.

>> now we have more on health care legislation from house republicans. when will hear about health care experiences in other countries where the government plays a greater role in the health-care experience. roy blunt chairs the group. this is one hour and 50 minutes. >> it may just be a coincidence that these of votes came anytime health care discussion was being held. they canceled a markup on the bill was going to happen in the energy and commerce committee.

we will assume that is a coincidence and try to work around the coincidental nature of us having to run back and forth a little bit for the votes going on on the floor. let me welcome you to the healthcare solutions hearing. we are pleased to have this panel with us today. as i said earlier, we will have a doctor joining us from the u.k. on the telephone. the group was formed six months ago at the request of our leader. the ranking members from the budget committee, the work force committee, the energy and commerce committee, the ways and means committee, have been active and many of our doctor numbers have been involved as have others. two dozen of us have worked hard to put ideas out the we think would send a system in a better direction. i think it's very fair to say this healthcare solutions group

wants to create a system where people have more access and competition that creates both a better price and more patient satisfaction, with a real focus on the doctor-patient relationship. beyond that, i would say we are here today to really talk about what might happen if you wind up with a government competitor that eventually becomes the only competitor. our panel is a panel with real experience in that both in terms of medical tourism, personal health challenges, and economic impact both in canada and great britain. let me go next to others for brief opening statements. let's see if we can make these microphones work. >> i believe is on.

surprise, surprise. mr. chairman, meant -- thank you very much for this working group. we have been working together, a group of about two dozen of us, and as he pointed out, the ranking members of the three respective committees of jurisdiction, education, labor, energy and commerce, and ways and means -- we have a number of position members and i'm also a member of the energy and commerce committee and house subcommittee. we bring a lot of talent and experience to the issue and we clearly feel health care reform is needed in our system, while it is the best health-care system in the world. it is not perfect. we ought to always strive for perfection and that is what we have done in this committee as we worked tirelessly to present

the republican alternative to health care reform. this does not turn it over lock, stock, and beryl, throwing the baby out with the bathwater, to the federal government. we are for insurance reform, delivery reform, not necessarily babies, but the delivery of health care in general. we clearly feel that liability reform, expanding electronic medical records, giving everybody access to health care, creating risk pools equalizing the tax treatment. i could go on, but there are the members of the panel where more expert on those areas that i am. i am proud to work with his group and i think we have a great plan is given the opportunity to sit down with the democratic majority and president, i think we could show

them how to fix the system and six right. i really welcome the panelists and look forward to hearing the testimony and asking questions. >> let's go next to the minority whip. >> thank you. i would like to commend you for having this panel today. i think it's very important that we respond to the many questions the american people have with regard to what a government health care plan would mean for their families. as we know, there are many people across the country that are very, very uncomfortable with the rush to get something done if we do not get it right. healthcare is obviously important to every man, woman, and child in this country. frankly, as we saw last night with the president's press conference, there are a lot of unanswered questions as far as his plan is concerned and that

is making its way through congress. the reality is that as it stands, there is a bipartisan majority against the bill which creates a government health care plan. the reason i think for all of that opposition has to do with the uncertainty around what government health care has produced in other countries. and what that would mean for the ability of american families who continue to access the kind of care, quality of care, and timeliness they have become used to or many who have health care are used to. i look forward to this hearing and would like to welcome the panelists and thank them for being here. >> let's go to the ranking member on the work force committee.

>> thank you very much, mr. chairman. i would like to thank the panelists for being here. it is particularly gratifying to have an expert of away from the united kingdom who is willing to stay with us on the phone. let me say briefly that we look at this bill with 1018 pages. then it was 1040 pages. there are very troubling concerns. we in the education and labor marked up the bill and try to amend it beginning at 10:00 on one morning and going straight until 6:00 the next morning. it was a very healthy debate as my friend said. there are many physicians. we have three physicians on the republican side and i can tell you they were engaged. we would have been happy to stay engaged if we could fix this

bill. our concerns are enormous. this legislation creates a new federal bureaucracy with a new commissioner we can only think of as a high commissioner because it's enormously powerful to fundamentally right to the delivery of health care in this country. i'm delighted to be here. i have all the work of my colleagues and am looking for to the testimony of the witnesses. >> [inaudible] thank you, mr. chairman. i just want to say briefly that there are three fundamental problems with the government takeover of this health plan. one is cost, despite what the

