we need to do that to unleash the market forces. which is to unleash market forces. don't think the government can do it. we need to give the right incentives and step aside and let market forces dictate the creation of the infrastructure to accomplish the goals we want. we need to do it more in the environmental area and especially have to do it in the health area. part of that infrastructure must be the maintaining and stable funding of the government areas. now, to whomever on the panel that wants to address this, legislation can a blunt instrument. we heard about the paperwork reduction act which has caused more paperwork, the reports and all the other things that will make things easier and instead they make had

them harder. i think we would welcome legislation to reform that area. but if we come in a blunt instrument, suddenly recreating the fda authorities or mandating things on the fda or looking for the department of health and human services to do things that they're not equipped to do and then, of course, we don't fund them to do it, i think we have to be cautious about some of the legislation that may be proposed. more than anything we want government to be there to work collaboratively but we still have to recognize the safety and efficacy that american people and most people here would certainly think is necessary for a new product. we want those products out as quickly as possible. i remember the days when we had the first evidence of the aids epidemic and the people that brought home the reform and fda to get some of these therapies

out quickly were the act up groups of the gay community. they studied the law of fda and argued you don't need to take so long. you don't have to wait till the end result to show that a therapy is safe and effective. you can have markers, you can get these products out more quickly. so i think the collaboration between the private sector where the market forces were pushed to move forward and we want government not to stand in their way by undermining them with less stability for their work, the private sector, the disease groups, most representatives of disease groups know more about those diseases than anybody else because they've worked so hard to try and understand what's at stake. pressing the government to be as flexible as possible. i think it's important for the infrastructure for the 21st century.

but i just want to say i would be a little cautious about thinking we can solve big problems with legislation with all the unforeseen consequences that can sit in a panel here years from now and bemoan. i guess that's not a question, but comments. i thank the witnesses and particularly my good friend and constituent mike milken for all he has done. >> joe pitts. >> thank you, mr. chairman, again for convening this roundtable and thank you to the expert witnesses for your insights. every time we have one of these hearings or roundtables, we learn a lot. and we had an excellent roundtable with dr. collins, dr. hamburg, our chairman, dr. burgess and frank pallone was

there. it's very, very important. and it was meaningful. doctor, let me ask you, you have forcefully made the case that it's imperative for congress to prioritize funding for nih. while i understand the importance of ensuring that funding for nih remains stable and predictable, congress is at a crossroads where federal dollars are already committed, particularly as they relate to federal entitlement and safety net programs. and if we're going to find resources to stabilize and/or potentially increase nih funding, congress is going to have to look hard at prioritizing resources that are focused on advancing science and research to help spur the next generation of cures. are there -- this is a question. are there existing sources of research funding such as pecori that congress should examine as it attempts to find

federal dollars to help advance the next generation of cures? your thoughts? >> well, i don't envy the position all of you members of congress are in with our nation in a very dif fiscal deficit circumstance trying to figure out how to balance the needs to support important government activities, and i would certainly submit that medical research is a very important government activity that if not supported by the government, the basic science that nih does will not get done. at the same time i know you have to figure out how not to have a circumstance where we bury our heads in the sand as the deficit grows so you're faced with many difficult choices. one of the things we have been trying to do and i think it has helped a bit is to identify other ways to support medical research other than the traditional nih appropriation. one that has just gotten started about six months ago is a partnership between nih and

ten large pharmaceutical companies called the accelerating medicines partnership which is really unprecedented in its scope. the goal here is to try to identify that next generation of drug therapies that we know is waiting to be discovered given all of the breakthroughs that have happened in the field of genomics which will get here sooner or later depending how organized we are and the expert december doesn't reside in either sector alone but putting them together, it could be pretty exciting. companies recognizing that and much to their credit are willing to engage in a partnership within nih where the data is made accessible and not one of those where it's hidden behind a curtain and would have a hard time participating if it were so this partnership which is being equally supported financially by both the companies and the nih, 50/50 split here in an unprecedented way is moving forward on diabetes, on

alzheimer's disease and on rheumatoid arthritis and lupus. my colleagues watching personally over this closely wanting to be sure it doesn't run off the rails i think are quite gratified by seeing how far it's come in six months. that's an example of creative ways how to do things and working in every way to identify partnerships with other parts of the government, darpa where we have a null of very exciting initiatives including some that aim to put cells on a chip to allow you to investigate their behavior. i have a kidney here on a chip, by the way and i got a lung over here and these are basically amazing technologies bringing together the engineering skills of darpa with biological skills of nih investigators to move things forward in a fashion that could be great for identifying drug toxicities as well as effectiveness. but you're asking about other places to go and look. i'm probably not in a great

position to say of all the various parts of government support, where are there opportunitys? you pensioned pecori -- on the board of it and it includes the nih and patient centered outcomes research institute is what it is and working hard on trying to identify in a research evidence based way what are the actual interventions that work and which ones don't work for patients in the real word. obviously issues that we really do need to know about. and it's a hard working organization that's only been around for two or three years. i don't know how to balance those particular kinds of decisions that people are struggling to make. i do want to promise, though, this whole group that we're not just at nih saying give us money and we'll just keep doing things the way we always have. i get it. we have to be creative. we have to make reforms in the way in which we administer our own funds that you all through the public give to us and we are looking in every nook and cranny

to come up with ways to be more efficient with what we've got. i promise you this is not just researchers with their hands out saying leave us alone. we understand the obligation to be incredibly efficient, creative about what we do and productive and we're willing to sort of put ourselves under the microscope about whether we're doing that right or not. >> mr. chairman, could i just suggest a couple of, one, i would say scoring. when we look at how things are scored, we need to totally re-evaluate that and quickly cite one example. fellow board member of mine and close friend for many years ward trip-cassells was diagnosed 13 years ago with advanced cancer and given a short period of time to live. he engaged in every known clinical trial in this case for prostate cancer. he recovered and over the next 11 years i would say 10

extremely productive. he led two tours of duty to iraq where he led our medical efforts in iraq. one in afghanistan while he was taking chemotherapy, became the assistant secretary of defense in charge of the health of every one in the d.o.d. when we had issues at walter reed, he was called on to solve the problems at walter reed. founded two bio science companies, was previously the doctor for both president bush as a cardiologist and hired 2,000 employees. in the scoring everything he accomplished in those 11 years not the least of which was 11 years more that his young children had with him, who are very young, 3, 4, 6 at the time, all of them will remember their father, their lives will be different, their children's lives will be different. his score was 0 of any benefits

of those treatments he got and so we just count the costs, we don't count the benefits of this great american patriot and the 11 additional years he got. every person and cancer dies approximately 16 years before their normal lifespan. i would say scoring. two, internationalize. the first gulf war supported by henry kissinger and other's efforts, the united states put up 20% of the money. other countries put up 80% of the money and the u.s. managed 100% of the money. there is an enormous opportunity to drive research. as we focus part of the state department and other international efforts, other countries on a per capita basis are far wealthier than the united states today. norway, for example, many years ago set up a fund as a rainy day

fund, their goal, 500 million u.s. that fund today approaches 900 billion. they've overshot that fund. and the united states that would be like if you had a fund of $60 trillion sitting there. they can play as many other nations can an active role in activities if we had the structure here to get financial support from them today. third, young scientists. many things have been created to encourage young people to work in the field of teaching and if you go and you get teaching degrees from universities, if you work in inner cities or difficult areas, we forgive their student loans that they've had. almost all nobel prizes have been issued for ideas within five years of school.

you might have been 60 years old when you received the nobel prize but the idea was generated when you were 25 and 30. today, the average age i'm assuming, francis, is in the low 40s, 42, 43 of the first time an individual has received a grant. how discouraging can that be for a person with new ideas? we all of us who have had children grow up and go to college and leave are intellectually challenged when our teenagers leave the house and go away to college as to how something works. this is the same technology that's available in science today, but we haven't found a way to encourage people. to stay in science, to stay in research, to stay with the nih and one of them might be easily to forgive their student loans that they've accrued being a doctor, a scientist, et cetera,

if they work in these fields so there's benefit the same as the teacher in the inner cities and lastly, matching, challenge the american public. challenge philanthropies, we have funded over 500 young scientists. it's amazing how little the money, a hundred young scientists for the fda, a hundred young scientists for the nih and others around the country. let's challenge the american public where you need matching grants for those young scientists and i think we could accrue billions of dollars in matching grants here to keep young people and further their careers. >> i have -- thank you. i have people on my list, green, castor, upton, cassidy, barton and blackburn. gene.

