we need to address these issues? >> very quickly. lightning round on that. >> i'll give you a quick answer. i don't think we should have an industrial policy, picking winners and losers. this goes beyond cyber. we lag behind the chinese. this is clearly chinese habit. we're not strategic in the broad sbens our security including economic security. china's goal around the world, they identify where the critical resources are. they invest money. they cultivate the local governments. sometimes they do it in ways that we could consider illegal. it's all in the sfgs having greater vision about protectsing your economic base. we are at best intermittent in doing that. i think that is a broader issue than cyber security. it goes to the very heart of what the government ought to be doing from an economic and national security standpoint.

>> there are others that have means that don't have the same calculus we have. i'm going ask that last lightning round. it's been seld since the end of the cold war, forecasting or political forecasting made astrology look respectable. i'm not expecting you to have the crystal balls. but it's a political year. bills are there. what's going to get past? start with you, kevin. real fast. tom? >> i'm a big fan of roger's bill. you know, i think as kevin said earlier, a number of communities are still doing work in the house. we'll see how it plays out in florida. we understand how that is going to end on the house side. of course, there's a lot of gears in motion over in the senate as well. so a lot of variables. >> nick? and can you see by camera also. >> nick? >> i think that, you know, we expect and hope that our bill will form the basis of the upcoming senate debate and we

look forward to sort of negotiating with others who have different ideas. i think there are lots of things that folks can agree on. we think that whatever passes needs to be bipartisan and needs to have some, as the secretary said, protections for critical infrastructure. >> i think we're really encouraged that we do see a lot of common ground between the house and senate. thats a really good sign. two, you know, the way we're working on this in the senate is we're going to come to the floor with a process and everyone has a chance to offer amendments that will allow us to figure out where the majority of the senate really is. and so with that kind of process, you know, there's no substantive reason we shouldn't be able to pass will bill. >> jeff? last quick word. >> like what everyone said. i think there are potentially other proposals coming out. i think we encourage them and look forward to debating them on the floor. >> thank you. let me, before we thank our many panelists, i think we covered an awful lot of territory. let me also say a quick thanks

to my staff who always do the heavy lifting. so thank you. and thanks to all of you for speaking today. [ applause ] ♪

tonight on c-span, a discussion on leadership roles for women including archbishop desmond tutu, the prime minister of thailand and chief operating officer of facebook. >> as main gets more powerful and successful, he's better liked. as a woman gets more powerful and successful, she's less liked. through early childhood and marriage and adolescence all the way through, we reward men every step of the way for being leaders, for being assertive, for taking risks, for being competitive. and we teach women as young as 4, lay back. be nice. until we change that at the personal level, we can't change this. we really have to go out there and say there's an ambition gap. we need our girls to be as ambitious as our boys.

we need our boys to be ambitious to contribute in the home. we need girls to be ambitious to achieve in the workforce. >> watch the entire discussion tonight at 8:00 eastern. and we'll have more from the world economic forum this week. thursday, the heads of the world bank and international monetary fund talk about the economic outlook for this year. and on friday, a discussion on the economic future of africa. plus, the ceos of several major corporations talk about their role in the global recovery. president obama recently rele e released his 2013 budget p proposal. in comparison, the fiscal year 2012 buget requested $3.8 trillion and added $1.3 trillion to the deficit. breaking down the budget further, we see the president is requested just over $74 billion

for the health and human services department. that is a $3 million increase over last year's budget. that includes a 26% increase for the centers for medicare and medicaid services. up next, hhs secretary kathleen sebelius defends her request for her department. this is just over 90 minutes. the meeting will come to order. president dwight eisenhower once said, and i quote, "unless we

progress, we regress." since passing the affordable care act we made tremendous progress on the health care fund. health reform is saving millions of americans money, giving them more choices and better access to their doctors. prescription drugs are cheaper for seniors. 3.6 million medicare beneficiaries save more thanned 2dz billion last year. and that's because health care reform fills the donut hole. to date, 2.5 million young adults, many facing a difficult job market, have been able to stay on their parents coverage. 40,000 americans were denied insurance due to pre-existing health condition and have been able to obtain coverage through state based high risk pools. a woman from billings, montana, can tell that you just how health care reform has helped her. like most seniors, vera lives in

fixed income. has to be conscious of every penny she spends to get by. before health reform, vera was forced to pay as much as $8$85 month for one prescription. now she is saving $20 a month on medications she needs which frees up money for groceries and other necessities. or take sheila lowpatch, a 24-year-old daughter in school and had no health coverage. thanks to health reform, young adults across the country like sheila's daughter can stay on their parents insurance coverage and parents like sheila can worry less. just as health reform reduced cost for individuals and businesses, the law reduced government costs most notably through medicare. the health reform law provided the biggest deficit reduction in more than a decade. according to our nonpartisan score keeper, the congressional budget office, the law will reduce deficits by $143 billion in the first ten years.