president says and members of the other side of the aisle say. every analysis that has credibility, including the cbo says the cost will go up. bureaucracy, stepping between a patient and physician, a sacred relationship, tremendously bureaucratic. we may hear more examples of that today from other countries. finally, a big concern, despite or you may be on pro-choice or pro-life, this provides for taxpayer foundered -- taxpayer funded abortions with 69% of the mail -- 69% of the american people being against that. there are fundamental flaws with the plan and despite which appeared democrats say, every single republican is not for the status quo. we are for true health-care reform, common-sense health care reform, not nonsense health-care reform.

>> i serve as the ranking member of the ways and means committee which mark this bill up last friday. given that we're here to learn of the experiences of other countries that have done this -- the congressional budget office tells us that not only is this bill not paid for in the first 10 years, i expect the majority will close that. but they are telling us cost growed 8% year and the office grew at a 5% a year. that means congress is on the verge of creating a new entitlement would be unfounded. it's an unfunded liability on top of the ones we have -- medicare and medicaid. i point this out because it's important that if the government is to take over the rest of health care system, outside actuaries tell us, two of every

three americans will lose the coverage have in about three years because of the cost shifting that occurs. if the public plan under pays providers, typically under 30%, what will happen is they will overcharge for private plans. this will precipitate an enormous dumping on to the public plan by which the option becomes a government run monopoly. under that kind of system, with huge cost explosions, a 38 trillion dollar liability for medicare, we estimate a $20 billion unfunded liability for medicaid and an additional unfunded liability for the new entitlement. the only way to solve the cost problem, the only way to deal with the spiralling debt and deficits will be to ration care. that is one of the reasons why in this stimulus package -- the

purpose is to decide what will and will not be paid and reimbursed for providers. we are very fearful that instead of addressing the problems we want to address in healthcare, cost, accessibility, making sure uninsured get insurance and making sure people with pre- existing conditions get insurance, we believe we can fix the problem with the government taking it over and without new taxes and spending. unfortunately, the pass this bill is on will put us in a position where bureaucrats will have to make the cover decisions on how the medicine is being practiced in america. if we are ever going to do with the cost explosion from the corner, the fear we have is it will take the patient-doctor relationship out. it will replace it with the people who did not know the uniqueness of the patients complaints. i know rationing is a dirty word, but it will inevitably occur. that's why it's valuable we do

not rush this to the floor, which is being done next week. we should look as patiently and learn from the experiences of other countries as to what this looks like. that's why i decided to be a part of this and hear the input we will get from witnesses. thank you. >> the common theme among sis is solutions to health care and solutions rest in reducing cost. that is the bottom line. you have are lot of different aspects to that. where does not reduce cost, we hear from the governor's conference about their concern about the increasing cost of medicaid. they are deeply concerned about the unfunded mandate. the congressional budget office sees the end sustainability of this bill passed 2012.

also, the mayo clinic -- the mayo clinic point out the problem with the bill and its sustainability. we want good, workable sustainability tickets to the issues at hand, and that is controlling the cost. at 17% and the rate growing at 1% year, everybody realizes with the issue is -- is containing costs. what you have heard is about making sure we maintain the integrity of the patient- provider relationship. that's also -- that's for the efficient decision making takes place. we must preserve that and to weekend to reduce costs. if we do that, we create a sustainable system of healthcare in the u.s.. the current pact is not sustainable in the bill currently before us does not create that sustainability and in their fears with the patient- provider relationship.

we are here to make sure we can achieve those goals in our effort and hopefully we will find people on the other side of the aisle that will be willing to work with us. thank you for being part of this. >> thank you. we're going to struggle with this for a while. women mentioned some of the things i want to say. the choices are not the choice is the president laid out last night. the president has created a straw man or we can do what he wants to do or we can do nothing. my belief is nobody on the republican side of the aisle in the house believe that we cannot make this system better. in fact, we are proposing plans and ideas and legislation that would create access for everyone regardless of pre- existing conditions that would create more choice and

competition. that will have more effect on price than anything else. we are convinced that if you have a government provider, every outside study that is objective and this indicates you will not be able to keep behalf even if you like it. something of a constantly here is if you like what you have, you can keep it. but if 114 or one under 25 million of the 160 million people to get insurance at work go to the new subsidized government plan, what you like will be there anymore. the costs will go up, those things will disappear. then you have government-run health care. we want to have discussion about that today. we have three witnesses with us. we of one witness on the phone from the united kingdom. four witnesses will testify.