>> good morning, thank y'all again for those of us who serve on the health subcommittee it's easy to have these kind of exchanges but dr. hamburg i want to thank you and appreciate the fda, what you've done with our gain act we passed last session, we have a follow-up, the adapt act that would give some more authority to -- unload some of the future of antibiotics and hopefully we'll do that but my main question, dr. collins, at the july 30th and 31st joint nih/fda meeting on the development of new aegs you said the u.s. government should launch a public/private -- establishing master clinical trials for antibiotics. similar to what mr. milken talked about bringing in many experts indicated that the public/private partnerships like the new drugs for bad bugs initiatives in europe.

i guess they like acronyms, n nd4bb were crucial to bringing together key stakeholders from the government, academia to tackle the scientific challenges facing development. smaller public partnerships at nih have already undertaken have been an important component to revitalize antibiotic r&d. dr. collins, can you tell us more about the plans for the larger u.s. public/private partnerships and the master trials protocol? >> i certainly can and thank you for the question, congressman. the fda and the nih and industry all got together at that meeting july 30/31, peggy hamburg and i worked closely to plan for this. and it's a very important issue because when you see the way in which increasingly infections particularly in hospitals, particularly in patients who are very sick in icus turn out to be

from organisms that resist all known antibiotics, we are on a trajectory that is really quite frightening. and the delivery of new antibiotics through the pipeline has been quite slow for mostly financial reasons, that is, the development of new antibiotics is not seen by most pharmaceutical companies as necessarily something that's going to be very profitable. you may have a small market, a short time that drug is delivered, a lot of liability concerns, so here we are in a circumstance where the bacteria are increasingly through evolutionary processes after being exposed to way too much drug prescribing which is going on both in hospitals and in agriculture are developing these resistances and we don't have at the present time a fully effective strategy. one of the things that we need as part that have strategy and this was the main topic of that meeting was to have a pre-existing network of clinical

trial sites so that if a company says we now have a promising new antibiotic, you want to use that on people who are infected with these highly resistant organisms but you have to find them. they tend to happen in outbreaks. if you don't have a pre-existing network with staff on the ground with consent forms, with irb approvals then the company has their drug but there's no way to check it out and see if it works in less than many, many months so the idea is to have a master clinical protocol and nih through our national institute of allergy and infection disease is very invested already in making this happen in order to provide industry with that kind of a platform. it's a great example of a partnership where we all have a lot of in common, a lot of needs here. there will be, by the way and the relatively near future a lot more information about plans that we've been cooking up over many months now about how to take a systemic look at this

problem of antimicrobial resistance and perhaps more coming from the president's council of advisers and from a bunch of the rest of us. >> we hear a lot about ebola and the only two doctors who are able to get something, but, you know, mrsa is in every hospital in the country and it's, you know, where we had our constituents so thank you for that effort and hopefully we can move forward with it. >> 30 seconds. [ inaudible ] >> that's great. yeah. that's good. bill parfet. >> i had the opportunity to go through your wonderful facility a number of times this last year

and see the advances of what you have done as it relates to animal testing that can then help the drug industry. tell us a little bit about -- as we think about trains traveling at the same speeds but the tracks are the same let's talk about what you've been able to do to improve the testing and expert indict the approvals of what you're able to do? >> well, you were there, fred when, we launched our molecular imaging capabilities in preclinical work and while image something not new its broad use is gaining momentum daily. and in many cases on a regulatory basis the regulations haven't kept up with this science. now, that's not a criticism. believe me, it's not a criticism at all, no, but this isn't one, but for example there's no fda imaging approved for bio markers for early stage. and yet when our clients and our

sponsors go for approval, the fda in a great way talks about the old archaic ways of working through toxicology and whatnot and even efficacy work and we know you're not required to do imaging but do you have any and of course we do and that results in it. now, what that says to me it's our fault that we're not keeping pace with changing technology. and so i think in the case of the regulatory environment within which we live, that it's so hard for regulations to keep track -- to keep pace, it's so hard for regulations to really help allow for new innovative methods to be tested and used that maybe there's some way to have an emerging issues task force or something along those lines and i'm sure you've thought of this before where when new technologies are available or being used perhaps not in the mainstream of regulatory approval but are being used to supplement insight

into drugs and again with imaging in particular for clinical trials it's incredible what kind of insight has been achieved as a result of looking again at bio markers and absorption et cetera so if there were emerging issues task force were in this case a collaborative way the preparer or the sponsors in this case, the researchers, the innovators could work with the regulators, could work with academia, the specialists, the subject matter experts so that we could quickly allow some of this to happen, and i know this is a litigious world but we're breaking new science and risk is part of it so you saw what you saw there is what is -- it's not -- there's a lot more advance technology in science than just imaging but it's coming of age today. it can clearly add significant insight, reduce costs, improve speed as you saw and you know. and i would encourage that part of your legislation would allow us in a collaborative way to be

able to work together to be able to allow to experiment and allow -- a lot of work -- let these new technologies help us meet the goals and objectives that you defined. >> just a quick comment on that. very important point and it raises two different issues in my mind, one really speaks to i think a broader opportunity that builds on this notion of the importance of public/private partnership and collaborative research in critical areas, there are things by joemarkers, various kinds of computer models or simulations or other kinds of approaches where no one company is necessarily going to want to take the risk of trying to develop it and characterize it and get it validated because there's a lot of risk and a lot of cost, but if these activities could be undertaken and we could

identify these new research and regulatory review tools, whole classes of products would benefit and many companies would benefit and so we really need to be able to find ways to take some of those research dollars and make sure that they are targeted to these critical areas that are gaps in current research funding that requires some of the kinds of new public/private partnerships as well so you get the best minds around the table working on these projects that often are really complicated and involve emerging technologies and how best to use them and we've seen the benefit already in the b biomarkers area, for example, in the biomarkers con sosh shnoiss these are precompetitive collaborative research and really underresourced in terms of research funding at the present time so i think it's a

critical need and it's one where we know that if we develop it, it will make a huge difference. the other thing is the regulatory process is really cumbersome and, you know, congressman waxman noted that congress recently gave us some new strategies and authorities to be more nimble and flexible, but, you know, putting regulations into place takes years and the notice and comments process is an important one forgetting input but, you know, it's lengthy, et cetera. so, you know, thinking about what are some of the models for how to work in more responsive more collaborative and more flexible ways in these kinds of situations where an emerging technology and an emerging opportunity is there i think is a challenge. i don't know if it can be fixed

by legislation per se at the present time but i think it's an area that we need to delve more deeply into because it really matters. >> and in the end i know in my earlier pharmaceutical industry that one of the major concerns was we have to do everything ourselves. it's our proprietary information. we're not going to share it with others. you don't see that anymore. there's thought a drug that's been developed by somebody cost license with somebody else. there is that collaboration so i think the movement is under foot. we just have to provide the framework that encourages it to happen so that we can indeed get these 21st century gears to the public more quickly. collaboration is the key. >> thank you. >> katherine. >> good morning. thank you, chairman and all my colleagues focused on this effort and to our expert panel,

thank you for taking the time to be here. since this effort was launched i've been hearing a great deal from academic research institutes across the state of florida, our great researchers at the moffett cancer center, the robust and growing biomedical field in florida and their top issue is congress provides sustained funding to the nih. that is the number one when you begin to talk about what the congress should be doing. that is number one. it's followed closely on the shortage of physician residents and these young scientists and i've heard some great ideas here today but we have this issue as well with how medicare pays for physician residents and there's a shortage in a number of states. we were supposed to go and look at nationwide the health workforce and we haven't done that yet and i think hopefully it could be incorporated into

what we're doing. i'd like to follow on the last exchange on the biomarkers because what i'm hearing at home after mapping of the human genome is that, boy, here comes some very cost effective tests through biomarkers that would be -- they would give folks quicker information that they need on their health. they would be a substitute for a very expensive invasive type of test and the folks want to know, well, why when we get these approved do i have to go back to cms and start all over again to get something approved for medicare to pay for or is this a problem that you all are hearing about maybe dr. theodorescu and dr. collins and mr. parfet can talk about that.