by more than $1 trillion in the decade that follows. we need to continue this progre progress. we look forward to hearing from hhs secretary kathleen sebelius today about how the president's budget doll that. today nearly 48 million americans are enrolled in medicare. as a baby boom generation retires, the number of seniors eligible for medicare will increase rapidly. over the next decade, 18 million additional americans will enroll in medicare. we need to insure these beneficiaries and future generations receive the benefits that medicare guarantees. to strengthen medicare, we need to continue lowering costs. we need to spend our precious health care dollars more wisely, efficiently. if we do, we'll lower premiums for seniors enrolled in medicare today and keep the program strong for generations to come. this is the path of health care reform took and we're already

seeing results. two weeks ago cbo released a report showing in the next ten years cost for beneficiary will onch just 1% a year more than the rate of inflation. this is significant significant than the last 20 years. this is major progress. but, of course, we can do more. if our health care costs which is slowed by 1% over ten years, the federal government would save $800 billion. secretary sebelius will provide you with the tools in the affordable care act to continue to lower costs when doctors and hospitals don't talk to each other, patients receive the same test twice. that's why health reform improves communication and coordination of providers diseases can be better manage

philadelphia caught early. health reform provide free preventative care. and criminals try to rip off taxpayers. health reform provides law enforcement new tools and new resources to protect medicare and medicaid from fraud. i'm pleased to hear that anti-fraud efforts recovered more than $4 billion just last year. we knew that some of the best ideas don't come out of washington but from our own communities. and that's why health reform created the medicare and medicaid innovation center to leverage the good ideas and partner with the private sector. secretary sebelius, i'm pleased to see that you're enlisting private sector partners. the recent challenge has sparked thousands of ideas from the best providers our system has to offer including some from my home state of montana. never before has a need to reign in out of control health care costs been higher. never before has the consensus or action been stronger. madam secretary, i urge you it continue to use these tools to provide the health reform act.

the goals and responsibilities for the department are broader than health care. our nation must revisit the ways we prevent poverty. our economy is continuing to recover and i'm pleased to see the budget reflects that positive growth. however, work is far from complete. the human service programs, we'll work on this year presents significant opportunities to build upon the strengths of the american people. we must find the best ways to help families. temporary assistance for needy families must be maintained. i was pleased to work with senator hatch and the many child welfare champions on this committee to reauthorize the safe and stable families program last year. we should consider the lessons we learned and the principles that guided us during that process as we work through the entire child welfare system. so let us improve these human

service programs. let us work together to strengthen medicare and medicaid. let us make our health care system more efficient. let us build on health reform law. let us heed president eisenhower's warning that unless we progress, we regress. senator hatch? >> thank you, mr. chairman. it's a pleasure to work with you on this committee. and all of the other members of the committee. i want to thank you for scheduling this hearing today and secretary sebelius, thank you for taking the time to be with us. we have a lot to talk about. since it has been over 300 days since you testified before this committee which overseas much of your buget. i suspect it comes as no surprise that our list of questions is long. the question that american taxpayers are asking is how the president proposes to balance the budget and how he intends to get our nation's debt and entitlement spending under control. after all, he promised when elected he would cut the deficit

in half by the end of the first term. yet with, a fourth straight trillion dollar deficit under the nation's belt, the expiration date on that election year promise has long passed. i think many americans would be willing to cut the president's some slack if he demonstrated any willingness to lead us out of our debt crisis. but with this budget, he demonstrates he would rather pursue his own political gain over fiscal stability. the budget completely fails to address the gathering storm of our entitlement crisis. don't take my word for it, just look at what everyone from "the washington post" to "the wall street journal" are saying about this budget. and we have a special chart here. according to the "washington post," the budget begins with a broken promise, owe mitts all kinds of painful decisions. the assessment of business week equally grim. the budget does little to restrain growth in government's huge health benefit programs. and "the wall street journal," i think, hits it on the head con