i'm struggling little bit to decide the exact best way to do that. but since i don't think we have gone to the second vote, i will introduce the first guest to has traveled from canada to be with us today. she was diagnosed with a brain tumor few years ago. because of the system in canada, she was told would be months before she could see a neurologist in canada. unfortunately, if you live -- fortunately, if you live in canada and, you are not far from the united states and not far from the mayo clinic. she was able to go there and received treatment. we appreciate the personal effort u.s.-made to be here today. we look forward to your testimony. >> been i feel strongly if we

don't start talking to each other in the same language that the truth is going to get lost in translation of this debate. it has always been my view and message that both canadians and americans have some and misconceptions about each other's current health-care system. i chose to become involved to offer the patient's point of view, using my personal experience for both sides of the border. i left canada for diagnosis in the united states because i could not access diagnosis in a timely manner with specialists for my condition which was becoming gravely worrisome. this is often the part of wait time which is ignored by steady and the improvements within the health-care system.

as many as one in six people in ontario are without a family doctor. that's the gateway to your care and specialists. out of 33 million people in canada, the same population as the state of california, we have 5 million people who are without access to a family doctor. i was fortunate enough to have a family doctor, one cared for me deeply. she was unable to expedite the tests we needed nor the specialists, the diagnostic testing, the imaging, blood testing, and some of which were not even provided under the government-run health care. one simple blood test could have saved me grief and expense that is not even available in canada. not because you cannot do the tests, it is a simple blood drop, but because the government mandates the laboratory hours. i required test at 11:00 p.m. at night and the government closes at 7:00.

within one week, i received a complete diagnosis from two former canadian doctors who work the mayo clinic in arizona. the most amazing part of my story is both of these doctors recommended i go home for this surgery and follow-up testing. as we now new with the issue was, that i should have been able to be treated rapidly through our free health care or government-run services. confident i was armed with the informational required to be tree august in the emergency list, this was sadly not the case. i was to find out many months later that doctors in canada are not required to take other doctors reports. the doctor i saw refused to review my records, read the diagnosis, and personally declined to call from the mayo clinic doctor himself as the frantic -- as he frantically contact him with updates on my condition.

sadly, stories like mine are not a rare case. as some are trying to discredit me by saying. our country is using the united states on a regular basis to help out with emergency when they arrive. -- with emergencies when they arrive. as recently as two weeks ago, two premature babies were born in one of the largest hospitals in my city and there were no facilities available for them. one was sent to buffalo, new york and the other was sent to ottawa, canada, seven hours away. when i came to the u.s., 26 people were whisked across the border for brain surgery to to a lack of neurosurgeons. i could tell story after story in this discussion, but the most compelling thing to me was the other day, when i spoke to the border guard, he reported to me the numbers daily of people crossing the border from canada to the united states for cancer treatment, and our eyes, and other emergency treatment.

-- cancer treatment, mris, and other emergency treatment. we have the average wait times in our area and we are sadly never near the target. lost in the language is coverage. the the basis that americans complain to me about not being covered are things like prescriptions, i exams, and the wait times to see an ophthalmologist are up to one year. hearing tests, even things like the cast on your leg if you should break it, the doctor tending your injury will be paid for his services, but you will be out of pocket for the cast, the crutches, the physical therapy, and the ambulance ride. i am saddened by the glib attitude that if it did not happen to me that it cannot be true. canadians are terribly proud of our health care because we fear

we have been raised to believe what america is like. no insurance coverage is very different -- very different from no access to care nor the ability to step out of the system and take care of yourself and your family without being fined. to leave your country to get treatment in a timely manner alone tells the tale of two much government control. i have yet to meet an american who boasts about health care in both the medicare process already in place in the u.s. and your va hospitals. sadly, many of those stories only mirror of our whole system. this debate seems to polarize people. it polarizes points and professionals. when i watched president obama give his speech the other day and he spoke i was surrounded by nurses because they did not choose the profession to get rich, it drummed into me what the problem once.