in seems to be these emerging cost effective tests out there that would help us save money down the road and give patients quicker answers. >> well, thank you very much for that question. i think it's really important and, you know, i think we're in the middle of three revolutions. when genomics, metabolo -- i think -- i'd like to answer your question with two sort of two answers. one is that i think in terms of public and private partnerships, i think we need to enhance the richness and the potential and the attractiveness of the data that the federal government provides to pharmaceutical partnerships by really providing a coalesce data set of all

clinical trials that are federally supported. that will make mining that data said by companies and in the examples that dr. collins gave would make the cooperation with the federal government a lot more attractive. that's how we can enhance things in terms of basically biomarker work as well as industry government partnerships. the other issue that would facilitate these biomarkers is as i was saying earlier is to support often the smaller companies that cannot really afford to do clinical trials with biomarkers with -- by expanding the coverage with evidence of development, the ced program and hhs. that's a good way to potentially cover some of these biomarkers as we're gaining the knowledge through registries to see if they're effective and also, you know, as you probably know,

moffett has the kind of total cancer care which we have a really good relationship with bill dalton there and about to launch a joint venture with them and so the concept of moving those kind of biomarkers through the orion system or the total cancer care where there's these large connoissesortiums and the validation of these -- it comes down to really managing and leveraging big data across multiple institutions to really not only develop new biomarkers but also validate them and part of that is the coverage with evidence development. if that could be expanded that would help a lot as well as supporting a central repository for federally funded clinical trials would be a boon to industry partnerships and making those very attract i have. thank you. >> thanks.

bill cassidy. >> first let me just thank you all for your good work. i am struck, though, i think it's a little ironic because i think congress has created a lot of problems that we have here or at least the federal government has, mr. camen, i'm struck. the tax you speak of is part of the affordable care act, an example. i have two questions but along that theme, i'm a fellow that formerly did clinical research and gone through those 40-page documents. we wrote those at sixth grade not eighth grade and thought it was the office of protection that required this. whenever i ask about centralized irb i was always told wait a second we're required to have a local representative and although i know there's a central irb in denver for whatever reason my institution did not allow that because they felt like the federal government

required and i'm looking at you, dr. hamburg, even though it's not under your office, so first question is i've always been told is because of washington, d.c. saying you had to have it. secondly, dr. collins, you and i have spoken about this in committee but there's a report coming out of -- we've spoken about how nih needs more funding but there's an article out of ucsf claiborne johnson, leslie gillem first speaking about how there's a very poor correlation in nih funding between disease burden however defined and where nih puts its money, now, this fellow wrote and he said ten years ago this was a critique but as he reviewed data ten years after that there had been no change. i think you had mentioned there's a little bit of wiggle room in terms of moving dollars around but what i'm most familiar with at cdc at one

point they were spending a balance on hiv and like 60,000 on hepatitis even though the number of deaths related to liver disease was at least as great as that of hiv and disease burden was even greater. so there seems to be a really lousy correlation between where we're spending our dollar and disease burden. so two questions, one, have we met the enemy and he is us when it comes to the complexity of getting clinical trial as proved and, secondly, to what degree is our ferguson agencies not taking this scarce dollar we have and moving it to things like alzheimer's, dementia and neurologic diseases when that is our balloon note, if you will, away from things that, frankly we've had a great deal of success with so dr. hamburg, you first. >> first i think that you have raised a set of really important issues that we're all working on and certainly francis and i have spent a lot of time discussing the value of central ir b's and

more broadly the importance of reducing the time cost and cumbersomeness of doing clinical trials in this country and anything we can do to reduce that and make clinical trials more accessible to patients because that is another barrier to advancing clinical trials and ultimately the delivery of opportunity and science into a real world product so i think that this is a really important issue, i think it's one that ultimately this effort, the 21st century cures will likely take on in some way or another and i applaud that and i think, you know, that it is an area where it has to be done right but where there are things that congress can do to actually make the situation better, not worse, big picture, there are many

others than fda that need to be engaged in that discussion and you're right. there is a critical office in hhs that's involved in this but work has been done, work needs to continue to be done but i think we're ready to do some things that will make a difference on a much smaller scale with respect to fda, there's something that congress could do very quickly that i think would enable clinical trials in the device area to be more efficient and effective and that is that the food, drug and cost mettic act actually has a requirement in it right now that mandates review of a clinical trial on a device by a local irb and we think that if that could be amended and, you know, i think it's a pretty simple fix, we could do some good. >> done. done. francis, go ahead. >> so congressman, appreciate both of those very significant questions, just a quick coda to

what peggy said about human subjects review there has been an effort under way for about five years to revise the common rule and particularly to emphasize the need for central ir b's instead of having every institution in a multisite trial have their own irb tinkering with the consent form, adding another paragraph and changing the tense of the verb and all that stuff ha ends up costing you a year of time and a lot of pages that get generated along the way, it is irrational. we need to stop this whole approach. actually nci, the cancer statute for their large scale cancer clinical trials is using central ir b's. there were some objections to that from institution that is felt they might be liable if their irb hadn't approved that but they've been largely overcome. we can do this. i appreciate you raising the issue. in terms of this correlation between funding support and specific diseases we look at that a lot. that's certainly one of the jobs i in the 2institute and center directors at nih talk about

almost every week when we gather around the table. actually if you look at the current plot and i'd be glad to send it to you it is not that wildly out of whack from what you might think if you look at various measures of disease, whether you're talking about deaths or talking about such things as dailies and qualleys which are more measurements of what the impact is on individuals on quality of life and disability that curve is a ream approximation to what you might think would make sense from a public health perspective with a couple of outliers like aids. >> aids, that's like saying aids is -- [ inaudible ] i'm always struck someone with hiv is more likely to die of dementia. >> so -- >> aids, it's kind of an odd thing. >> i'm saying aids is an outlier in that graph but i think there's scientific reasons why that has been the case namely

that this is not just a disease of this country, it's a threat to the entire global circumstance. >> alzheimer's -- >> thank you. >> your relative funding of alzheimer's, relative to that is minuscule and again my dad dies of it. my, you know, we all have a parent and i got to say, when i look at your funding for alzheimer's it seems minuscule relative to the disease burden and the future expense, the near future expense to medicare/medicaid, et cetera. >> i'm deeply concerned about alzheimer's, congressman and actually have spent some of my own personal efforts trying to do some re-adjustment on the way our current portfolio supports that research because this is clearly a major threat to the future of our nation and the world and an enormous burden upon individuals and their families who are stricken with this disease and probably nobody in this room that has not been touched by that and take your point we need to see that as a particularly high priority right now ainge that has been, in fact, what we have been trying

to do at nih over the last two or three years, the other thick i want to say and don't want to take up too much more time we have to be careful with the way science has developed over the last four or five years particularly coming interest insights from the genome. there are connections between diseases we never knew about and would not surprise me if the next breakthrough that we're really waiting for in alzheimer's disease came from a researcher who at present time we would not say is working on that disease but is working on some other area. these connections between pathways continually surprise us and so i think we do have to be careful not to be so targeted that we miss out on the unexpected where somebody working in one field actually comes up with -- >> but the billion spent on aids has paid great dividends and so targeted research cannot be replaced with seren ddipity is point. >> i think we need both. i think targeted research is critical when we can see a pathway towards fining a

solution for a disease but serendipity and supporting basic science that is not too tightly connected to a disease is one of the reason america has been so successful for the last 50 years. >> >> great point. >> thank you. >> i don't know if i'll get this mike on or not. is the mike on? >> yes. >> oh, good. good. i want to thank all the members of the panel. you've done a fantastic job. i apologize for coming in and missing an important aspect of it. representative degette, chairman upton this 21st century cures initiative and roundtable discussions i think have been absolutely invaluable. there are a number of physicians, of course, on our committee. there are a number of people on our committee that have knowledge far beyond my limited medical knowledge but it has