including clueding that it is a brilliant piece of misdirection. voters need to suspend disbelief for another nine months. at the same time that the president cuts the defense budget and complains about the lack of spending on infrastructure, his budget ignores that entitlement spending is crowding out these priorities. medicare, medicaid and social security will increase as a percentage of gdp from 9.7% to 11.2% over the next ten years. federal medicaid spending is a percentage of gdp. that's an astonishing 30% increase in the federal portion of the program. mandatory health spending under the president's budget actually increases by $72 billion. since the modest $366 billion in savings over ten years are wiped away by a proposal to fix the

physician payment formula. i wish you could see that budget contains smoke and mirrors but it doesn't. it is rather a transparent ab i did indication of any attempt to fix the crisis. medicare remains on a path to bankruptcy and with its senior impoverishment. under the president's baseline estimates, medicare and medicaid are projected to spend $11.1 trillion over the next ten years. this level of spending is simply not sustainable. according to the 2011 medicare trustees report, the hospital insurance trust fund has $8.3 trillion in unfunded liabilities and is expected to be insolvent by 2024. real choices, difficult choices are necessary but the president refused to make them. he refuses to neighboring them now. astonishingly, the president's

h health law failed to sustain the growth rate formula. they pay physicians despite cutting $529 billion from the medicare program. with respect to medicaid, the budget baseline proposes spending $4.37 trillion on the program over the next ten years. this amount includes the new spending on the largest expansion of the medicaid program since it was created in 1965. furthermore, the bunt fails to respond to repeated requests from governors for any real flexibility to implement solutions that might work for their citizens. for the third year in a row, the president's budget proposals increase spending while failing to propose a financial responsible long-term authorization of the temporary assistance for needy families program which will expire at the end of this month. in his health law, the president famously promised to bend the

cost curve with respect to health expenditures. he failed to do so with that law. and with this budget, he has failed again. over the next ten years, total mandatory spending for medicare and medicaid will exceed $11 trillion. now we have another -- as shown on the chart. the president's budget would only reduce that amount by $366 billion over ten years. that's a trifling reduction of 3.6% over the next decade. over the 75-year window, it translates into a rounding error, reduction of .5%. as insignificant as these, are it is clear that president's not serious about achieving even then. he suggested unless congress adopts his tax schemes for wealth redistribution, any adjustments to entitlement spending is off-limits. the president's re-election advisors in chicago might think that it is politically

advantageous to hold entitlement reform proposals. but it is fiscally irresponsible. again, thank you, mr. chairman, and secretary sebelius. i look sebelius, i look forward to a fruitful dialogue and i look forward to chatting with you. >> thank you so much, senator. i would like to turn to our honored guest and witness, secretary sebelius. madame scare, you know the drill. your statement's automatically included and we urge you to tell us what you want. you know, candid, direct, and take your time. not too much, but i'll give you enough time so you can say what you want to say. >> well, thank you very much, chairman bacchus, senator hatch, and members of the committee. i look forward to the opportunity to discuss the president's 2013 budget for the department of health and human services. our budget helps to create an american economy that's built to

last by strengthening our nation's health care, supporting research that will lead to tomorrow's treatments and cures, and promoting opportunity for america's children and families, so everyone has a fair shot to reach their full potential. it makes the investments we need right now to keep our economy going in the right direction, while rueducing the deficit in the long-term, to make sure the programs that millions of americans rely on will be there for generations to come. now, i look forward to our dialogue and answering questions about the budget, but first i want to just share some of the highlights. over the last two years, we've worked diligently to deliver the benefits of the affordable care act to the american people. thanks to that law, more than 2.5 million additional young americans are already getting coverage through their parent's health plans. more than 25 million seniors have taken advantage of free recommended preventative services under medicare. as small business owners are getting tax breaks on their

health care bills to allow them to hire more employees. this year we'll continue to build on those important efforts by continuing to support states as they work to establish affordable insurance exchanges by 2014. once these competitive marketplaces are in place, they'll ensure that all americans have access to quality, affordable health coverage. because we know that a lack of insurance is not the only obstacle to care, our budget also invests in the health care workforce. the budget supports training more than 7,100 primary care providers and placing them in the parts of the country where they're needed the most. it also invests in expanding the network of community health centers, together with the 2012 resources, our budget will create more than 240 new access points for patient care, along with thousands of new jobs. altogether, health centers will provide access to quality care