this is unfair to assume the driving cost of health care late on the backs of only one specific field of individuals. the yet doctors, the medical profession, pharmaceutical companies, the insurance industry, or patients themselves, this is irresponsible. canada, with our free health care, battles the exact same suffering, the exact same issues under socialized medicine. health care is expensive. the only way to control costs is not through competition, not through choice, but with more taxes or ration services. everyone wants and deserves of care. they want affordable health care. most important, what accessible health care. this is the lesson i have learned in the past few years. looking back, i chose what kind of canadian statistic i would become. i mitigated and damages. i came to the united states and saw firsthand our top quality system and how to run.

i chose to speak out. thank you. >> thank you. we will take a 10 minute break. then we will begin uninterrupted and finish this up. we will be right back and get started. >> we are grateful to have the witnesses we have today. sorry for the technical challenges and voting challenges we have had. we're going to do next to the medical director of the cancer partners united kingdom, which is responsible for created the largest independent cancer network in the uk. there are pictures on the screen

and he is on the phone with us. among his many accomplishments is he has been a physician in the national service for the past 37 years. he is the author of over 300 papers and numerous books. we're glad you are with us and we look forward to your testimony. >> a pleasure. thank you very much. i think i have circulated a preamble about this and a problem is not unique to any country. all developed countries are struggling with new technology, an aging population, and informed public which is engaging like consumers on health care. the aging population is running about 10% in all economies. in britain, we have had a national service for 60 years. it had its 60th birthday last year and was a great celebration. it is creaking and there's no doubt about that. we are sort of love with it, it is sort of a religion.

we have created free at the point of care and not the ability to pay. the great thing about it is the universality. no one is uninsured. that's a tremendous after the. the difficulty is politicians play with the health service for political gain. it is inevitable if you have a government-run health service that is essentially run by politicians. they're going to look for ways to score folk. this happens locally, in small areas where service managers to change [unintelligible] and politicians make political statements to encourage people to vote for them. nationally, in terms of policy, if you take my area, certain cancer becomes more important because it is politically more important. breast cancer is more important

than: cancel, for example. if you are a rational provider, like a supermarket or phone company, you want to please your customer. in health care, especially government-run services, it's very difficult to do. there are five problems with government-run health services. first, you get bureaucratic work forces. we're the largest single employer in the whole europe. the second problem -- when you have a large work force that is bureaucratic we structured, it is tremendously difficult to change. if you look at the high street shopping mall, it has change dramatically. our health care system remains almost exactly as it was 30 years ago. the second problem is what i call the value equation to read

-- but i call the ball you equation. competition drives value. quality of care and access to care, that patient in canada had to wait several months. [unintelligible] it's the quality goes up and access goes up and cost is down, [unintelligible] and that's the driver in any consumer industry. those that provide better value as judged by the and dinner -- and user wind. those that provide for volume without. the third problem i have already mentioned is political processing. we have seen it going on in the

health care service. it's one of the most important issues. politicians struggle to find ways to solve the crisis and one way is to pretend it will all go away. the consumption of gdp potential is massive. the fourth problem is a delicate one -- the majority of health care goes to seniors citizens. i'm going to be one of them very soon. for older people, they tend to pay less tax. so in a tax-based system, you are asking older people who now have all this wonderful technology of their disposable -- at their disposal to get it at the cost of younger people who have to pay the tax. more and more tax on the unemployed people to pay for health care wishes of aging health care consumers. inevitably, you get to a

sticking point where its no longer possible to tax the younger people more and that's a huge political problem. the last problem is you have to ration it. it's the only way to do it. we sort of do it here through an organization you have for a lot about. the problem with the program is its value judgments are not agreed with by everybody. you cannot reduce health-care to single commerical comparatively. the user has a cost for quality. you try to calculate that and there are all sorts of arguments about the calculation, but in my area, cancer, which is going through a surge of new technology, mainly in drugs, how do you know if it's a better health-care intervention and doing something for handicapped children? that's impossible to put into single numbers.

