholders and construction experts to work on projects? >> dash george answer is yes. in fact secretary mcdonald and i met two weeks ago with the leadership of the association of general contractors with large and smaller contractors that work with us on a regular basis. this was a very specific topic every talked-about and

we agreed to come together to look specifically at those opportunities here also actively considering an opportunity is emphasis go for public-private partnership. >> will the cost overrun of the denver medical center from the outpatient clinic and other construction projects the president has prioritized? >> i don't expect what we're doing in denver will have any adverse effects. depending on the ultimate funding source that we worked out with congress, i cannot say that it will not affect major construction projects because that is an option on the table but i think there is a strong desire to not adversely impact those projects images

less likely to see that as a source of funding. >> in april there was an announcement at 15 major projects would be too late for the corps of engineers and five were still questions for courage you have an idea which are still under consideration? >> in terms to ring gauge the court to become the construction agent there were five that v.a. agreed there were too far along. we have taken the not - - the number up to seven that we agreed we were turned over for them to be the construction agent and three were relatively smaller transactions fell be felt the most sense to hang on to. >> can you identify which is which?

>> i will get that for you. we have the list and he may have it in his book over here. >> what is the price differential between the v.a. medical service vs. non at v.a. by whatever metric you have? >> i will defer to the clinician. >> i am not sure. it is not in my head but we can get that information for the record. >> what about health care outcomes what is the difference from v.a. first non v.a. base services is? >> i don't know that we actually have our own data but there are plenty of research studies that have been done looking at outcomes between private sector and v.a. that have found the quality is comparable whether v.a. or outside. one of the things i would

suggest we do is a comprehensive tool briefing to evaluate the care quality patient safety access, satisfaction and many metrics that we use are also accused in the private sector's we have the ability to compare the rates to get somebody to have a briefing. >> what about the hepatitis c treatment is to is that show a good health care outcome? >> it is very early to assess that process. many of these arms over months as a course of therapy but the study done shows they have very high cure rates with much lower side effect profile than what we had in the past. >> since so much resources are in that direction we need have a clear

understanding edition results -- it did show results. >> thanks for being here today and want to expand upon what he was talking about the cost and we had this discussion before you told me you are always away from assessing that and one of the best ways how much are you spending from your physical plant and supplies and administrators because that is what a private practice has to do i assume you're not at that point yet? >> i don't think we are but we are getting closer. >> we have done it cost per rvu based on the data i'm about to'' is based upon the salary and benefits than

direct cost so it is equivalent to what we would pay the provider that cost per rvu is much lower than private sector. >> probably would be but you don't take into account the private sector pays for their insurance and all those things but that is how you really evaluate because in a business model which is what we're trying to get to that i don't think v.a. has ever been there but you have to assess because at some point he'll have to say we have more buildings then we need your read the more than we have. that is where we needed to be headed bayou have to take into account all of that because that is what the private person does when the v.a. pays the provider they are not accountable for the other expenses that the person takes in so we're not comparing apples to apples apples, as we do that.

we'll flee we will proceed to make wise decisions together going forward we need to keep looking how to reduce the fixed cost and still provide the same level of care. i am encouraged today that 11 of 10% increase how did you do that? >> i think it is a combination of factors like extended hours that has allowed us to make more efficient use of airspace. have scrubbed primary-care panels and appointment grids that kind of scrubbing process to develop a couple of different productivity assessment tools to push the data out to the individual medical center to the provider to see how a relatively productive the clinic is in relation to the

volume of appointment activity and folks are beginning to now make adjustments that they have access capacity. >> are we reaching a to the providers to ask what do you have to do that makes you less efficient? we talk about you were working out of one treatment room that is inefficient so we need that feedback from the providers especially those cetera in private practice. you each me up to restock the cabinets when they should be seeing patients. i hope we get a good provider implies. >> my sense is that we are and i get it in the field. we undertook a major initiative one year ago to look at support staff for specialty providers which gathered vast amounts of data in the field with the obvious conclusion we were

way under leveraging the specialty providers so we have been insuring the we are adding support staff into the support clinics. >> another thought that veterans do choose to go to the v.a. they want to be there even with other care like private insurance. if the v.a. is their choice then build their insurance to get on the plan. >> if they have it somewhere else then veterans don't use v.a. because they want more funds to be there are. >> today if they have private insurance we do build their insurance sometimes it is the medigap coverage and we may not get paid to them don't have the authority to bill medicare or medicaid for the tri care

