example the fbi's opr. and what has happened now is we have writer first refusal. so we take the most sensitive cases, the cases where there needs to be independent review, where there's high level officials involved, and opr for dea, fbi, the marshal service, et cetera, handle the other matters. that could stay as the process, or congress could decide that we should have all attorney misconduct no matter who or what it is alleged to have done. >> all right. in addition to opr there's the doj's national security division oversight section as well. and as you've put forward in your testimony they're provided access to the information that the oig has had trouble accessing despite the language of the statute. so what is your understanding as to why doj leadership is more

forthcoming with these documents and materials to these other entities as opposed to oig? >> our presumption is because we're independent and they're not. so there appears to have been a conclusion that there indeed does need to be a finding that our reviews are of the assistance to the leadership. it's self-evident for the other entities, opr, nsd, because they are working for the leadership. we are statutorily independent. congress set it up that way. and therefore it would appear the decision's been made that somehow we need to go through this process so that it's clear our reviews are being overseen or are being of help to the leadership. and of course that's entirely inconsistent with what congress has set up in the i.g. act. >> all right. thank you. mr. chairman, i yield back. >> chair thanks the gentleman and recognize the gentleman from texas, mr. gohmert for five minutes. >> thank you, mr. chairman. thank you, inspector general. appreciate you being here.

and we appreciate your candor and your efforts at trying to get records. we had the attorney general testify in here early during his tenure as attorney general. and there was a reference about how close he was to -- that he made about how close he was to the inspector general at the time. that caused me concern because i had hoped that there was more independence from an inspector general. nobody is supposed to be an inspector general and be big buddies with the attorney general, although he's called me his buddy. i take that as a term of endearment even though he said it, you don't want to go there, buddy. but we never intended for you to have trouble, have any impediment to getting documents.

and just so you're aware, mr. horowitz, for almost all of this administration i've been seeking the documents that the justice department gave to the defendants in the holy land foundation who were convicted of supporting terrorism. this attorney general has used such lines as, you know, classification issues, things like that, when actually it's very clear if you give documents from the justice department to terrorists who are convicted then it's probably okay to give them to congress. and yet still the most that i've been able to get after all these years is a notice that i can go online and check out some websites that have some of the documents that were admitted. so i share your pain in trying

to get information from this administration that should have been a slam dunk, very easy. just give me discs, give me the papers, whatever. i've been through boxes, i've been through, you know, masses of cds as a judge and lawyer. so what do you think we can do, just the top thing that this congress could do -- or i'll put it this way, the house could do to make your job easier and make your position more effective? >> i think, frankly -- >> the number one. >> given where this is at olc right now, i think having comments by the ranking member about the intent of congress and pressing for an answer to the question by congress on does section 6a of the i.g. act that congress passed mean what it says? that's the number one issue we

are waiting to get an answer to right now. >> all right. well -- >> gentlemen? >> yes. >> i just wanted to invite you to join with me in this endeavor because i think you're interested and learned a lot about it. >> well, and i would certainly be willing if i would think that a sense of the house might be what we should try to pass as quickly as possible to make clear about our bipartisan belief in the importance of inspector general. and i very much appreciate the ranking member, the former chairman, understanding that this should be a bipartisan issue because we change majorities the white house changes, but we have got to make sure inspectors general can get the information they need. so i very much appreciate the ranking members. >> thank you. i look forward to working with you. >> mr. horowitz, you don't have

to come back here for a hearing to seek individual assistance in your job. any of us can help. all of us, i know the chairman, any of us would be willing to assist in any way. you let us know what we can do. it is critical for any democratic republic as this is supposed to be to function efficiently if an inspector general cannot get direct access to the information he needs. so thank you for being here today. >> thank you, congressman. >> chair thanks the gentleman and recognize the gentleman from texas for his questions for five minutes. >> thank you, mr. chairman, mr. horowitz, thank you for being here as a member of this committee and the oversight and government reform committee. i'm acutely aware of the benefits that the inspector general community throughout government provide to the

citizens of this country. you are the first line of watchdogs right there with the whistleblowers that combat waste, fraud and abuse in the government. the idea behind inspector generals were they worked within the agency, but they were independent. so they understood how the agency worked. felt like there would be less reluctance of the agencies to share information with the i.g. for internal investigations and the like. but the stuff we've been talking about and hearing about today has taken this to -- into politics. and that's where i think the trouble is. again, one of the advantages of the i.g. is they're within the organization, essentially nonpartisan. that's the intent. and rather than having congress subpoena a bunch of documents and do an investigation

ourselves where politics get infused in it, a lot of stuff can be taken care of within the i.g.s within the agencies. but this situation seems politicized. is that the sense that you get? there's a political element to this? >> you know, from our standpoint what we've seen is simply in lots of different reviews objections being raised. no one has said to us that it's being done maliciously or for other reasons. i'll let others decide, you know, how this all came about and why. >> well, it's certainly been my experience in trying to pry information out of this administration that delay, stonewall and quite frankly when dealing with the irs outright lie seems to be the rule of the day. and eventually, you know, some of these -- y'all got some of the documents that y'all were after, but this was only after

the leadership in the doj determined that they were positive. and, again, this points to politicism of it. i just want to express my dismay at the dismantling of what i think one of the most effective oversight and reform tools within the government of the inspector general is being co-oped and in my opinion politicized and misused. it's a horrible indictment of an administration that early on said they wanted to be the most transparent administration in history. and clearly that's not been the case. this is just another example of it. and i struggle not to be numbed by it. it's like we have another scandal that comes out every two weeks. any one of which would have had folks head exploding not that

many years ago. and it's disheartening. i'm going to yield back the remainder of my time. thank you. >> chair thanks the gentleman. recognize the gentleman from georgia, mr. collins, for five minutes. >> thank you, mr. chairman. coming back in we get a lot of things going on. but i'm glad you're here. serving on oversight as well as judiciary the importance of what you do is really amazing to the government. i wish we actually had more work this way. i think for my folks in the nint district were stunned you don't have access to information that frankly i as an attorney but others as well believe you are entitled to. leading up to the letter, leading up to the issues, based on your experience, is it particular people? is the some body? just an agency culture under this environment and this agency leader? >> what do you think led up to the necessity of them to write this letter and say, you know, we don't think you're getting the access that you need? >> you know, this all began a

couple years before i became i.g. but there had been a series of reports that we issued and reviews that we issued that were critical of some of the handling of some matters. this followed shortly thereafter. and what happens once this begins is we start to see this among other components and in regular reviews and the roadblocks become more regular. and that's the problem with not resolving it and dealing with it promptly. >> well, and i think just, one, it gives the impression especially government-to-government, if you're roadblocking yourself, it's like -- frankly just leaves the opinion you're hiding something. that's just the way it looks. your review of the different departments use of different material statute published this past thursday a page by page review of the documents and redacted anything it considered to be grand jury material. as a result the review states documents were not useful and the review came to a standstill.

while the deputy attorney general ultimately granted you access to certain documents under the foreign intelligence -- this avenue is not without its delays. how long did the oig have to wait for the grand jury material in all? >> it took us almost a year from start to finish to get the material we asked for in terms of completeness of the process. >> and there was really at this point no reason for that year's delay? >> there was no reason, from our standpoint certainly. >> so basically, again, we're stopping, hiding, whatever you want to call it -- frankly if you're going to stick with a story. like i told my kids, if you're going to lie once or start telling stories once, then you're going to have to tell the story the whole way through. now coming back and giving you the information when they first said they couldn't. >> right. and i'll add on top of the delay to our review you have a whole bunch of lawyers in the fbi who have a lot of things on their plate, spending time going

through page by page documents we should be getting. you have my auditors and teams, lawyers, et cetera, being put on hold. not being able to complete the work. so there's waste along with it. not only this delay but wasted resources going on. >> i understand. and i think that's another whole issue is wasted resource. we're in an environment where we're trying to find every penny we can to properly use taxpayer dollars. also according to that report while waiting for a doj returning, the fbi was busy redacting from document it was providing from you. what information was that and what was their rationale? >> well, the fbi had come to us with a list of areas that it had concerns about producing. and so we ended up having to negotiate and discuss with them a whole variety of categories beyond that before we could get what we thought was complete. but again, since they're controlling the process and we're not getting direct access, we're relying on their interpretation of the statutes

and what's relevant and not relevant. >> again, not to disparage, but in a sense we're looking at an investigation here that is coming internally is something should be worked together on and not pitting, you know, us against them. this is just their honest truthful mentality. what are we doing? we just got back off of a working period in which we were -- i was in three town halls. that's the biggest thing i hear from most of our folks is they don't trust the government anymore. and i've made many discussions about this. they've come up and they'd say what can we do? we've got to restore trust. and part of this trust factor is going to our own internal inspector process, going through our own internal process and not going for what i call busy work, doing that. the letter was courageous. i think there's a lot of things that could be happening. in my short amount of time here real quickly, other than the hearings and i appreciate the chairman for doing this, what action do you hope congress will take in response to what has been brought forth today and what we've talked about?