in conclusion, trying to get some sort of system that allows the benefits of the universality which the nhs does but allows choice and competition to move through is the way to do it. what i admire about what you are doing is that you seem to have a greater realism and political honesty about that. we tend not to have that, but it's coming in next three-five years because of the increased cost of health care. and the fact the new technology will keep coming at us. solving the problem today does not mean it will be solved in two years. thank you very much. >> thank you. if you could stay with us, we have two witnesses and i'm sure we will have questions for you as well. but the next two richard baker. he founded timely medical alternatives, an organization

that sends thousands of canadians to the united states for surgical procedures. he has become one of the leading spokespeople for free-market reform in the canadian single payer health care system. he has appeared often on radio and television to discuss health care reform. he has made a considerable effort to be here today and we are glad you're here. thank you. >> mr. chairman, ladies and common, my name is richard baker. six years ago, i founded an organization to help canadians who are oblong medical waiting list to get the kind of care in u.s. hospitals. currently, there were over three-quarters of a million canadians waiting for surgery which americans routinely get in

days. in some parts of canada, the waiting time for an mri, a very routine tests, the wait is over one year. a basic diagnostic image. the canadian supreme court has admitted people are dying on waiting lists in canada right across the country. over the years, organization has sent well over 500 canadians to the u.s. and we refer to the u.s. as canada's health care system of last resort. if you are dying, if you cannot get care, there's always the option to go to the west. two years ago, building on our success and experience, i founded north american surgery. this company negotiates deeply discounted prices for procedures for uninsured americans.

in the course of this work, we have saved the lives of six of our fellow canadians. we never had the opportunity to work with the other member of the panel, but we do have many people whose stories are compelling. we helped and eight-year old girl with a massive cranial infection. she was on a 15-month waiting list in canada to have the most simple surgery's. she needed trains put in her ears, she needed her tonsils and adenoids out. this is the simplest possible surgery and yet she was on a 15- month wait after having gone deaf in january of 2004. she cannot hear her teacher or participate in school. in the ninth month of the 15- month wait, we sent her to research and in seattle. he told her father that had she waited for the 15 months she is

asked to weigh in canada, she would be dead. he said never mind her hearing, he said my job is to try to save her life. happily, the surgeon did save her life. this little girl lost all of her hearing in one ear and half in the other. our client in toronto was diagnosed with a brain tumor in 2006. the family doctor estimated it would have taken seven and a half months from the time he collapsed on the street until he would have finally got his surgery. that included a four and a half month wait for and mri to confirm the initial diagnosis of a brain tumor. we sent him down to buffalo, new york, where he had a malignant brain tumor removed.

we compressed the seven and half months into four and a half weeks. he had his first hearing in court yesterday. he went to the supreme court and is suing the canadian government for its violation of this charter rights, specifically the charter right of security of person. it would be ironic if just as canada appears to be going more to the right on health care delivery, the u.s. would be copying the canadian system and going to left. it would be very ironic. another client in british columbia was told by her vascular surgeon that she had two or three weeks to live to to a block in her arteries. she was starving to death and cannot digest her food and lost 40 pounds.

>> that's another disruption. >> surgery with plan in british -- surgery was planned in british columbia and she is on the table being prepped for surgery when the word came down all elective surgeries were to be cancelled for the day. this is a routine procedure. they do not have sufficient beds. if she had had her surgery, there would be no bed to go to. why are there no beds? they don't have money to hire nurses to tend to patients and those that. so she waited and her second surgery the following week was canceled. her surgeon said get in touch with timely medical alternatives, our organization. they will help you get care in the last. the next day, she was at an excellent hospital in washington where her surgeon said you were

hanging by a thread. you have lost some one week to live. he saved her life. this is an important part -- she went back to canada. she went to the government and someone money back. they said why would we give you your money back? she said because there is a contract. i have been driving a school bus all my life and i have played -- have paid a crushing taxes all my life. the implication is health care would be there for me and it was not. i want my money back. she was told that her decision to leave the jurisdiction was an elective decision and your application is denied. this brings up an important point. her response to that, was the only thing elective about my decision to go to the u.s. is i elected to keep on living. i thought that was great.

but this brings me to an important point. you will hear from proponents of single payer health care that there is anecdotal evidence in canada that some elective surgeries are sometimes postponed. the indication is the planned tummy tuck has to be postponed. elective medical procedures in canada, and the condition that this not immediately threaten life or limb. if you are hit by a bus in canada, you get immediate and competent care. that is an emergency situation. if you were hit by a bus six years ago and you need spinal surgery now and a walker to get around and you are addicted to painkillers, this is an elective condition. you may not be able to function, but it's an elective surgery or looking for.