been a great effort as we go forward in the 21st century. dr. hamburg, i'm going to address my question to you, representative green, my colleague on the committee from texas and the co-author of the g.a.i.n. act. we are now, of course, working on the a.d.a.p.t. act to take it a step further for limited population anti-bacterial drugs and maybe you could -- you didn't get a chance really to -- he diverted his question back to dr. collins so didn't get a chance to discuss that but i would like for to you spend a little time talking about the a.d.a.p.t. act and what that model may be can be an example for other efforts in bringing other drugs to market and medical devices in these highly specialized need areas resistant

antibiotics, limited population. >> well, thank you for the question and thank you for your leadership on the critical issue of how can we ensure an adequate pipeline in terms of new drug development in the antibiotic arena which is ever more important as we're seeing drug resistance spread. you know, i think dr. collins did address a critical part of why the g.a.i.n. act was important in terms of needing to create new focus and incentives for drug development in this area. it has been a hard area in terms of companies wanting to really invest because market forces don't make it just irresistible in terms of return on investment epa when you have to take risks. i have to be honest and say fda didn't make it irresistible either because we were really

asking for very elaborate, large clinical trials that were timely, costly and hard to recruit patients for all the reasons that we talked -- that dr. collins mentioned in terms of the complexity of doing these studies and being able to have the clinical trial ready to go and the patient appears sometimes deathly ill with an infection that needs to be treated. so i think, you know, what we're trying to think about now is how epa in the context of antimicrobial resistance which is such an urgent problem how can we really design regulatory pathways that enable us to get meaningful answers as quickly as possible and reduce the risk for developers and a sort of special population approach enables us to sort of look at the highest risk and of a spectrum of patients that might be treated and really narrow the focus so

that we can ask and answer questions where the rick benefit falls out as clearly as possible and enable us to move forward more swiftly and i think, you know, that that's really what we're thinking about there, it applies in antimicrobial resistance in new microbial antimicrobial development and applies in other areas important to public health, as well, including a very heterogeneous disease category like obesity where if you can sort of narrow the indication, the development process can actually be sped. >> thank you, doctor. >> joe barton. >> thank you mr. chairman. >> joe brought his own expert with him. >> yeah. i didn't think we had enough firepower here with the head of nih and hhs and one of the

billionaires who's put a lot of money into medical research, so i brought my own, you know, in is my volunteer staff assistant, dr. yomot, vice chancellor for research who calls dr. hamburg peggy. he said, oh, peggy is down there. i want to go say hi to peggy so we were -- >> you can call me peggy too. >> but i am very impressed, mr. chairman, with the panel you put together today. obviously to have these eminences here is just amazing. my question will be pretty similar to mr. pitts but with a little different twist. you know, we brought the deficit down from a trillion and a half to half a trillion but it's still half a trillion. and with all the good intentions in the world, we -- and i introduced nih reform bills and

double the funding of nih back in the gingrich era and, you know, i've introduced authorization bill that increased funding for nih every year but the reality is you're going to get what you get plus a little bit, that's just -- so given that i want to ask mr. milken, is there anything we can do incentivizze the private sector to give more to match some sort of a special tax break for medical research or perhaps even some sort of a government match if the private sector puts up so much, the government will match it dollar for dollar or maybe one for two or something because we obviously and i think the chairman is with me on this, in a perfect world we'd want to increase across the world but in the real world, we're going to have to find ways to do better with what we have right now, so

are there some things we could do next year in terms of giving incentives to the private sector that might actually result in, you know, measurable increases in private funding in these areas? >> thank you and i want to thank you for your work that you do and i'm excited to see my good friend keith yamooto with you today. as he's aware there are a number of efforts right now on the potential for a match where you would go to private citizens, foundations, corporations and the government would challenge them by offering to put up a dollar if they were matched for a dollar in the philanthropy standpoint. one of the things -- there are other countries in the world that allow you to have a higher deduction if you give money to medical research or bioscience.

in the united states today you are limited on your deductions to 30 -- you can use 30% of your income for public foundations and 20% for private. in some other countries they have allowed you to have a tax deduction up to 50% if it's for medical research, science, et cetera, so i think as we saw in the efforts in acid rain and so2 that you can create incentives that would direct funds accordingly and one of the risks we run, i think we're all aware of, a number of the people that have accumulated net wealth are not as focused on inheritance taxes because they're planning to give their money when they pass away to foundations. and the opportunity to accelerate that. one example i might give you is i.r.a.s and 401(k)s but

particularly i.r.a.s today when you're 70 1/2 you begin to draw money out of those i.r.a.s and are potentially taxed. i think many people if we afforded the opportunityiras. i think many people, if we afforded the opportunity to give money to charity now instead of waiting 20 years or 10 years would give the money in their iras and 401(k)s. there was an experiment that was tried a few years ago where you could give up to $100,000 without tax out of your iras, it ran for two years and was given the limit. but if you took 100,000 off and tried it for a couple of years, you might be surprised how much private sector money is willing to go. and if you decided it needed to go into medical philanthropy or whatever the decisions were, i

think you could tap that. third, i think today the issue of young scientists, i think we had a formal program initiated, it would have a lot of funding from individuals, whether it's through their own academic institutions that they went to, to support these young scientists, and we have spoken to dr. collins and also commissioner hamburg about the possibility through their private foundations could we help augment the funding. many years ago, i was in the nih and saw a young scientist and they there wasn't going to be funding for that scientist. so i called the nih for funding for that scientist. nine months later, they figured

out how to cash the check but told us we should never do that again. and there was another agency, irs. but they're getting better. but i think we have not appealed to the american public enough to incentivize them. we see initiatives such as recently with als, and putting an ice bucket on your head, they raised $100 million and they used to raise $200 million. the growing of a mustache in november, world wide now raises $150 million a year. so how do you communicate? and one of the challenges has been how do you get small amounts of money from larges amounts of people? and this has been a challenge and companies like safe way, through their check out program, probably have raised a half a billion dollars for different

diseases, breast cancer, prostate cancer, muscular dystrophy and others. average donation, $2. if you sent a check in to a medical research fountain, it probably costs us $15 to process it. notify it, et cetera. and so these other mechanisms which safeway did at the check out counter, rounding up, allow you to get millions of people involved with small contributions. and i think you can through some policy changes, run some tests here and maybe run them for a year or two and see what happens. i think the risk is in an area i spoke of earlier, coring, they think it's going to cost a billion dollars in future taxes in the next 40 years. but i come back to the statement that 50% of all economic growth has come from advances in

extension of life and increasing the quality of live. and i think by accelerating the giving, we have young people in our country today that are in their 20s, that are worth $30 billion. should they wait until they're 70 or 80 years old? or should we try to tap in to both their intellect and their funds today by incentivizing it to support it. so i think there's a number of areas that we could test. there's trillions of dollars in these iras. should we wait, if you wait until you pass away, you can give it to your foundation tax free. no estate tax. why don't we encourage them today to participate? so i think there's a number of things we can do with private industry. i think there's another factor. we have surveyed cancer

patients, we have set up so many regulations, and collection of data and accessing of data. we are protecting people that don't want to be protected. 600 million people on this planet go to facebook every day. they put information and secrets up online that anyone in the world can access that you can't even believe that they're saying that or putting it up on their website. more than 70% of all cancer survivors would be willing to make all their data public, all their tests public, so that any graduate, phd, md student could access that data? how do you waive hipaa? how do you give up those rights to protect information you don't want to protect? i think there's a lot of work that could be done in data

collection. when i was at berkeley in the 1960s, and there was -- as a student with little to no money, i was able to access free, the chris tapes which summarized financial transactions and markets, under the guidance of the university of chicago covering the previous 50 years at no cost. to try to create these data sets sometimes could cost $100 million. who has access to this data? we could provide enormous data, but i think one of the elements is how do you waive your privacy rights if you don't want that privacy? >> that buzzer means that's 12:00. we're going to have a hard stop at 12:00 so we are. i want to really thank, you know, it's really thank everybody here that was involved in the thoughtful discussion.