for 21 million americans, 300,000 more than were served last year. this budget also continues our administration's commitment to improving the quality and safety of care by spending health dollars more wisely. this means increasing our investments in health information technology and improving care for those who rely on both medicare and medicaid, the so-called dually eligib eligible. it also means funding the first of its kind cms innovation center, which is funding and partnering with nurses, hospitals, and others who have accepted the kanchallenge to develop a new sustainable health care system. in addition, the budget ensures that 21st century america will continue to lead the world in biomedical research by maintaining funding for the the health and we'll support their work with an emphasis on outcomes research that compares

the risk benefits and effectiveness of medical breakthroughs so we can get the biggest payoff possible for our research dollars. this administration also recognizes that in order for our country to succeed, we need to invest in tomorrow's scientists as well as tomorrow's teachers, engineers, doctors, and architects. but today too many young children have their futures shortchanged because they start school too far behind and never catch up. we know that high-quality early education programs put children on a path to school success and to a lifetime of opportunity. high-quality early education doesn't just lead to higher test scores and graduation rates, it leads to more productive adults, stronger families, and more secure communities. and that's why our budget increases funding to support the 962,000 children in head start, the 1.5 million children in federally funded child care assistance programs. our investments will also

support critical reforms in both head start and child care programs to raise the bar on quality. this year for the first time, we'll require head start programs that don't meet important quality benchmarks to compete for funding, and our budget supports a new child care quality initiative that allows states to invest directly in programs and teachers so that individual child care programs do a better job of meeting the needs of children and their families. investing in health care, cutting-edge medical reshlg, early childhood education and other priorities that will help us create an american economy built to last requires resources and that means we have to set priorities, make difficult trade-offs, and ensure we use every the dollar wisely. our budget does this, helping to reduce the deficit, even while we invest in areas critical to our nation's future. that starts with continued support for president obama's historic push to stamp out

waste, fraud, and abuse in our health care system. now, over the last threeery dol health care fraud and abuse control has returned more than $7, a pretty good investment. last year alone, those efforts were covered more than $4 billion for american taxpayers, and our budget will build on those efforts by giving law enforcement the technology and data to spot perpetrators early and prevent payments based on fraud from going out in the first place. the budget reflects the careful review we gave to every program, looking for opportunities to make them leaner and more effective. and it includes some difficult cuts we wouldn't have made if our nation's fiscal health and tight budget times didn't require them. the budget also contains more than $360 billion in health savings over ten years, most of which comes from reforms to medicare and medicaid. these are significant, but they are carefully crafted to protect

beneficiaries. for example, we proposed significant savings in medicare by reducing drug costs, a plan that will put money back in the pockets of medicare beneficiaries. our budget makes smart investments where they make the biggest impact, it ensure millions of americans will have access to health care they need. it funds cutting edge biomedical research, invests in our youngest children so they achieve their fullest potential, and it puts us all on a path to a stronger, healthier, and more prosperous america for the future. thyonatohatch and i look forward to our conversation. >> thank you, madame secretary. i would like to talk to you about two subjects. one is innovation center.ir ide health coaches and expanding medical homes. i tend to believe that the innovation center, the funding move us toward more efficient systems,

but could you tell us just a few words, just how that's progressing and what's working at the innovation center and what's not working and what you've done to make it work better? >> well, thank you, mr. chairman. i think the innovation center is one of the great initiatives funded as part of the affordable care act. and it's really the research and development arm of our major health care initiatives. and in thouat way, it spends abt 1/10 of 1% of our overall health care spending is dedicated to finding the best new ideas that improve quality and lower costs, and therein pockets around the country, but not taken to scale patients and a strategy that's tried some place and we're trying to improve it. the accountable care organizations, both pioneers who are really way ahead of their

time in coordinating care with doctors and hospitals. the kind of bundled payment strategy, to make sure when a patient is dismissed from a hospital that he or she isn't on their own to figure out strategies of how that care can be improved to prevent an unnecessary readmission. we've got some very exciting projects underway with states around the better care, better cost outcomes for the dually eligible. those americans who qualify for both medicare because of their age or but also medicaid because of their income. a fast-growing population, but t care challenges. so we're very excited about the investments made. we think it has enormous potential not only to reduce the costs and improve care in