again, there are three-quarters of a million canadians waiting for elective procedures. one of these is a client from vancouver. her son needs a major spinal surgery and he's only 15 years old. he needs a lumbar fusion. she needed the same surgery when she is 15 and did not get. by the time she is 28, she could not pick up her babies and hold down a job. she walked with a walker and was addicted to morphine and, worst of all, in my view, she had to walk around all day in diapers at age 28. the mother of two, walking around in diapers. she asked researcher when she could get the surgery. -- she asked her surgeon when she did the surgery. she said you are too young to get a spinal fusion. she was too young for spinal surgery and was also told there

are some many others waiting in line ahead of you and we have to operate on first. and besides, you have not yet suffered long enough. i want you to remember that phrase. you have not yet suffered long enough. a 28-year-old mother of two in diapers and addicted to morphine. the lack of health care system in canada. three years later, she finally got her surgery and came to us weeks ago to help us get surgery for son who has the same condition. she told us she would pay anything. she would mortgage her home or sell her home, she would do anything to avoid having him go through the same suffering she went through. we will be sending her son to an excellent physician in south dakota for his surgery in the next couple of weeks.

you will hear from prominent canadians on the left of the political spectrum about how wonderful the canadian health- care system is. the leader of the socialist party in canada recently came to washington to tell you how wonderful the canadian health- care system as. why would he do this? why would he care? here is why -- the only reason canadians put up with our dysfunctional health care system is the fact that the government tells them it is ours and it is the best health care system in the world. however, when canadian citizens are willing to pay to get timely care in the u.s., even though it is free in canada, people begin to question the government's propaganda as inconsistent. why would they come to the u.s. if it is free? if the canadian and american governments can arrange things so both countries have the -- have single payer health care,

the freedom train my company operates will have no place to send canadian clients. that is why i am here today. americans need to know about the truth about the strengths and weaknesses of both health care systems and, with six years of experience working in both systems, i have a unique insight into the subject. you will hear from congressional leaders in the west we have the doctors on our side. i work closely with 60 u.s. doctors. i have not talked to a single doctor, not one, believes the single payer health care system is the answer. the association of american physicians and surgeons is against the single payer plan. i noticed the title of the discussion today is health care solutions. so far, all i have been doing is talking about a solution that will not and cannot work.

interestingly, you should know that our organization has been able to negotiate pricing for canadian clients and on insurer american clients to prices significantly below the customer prices charged to american citizens. for example, at replacement cost of uninsured people $42,000 in the u.s.. american insurance companies get a break and don't pay that much. they pay $24,000. our canadian clients we sent to the u.s. pay $18,000. we get far better prices than the insurance companies do. i believe this is a free market solution in part to the perceived health care crisis in america. it was stated earlier that the solutions rest with reductions in cost. i have been able to find a way to reduce costs dramatically. in conclusion, as you americans

work to create new laws and government delivery of health care in your country, you should know the canada health act, which governs healthcare, has caused more pain, more suffering, and more death and any other piece of domestic legislation in the history of canada. thank you. >> thank you. let's go next to the president and ceo of the small business and entrepreneurship council. we will listen to her testimony and then we will go to questions. >> thank you. let me thank all of you for hosting this event today. and for inviting small business to be part of the discussion. i feel i did not have to go into

too much detail about the challenges faced by small business owners regarding their epic struggle to provide cheap health coverage to employees or themselves. this has certainly been a long- term problem for small business owners, as you know. the central issue is cost. high-cost and rising costs. even in the best of times, these rising costs have for growth and investment, hiring opportunities and competitiveness. during this tough time, coverage has become an extraordinary challenge. for the many who did not provide insurance but want to and cannot afford to, it goes without saying that economic conditions have exacerbated the situation. many small businesses are in survival mode. they're cutting expenses, cutting hours, cutting jobs unfortunately, and doing what they can with very limited resources. like many americans, economic

confidence among small business owners is rather gloomy. a legion business watched survey found 59% of small-business owners rated the economy as poor. 30% rated it as fair. only 8% rated as good or excellent. 57% believe economic conditions are getting worse. 49% believe conditions for their own business is getting worse. these numbers and a lack of confidence don't bode well for the economy. given these tough economic conditions, and the important role small-business play, you think lawmakers would do everything possible to help our sector. that's certainly what my members in my organization has heard regarding health care when congress started down the path of health care reform. namely that coverage cost would decrease for small business owners under the current legislation. unfortunately, that's not the case.