>> i think the kind of statements and message that has been put forward by the ranking member today who talked about what happened back in 1978 but other statements, for example, in 1988 and in the 1993 reform as to the -- our office. what was meant by accessed information? did congress intend us when it gave us authority in the early '90s to oversee the fbi and the dea, we should be look at their files like title 3 information. there has to be otherwise giving us that authority would be largely meaningless. >> well, i thank you for bringing this up and if you doint have access, basically we're telling the american people we're doing something we're not doing. and that has got us to this trust issue. americans demand more. i thank you for what you do. with that, mr. chairman, i yield back. >> chair thanks the gentleman. chair has one additional follow-up question and check with the ranking member to see

if he has any additional questions he'd like to ask. the fbi's argued that based on its interpretation of section 6b-2, it has the authority to refuse your request office of inspector general request for documents so long it deems its refusal to be "reasonable," will you explain the basis for this conclusion by the fbi and your opinion as to whether there's any merit to that position? >> frankly, i don't think it has any merit. i think congress quite clearly put in place in section 8e of the act the process to be followed if there are sensitive documents that shouldn't be disclosed to the i.g. or the i.g. shouldn't be disclosed publicly, that leaves the power with the attorney general. not with anybody else in the organization. so we disagree entirely with that. >> and where does that phrase, reasonable, emanate from, do you know? >> i think that's their interpretation of the i.g. act.

>> thank you. >> mr. chairman, i have no additional questions. i want to thank again the inspector general for his very thorough and complete testimony today. >> and i want to join you in thanking mr. horowitz for his testimony and we will work together in a bipartisan way to make sure that anything that congress can do to bolster your ability to conduct neutral investigations into how our government under any leadership operates, i think it's important to set the precedent correctly as we did in 1978. and if we need to reinforce that today, we'll do so. so i thank the gentleman. this concludes today's hearing. we thank the inspector general for joining us. without objection all members will have five legislative days to submit additional written questions for the witness or additional materials for the record. and this hearing is adjourned.

congress is on break until after the november elections. what do you think of that? the conversation is underway on c-span's facebook page. here are a couple of the comments. anna writes, oh, they came back from their august/september break? it's time to put them on part time status, wages and benefits. royce responds, the military works like this, if there's work to do, we stay on the task at hand, no leave and stopgap when the mission requires it. you can join the conversation on c-span's facebook page. two former members of congress are running for governor in arkansas.

c-span will have live coverage of a debate between democrat mike ross and republican asa hutchinson tonight. here's a look at some of the ads that voters are seeing up until that debate. >> the democrat gazette said the attacks on mike ross are not true and a smear on his family business. there was never a justice department investigation and the house ethics committee approved the sale. so why is hutchinson attacking ross's family for building their smalltown business into a success? to cover-up the fact he got caught cheating on his taxes and the fact hutchinson was a d.c. lobbyist who has a record of putting -- sorry, asa, this cover-up won't work. for our schools, a choice for governor. there's asa hutchinson. >> he voted to cut college loans. >> and pre-k programs. >> and he opposes mike ross's plan to expand pre-k. >> i think it's the wrong

direction. >> but mike ross says education must be a priority. >> a pre-k plan that works for arkansas. >> a focus on career tech training ask college opportunities. >> under mike's plan i know my kids will have what it takes to get ahead. >> that's why teachers have endorsed mike ross for governor. >> on education, mike has a record i can trust. >> have you seen this latest smear piece paid for by allies of barack obama? here's what they don't want you to know. asa hutchinson found a mistake in his taxes and reported the mistake himself and paid his bill in full. many of us have made mistakes on taxes. asa was honest enough to admit it. but that doesn't stop team obama. they hope it works for mike ross as well. fortunately, arkansas knows better. >> it's a $16 billion industry. and arkansas's largest. and with 97% of our farms family-owned, our next governor must fight on their side. so when some criticize free

trade, it only hurts our farmers. whether it is rice, wheat or poultry, i want to keep arkansas business open to the world. it's the best way to grow our economy and create jobs. i'm asa hutchinson. as governor we'll hit the ground running and never look back. >> mr. ross served as a u.s. congressman for 12 years in arkans arkansas's fourth district. mr. hutchinson is a former -- in arkansas's third district. he's also served as the administrator of the u.s. drug enforcement administration. the two will debate in little rock, arkansas tonight. you can see live coverage on c-span starting at 8:00 eastern. >> with live coverage of the u.s. house on c-span and the senate on c-span2, here on c-span3, we compliment that by showing most public affairs

events. c-span3 is the home to american history tv with programs that tell our nation's story, including six unique series, the civil war's 150th anniversary visiting battlefields and key events, american artifacts, touring museums and historic sites to discover what artifacts reveal about america's past. history book shell with best-known writers. policy and legacy of our nation's commanders in chief. lessons in history with top college professors delving into the past. and real america, featuring archive government -- c-span3, created by the cable tv industry and funded by your local cable or satellite provider. watch us in hd, like us on facebook and follow us on twitter. here are just a few of the comments we've recently received from our viewers. >> calling about c-span3. all the c-spans, but this

weekend some shows president nixon and his resignation and so on and so forth. the only thing this morning i was hoping to watch the f-100 super saber restoration, that was our first supersonic jet fighter. and it had something about the panama canal. no big deal. that was interesting, but if it was supposed to be the supersaver, i'm hoping they'll show that again or, you know what i mean, show it -- i guess it didn't get shown this morning, but either way. looking forward to maybe seeing that. but this weekend c-span was just -- c-span3, just so many good shows. >> this is for the show called benghazi hearings, which commenced today which are on c-span3, which i have no way to receive and i don't have a

computer. anyways, what about the fact that there is no embassy of any description in libya subsequent to benghazi? how come that's not being addressed? why don't you make that a topic? >> you're my favorite station. my husband's also. but we can't get c-span3 in portland, oregon. now, i wonder if you could tell us how we could manage to do that. >> we're just calling because we note at 10:00 there was supposed to be a show on c-span3 which is the hearings, but we can't get c-span3 and we feel this is a very important program to watch for a lot of americans. and we'd like to see that either repeated on one of the c-span 1 or 2 or made available immediately on that stations. >> and continue to let us know what you think about the programs you're watching. call us at 202-626-3400.

e-mail us at comments@c-span.org. or send us a tweet. join the c-span conversation, like us on facebook, follow us on twitter. now, filmmaker ken burns on his new pbs documentary "the roosevelts." the seven-part film covers the lives of theodore, franklin and eleanor roosevelt. he spoke about it at the national press club and answered reporters questions. >> for more than 30 years ken burns' documentaries have presented the stories of the american experience with drama and flair. his topics have ranged from the brooklyn bridge to baseball, from mark twain to jazz, from prohibition to the national parks. remarkably his works never become outdated. as we congressmen rate the 150th anniversary of the civil war,

his pbs series on that war remains as relevant today as it was when it debuted in 1950. burns captures the historic moments of american life with deep dives into archival materials like personal letters, diaries and newspapers. his use of still photographs have been revolutionary. he has called photographs the dna of everything he has done. and his e voktive slow scans have transformed subjects into a sinmatic experience. the slow-moving -- the slow-motion scanning technique is now even called the ken burns effect. his new seven-part pbs series "the roosevelts" premiered last night. and i have reliable information that the ratings were extremely high and that they are soaring. the series will be broadcast every night this week. in this film he focuses on the towering but flawed figures who

before they were history were family. he was able to draw newsreel footage, radio broadcasts and personal documents. notably a troef of duly discovered letters between fdr and his cousin daisy as well as a number of photographs. ultimately nearly 2,400 stills were used in this series. burns has always rejected using the voice of god approach to narration relying instead on contemporary voices to bring his subjects' words to life. in "the roosevelts" you'll hear some of america's greatest actors, edward herman as franklin and meryl streep as eleanor. ken burns is also a frequent guest at this podium because like his films he never becomes outdated.