>> that is robbing peter to pay paul with taxpayer dollars but private insurance is different. >> those collection rates have been going up steadily year after year. >> i yield back. >> mr. chairman thank you for being here. the statement on fiscal responsibility i was reading the is richer general's report last week who said they didn't know they have $43 billion in the account it was sitting there three years then i looked at the choice act but there are $360 million put aside for awards and bonuses? being a businessman i am in support of the bonus and

award when it is appropriate but is that accurate? >> no. is not there is no money set aside for bonuses. you may be referring to the caps upon the cost associated with the administration of the plan. >> 360 million? >> i think the initial was 300 million if i remember right to it is now higher than that but the money we paid a third-party administrator to do the program. >> let's talk about the lack of non v.a. providers to get them into the choice program. you brought up the subject of the rate of being paid that what i see in our district and the redress to

this previously is not the rate but just getting paid and i was in district last weekend with three separate providers say i have not got my money going on tour three years. water redoing? i know you give us figures before and we're doing better but the word on the street is there is still some issues. >> one of the advantages of choice the party is paid by the third-party administration that is consistent with than 30 days we monitor that. v.a. is known to pay a low and slow and that is not how you want to deal with your provider network. >> do we have something in place? >> over the last nine months is to organizationally

consolidate. organizationally river to when the payment process through 21 separate headquarters through 70 different physical locations to process invoices for care. based on what i have heard we probably did it in 150 different ways so we consolidated organizationally tears tackle the staffing issues issues, the process issues and technology issues none of which were tackled unless they were addressed in a work around situation at another location we have locations instead of establishing a call center available to handle those inbound questions, we have a processor processing and payment they would answer the phone and to do business in the way you would never see in the private sector.

we now have that report and receive the times improve and we are sailing into a headwind but they are processing a lot more invoices but they're barely keeping up the we have made progress. >> but then you have to come back to a. >> we are short. but for 16 that is not adequate unless we ration care.

but then we put those two choices with that safety valve. >> thank you mr. chairman. >> i want to continue with my line of questioning on hepatitis c but right now you don't ration care. i wanted to get some idea about the experience of the veteran who has hepatitis c. does the physician have full discretion when that

medication and shed a accessed or prescribed? what is the internal process we have guidelines for treatment of patients with hepatitis a when they should be used as well as a hierarchy for those to be treated first with the decision to treat or not is individual between a clinician and patient. >> so the physician has a considerable amount of autonomy i have been reading disturbing cases and in the eric times about a woman and her physician that would rather provide the of medication at a later stage of the disease with the

advantage plans the current situation now is honored. >> there are many places then medicaid will not cover the new drugs some private insurance is to and don't and the patience that has advanced liver disease as a result of hepatitis a iraq risk of cirrhosis if you have advanced liver disease you're definitely a candidate for their pay if you don't have active liver disease you were low were down in a priority list and

infectious to other people it is a blood borne disease through contact with my wife and kids and people in my household if you do not have active and liver disease but may still have concerns. >> you are reluctant for what you pay. was the correct with the manufacturers or is there more than one? >> i a misunderstanding there is only one patent. >> there are multiple manufacturers but they each make one patent drug. >> medicare cannot negotiate

in the way v.a. can and medicare spent with the hepatitis c treatments 50 times over what is spent the year before i don't know the experience of the v.a. i know you're not willing to reveal that looking at what people are experiencing with private health care insurance. especially the seniors to not wait on the insurance company with a much more superior service to the veterans and demon gin to secretary gibson for the