not only today, but in recent months as well. your ideas have in fact triggered us to move. i want to commend our staff. that's really -- [ applause ] but we're not done. this is the last formal meeting, you know, this month. we have another session, i think, next week, but during the next couple of weeks, next weekend i'm going to oregon and washington state, there's going to be an event in kalamazoo, and in texas and florida. i encourage our members to reach out and to continue to listen because when we do come back, we're going to start writing, we're going to try to do our best to do it right. as i said at the beginning, our goal is to move this early next year. have a draft proposal done early

next year, and in all likelihood it won't be done this year. so we'll miss you dr. gingrich, because he's retiring from the congress. and some others, mr. waxman and others, but the ideas need to come in because we really do want to do this right. and lots of shoulders, we're going to be leaning on to make sure that it happens and we're most grateful for the administration's support too. peggy, you've done a good job, you realize constructively where we need to go, sylvia burrwell said again confirmed that the administration's support for this, reaching out to the senate, doctor cor. collins has superstar in traveling to different parts of the country. and michael, your work again, we stole a lot from you over the last couple of years and just outstanding work that you have

done and committed in the foundation and the organization that you have has truly helped us. great entrepreneurs bill parfitt and dean cameron, thank you for your work and two weeks ago in colorado, but now, we're very grateful for that assistance and we're going to turn the green light on in this green room. thank you. >> thank you.

coming up tonight on cspan 3 former virginia democratic senator jim webb. later remarks by british labor leader ed milliband at his party's annual conference. former senator jim webb of virginia spoke at the national press club, mr. web who is considering a presidential rung

speaks about the economy and foreign policy, this is an hour. >> good afternoon, and welcome. my name is myron belkheim, i'm a professor at the school of media and public affairs, a former international bureau chief with the associated press and the 117 hth president of the national press club. the national press club is the world's leading professional organization for journalists committed to our profession's future through our programming with events such as this while fostering a free press worldwide. for more information about the national press club, please visit our website at press.org. on behalf of our members worldwide, i would like to welcome our speaker.

those of you attending today's event also. our head table includes guests of our speaker as well as working journalists who are club members. if you hear applause in our audience, i note that members of the general public are attending. so it's not necessarily evidence of a lack of journalism objectivity. i would like to welcome our c-span and public radio audiences. follow the action on twitter. using the #mpclunch. after our speech concludes, we will have a question and answer period. i will ask as many questions as time permits. it's time to introduce our head table guests. i would like each of you to stand briefly as your name is announced. john doeman from your right. reporter for wnew. jill lawrence, syndicated columnist. eleanor clift, washington correspondent. for the daily beast and

mclaughlin group panelist. james r. webb. soften son of the speaker. mark shields, political analyst news hour. hong lee webb, wife of the speaker. jerry zeremski, chairman of the npc speaker's committee and former president of the national press club. angela king, white house correspondent for bloomberg news and former president of the national press club. amy webb. rachel smoker. john failes, known throughout the country at sergeant shaft. mike deigel. principle people mow part nevers public affairs. a round of applause for our head table. [ applause ]

here is what we know about jim webb, our speaker today. he is a former one term democratic senator from virginia, a decorated marine who served in vietnam, secretary of the navy, an award winning journalist, filmmaker and the author of ten books. what we don't know is whether he will be a candidate for the democratic nomination for president. there have been some hints. webb visited iowa last month and is planning a attribute to new hampshire. while not everyone who goes to iowa and new hampshire becomes a presidential contender, no one who hopes to be in the race ignores those early primary states. two weeks ago, he tweeted a link to a "new york times" article with the headline, populous could derail clinton train. as he told a labor audience in iowa, i am comfortable to say i'm the only senator elected

with a union card three tattoos and two purple hearts. [ applause ] while in the senate, webb served on the foreign relations, armed services, veteran affairs and the joint economic committees. his legislation, the post 9/11 gi bill is the most significant veteran's legislation since world war ii. [ applause ] as chairman of the foreign relation committee's asia pacific subcommittee, webb called for the u.s. to re-engage in he east asia. in 2009 he went to burma, the first american leader to visit that country in ten years. though the trip was criticized by some in the pro democracy movement, subsequently, relations between the two countries were resumed.

webb graduated from the naval academy in 1968. when he returned from vietnam, he got a lot of grief from georgetown. webb was a staffer on the house veterans affairs committee before being appointed as assistant secretary of defense and then secretary of the navy. in addition to his public service, webb has had a varied career as a journalist. winning an emmy for his pbs coverage for the marines. he wrote the original story and was executive producer of the film "rules of engagement." his books include a history of the scotch irish culture and i heard my country calling, a memoir of his early life published this year. webb has been to the national press club on several previous occasions and we are very happy to welcome him back to the national press club. [ applause ]

>> thank you very much. i appreciate all of you coming today to be with us. i have noticed -- i should point out here at the outset that jerry has enough questions, i think, to last for about an hour and a half after i'm done. i hope you will be kind in the questions that he chooses once i am done. first let me say how proud i am that three of my family members are with me today up here at the head table. my oldest daughter amy, who as a small child used to ride on the lap of some of my disabled friends from vietnam as they did wheelies in their wheelchairs and races in the hospital. she found her calling at a young

age and works with disabled american veterans. [ applause ] my son jim, who left penn state during the height of the iraq war and enlisted as an infantry rifleman and fought in some of the worst fighting of the war in a place which is now becoming familiar to us. and my wife who in many ways represents what the american dream is all about. her entire family, extended family escaped from vietnam on a fishing boat. her father was a fisherman when the communists took over south vietnam. they were rescued by the united states navy at sea. she spent time in two different refugee camps. neither of her parents spoke a word of english. through all that, she ended up as a graduate of cornell law

school. that, folks is -- [ applause ] that represents the best of what our country is all about. i have said for many years that the truest legacy of my time in public service will always come from the contributions of those who served either under my command in the marine corps or on my staff. our country has heard and will continue to hear from these talented men and women wherever they go and however they choose to serve. and a good number of them have made the trek over here to join us today. we did great things during those six years. they continue to show us that they are all stars in a multitude of endeavors. i would be pleased if they would stand or wave and be recognized right now. [ applause ] there have been a lot of things

going on in the last couple of days. i'm sure i'm going to get questions about them. what i would really like to talk about today in my opening remarks is what's going on in our country. and what we can do to make things better. let me begin by stealing a quote from gor vidal. he was one of the most brilliant minds of the post world war ii era. you never know when you have happy he wrote. you only know when you were happy. the same holds true i think for the times in which we live. we seldom know when we are living through a period of true historic challenge. we only know after it's over that we did. the internal workings of national policy are not a part of most american's lives. he wake up every morning. you go to work. maybe you try to find a job. you take care of your family. you pay your taxes. you turn on the tv and watch commentators.

sometimes you agree with both of them. sometimes you agree with neither of them. bad things happen in the world. that will never change. at the same time, i think it has been rare in our history when our economy crashes at the same time we're at war as has been the case in the past five or six years. here in america, our multicultural society lives in a state of constant disagreement. this is frustrating. it's also creative. but the discussions during recent years have taken on a different tone. the very character of america is being called into question. who are we as a people? what is it that unites us rather than divides us? where is our common ground when the centrifugal forces of social cohesion are spinning so out of control that the people at the

very top exist in a distant outer orbit completely separated in their homes, schools and associations from those of us who are even in the middle and completely disconnected from those who exist paycheck to paycheck or those at the bottom who are often scorned as undeserving takers who simply want a free ride. now think about that. how can we say we're fellow americans when tens of millions of people are being quietly written off, not only by our most wealthy but even by many of our political leaders as hopeless? who will never be fully employed. who would be or should be avoided on the street, feared rather than encouraged to enter the american mainstream. we live indisputably in the greatest country on earth. the premise of the american dream is that all of us have an

equal opportunity to succeed. if you are 10 and black and living in east baltimore and go ing to the bathroom in a bucket because the landlord won't fix the plumbing and your school is a place of intimidation and violence and the only people on the street who seem to be making money are the ones who are selling drugs, no matter how hard you work, you do not have the same picture of the american dream as a kid your age who is being groomed for prep school and then to go off to the ivy league. or if you are a kid growing up in the appalachian mountains of clay county kentucky, by most accounts the poorest county in america, which happens to be 98% white, surrounded by poverty, drug abuse and joblessness, when you leave your home in order to succeed, and when you do, you are welcomed with a cynical