please join me in welcoming the documenttarian and press club member, ken burns. [ applause ] >> thank you. thank you all very much for coming. i'm so happy to be back at the press club. it's really been a home base for many, many of our long arduous promotional tours for the film. and today is no exception. i do feel compelled to edit myron just one little bit. he had the civil wars series coming out in 1950. i was negative three years old then. and though i was already working with stills, i had not yet perfected what we call the ken burns effect quite then. i also feel now that you've brought up the civil war, myron, that i reminded you 24 years ago in 1990 when we came with the civil war that i reminded you

what william tecumseh sherman felt about newspaper men. he hated newspaper men so much that he was sure if he killed them all there'd be news from hell before breakfast. and of course unfortunately you do not escape unscathed with the roosevelts, though all three, eleanor who held twice-weekly news conferences with women only, the first time a first lady did that. and frankly, who because he had been an editor of the harvard crimson felt that made him a newspaper man himself and loved to develop and cherish the development of personal relationships with the newspaper men that he crowded in, men, that crowded in 998 times for news conferences during his presidency. but theodore was equally adept at manipulating the press and making them feel like they were friends and ushering them into his private world, though he did have a special purgatory for

those people who displeased him with his writing. he called it the annanias club from the ancient liar who was instan tan yously stricken down from having told a lie. and if you were compelled to the club, you were not in theodore roosevelt's good graces. i'm sure that's not true of anyone here. he did kind of walk it back a little bit. he'd often confide to the reporter that the reason why he'd criticize them so heavily had less to do with their writing than with the s.o.-o-b owned the paper. simply taking it out on the messeng messenger. i do not come here without the assistance of hundreds of people. those of you who had a chance to watch last night's film, there was a credit sequence that went on for many, many minutes that thanked quite correctly hubs of

people. first of all, because this is public television, we are dependent not on our sponsors but our underwriters. there's a huge and very important difference between them. and i would just like to take a moment to thank the bank of america which has been our sole corporate sponsor since 2006 and has planned to be involved through 2020. they have been an enlightened corporation that has helped us. i'm also grateful to pbs itself and publication for broadcasting and endowment for the humanities, i began this business an awfully long time ago in the late '70s. and i had the great good fortune to work with its chairman, joe duffy, who turned up today not like a bad penny but as a welcomed old friend. it's great to have joe here. thank you, joe, for all the support you and subsequent chairmans, there must be about a dozen now since you, that have been supporting our work.

we also have the sustained support of the arthur vining davis foundations, individual contributions, significant individual contributions from jack taylor and roslin and we enjoy the support of a new organization, the nonprofit called the better angel society. and john and jessica fullerton and joan newhouse newton and the golkin family and bonnie and tom and the file foundation have all contributed to our film. and i would literally simply not be here without their support. nor would i be here without the support for the corporation for public broadcasting and for my long-time production partners for almost 35 years of weta, which is the washington, d.c. based public television affiliate. and its head sharon rockefeller. and they've been our production

partners for that long. i'm also extremely grateful to our network. i think the best in the business. you know, we live in a place in which we are saturated, buried in information, a little bit more on that later. but we also enjoy one home where we know reliabebly whether it's our children or delving into science or nature, whether it is about public affairs or artistic performance, whether it is public affairs or history we have the best place on the dial. and that's pbs. and i am so honored that my president is here today. whatever you like about what we do, it's them. and the pick they set for me. these films are also not made by a single person. writers have that and reporters for the most part who are now not having to blog and do video posts and all of that have that

luxury of working alone, but i also have what i think is the greater luxury of participating in an extraordinarily collaborative medium. and there are many people responsible for this film, editors and producers, paul barns and pam, all the extraordinary archives that helped us collect the more than 25,000 still photographs that went into the 23 -- 2400 that made it into the final film. same too for the archives that found the extraordinary and in some case never before seen moving pictures. all the sites from campabello island, most of united states parks service sites opened their doors and let us film at ungodly hours. but the most significant person involved in this project has been my long-time collaborator, collaborator of 32 years,

jeffrey ward, who is here, i'm also to say happily with his wife, diane. and we have just been making films together for an awfully long time beginning not, again myron, editing your text, with the civil war, but we began when he was an advisor on a film we made on the sell bat religious sect the shakers and our next film that came out five years before the civil war on the turbulent life of the southern demagogue hewey long. we have been making history together. and we have been talking together for almost all of 32 years about making a film or a film series on one or more of the roosevelts. jeff himself has written two extraordinarily great books on the roosevelts. on franklin's roosevelts -- trumpet takes him from his birth to his marriage to eleanor.

and the second which is one of the greatest biographies i have ever read and please run to your note pads to jot this down. a first class temperment. it is a remarkable story. and it is a remarkable story about an extremely complicated human being overcoming one of the most devastating illnesses that you could imagine and still managing to become president of the united states. part of a story we want to tell. so now that i've completely buried the lead i will rescued by myron, who is absolutely correct to say that for the last seven years jeff and i and our team have been producing a seven-part 14-hour series on the history of theodore, franklin and eleanor roosevelt. pbs began broadcasting this series nationally in

unprecedented fashion last night where they showed the first episode and then showed the first episode again at 10:00. and each subsequent night we'll show another episode until this coming saturday, the 20th. we believe it's the first time short of a national tragedy when a single network has shown -- taken up an entire primetime and then some. it goes from 8:00 until midnight, an hour out of primetime, for one single show. and we're very happy with public television's confidence in the work we've done. and i'd like to spend a few more minutes before the good part where i have a chance to have an exchange with you to tell you a little bit about what we're trying to do. those of you who saw last night, saw the table setting episode in which we set in motion what is the most complicated and intertwined and interbraided narrative that i think that i've ever undertaken. i certainly think jeff thinks so as well even though we have tackled together a history of the civil war, baseball, jazz,

the second world war and are working right now on a history of the war in vietnam. we were drawn to doing all three in part because of that avalanche of information that i mentioned to you earlier. we live in a media culture in which we think we know everything. we have lots of information and almost no understanding. we are drowning. and one of the default positions of this excessive information is we tend to form superficial conventional wisdom about the subjects we think we know about. either those happening today or those that took place in the past. and so it seems that for almost the entire history of this country since the roosevelts we have been compelled to focus either on theodore, and there's a lot of books and very good books, and films on him, or franklin and a lot of good books. and jeff has written two of them. and franklin and eleanor and

little bit less on eleanor. but no one has put it together as the complicated family drama that it is. i guess this has to do with the fact that in that superficial glance we look at theodore and say republican and we look at franklin and eleanor and say democrat and we think that we can segregate them in their own individual silos. it is interesting as individuals and certainly franklin and eleanor as a pair, it is exponentially more interesting if you have the opportunity to get to know them in concert. and that's what we've tried to do. it is a complicated russian novel of a story that has not only these three primary characters but dozens of secondary and tirs yar characters and of course a world they compelled and a world that compelled them that is dealing with the late 19th century coming out of the civil war, the guilded age, the age of monopolies and trusts, world war i, the roaring 20s and jazz age,

the great depression, the second world war, the greatest cataclysm in human history. and the cold war from when theodore roosevelt was born in 1858 when our series began to when eleanor dies in 1962 when our series ends this coming saturday night we are dealing with a century, 104 years, an american century in a place and a time where so much of the modern world was created. and these three people are as responsible for that world as anybody that i know. we say, and we say with absolute conviction and confidence in the opening of our film which you might have seen last night, that no other family has touched as many americans as the roosevelts. and that is true. you only need to stop and think about the world we live in. if you've ever flown out of laguardia airport, you're in something that franklin roosevelt did, or went through the lincoln tunnel, or took a

drive on the skyline drive, or the blue ridge parkway, or road the elevated in chicago, expected in the tennessee valley to see lights come on when you turn on a light switch, or in the northwest or the southwest, you have traveled over thousands of bridges built during their era. you have seen or attended thousands of high schools. you have driven on miles and miles of roads that they originally blazed in this country. and more importantly you will enjoy or you are enjoying cashing a social security check. you like the idea that our government takes its soldiers and pays for their college education with the g.i. bill. i'm sure you're thrilled that your children do not work in mines seven days a week, 14 hours a day, that there are such concepts as a minimum wage and livable hours. i think you are certain that big monopolies ought to be at least

regulated if not broken up. i think you enjoy visiting our national parks and national forests and other sanctuaries of the beautiful wildness that our country still has preserved, preserved in large part thanks to these two extraordinary presidents, theodore and franklin roosevelt. their legacy -- this is only a small, small portion of their legacy. they of course raise questions that are not always positive. and i do not in any way want to suggest to you that the film we've made is in some ways a valentine to these three human beings. that it is in some ways hero worship. in fact, we are interested in telling a complicated portrait of their great strengths, but also their great weaknesses and flaws. and my goodness, ladies and gentlemen, they are on vivid display with these three