seniors that are limited to year medicare with the medication verses of a veteran. >> later standing is that medicare has an annual cost ceiling. so you would be capped out. >> so they have to pay that difference? while. for low income that is a big problem. >> it is a strong incentive and it applies not just to the hepc treatment but whenever a veteran may be pursuing there is some preventive treatment that medicare has no copays so truly they have a choice with -- without consequences but if it has a co pay then they will make a rational

economic decision. >> i will respond your comments because i don't thank you were here that the prescription drug bill when we pass it may directed the secretary not to negotiate the price of the drug so that was a part of the bill the ready to hear when we did that but in addition to the affordable care act that is now standing so seniors will not be out of pocket. >> was aware that i was trying to suggest the nba is doing business in the better way. >> absolutely.

thank you. >> good afternoon secretary thank you for your testimony especially about the improvements and access to health care for veterans faded to the secretary for the feet -- v.a. pacific islands to represent your department during the most important holiday in america, flag day commemorating the netherworld and thank you very much. i don't know a few are aware of the medical personnel that are provided in the va clinic audiology and

equipment but no specialist operated by a branch of physical therapy equipment but no physical therapy specialist so how many if any staff members for american samoa? >> i am not able to answer your question off the top of my head i see the doctor writing down we will give you an answer back. how can the va improve the budget planning to make sure the department is better able to anticipate to react to higher demand for care. >> that is the great question and i alluded in reopening statement as we

had is a department to forecast of two changes of reliance with the v.a. care and with market penetration in a particular market and how many are in bold for care with v.a. i know phoenix was under penetrated so there is a part that looks at the response that we saw earlier that is not necessarily surprised but it typically we don't factor those elements or measure them effectively.

and in the relatively short period of time it gives us an opportunity to gain better insight and data as the forecast future instances we can look a the lists to understand better the anticipated response and lastly on vacation one of the lessons we learned was very early to identify what you will read characterize a high price tag to build into planning as early as we can with cardiology drug setter in the pipeline that are blockbusters coming down the pipe that we try to make allowances for. >> to just add to that today

we use the best ensure it - - actuarial firms in the world and those models work well in stable environments but when that environment is perturbed by changing the benefit structure in some way it is hard to predict to understand what would happen with a lot of interest with the 40-mile benefits. we try to see what that looks like but you have to make assumptions that may or may not be correct there may be in dynamically conditions it is hard to do the modeling the you were talking about. >> thank you, mr. chairman chairman i yield back. >> 84 a very short question. >> ag for your indulgence i appreciated for i have

highlighted by earlier testimony the impacts might district is already feeling. the issues that they raise the is the evaluations are slowing down as well those that work in my congressional office feel the impact but you said 600 million you found a 600 million i am wondering will that mitigate the impact my district faces in the short term? and if congress does not act on the shortfall but will this look like in july and august and october the first? >> the number we could have used that we could have provided congress for care

in the community without the ability to open the aperture with the additional choice funds we get into dire circumstances before we get to the end of august but to deny care to veterans for the resources i don't think anybody wants to see that happen. it could be unpleasant and unsatisfactory situation. >> would you give us that information to have that real data? so if we can those dollars

you will have to sustain care for veterans the feeling that there will have to be a lot of communication that goes down to the medical center level so they a understand what happens in their district. >> is with the transfer of money, 358? can i go back to my district to tell those that are waiting for adult day care we have extra money to address the issue? >> part of what we are going through right now is leveling against different locations so a lot of bad is happening where one may have one center that has additional resources ed

there is leveling happening at the top of the h.j.. we will look internally in the short term for opportunities that we're able to distribute while waiting for the appropriators not on the additional $350 million we ask that they allow us to transfer. . .