unbelieving stares and whispers of american that don't understand you and that can exclude you from education with the false promise that if you are white you are by definition have some kind of social economic advantage, what do you think about your government? if you are a man or woman who did time in prison as have so many millions of americans in today's society, you paid the price for your mistake, which could be as simple as a drug addiction or a moment of absolute but culpable stupidity and you want to re-enter the community you left behind when you were knocked up, neglected, possibly abused and marked for the rest of your life on every employment application that you

ever fill out, how do you do that? when there are no clear programs of transition that can prepare you for the structured demands of the work force or society itself, which is going to fear you because you spent time in prison. what do you do now? do we as a government have an obligation to provide a struck tur that can assist you so the rest of your life is not wasted? or have you become another throw away like the kids in east baltimore or clay county kentucky? let's say you are 30 years old without a high school diploma. maybe you hit a rebellious streak when you were 17. you got a dead-end job or got pregnant and became a single mom. now you are looking at the rest of your life. you feel hopeless. the big debate between the two political parties seems to be whether you should get a higher

minimum wage, whether the government should start universal programs to put kids into school from prekindergarten. what do you need more than a minimum wage? even if your kids attend pre-k, what happens when they come home? is your life over at 30? would it change if we had a second chance program where you could finish school and show your kids your own diploma and tell them to stay in school and study and be an example and aspire to a real job that pays more than minimum wage? what would it take to turn those things around, or is it impossible? or should we just decide that it's something beyond the role of government? this societal dislocation has been happening at a time when america's place on the international stage has become increasingly unclear, both in terms of our position as the

economic beacon of the global community and our vital role as the military guarantor of international stability. for more than two decades since the end of the cold war, our country has been adrift in its foreign policy. the greatest military power on earth has locked a clearly defined set of principals that would communicate our national security objectives to our allies, to our potential adversaries and most importantly to our own people. over that same period our debates over domestic policies have been more polarized, driving our people further and further apart rather than bringing them together. in many cases, deliberately exaggerating divisions based on race, class, gender, sexual orientation and geography. not surprisingly, the american people have grown ever more

cynical about their national leadership in both parties and increasingly more pessimistic about the future. so make no mistake, how we redo dissolve these two formidable questions is going to determine what america looks like ten, 20 or 30 years from now. in the not too distant future, depending how we resolve this we will look back and judge ourselves. did we have the courage to face the hard issues to make the difficult decisions, to prove we were worthy of the sacrifices of the ep generation that went before us? or did we fail? watching passively as the greatest nation on earth descended slowly into mediocrity because it burned itself out through bad choices, petty debates, trivial party politics and the inability of our leaders to come to grips with these sorts of challenges and to work

together to actually solve them. so we have reached an unavoidable and historic crossroads. the way we choose to address the conditions that now so deeply divide us over the next few years will define who we really are as a people and what our future will look like. what are the responsibilities of our government? provide for the common defense, promote general welfare, maintain order and public safety for all, whether you are in east baltimore or north arlington. erect standards of fairness when it comes to the opportunity to succeed. don't pick favorites based on several access to the corridors of power. despite any of the barriers that have too often divided us, i'm naive enough to believe that those of us who love our country can come together to rebuild our infrastructure and to repair the

torn fabric of our national spirit. true fairness is not an impossible dream, nor is the notion that we can return to a time when we can look at a fellow citizen and feel a moment of comradery rather than a feeling of mistrust, dislike or fear. we need the energy and the talent of every american trained and put to use in ways that will make them more productive, their neighborhoods more vibrant and our country stronger. more than that, every one of us should view this as a duty, as a citizen if nothing else and participate in the national discussion. let me mention a few areas where i believe we can make a difference. first, we must develop a clear statement of national security and foreign policy. an understandable statement of our national security interest is the basis of any great

nation's foreign policy, clearly understood principals and the determination to stand by them are essential to stability and also to public support. our allies will be able to adjust to our clarity, our adversaries will know we are serious. we do not have that now. our foreign policy has become a tangled mess in many cases of what can only be called situational ethics. what does the united states stand for in the global arena? under what conditions should we risk our national treasurer, our credibility and more importantly the lives of our military people? here is a quick bottom line. tell me what our national interest is, how we're going to defend it and how we will know we have accomplished our mission. unless you can do that, you

don't have a strategy. once the cold war ended, strategically we lost our way. we have yet to regain it. in the area of international relations, it's not a healthy thing when the world's dominant military and economic policy has a policy based on vagueness. so we ended up and continue to be trapped in the never ending ever changing entanglements of the middle east, beginning with the pandora's box that was opened with the invasion of iraq and continuing through the still fermenting nightmare of the arab spring, particularly our inadvisable actions in libya. i was one who warned before the invasion of iraq that our entanglement would destabilize the region, empower iran and weaken our influence in other places. let me quote from an article i wrote in the "washington post" on september 4, 2002. five months before we invaded iraq.

america's best military leaders know they are accountable to history. our time bringing an expansionist soviet union in from the cold was accomplished not by an invasion but through decades of maneuvering. with respect to the situation in iraq, our military leaders know two realities that seem to have been lost in the narrow debate about hussein himself. the first is that wars have unintended consequences. the second is that a long-term occupation of iraq would beyond doubt require an adjustment of force levels elsewhere and could diminish american influence in other parts of the world. then later, in japan, american occupation forces became 50,000

friends. in iraq, they would quickly become 50,000 terrorist targets. so what should our governing principals be? first, if a president wishes to conduct offensive military operations, he or she should be able to explain clearly the threat, the specific objections of the operations and the end result. second, we should honor all our treaty commitments. we are not obligated to join a treaty partner if they elect to use force outside boundaries of our commitment as in libya, for example. third, we will maintain superiority in our strategic systems. this includes not only nuclear weapons but also such areas as technology, space and cyber warfare. fourth, we will preserve and exercise the right of self-defense as guaranteed under international law and the u.n.

charter. fifth, we have important allies around the world, especially in asia and the middle east. who we will continue to support in many ways. this will not cease. in fact, as we clarify other commitments, these relationships will be strengthened. with respect to the war against terrorism, we should act vigorously against terrorist organizations if they are international in nature and are a direct threat to our national security. this includes the right to conduct military operations in foreign countries if that country is unwilling or unable to address the threat. we have this right through international law and specifically through article 51 of the united nations charter. but there's an important caveat to how our country should fight international terrorism.

having ignored this principal has caused us a lot of trouble since 9/11. can do no better than quote from an article i wrote the day after 9/11. do not occupy territory. similarly, it would be militarily and politically dangerous for our mill tear require to operate from bases permanent or semipermanent or to declare we are defending specific pieces of terrain in the regions where the terrorist armies live and train. finally, with respect to national security, a warning spurned by the actions of this administration in libya. there is no such thing as the right of any president to unilaterally decide to use force in combat operations based on the vague concept of humanitarian intervention. if a treaty doesn't obligate us, if american forces are not under

attack or under threat of imminent attack, if no americans are at risk, the president should come to the congress. second point for consideration as we look into the future is we need to give our people some hope on issues of economic fairness and social justice. working people have struggling following the collapse of the economy while those at the top have continued to separate themselves from the rest of our society. if you look at the stock market since march of 2009, when this recession bottomed out, it has moved from 6,443 to more than 17,000 as of today. the stock market has almost tripled as we have come out of this recession. at the same time study after study shows that real income

levels among working people have suffered a steady decline since january of 2009. not only for our workers. according to the wall street journal, loans to small business who traditionally have been the backbone of the american success story have decreased by 18% since 2008. overall business loans have increased by 9%. the growth in our economy has been increasingly reflected in capital gains rather than in the salaries of our working people. in many cases, corporate headquarters, financial sectors are here while the workers are overseas. many of our younger workers in this country right now are subject to complicated hiring arrangements that in many cases don't pay healthcare or retirement. corporate success is measured by the increase in the value of a stock, corporate leaders are paying accordingly. when i graduated from the naval academy, the co made 20 times the worker's pay. it's not a global phenomenon.