characters. and more importantly their deep wounds. and that's, i think, where the subtitle of our film comes in. this is the roosevelts in intimate history. having said that i feel qualified in the early 20th century to have to warn you that this is not tabloid history. we are interested in getting to know them. we often debate in our films the tensions between a topdown history and a bottomup history. this has been for many years the dynamic and argument within history. is it only topdown, is it only about famous people, wars and generals and presidents? or is it also about so-called ordinary people, women, minorities, labor, people like you and me for whom the real history of america is written. we believe it is a mixture of the two. and even in a film like this we try to engage a topdown alongside a bottom-up history to tell something more complicated, more nuanced with undertoe, et

cetera. but this is also an inside-out history. i don't mean to suggest this is in some ways filled with psycho babble. it is a family drama. we want to understand about their parents. we want to understand about their childhoods. we want to understand about their spouses and their children and their lives within their families. and we feel that by understanding it, particularly for these three ordinary people, and ladies and gentlemen biography has been a constituent building block of almost every film we've worked on. it is hugely important to understand the world they created. and that is essentially the world we have inherited, at least in a political and social fashion in the united states. it is hugely important to understand where they came from. and just stop to consider for a moment the topicalness of their

story. the central question of theodore's time, the central question of franklin and eleanor's time is the central question of our time. what is the role of government? what can a citizen expect from his or her government? what is the tension between pragmatism and ideology? what is the nature of leadership? how does character form leadership? how does adversity in life create character which in turn forms that leadership? these are the questions we ask the means testing we apply to our own leaders today. and they are as relevant now as they were back in the time and vice versa. and our film is essentially an exploration of their lives, inner and outer, the way they shape this country and to try to deal on the fault line of that. now, we live in an age that same media culture whose default

position is also to lament the absence of heroes. we're constantly saying, oh, and doing a film like this and promoting a film like this has brought out myriad comments that we just don't make heroes anymore. but let's just remember that we are expecting in this superficiality of our media culture today, we are for some reason expecting perfection in our leaders. and when we find they aren't perfect, we turn away from them and say there just aren't leaders. but let us examine the very nature of the word hero. it is, we get, from the greeks. and the greeks in no way defined it as perfection. in fact, they understood heroism to be a very complex negotiation, sometimes a war between a person's obvious strengths and their equal and perhaps not so obvious weaknesses. and it is that negotiation, it is that war sometimes and with these three people it is indeed

a war that defines heroism. achilles had his heel and hub ris to go along with his characteristics. in some ways people ask what do we want from the series, we say we want you to enjoy what we think is a rip snorting good story. we might also want us to re-examine the way in which we apply that superficiality to the people of today so that we might gain a little bit more tolerance, perhaps a little bit more civility in our conversations. everything will not be just black and white. now, the roosevelts provokes that in some people, but what we've tried to do is offer a nuance portrait. let's consider the oldest for just one second. theodore roosevelt born in 1858 was a sickly asthmatic child. he overhood in childhood as you might have learned last night that he was not destined to live.

he heard a doctor telling his parents that he was going to die very early on. he struggled all his life to remake his body, to turn it into -- as his father said, get action, be sane. and all his life theodore roosevelt worked as hard as he could to make and remake his body. he never escaped the asthma that afflicted him as a child, but he did remake his body. and he became somebody. but his branch of the family, the oyster bay branch, was also susceptible to a good deal of depression, susceptible to alcoholism, susceptible to mental illness. and he felt all his life that he had to be in action not just to escape the specific gravity of his physical ailments, but to escape the dark gloom that seemed to overtake him when he wasn't in a constant frantic rush. he once said, black care rarely

sits behind a writer whose pace is fast enough. black care rarely sits behind a writer whose pace is fast enough. that tells you it's a wonderful 19th century way of saying something very understandable in the 20th and 21st century which is you can outrun your demons. and theodore roosevelt spent his entire life not for a moment hesitating trying to outrun his demons. if you look at the oldest photograph you can think of in your mind of an ancient theodore roosevelt, he looks to be about 85 years old. he died at age 60. i am 61. it is an amazing life dedicated to this escaping this specific gravity. and he also had to overcompensate for a deep flaw his wonderful father, a man he adored more than anyone else in life had, his mother was an unreconstructed southerner and insisted her husband not fight

in the civil war. he did what many wealthy people did in that time is he bought a substitute, paid someone else to fight for him. and this was a flaw which ate at theodore roosevelt and made him, i feel we should also say say, december piet all of his great affluence. and may i say this evening, episode to his presidency, you will get to meet theodore roosevelt in all of his wonderful glory. all of the wonderful thing. he always thought if you didn't have great crisis on your hand, you couldn't be judged as a great president. many people thought he was the skrie sis. and perhaps we were lucky that we didn't have a major crisis on his watch. but his presidency is a model of engagement with its citizens. you know, the united states was in a period not dissimilar to now. when there was a huge disparity between the wealthiest and the

poorest. the middle class was disappearing. and theodore rose velt rose to the rescue. he understood that government had to be an agent. a player in a complex dynamic between industry that was unchecked and between the worker that was not getting a square or a fair deal. and he did that all of his life. and i invite you to revel in all of the great strengths and delights of getting to know theodore roosevelt. of the three, he's definitely the person that you go out and have a beer with or drive across the country with. and i engage you to spend this week driving across the country with theodore roosevelt. but he did have this thing. he thought war was a good thing. he was reckless that day on san juan hill. he was disappointed he didn't get a disfiguring wound. he was very proud of the fact that his regimen has sufferabled the worst casualties. and to the horror of the united states army, he lobbied

something to win something you never do, your honor with the congressional medal of honor. so we need to look at theodore roosevelt. and as you will see in our episode three, which is tomorrow night, tuesday, he pushes his four sons as close to world war i and combat and danger with the most horrible, trajic consequences you can remember. that will make you want to weigh very carefully. and i would urge you not to make a final judgment. weigh very carefully these twin polls of one of the most extraordinary presidents, theodore rose velt. franklin, we know his story pretty well. he was stricken with infantile paralysis, polio, at age 39. up until that point, he had been the pampered only son of his parents and they pampered him in

all the comforts and optimism that any child has ever had. but he was essentially a very lonely child and a little bit too thinks a little bit too ambitious, a little bit too charming as he tried to hit all the marks, all the footsteps of his more famous fifth cousin, theodore, as he, too, tried to emulate his preposterous and unrepaired for trajectory to the presidency. it's only when he could not take another step that this extraordinary empathy entered into him and was producing. and he became what we would say is the greatest president of the 20th century. and arguably, has come up to parody in my eyes as arguably the greatest president in american history. he is infur ratingly opaque and manipulative. and we need to take those scales and balance them in the same term.

i invite you to watch as he and el nor, in this episode tonight and in the next one, begin to transit away from theodore roosevelt who dies at the end of our third episode. and then the four through seven is really largely about franklin and el nor and the world that they inhabit as well as the ghost of theodore who is watching over everything magnificently and never fails to make an appearance of some kind in each one of those subsequent you belie episodes past his debt. ele aurksanor roosevelt, al not a president but arguably the most important woman in american history, she is, as jeff ward likes to say, a miracle of the human spirt. she should not have escaped her childhood. her father, the president

theodore rez volt's brother, elliot, was a hopeless alcoho c alcoholic. hopelessly mentally ill. she spent her whole life idolizing him, unnecessarily, i think. her mother was this exquisite beauty but very remote and was disappointed in her daughter's looks and called her own daughter granny. both parents were dead by the time ele aurksanor was ten year. she was absolutely terrified of everything. but out of these experiences, she began to notice that if she was useful to other people, she could be loved. and she decided to translate that problem, that fear, into action. every day.

she got up and she faced her fears. it's an amazing thing. i've got father daughters that i am so proud of. my second daughter was terrified of the vacuum cleaner. whatever it was roaring, she had to be out of the room or asleep or u you know, out of the house. but one day, when lily was a year and a half, two years old, she walked into the room where the monster was roaring and walked over and sat down on it. and in our family, sitting on the vacuum cleaner is what you do in life. you move forward and face the fear that worries you the most. eleanor roosevelt moved forward and sat on the vacuum cleaner every day of her life. it was said by theodore rez v roosevelt that he has distance in his eyes.