>> >> if we were successful it comes down to 2 billion is still basically up pool of 2.5 billion dollars for care in the community where we want to be able to sustain

that care. >> very good. one thing that concerns me to the answer of the questions to talk about getting to a point where you have to begin rationing care to folks with hepatitis c, i thought that was not your intent to enter the would not go to something you have already testified to today that you can go to take money out of the bonus program to plug that whole if necessary. surely which used to draw money out of the bonus plan to provide the hepatitis c drugs to keep the program whole. >> we are not doing any rationing of care to date and we don't expect to with hepatitis c but what allows us to do that frankly is choice.

if we don't have the resources to provide the care within 30 days and we referred the veteran to a provider in the community. >> and stan that be were your dancing around of the $360 million worth of bonus money sitting there that you can go to and i don't want to hear anybody say we choose bureaucrat bonuses over veteran health care. >> and stand your point. >> thank you for being here we wish you a happy independence day. we have another hearing in this room in 15 minutes. with that this meeting is adjourned. [inaudible conversations]

[inaudible conversations] >> the committee will come to order. the committee meets to have a hearing on nuclear deterrence in the 21st century. i ask unanimous consent for complete opening statement be made part of the record. i am afraid we will have posted a few minutes. let me say, in my view our nuclear deterrent is the cornerstone of all of our defense efforts as well as a source of stability around the world and in my opinion for too long we have taken it for granted neglecting the systems, infrastructure, and people involved in making all of those complex machines safe reliable, and

effective. unfortunately, the investment that we have made in delivery systems and weapons in the past are all aging at about the same time which presents us with a substantial challenge, especially when we emerge that with what other nations are doing. the committee has had a series of events over the course of the past week or so classified and unclassified, looking at various aspects of this problem. i understand the oversight investigations subcommittee will have a further hearing on this matter this afternoon. so i think it is appropriate that we have our witnesses with us today to examine these issues. i look forward to introducing them in a moment mr. smith has been detained for a brief time. in his absence i yield to the distinguished in woman from rhode for comments. >> thank you.

on behalf of the committee i welcome my witnesses today. i look forward to your testimony. mr. smith is at a physical therapy appointment and will be here shortly. he welcomes you and in the interest of time mr. chairman, without objection i submit the full statement for the record and yield back clicks i thank the gentleman and without objection, so ordered. let me welcome our distinguished witnesses. your presence is evidence of the seriousness with which the administration takes this issue. we. we're pleased to welcome the deputy secretary of defense deputy secretary of energy and the vice chairman of the joint chiefs of staff. let me also say, adm. the odds are this may be your last hearing in front of the house armed services committee, and my memory is something like 37 years.

thank you for all of those years, not only in your current job or we have been able to work with you on a number of issues but an incredible history of service. thank you and congratulations. mr. sec., you mr. secretary, you are recognized for any comment you would like to make. without objection your written statements will be made part of the record. you may have to punch the button to get the microphone >> i want to thank you and the members of the committee for the support you continue to show. i and everyone in the department greatly appreciated and simply cannot maintain the finest fighting force in the world without your help and everything that you have provided. provided. i am delighted to be here with the dr. from the

department of energy. as you said the vice-chairman to talk about this important subject. i would like to touch briefly on three topics the critical role our nuclear forces continue to play the continuing importance of the nuclear deterrence and the action the program is taking to maintain a safe reliable and effective nuclear force. the survival of our nation is our most important national security interest. the interest. the fundamental role of the us nuclear force is to deter attack on the united states which is the only existential threat. extended deterrence.

well we seek a world without nuclear weapons we face the harsh reality that they are modifying their already capable nuclear arsenals and they are being developed. a strong nuclear deterrent force will remain critical to our national security for the foreseeable future. i would like to address russia's provocations as members of this committee will know. senior russian officials continue to make irresponsible statements regarding the nuclear forces and reassess that they have been doing it to intimidate our allies and us. these have failed. if anything they have really strengthened the nato alliance solidarity. in our estimation our goal is to return the viability of that treaty. under any circumstances we will not allow them to gain significant military

advantage through imf violations and are developing and analyzing response options with the president and consulting with allies. let let me just say this about russian military doctrine sometimes described as escalated the escalate. anyone who thinks they can control escalation through the use of nuclear weapons is literally playing with fire. ..