in germany, which has the highest balance of trade in the world, the average ceo makes 11 times what a worker makes. many of our brightest economic analysts, high along them ralph gamori who is here today, point out that this disparity came about not because of globalization but because executive compensation became linked with value of a stock rather than the company's actual earnings. investors will not complain. they invest in stocks. our workers, the most productive work force in the world, are the ones who have been left behind. i would agree that we cannot tax ourselves into prosperity. but we do need to reconfigure

the tax code so that taxes fall in a fair way. third, we should rebuild our national infrastructure. the technology revolution has pushed a lot of louer skilled people into unemployment. yet, every wrf around us we see roads that need to be widened or repaired, bridges that are beginning to crumble. others that need to be build. traffic jams from clogged highways, schools that need to be built, expanded or repaired. inner city neighborhoods with cracked sidewalks, broken windows and people on the street. roosevelt mobilized a nation whose unemployment rate was at 25%. the civilian conservation corps planted trees and cleared land. we built roads. we put people to work. we cleaned things up. eisenhower, his vision brought us the interstate highway system and the jobs that it took to build it.

there are people who need jobs. there's work to be done. along the way, i believe it's possible to meld such a program with another one featuring adult education for those who did lose their way when they were 17 and now know how important it is as a worker and as a parent to get that diploma, earn some money and be a role model to your kid. fourth, we need to reform our criminal justice system. this is not a political issue. it is a leadership issue. it has dramatic manifestations throughout our society. the united states has the highest incarceration rate in the world. since i doubt we are the most evil people in the world, many now agree that maybe we're doing something wrong. millions of our citizens are either in prison or under the supervision of the criminal justice system. during ply time in the senate, we worked to examine every component of the this process

from point of apprehension to length of sentencing to the elements of life in prison, including prison administration and to the challenge of re-entering society and hopefully living productive lives. when one applies for a job, the sigma of having been in prison is like a tattoo on your forehead. in many cases, prison life creates scars that can only be remediated through structured reentry programs. many of them are non-violent offenders who went to prison due to drug use or dependence. those who wonder whether we can or should put such programs in place, my answer is this. do you want to see these former offenders back on the street coming after your money or your life? or do you want them in a job making money and having a life? finally, let's find a way to return to good govern answer. it will take time but it's possible to rebalance the relationship between the executive and legislative

branchs and to carefully manage the federal government which is surely the most complex bureaucracy in the world. a lot of people running for president and a lot of people covering those who are running for president seem to skip past the realities of governing into the circus of the political debate. the federal bureaucracy is huge. i have seen many people come to public service from highly successful careers in the business world only to be devoured and humiliated by the demands of moving policy through the bureaucracy and then the congress. the very administration of our government needs to be fixed. with the right leadership and the right sense of priorities, it can be. i spent four years as a marine, four as a committee counsel in the congress. six years as a member of the united states senate. i am well aware and appreciate that there are a lot highly

talented dedicated people in our federal work force. i know they would be among the first to agree that we would benefit by taking a deep breath and basically auditing the entire federal government in order to re-justify the functioning of every program and every office. [ applause ] the way to solve these challenges and others is the way that other such challenges have always been solved in the past. find good leaders. tell them where the country needs to go. free them up to use their own creative energies. trust their integrity. supervise, hold them accountable just as they should hold our own people accountable -- their own people accountable and just as the american people should hold every national leader accountable. have the courage of your convictions.

have the humility to listen to others. remember the greatness of our country and the sacrifices that have gone before us and never forget that history should and will judge all of us if we ever let the american dream die. thank you. [ applause ] >> thank you. [ applause ] we will now go into our q and a session. as i said, we will try to make it rapid fire to get as much as we can in this next few minutes. sir, are you considering pursuing the democratic nomination for president?

would you consider running as a independent? >> i would say we have had a lot of discussions among people that i respect and trust about the future of the country. and we are going to continue having these discussions over the next four or five months. i am seriously looking at the possibility of running for president. but we want to, you know, see if there's a support base from people who would support the programs that we're interested in pursuing with the leadership. so the answer is, i'm a democrat. i have strong reasons for being a democrat. basically, if you want true fairness in this society, you want to give a voice in the corridors of power to the people who would not have it, i believe that will come from the democratic party. we're taking a hard look. we will get back to you in a few months. [ applause ]

>> what trait is most important in a person wanting to become our president? and what is your best trait? [ laughter ] >> how many questions do you have on that stack before you pulled that one out? i think trust an integrity and vision and loyalty. you cannot run or lead unless you have that and unless you have that in the people who are with you, too. it's one thing i used to tell my staff when i was in the senate was that i met every day with weinberger when he was secretary of defense. you will never see one word that was ever said in that meeting when the door is closed. i owe that to him and to good governance. the issues of character override even issues of intelligence. i would rather have someone loyal and trusted than someone

who is smart and couldn't be trusted. [ applause ] >> hillary clinton, of course, is widely seen as the democratic front runner for president in 2016. what do you see as her strengths and weaknesses? >> well, i've had the pleasure of working with hillary in the senate. she has a broader forum to answer that question than i do. >> a follow-up regarding mrs. clinton. hillary was secretary of state for four years. how responsible is she for the

tangled mess of u.s. foreign policy that you cited in your remarks? >> again, i think that's a question that really should be directed at secretary clinton. i'm not here to undermine her. i'm here just to explain where my concerns are as someone who has been involved in the military and in foreign policy all of my life. it wasn't a political comment when i made it. we need to be much clearer in terms of our national goals and our objectives around the world. [ applause ] >> as someone who didn't really embrace the task of being a politician while serving in the senate, why are you considering a run for president when that job demands so much politicking to be effective? >> you know, i think a lot of people misunderstand the approach that we took during my time in the senate and how much i valued being a part of the united states senate. i look at these positions more

as opportunities to lead rather than to conduct politics, per se. i was raised on the notion of what it takes to be a leader. and i think if you look at what we were able to do during our six-year period in the senate, it's pretty remarkable. we did it by bringing strong, dedicated people into the staff, trusting them, giving them what the marine corps would be called mission-oriented orders and approaching issues such as criminal justice that a lot of other people in the country were afraid to touch and bringing them to a place where we bring these issues out of the shadows and into the public debate. so it's a very tough thing to run for office. but it's also the way that the american people get to know you

and to make their own decision about whether they want to trust you. that's the process of a democracy. >> related question. what's appealing about the job of president when partisanship and unwillingness in congress to compromise and work together makes getting little things done so hard? >> i think with the right leadership, we can get a lot of things done in this country. and we have seen this over and over again. i'm going to give you a bipartisan historical response to that. this country was completely in the doldrums when roosevelt took over. people had a feeling of hopelessness, that things couldn't be done. he came in with vision and leadership. put programs into place all over the country.