i believe all three of these remarkable people had distance in their eyes. and no one more so than eleanor. liberated from having constituencies as her favorite uncle and husband did, she could see all the coming issues of race, of poverty, of women, of schirn, of labor of absolutely everything that is on the front page of our discussions today. and she was right on every single one of those issues. a testament, indeed, to the human spirt. so these are our three roosevelts. flaw, wonderful, deeply rooted who all basically reduced their philosophy into one spectacularly simple equation. we all do well when we all do well. it is very fashionable, ladies and gentlemen, to blame the united states government on absolutely everything.

it has now become something other. but we are obama to but we are only to blame. if you don't like it, stop [expletive] and moaning and complaining and do something about it. that's what the roosevelts did. and theodore roosevelt said the government is us. you and me. thank you. [ applause ] >> we have enough questions to go for two hours, so, please, i apologize in vansz. so i think through rapid fire u i'll try to ask them. >> tr and fdr were strikely different personalities.

fdr being charming and manipulative and elusive. which of these figures did you find harder to grasp and why? >> that's interesting. all the adjectives describing theodore are all positive and two or three out of them for franklin are negative. so there's a little bit of a thumb on a scale that we didn't feel comfortable doing. they're both equally disturbing and equally magnificent. franklin roosevelt is the much better president and, in some ways, human being, i think. but you will be infur rated by his manipulativeness and at least early on, his overweaning ambition. but they're all complicated people. shakespeare was described as having negative capability. the ability to hold in tension these things, when the wrerest us want to make a choice. the best figures in our lives and in our drama, our art, our

literature is where we have held the very complicated facets. and i think that's what we try to do in this series. >> most historians rank fdr just after lincoln and washington on the list of great presidents with teddy not far behind. that being the case, why does it seem that the roosevelts have faded in the public's view compared to say reagan and jfk. >> well, when you live in a media culture and a consumer culture thaurks is focused on this all-consuming and thereby disposable moment, blissfully unaware of the historical tie that is brought us here or the ties that will take us away, it's very understandable that we'll forget our past. but each one of those presidents, that you mentioned jfk in particularly ronald reagan whose great hero was franklin rose veosevelt, you'lln to understand how they shaped

the world we live in today. and it may be just the mile op ya of our kpisz tense that we don't have distance in our eyes, back wards or forwards, to understand the centrality of the rose vemts to this present moment. >> the rez velts lived when public figurings could preserve a modicum of public lives. how did this create an intimate portrait. >> they wrote a lot. they are hugely important. so they have been written a lot about. and we tend to romanticize of those earlier days. when the greatest economic dislocation in the world happen. simpler, like in the 1940s when the greatest catty clichl in the world happened. those reporters who may have turned off their newsreel

cameras just as he went into the process of standing up or sitting down and the arduous, sweat-dripping, painful process which we would not do today. we'd be grasping for every single moment of it to feed the hungry maul. nev nevertheless knew exactly what it cost him to stand up. understanding more what was intimately going on in the pressing issues of the world. we now have a presidency surrounded by a gigantic mote, a bubble, we call it, that does not permit we think him or her to understand us. but, in fact u it's the other way around. we don't understand him and so, default, again, to that conventional wisdom. i think we know as much about the roosevelts and we know a good deal with their private life. and that's been extremely helpful. especially with regard to the letters of d auraisy spippley.

>> fdr and eleanor each grew on a wide circle of friends and supporters. what did they draw from one another? >> well, as much as our tabloid sensibility wants to 5:00 sen chew wait their differences, this is one of the most remarbleble, if not the most remarkable parter in ship that i've ever come across in my life. she was his conscious. the conscious of his administration. he betrayed her with an affair when he was assistant secretary of the navy during world war i, had an affair with her social secretary. and that, in some ways, became a liberating moment for eleanor roosevelt and i think it's important to understand that sometimes, aout of this adversity, sometimes great things, it gave her already spectacular social conscious. a kind of goad and permitted her to go out however angry or

wounded she was, out into the world and do the kinds of things she did. become the kind of woman she did. but they never lost sight of each other. they knew where each other was. in good times and bad, when they were mad at each other and when they weren't. they were working together. and how fortunate for the rest of us the thing they were woirking on was us. that is to say they had transz lated their problems and add verszties and figured out that it would be helpful. it would be helpful if he taught other people how they might be able to escape the things that aflected them. >> what did your research reveal about eleanor's alleged extramarital relationships? >> nothing. she had close friendships with a number of women, some of whom were committed to one another. beyond that, we don't know anything.

i would also remind you that the film reveals their genuineness and her abslupt passionate relationships with three men, other than her husband, though not sexual, until the end of her life. i inviet you to stay tuned to episode 7 to find out what that is. >> i'm glad we asked the question. and thank you for your answer. some press-media related questions. fdr was famously available to the press. can you talk more about his relationship with the press and how it shaped its historical image? >> well, that's a really good question. and he was famously accessible, as i describe. i don't think it's shaped his historical image. in fact, the image that comes

down to me is the this one that i was describing a little bit earlier. a sense of how kind of naive earlier times were where they turned off the camera. that the secret service would turn off your camera or confiscate your film or it was just a jentle man's agreement that we wouldn't cover the degree that their president was aflikted with polio. there's discretion, but it is in no means naive. they knew as franklin roosevelt knew, as his advisors knew, that to see this process -- ladies and gentlemen, there were many, many audiences when this was on full display. it was a secret, it was held by hundreds of thousands of americans who got to meet the president or see the president or hear the president up close and in person. but he -- this is, you know, a sort of a red herring about mim. they knew about it and didn't think it was necessary. they understood that if people pitied him as you would do and

if you saw and understood the full dimension, jeff and i are as proud of that part of the story telling as anything, to tell the full dimensions of what polio meant. most people say he got polio and here's what the press dpnt show and leave it at that. it's really important. and a good deal of our fourth episode, the 1920s, is dealing with what it took for this human being, still a human being, to actually figure out how to go from being paralyzed for the rest of his life to being president of the united states. and it is a hell of a story that they understood that if they pitied him, that was political poison and everything wasover. >> how important was radio for fdr's administration? >> jonathan walter has a wonder 68, wonderful passage in our film at about the time he's delivering the first of his fire side chats.

theodore was a master at using the press and using the bully pulpit and using the great moral office that both men felt the presidency had become to communicate to citizens about what they thought the country had became. but as alter says in our film, every politician had, up until that point, talked like this when communicating with their citizens. and franklin could talk like this. he could tell you what the bankers had done wrong. he could tell you what the whole principle of banking was, he could tell you that hording had become a very unfashionable past time and he really helped that the next day, monday morning, when the banks kwit their bank holiday, his cheery name for it, that you might put your money back in the bank.

and the run that had been expected the next morning didn't happen. people put their money back in, just as their president told them to do. and a lot of it had to do with the way he spoke to them. just like this. in the intimacy of their homes, leaning in, which is what happens when you create an intimacy. it's not manipulative. it's smart. it's good. it's right. and it worked. as it was said after that speech agt days after he was inaugurated, he saved ka ed capm in eight days. and there's good evidence that that's what he did. >> why didn't the political opposition use fdr's polio against him? >> well, i'm not sure they used that against him. the principle argument about against him was he was a trader to his class and a socialist and a communist and i'm sure if they were convinced he wasn't born in this country, they would go after that, as well.

but there was concern that he was not up to the task. roosevelt had hired a journalist. let me repeat that again. roosevelt hired a journalist to write a report on his health. and that journalist, in turn, with the urging of the roosevelt campaign, hired three ind pend dent doctors who all attested to his health. but as a result of that article, they were compelled to never come in again. they would say it's not a story. it bham less the polio and more his physical health department as he visibly decayed in front of his fellow country men and women that became an issue. and it certainly was an issue at the third term and a huge issue at the fourth term.

>> i'm not sure that rose velt could get out of the iowa caucuses today. that is to say that we would focus on the extent of his illness and not the content of his karktsder or his programs. and we would be distracted by that. certainly many commentators would say that he couldn't possibly be able to have the stamina to get us through any crises. and this is the man who handled the two greatest crises since the civil war, the depression and the second world war. >> a slight elaboration.

how do you think fdr would have fared in today's made ya and political environment? >> i say i don't think, but then, again, having franklin roosevelt after something, it's hard to imagine. we did have a democratic senator from georgia, max cleeland who was a triple amputee from the vietnam war. we're doing a series on the vietnam war and we've interviewed him. and he made it to a fairly high level of political office, the united states senate. and so i would never say never on franklin roosevelt. i feel the same way about theodore. you know, he was irresistibly himself. people loved him even for his coke bottle glasses and his harvard 5:00 acceptabili harvard 5:005: harvard accent and nasally voice. he might have had ten howard

dean moments a day. and maybe not gotten out of iowa. i don't put it passed any threeover these roosevelts. >> how were the vices selected for theodore, franklin and eleanor? >> well, you know, we have a remarkable supporting cast. and one more edit, and this is it, we do like third person narrators. we are very, very proud of that. we believe that in the beginning was the word and the word is not the enemy of images. so our films are very much written in the third person and read spectacularly after being written so spectacularly by jeff, by peter coyote. but we did want to temper that voice of god, which, by itself, sometimes is just a voice telling you what you know.

which is, like, homework. rather than a voice that's sharing with you a process of discovery, which we would like. and so we have, for the last 35 years, tempered those -- that third person voice with a choral us of third person voices. we've had theodore rose velt, his past through our films and we've had various actors reading him and wanted very much the finest actors of our day in paul giamate. and i think as you'll see, he's just spectacular. his agent wrote me today and said good casting. and it may have been him. and we agree wholeheartededly whomever that was. ed herman has played franklin roosevelt has gotten hudson valley lockjaw down and has played him in the stage and small screen and large screen for many, many years. and has really taken him in.

and then we were able to get a lit lt known actor named meryl stream. i want you guys all to remember that name. s-t-r-e-e-p. i believe she's going places and we just feel terrific that we're able to get her early on and we'd be able to do it. no, she is, obviously, the greatest actor of this or any other generation. her gift to us is an inkal cab, unmeasurable and we dpoeon't ha the words to thank her. >> a few personal questions. don't worry. did you get good grades in history as a young person? [ laughter ] >> i did, actually. i knew from age 12 i wanted to be a film maker. that was it.

the fact that i did well in history. i remember bumping into somebody from junior high, you were so good in the history class we knew you were going to be a historian. and i don't remember giving the impression that that was where ifrs headed. i was headed to be a film maker but i was fortunate enough to bump into history very early on. the last time i took an american history course was 11th grade, you know, where they make you take it. >> how do you juggle so many projects at once? and how do you select your projects? and do you take requests? i apologize for a three parter. but you can answer. >> you mean, like, sing? a song right now? i don't think you'd want to take requests. we are would recollecting, besides promoeting the roosevelts, which, itself, 1 a full time job.

we have five films in production. and they're all in various stages. it's not juggling, it's just timing and management. it's like planes landing. this one has already landed and is tax silling up to the gate and we have a couple on final approach. i'm serving as executive producer and co-writer on. but i am producing and directing and writing with my daughter and son-in-law, sarah burns and david mcmahan a two-part history of the life of jackie robinson. the whole life. not just 1947. we are actually more than half way through editing with our colleagues and most importantly, the ten-part, 18 plus hour history of the war in vietnam. which will be out in 2017, early 2017. and then we are already shooting a massive series called i can't stop loving you about the

history of country music. and we've also begun early stages, a big biography of earn hemmingway. once they do, we'll start talking to you about them and i'm already in discushions with pbs to talk about what the 2020s look like. and i want's very clear, jech and i sort of feel that if we were given a thousand years to live, we would not run out of 2 to topics on american history. >> you have a new app that draws from your many document tears. describe it as not a collection of your films, but as an entirely new way of looking at american history. can you tell us a little more? >> that sounds like it was written by somebody in pr. so we have an app, it's called the ken burns app. what it's attempting to do is

take moments, little tiny scenes from all of the fill ms, it's up there, 25, 26, 27, whatever it is. and sort of cure rate them among the themes that i've seen take place. the recuring themes that i've seen take place in american history on innovation, on art, on politics on war, on hard times and on race. and we've just added a new thing on leadership. and we'll continue to add them as we continue to add films. it's a way to access all of the films at any point anybody can jump and go look at them from p pbs.org or go to itunes or netflix and go there and get the films. but this was a way to cure rate these themes from many, many different films and show them the way american history is related. i don't think their cycle streams. i don't think we're condemned to repeat what we don't remember. i do think human nature remains the same and superans poses

itself on the randomness of events. it becomes h historian's responsibility to try to perceive some of those patterns and to reflect them back. and the app is just no way to cure rate in a much more manageable way. the magazine "wired" decided it would take 5 s1/2 days to watch all of our films back-to-back. this is a way to sort of get samples of these themes. >> thank you. we are almost out of time. and i would just like to make a few two-point part conclusion. first of all, i'd like to remind you about our upcoming events and speakers this wednesday, september 17th, john stump, this friday, september 19th, larry burrow, president and ceo of cbs and jim web of virginia.

second, i'd like to present our guests with a traditional national press club mug to add to your collection. >> i now have this complete set. >> and your new national press club membership card. >> thank you. that's great. [ applause ] >> and the last question, with 45 seconds left, have you ever kshd doing a documentary on the palin, s? and if so, where wow you begin? this is a very important question. i think i would begin in russia so i can have the best view of the palins that one could possibly have. and this would be another d dynamic american family. i just read a recent news report in which there were punches thrown at a party. so we know it's not going to be lacking for drama in any way. >> thank you, ken. [ applause ]

>> thank you all for coming today. we are adjourned.

>> when you're battling for cancer, you pray for a cure. >> greg abbot was charged with overseeing the state cancer research fund. but he let his wealthiest donors make off with money that was meant to find a cure. i pray that greg abbot never becomes our governor. >> new allegations against texas democratic governor wendy day vis. >> democratic candidate wendy davis didn't always recuse herself when the city was

affecting her business. >> she approved $25 million in tax breaks who used her title insurance company in the sale of the building. >> every week, businesses leave kra kr california to escape high taxes. they come to texas because we keep taxes low and regulations reasonable. i'm greg abbot. my job will build on that. we'll control state spending and keep taxes low so small business can grow. together, we'll keep texas number one in jobs. >> in the texas courtroom, greg abb abbott made the case gerns our children. and now, abbott is proposing

giving standardized tests to four-year-olds. wendy davis will reduce the number of standardized tests our kids take across the board and will use an education to build an economy for all hard-working texans. >> this is the first time in 14 years that texas will elect a new governor. texas gubernatorial candidates, democratic state senator wendy davis and greg abbott face off in a debate tonight. you can see it at 10:00 eastern on c-span. >> with live coverage of the u.s. house on c-span and the senate on c-span2, here we compliment that and then on weekends, c-span3 is the home to american history tv with programs that tell our nation's story.

and our new series, real america featuring article kooifl government in educational films from the 1930s and '70s. c-span3, funded through your local cable or satellite provider. >> next, a conversation about health insurance companies trying to control costs by excludeing from their health plans certain doctors, hospitals and other medical providers. this is an hour and a half.

>> good morning. on behalf of the alliance hilt reform, i'd like to welcome you to this morning's session about network adequacy. i'd like to thank our two sponsors, the blue cross blue shield association and the miss r pittsburgh medical center. if you are following us on twitter, the hash tag is network adequacy. if you are listening by phone or watching only c-span 2, you can e-mail questions to us at questionsatallhealth.org. so the title of this session is network adequacy. but we've heard many names for these networks. we've heard anything from limited networks, value networks, why are we having so much trouble naming these things? >> first, what are they?

some new insurance plans in the marketplaces offer consumers networks that are -- that do not include certain doctors, hospitals or other medical providers. some are saying that these smaller networks are causing problems for provider access choice while many are saying that if done the right way, this can help by creating competition and controlling costs while also maintaining quality. so there are a lot of questions about these networks, therefore, the trouble naming them. do they save consumers money 12? is the quality of care as good in consumer networks? do they need all of that choice? how prescriptive should the federal government and/or the state governments be in setting requirements for the networks. what is the consumer experience so far and what will it be going forward? so we're fortunate today to have

three experts with us. and we are going to start with ted nichol today, he's wisconsin's insurance commissioner. and he also plays a leadership role at the national association of insurance commissioners where he is a point person on this subject and is heading on efforts to update mod regulations for the states. joel ario was the first director of the office of health insurance exchanges at the department of health and human services, what we now call csio. he's pennsylvania's insurance commissioner and also oregon's insurance commissioner. michael churno, on the other side of ted nichol, is a professor of health care policy and is a member of the congressional budget panel and of the institute of medicine's

committee on national statistics. he's also a former vice chair of med-pac. once the three of them have given presentations, we'll open them up to questions and answers. and, at that time, diane holder who is the executive director and a lerlina pavin of the blue cross blue shield of michigan will join us for the q&a. so we're going to go ahead and start with ted. >> good morning. thank you for having me here today. this is really a very important discussion and is one that's going to continue for quite some time into the future. but it really is -- we really want to focus on the issue of network adequacy. i'd like to start off by providing a little bit of background and an update from a regulator's perspective on the

network adequacy. first of all, it's really important to know and realize and to remember that there are a lot of conflicting issues surrounding network adequacy. for consumers, the main issue is whether or not their doctor or their hospital is an insurance plan and whether or not they can receive the care that they're looking for. and, also, whether or not they can you wi can ultimately be able to afford their care and to keep their health care costs down, as well as their health insurance costs down. for providers, on the other hand, the wider the networks, the greatest the reimbursement rates. the more attractive it is for consumers to increase those plans and patient numbers. providers are obviously constantly ne gauche yating with insnurers for higher reimbursement rates. insurers view wide networks a little bit differently.