things started to change. by the way, many of us lived through the carter administration. and if you recall, in 1979 and 1980, there were a lot of people saying, nothing can get done. everything is so paralyzed. the people were writing that the presidency was now too big for any one person to handle. and ronald reagan came in. he was a leader. some of my democratic friends don't like it when i say that. ronald reagan was once a democrat. he was still a leader. he brought strong people around him. he had a vision where he wanted to take the country and things started moving again. leadership in this world requires that you sit down and talk to people and give them a clear vision of where you want to go and listen to them. i think we did this probably

most clearly when we got the g.i. bill through the united states congress. i wrote this bill with legislative counsel before i was sworn into the senate. we introduced it on my first day. we worked extremely hard across the aisle. we got two republican key sponsors, two democrat sponsors, two world war ii veterans, two vietnam veterans. in 16 months, we got a bill through a paralyzed congress that now more than a million of the veterans post 9/11 veterans have been able to use and change their lives. [ applause ] >> you have opposed u.s. military intervention in iraq and libya. tell us why you reaction to owe -- to the president starting air strikes and respond to the

remarks the president made three hours ago. >> i would start -- mark shields will remember this. i will start with a comment given to me when i was in beirut reporting more than 30 years ago. i was at a marine outpost that started taking fire from an outpost because there was a lebanese army position located with the marines and then some unknown militia started joining in just because it was beirut and then syrians came up and were firing 25 millimeter into it. a young marine turned around and said, sir, never get involved in a five-sided argument. during the hearings when i was

still in the senate and they were considering doing something in syria, that was one of the points that i would raise, that if you think lebanon was bad, syria is lebanon on steroids. look at the situation that we now are in. isis, whatever -- however you want to define that. we need to be very careful to define what the membership of these entities really is, because in that part of the world people tend to drift in and out of organizations, depending on who they think is getting something done. we have isis who supposedly is anti assad and wants to create up there and we are going to arm and train another syrian opposition whose mission up until a couple of weeks ago was to help take out assad, now they are going to fight isis. we have a quiet agreement with the syrian government as this time, one would assume from what

i'm hearing, the same government that the president a couple of years ago said must go. we have a tacit participation by iran on some level. you know, the country that many in the region believe we should be most concerned about. it just shows you, that is this region. it has been this region for 2,000 years. and what i have been saying since i was secretary of the navy, not just before the iraq war, is that the united states can assert its national security interests in that part of the world but we should never become an occupying force in that part of the world. so when i look at what the president -- the strikes that the president ordered, i would say this. if he is ordering these strikes based on the notions of

international terrorism, to borrow from remarks that he made. and the national security interests of the united states are directly threatens and he is conducting limited strikes, i would say that is legal. that is legal. the question of judgment will remain to be seen. i will stop right there. folks, this is a very, very complicated part of the world. we have to deal with our national security in a way that is -- make sure that we do not get entangled on the ground again. >> the president's advisers are saying that attacking al qaeda is not an expansion because congress authorized war against them over a decade ago. do you agree with that?

>> i had not heard them say that. i would expect them to say that t. goes to the portion of my remarks where i said that even without the congressional authorization they are mentioning, we have the right of self-defense under international law and under the united nations charter if there is an international terrorist organization that directly threatens our national security interests. so in that context, these types of limited raids are really no different than what we have been doing in places like yemen. >> do you think that the obama administration is handling -- how do you think the obama administration is handling the situation in the ukraine and how would you deal with putin if you were president? >> i do believe this administration has been taking the right approach with respect to the situation in ukraine.

first, this is -- the issue of the russian involvement in ukraine involves larger players in historic europe, countries like germany, which have an impact on the actions of the russians. second, it's possible -- always possible for the russians to have overplayed their hand. we saw this actually with the soviets in afghanistan in 1979 where they went in, they overplayed their hand and over time they had to adjust their policies. i believe the policy of sanction and working with our european partners is the best way to go. what we can be thankful for right now, by the way, is that ukraine did not become a member of nato as many people were advocating during the time i was

these situations. we need to preserve our options and to work with our european partners. >> going domestically for a few questions. does it bother you that all of big financial firms and banks found responsible for the 2008 great recession have only had to pay fines? are we monetizing felonies? >> let me just say this. i will give you a historical marker here. when we had to vote on whether to provide $700 billion under what was called the tarp program

to appropriate $700 billion to a lot of companies who had, i think, abused our economic system, i called a lot of people trying to get their thoughts on which way i should vote. and one of the pieces of advice that i appreciated most came from an individual named martin bigs, who was with morgan stanley for many years. he helped me when i was bringing companies -- american companies into vietnam many years ago. very, very smart, macro economic thinker. and i said, which way do you think i should vote on this? number one, he said, you have to do this. if we do not stop the bleeding

within weeks the economic systems in the world economy will have a cataclysmic free fall. number two, he said, we need to reregulate. we need to get back to proper regulation of the financial sector. he said that as a hedge fund guy. he said, number three, you really ought to find a way to punish -- and that was his way. you ought to really find a way to punish the people who created this situation. who's negligence and activities created this situation. so, with that in mind, we worked from our office to pass a wind fall profits tax. i'm not big on long-term taxes like that, but after reading an article by martin wolf in the financial times actually, very conservative economic newspaper, where he was recommending because these companies got

bailed out through the moneys of the average working people in this country the tax money of the average working people in this country, they ought to pay, they ought to pay back in. and so we put together a refined piece of legislation that basically said, if you were one of -- i think there were 13 companies that got more than a certain amount, very top amount from the tarp program, and you're an executive, you get your full compensation and 400,000 bonus on regular taxation, but anything above your $400,000 bonus, you split 50/50 with the people who bailed you out. i thought that was extremely reasonable. the most interesting thing about it was when we got it to the senate floor, it was the democrats who didn't want to vote on it, not the republicans. nobody wanted to touch it and as a result we didn't get a vote on it. >> one more question before we

go to some questions about veterans. do you believe obama care is a step forward? why or why not about fairness? >> the whole issue of obama care, i think, was the most difficult issue that we faced during my time in the senate. whether to eventually vote in favor of it or not. and first i would say, i believe the administration made an error, a strategic error of calling for that legislation at the time that they did, which was the beginning of their administration. it was an issue that had been very popular during the elections cycle but you will remember two months before the election the economy crashed. and to bring something this vast and potentially costly as your

flag ship piece of legislation at a time when the economy was still suffering, was not a strategically smart thing to do, quite frankly. there were a lot of pieces in this legislation i did not like. i voted with the republicans 18 times on different amendments trying to bring the legislation to a place that i was more comfortable with. in the end, i did vote for it. and i'll tell you what was in my mind when i did. let's say this is 50.1% what you like and 49.9% what you don't. but my mother grew up in east arkansas in some pretty difficult surroundings. she was one of eight children. three of her siblings died in

childhood, not childbirth, childhood as did her father when she was 10. and there wasn't medical care in east arkansas at the time. and if you go back to that period in the 1930s, even on issues like do we create social security, any program that was put up where the government was going to take a greater responsibility for the individuals to go back and look at it, they're all screaming. you know, this is socialism. how are you going to have social security for these people? 1960s, medicare comes along. it's socialism, you know. so, that really pushed me over. i think there's -- to vote in favor of it. i don't regret voting in favor of it. but there's a lot in this program that could be tightened and adjusted. and i would hope that's where

the congress can come together after this election. let's -- it's not going to go away. let's tighten it up and make it better. >> we have many veterans in the audience, including yourself. i would like to ask a general one and have you respond before we conclude. many veterans are struggling to find work. is there more we can do to ensure the men and women who serve are better prepared to enter the civilian work force. >> what i would like to see is a better understanding among potential employers about the value that a veteran can bring to the workplace. we've had discussions over the years on this issue. i was a councilman in the veterans economy after leaving law cool worked on this many, many years. and if you're in the military

today and you're an officer and have been able to not only have a college degree but have in many cases an advanced degree and you've got a skill set that people in the civilian world can understand, you don't have a terribly difficult time selling yourself. if you're enlisted, particularly non-career enlisted, career -- the citizen soldiers, the people that i designed this gi bill for, you interrupt your life, you go out and pull a pump or two in iraq, afghanistan, you come back and some of the best leaders in that environment are the ones that are in the combat arms but they come to an employer and they have a dd 214 that doesn't have a degree or a computer school, it says i was a squad leader. we need to have a better understanding among potential employers what that means. that means i had to get things

done everyday. i had to lead people. i had to motivate them. i had to work across ethnic and other lines, i learned how to lead and how to get things done. and the more people understand that then the easier it becomes to resolve the issues that you mentioned. >> we are almost out of time, but before asking the last question, we have a couple of housekeeping matters to take care of. first of all, i like to remind you about our upcoming events and speakers on october 15th. deborah rutter, the new president of the john f. kennedy center for the performing arts will outline her plans for the center's future. october 20th, thomas perez, secretary of the u.s. department of labor. on october 21st, bob bosby commissioner of the big 12 conference. next, i would like to present our guest with a traditional national press club

mug. you can add to your set at home. and our final question. sir, two of our greatest presidents, teddy roosevelt and fdr had backgrounds at the department of the navy. do you sense a trend developing there? [ applause ]. >> unfortunately we're not cousins. thank you very much. >> thank you all. we are adjourned.