they would typically see those as decreasing their ability to managed care. insurers are constantly negotiating with providers to narrow at times networks to increase and better manage the care of paishltients and consum. all of this is to a point. through the regulators per spektsive,the networks must be sufficient or the insurer may have to pay innetwork benefits to out of network providers. with the divergent issues all in play, how do we, as regulators, referee. it's really a mixed regulatory approach. it differs from state-to-state. networks are subt to a number of different reviews. first is state review. a network must meet state standards. and then there are a number of -- excuse me. then, any number of insurers may

try to become accredited by national accrediting firms such as ncqa or buraq. this is optional, but it's a sign of quality. a good housekeeping seal of approval. for insurers selling on exchange or opting for qualifiered health plan designation, they also must follow federal standards. gempb, from a regulatory perspective, who do we regulate to assure network adequacy and network folks following networks. for the insurer,do we regulate tpas? for a fully insured plan, it's pretty simple. the insurance regulators regulate the insurer and can regulate the plans through that process. for a self insured plan, it's not quite as clear.

as a result, some states have looked at regulating third party administrators to get to the issues. most states will only be able to regulate the network issues through the insurer oversighted function. it's also important to note that there may be different standards for different products. in wisconsin, for instance, an hmo or a closed panel may be rierp required to allow direct access to certain providers such as ob/gyn. they may have certain appeals processes in place for emergency care. ppos may have lesser requirements because consumers do have an option to choose from any provider. one of the other debates, at some point, may end up being evolving around this business of mult multi-tiered plans where one of the plans has very small co-pays, one of the networks has

very small co-pays and the other is attached with higher co-pays. the question might be do we look at thee tiers how do we look at these tier sns should the smaller tier be regular lated and should it have to be a full network? typically, that tier level does not include specialists. all of this is to get at my next point. many cases, the passage -- in the past -- excuse me. in many cases, the passage of the aca has resulted in the a l accelerated use and focus on narrowing networks across the country. harking back to hi earlier point, control can lower costs for insurers. wider ben fwits under aca have increased the cost of insurance. insurers to keep insurance costs lower look to network design to slow the anticipated increase in rates.

renew ewed two cusfocus also ca the naic to revisit. usually, environmental factors cause the naic to update our model laws. the current neic model has not really been looked at or up dated since the late 1990s. but states are still able to adopt the model and able to make their own changes at any time. the model was adopted in 1996 and very flexible and is still very good. its pliability reflects the diversity in terms of market differences, large versus urban, excuse me, large urban versus vast rural and the way insurance operates. but still keeps the same standards. the model itself requires a su

efficient number of covered services or provide coverage at no greater cost to the consumer. also, provider distances and wait times should reflect the norms of the area and requires insurers to file an access plan to insure the meeting standards of the area. wisconsin share that is group and is charged with revising the model. this chair, we've saugt a lot of input from all parties affected by the law. consumers, providers, insurer and accrediting organizations. we've received 26 comments thus far from interested parties. and once we're finished reviewing those, we'll continue working on revising the model. and the goal is to add all of those changes and look at all of those changes and then take a fresh look and go through the model yet one more time. a great deal of important questions to ask in and around network adequacy.

in some cases, we may not be able to come up with an answer. as a regulator of insurance, it may not be our place to answer. issues that will be grappling with include narrow networks even a problem? what if no wide networks are offered in a particular market? what if an insured is not offered out of network coverage? how narrow is too narrow? what does it matter if an insurer covers all out of network services? what is the appeal's process for uncovered services. should there be a single statewide standard. what happens when a doctor or hospital leaves a network? and to what degree of continuity of care requirements should there be? and then, of course, consumer notice requirements as well. the list goes on and on. and, fiejly, i just want to, we, as regulators and folks working on this really important issue need to keep a cup 8 of things in mind, as we feel.

we always need to be mindful of cost. we need to look at access to medical care for consumers. and we need to recognize and understand that we, as regulators, do not have all of the answers. the bottom line is that we need a model that can address the existing and emerging issues for another 15 or 20 years. with that, i'll turn back to you. >> okay, great. >> actually, before we move on. can i just ask you what can you tell us at the moment? i understand that you haven't finished your work at the naic, bum what can you tell us about where you think we're headed with these regular lagszs? are there any, based on the comments, based on where the other insurance commissioners are, what can you tell us about where you think we're headed with these regulations on some of these questions that you've raised? >> that's a broad question. it's clear,and i was talking to some of my fellow commissioners,

regulators last week, and it's clear that this business of state-to-state differences and needs to be recognized. we have states with significant urban populations and then you have states like wisconsin with pockets of urban populations surrounded by cows. and it's drk it's important to make sure that there's a model in place and there's a framework in place to get consume i recalls the type of care, get the consumers the type of access they need but, again, keeping in mind, keeping in mind the cost issues. the other issue that we've seen so far is in talking with other

regulators and talking with some of my staff, 1 this whole issue of network adequacy. while always being something we get compliants about or something we get questions about. we have not yet seen an up tick. we haven't seen an up tick in the amount of questions about, gosh, you know, my insurer cancelled my network or they threw out my doctor. what are they going to do? we're not seeing that yet. we're trying to keep all of those things in mind as we look to, again, update the model. and update it with an eye toward, an eye toward there's new products out there. there's new technology available. there's a lot of just -- the entire health care marketplace, you know, the entire health insurance marketplace has changed since the model has passed. so we're heading in that direction. of updating the model given a

lot of the environmental factor that is we're -- that we've been experiencing that we've seen. >> okay. great. and one more very quick follow up question and then we'll move on. regarding the comments that have come in, from stake holders and others, are there any particular themes that you -- thread that is you saw in those or any distinctive disgreemt that is you think are going to make your job a lot more difficult? >> i think the one issue that's always going to be a challenge is access. you're going to want -- there's going to be a certain folks that want to have just complete, wide access to whatever's available out there. around you're going to have the other side pushing back saying it's a great idea, but it's just not affordable at that level. and you're also going to -- you're also going to -- we've

seen that there's a need for more managed care. there's so much more technology out there. there's so many ways to better handle individual care. and imthink jo think joel is go address it at some point this morning. this idea of focusing and narrowing of networks and better managing care is really becoming a huge part of landscape. and it's really -- it's really promoting healthier outcomes. and so there's going to be that -- there's going to be that struggle. there's going to be those back and forths on, you know, wider the better versus narrower the better. and i think that's what we're going to be grappling with as we look at updating them. >> okay. so let's move to joel now. >> okay. thank you. i always enjoy following ted at these kinds of events because it

reminds me of why i love my years in the neic, a sense of deem knowledge of the issues, a sense of balance and professionalism about how to handle them on a lot of these kind of issues looking to to the neic and the different perspectives and the different states and the different representatives 1 a good way to get a window into the issues. so i thank ted for his comments here and i hope we do keep this issue primarily at the state level. i think it's the kind of issue that differs dramatically across the states. one more comment i want to make is the event that shawn carr asked me to organize and attend. and then shortly after i learned of his sudden death. he was a reporter in the very best tradition. just a natural curiosity about issues and just did a bang-up job of covering these issues, particularly at the neic. with that, i'll get into my

comments. i basically have three-points to make. one is around the net works and what was intended in the aca in terms of setting up the exchanges and corp. tigs was in the exchanges. two, what are some of the broader issues within the aca that we waive to the network issue with intent to shadow them with the managed delivery systems and so forth. and then, three, what are some of the consumer concerns here? i think ultimately, consumers will be the prompter on this issue. and if they react like they did in the '90s to some of these narrowing of networks, we're going to have a different outcome then if they see it as one choice and one of many in a market place. so starting with the first comment, narrow or value networks, i'll try to use both terms. it shows you how controversial the terms are. you get in trouble right away depending only what you call these things.

but they were clear lly intende in the aca. when you take out a lot of the other variables, insurers are used to come peeting with each other on particularly risk selection. that's a form of competition. it's not completely gone, but it should be gone and it will be gone. and then you have to look at other ways to compete. i think it was pretty clear as the arksz ca was set up that one of the things that insurers were going to do to compete with each other was really ask hard questions about their networks and try to manage price around how they set up their networks. it was also envisioned, i think, in the aca, that part of the reason that would work in counter distinction to the '90s was because the exchange would offer a multitude of choices to identify other. it wouldn't be your your employer trying to go with ahmo and it's a one-size-fits-all situation. if people want, they can choose

broader ppos. if they want, they can choose other kinds of narrower products. and i think that's very important. and if i were running an exchange, i would want to make sure that all the products weren't narrow networked, tightly managed network-type products, that there were some choices for consumers out there in the p,o. and i'll come back when we talk about the consumer side of this. the consumer has to be educated and know the difference between these kinds of issues. the first point is this is not a surprise to people who put the aca together. this 1 what was intended in the competition. and it's a healthy kind of competition to have in the marketplace. and if i feared one thing more than anything else in this whether or not he will arena, it would be that some events happen that cause people to sort of set a one-size-fits-all solution to this problem. and it takes away the rich competition that can happen around different aproeps to network.

so that's point one. point two, if you look at the rest of the aca outside exchanges now, you do see the things ted talks about right at the end there, the affordable care, accountable care organizations which could call them affordable care organizations, too. but the acos, and really, other dimensions of the payment reform initiatives that are coming out of cmi, innovation center, bundled payments, they all required tightly managed oversight of provider net works and integration between the provider network and the insurer, could call them kaiser-like approaches to the issue. when we were setting up the original kind of network rules and some people were proposing, you know, fairly stringent kind of standards that would apply to everybody, as we're just kicking around ideas, i would always ask the question, well, what would you do with kiez i recall undka

that kind of simpluation. people would say oh, kaiser is kimpbt. so you can't just say kaiser is different. you've got to let everybody have an opportunity to do that or you say you can't do it at all. and i think those kind of integrated delivery systems is different. we saw an earnings call last week, they both talk ant the importance of having some flexibility around networks and how their aco worked, which they're busy creating acos, in conjunction with their insurance activities, that those become examples of products. and i think teddy, i saw your state now or the chinese plan in san francisco. you're going to create these plans in local areas that have a select network that works 234 the local area. and if i'm an exchange director, i want those on my exchange. again, not as the only product, but i do want them. in some ways, the insurers are

going to have to be pushed in creating these products. in massachusetts, it was the sledge slayture who had to say we wachblt all the insurers to offer products with a lower price point because we want that choice available. available. so, i think all of that is important here. it's intended for price competition, but it's also key to managed care and improving the quality of. at the same time, you're reducing the costs. the way in which networks are managed are critical to that and i think the future holds these aco type developments around the country will show up as targeted products on the exchanges. so, that gets me to the third, probably the most important point because i think consumers are the ultimate barometer here. everybody part of this system is depending on what consumers say

will react to that and the rules will differ. so i think two issues are important to make for a vibrant and competitive network. one is tran sparnsy. consumer does need to know who's in what networks and which plans are which kind of networks. unlikely to see a kaiser being challenged on its networks because of where it operates. they know what they're getting there. in more or less a closed system. it's a much different thing if a broader man that's got a reputation and advertises as we have actors in the state and our networks and so forth. there was a small print who said that's not part of that. you don't have that. we have something else. you should be able to do that and have those networks. it has to be transparent. there is a lot of work to be done. finally i think there have to be

some kind of safety valves for out of network protections if you are going to draw around the out of network and reward people around the state and network and big penalties and no reimbursement out of network. you have to have rules like i go to the in network hospital and i get a bill that said unbenounced to me, one of the professionals is not in networking. new york now regulates that and said consumer doesn't know about it ahead of time, they get the in network price. a lot of issues to make sure the consumers are educated around these issues and that there is full transparency. it would be wise and i suspect that they'll come to this conclusion that we ought to give states wide latitude to regulate this in response to local market conditions.

>> so let's turn to mike. >> great. thank you. i am thrilled to be here. when i speak at events like this, sometimes speakers disagree and there a lot of fireworks and it's exciting. unfortunately i am going to be in agreement with the previous speaker. for those who wanted a jerry springer event, i don't think we will have one. maybe later. first let me start by saying something about the term narrow versus value. value and narrow, narrow networks may be high value. about but value imi plies cost and not just that. value has a specific manying about what you are getting for the amount and not to be used for the sake of that. you could have a high value, but

you may not. i think the discussion here is what to do when you have a narrow network that is not high value. let me start by laying out a general part. one of the things i find frustrating is when i read articles, the topic is when they move to another area and they forgot what was written last week. there was a lot written about the prices we have that are high. that's an issue. so one advantage about having narrower networks, the price that is paid to providers. one advantage of narrower networks is it strengthens the hands of the people who are focusing. he is buying a car and he funds to his wife and one of the sales men. i don't care what we do, we have to get the car today. it was interesting to say it wasn't that useful in the negotiation process. if you are negotiating and the other person knows they have to

be in, it changes the price. if you are worried about the price and you may or may not be in a market system, the ability to exclude becomes important. another topic that has been interesting and we get the geographic variation. and actually across providers. there is a lot more. if you knew that, wouldn't it make sense to try to construct a network for you folks on those providers and follow more efficiently the advantage of having a narrower tactic. there other reasons. if you can concentrate enrollment and it facilitates engagement and may reduce administrative costs. i can make a strong case for why

there is merit to these types of things and that said, there is a lot of reasons to be concerned about the products. most importantly, people need access to good doctor and convenient doctors. they need access to their doctors and we very much want to have people have that opportunity. the problem is in general, you choose your plan before you get ill. it's not clear who you know. i can name one doctor who is my doctor. i have a lot of body parts and all of them can break. i have no idea which doctor i would want to go in that eventuality. i would be forced to choose my plan. i don't want to investigate who

the best neurologist and dermatologist and whatever else i might need before i choose my plan. i can't make that choice. even though i agree with the other speakers, the consumer awareness is important. it would be how much we can inform consumers. the time they choose their plan versus the time when they need their care. in the case where you use a lot of doctors, it may be difficult to get the doctors you need into the plan. i might not know and the -- my mother's relationship with the oncologist and you wouldn't want that to be the case. there are many conditions where people have serious and important relationships with their physicians and in these models, it is difficult to say to certain people, well, now you have to choose and we have to figure out how to balance that concern with the other advantages that i mentioned before. so transparency is obviously important. it's not going to be a full solution.

regulation of network changes i think matters. there's a concern about a bait and switch thing that might happen, you know. you join a plan you thought your doctor was in and in the middle, network changes. maybe because the doctor left. not something the plan did. you're stuck and we have to think about how to deal with that. both said and i think it's important one of the ways to deal with this type of problem is to reduce the consequences if your physician or hospital ends up being out of network. what do you have to pay to reduce the harm that occurs if there is some mismatch between what you want and need. there is another problem. another concern about the types of networks, the concern related to selection. it is true that i can make a compelling case with variation and proficiency and pick those

who are more proficient. you might be able to pick different patients by picking certain doctors. we have to worry about them. i believe in a personal comment, we have made a sufficient advance in risk adjustment. i could show you evidence that suggests it might be more appealing for plans for folks with chronic disease as opposed to out with the way we do risk adjustment. that's the end of the process. i think that matters. a few other final points, the first is and i hate to say this because we are going out on tv somewhere, but i believe this. fairness to providers is important, but it is not the fundamental goal of the health care system. there is sometimes fair to providers. i do believe we need to be fair to providers, but at the end of the day, the ability of

providers to get into a network is not ultimately what we're concerned about. it's more about patients having access and the cost they can afford. we will see through the networks a big reorganization and how the providers respond and that will be one of the most important to monitor. the providers are going to have to negotiate in different ways with the plans. a few other things as was mentioned before, we need to think about the issues that is narcotic and not plan specific things. that creates challenges and i'm glad i'm not one. we have to focus on that and the second thing is ideally, we would be able to focus on measures of out come and not