the house bill, the affordable health choices act, is not an affordable plan for small business. in fact, the financing of the bill appears to fall most heavily on small business owners. that includes new taxes, new mandates, penalties and regulations that will raise costs. this is not was small business owners need when we are struggling to survive. the mandate requiring employers to provide insurance, acceptable coverage as defined by the central government, or pay penalty will drive up costs and kill jobs. the tax on business owners is not make sense on a time when capital is tight and we need entrepreneurs to invest in businesses to keep employees on the payroll. we are in a recession and the economy and private sector needs this capital. we need to keep capital in the hands of productive business owners and not punish those who are working hard to bring the economy back to growth. but the government defining what is acceptable coverage, we are

concerned this will drive insurance cost fire for many small businesses. acceptable benefits plan would include a mandates and services of included in some plants, which means costs will increase. we're also concerned about the overall regulatory compliance. you cannot read this bill and not acknowledge it is a regulatory monster. complying with the bill will be complex and costly. the federal current will develop a system to track whether businesses provide insurance, making them contribution to employee coverage and the proper proportion amount for non-full- time employees, filing and will report, the correct penalty tax, analysts goes on and on. none of this will lower costs for business. as we know, the cost of regulation falls

disproportionately and is more burdensome for small business. small-business owners desperately want reform. they need reform and have been leading the parade for reform for many years. but has to be small business family and lower-cost. it has to produce a reasonably priced coverage and more choices for small-business owners. small-business owners have led us out of previous recessions and they can lead us out of the current one thbut that will not happen if they are encumbered by taxes and penalties. unfortunately that is the direction of the legislation moving through the house and is certainly not a plan small business owners can afford. thank you. >> thank you. what i would like to do is, i think we can go until two o'clock. we will give each member five minutes to ask questions and we

will watch the clock since we do not have a clock in front of us. i may tap the gavel if i need to. but we will try to do this in the orders in which the members came to the meeting. [reading names] if there is any time questions left, i will be last. >> thank you, mr. chairman. let me think the witnesses. it has been absolutely tremendous. i'm from minnesota. canada is in neighboring. we see anecdotal evidence all the time of canadians coming to minnesota because we have a mayo clinic there. i'm not sure why you travel all the way to arizona. we have a male clinic in

rochester, minn., that is famous. you could have chosen to come to several hospitals in meristem that -- and minnesota. we have had examples of hospitals around country where canadians have gone. you did that because he needed to, you had to, and you could. i think the phrase mr. baker said was the u.s. is the canadian system of last resort. so let me start with you, if i could. if the united states were to adopt a system like canada has, with a government-run health plan, to you think the mayo clinic in rochester and others would be able to provide services for you and other canadians?

>> i'm not sure that would continue to happen. i don't see where the need would be on either side. what i think is if americans needed a place to run if your facilities are completely bogged down and back up and mirrors the system we have, would canadians be able to turn around and help americans that could not get help? i think what went -- i think we would become neighbors with the same problem and the solution. >> mr. baker, you did leave us with some thoughtful and terrifying quotes. the one of the doctor saying you have not yet suffered long enough.

i wonder how one determines when some has suffered long enough -- when someone has suffered long enough? if you have a bureaucracy making that determination that he will have many people suffering for a long time. let me move quickly. you are providing a service. you are an entrepreneur with a program and you have seen a need and canadians are being referred to you by concerned physicians who say i have to get help for my patient. you are providing a service. i have heard, as we are trying to catch up with the canadian system does, the canadian government may actually try to create something that would compete with your services. >> if they did create something, i have said many times that i would feel blessed in operating

my business that the major competitor is the government. who cannot succeed in business if they're only competitor is the government? my competitor offers the same product i do, but they don't charge for it. it is absolutely free and i charge for my service and people still come to me. what kind of indictment is that of our system as people willingly pay for a product service that is free? >> i think it's a clear indictment. i just have a comment and one more question. i have all of colleagues who are waiting. when we were marking up the legislation and talking to colleagues and businesses back in minnesota, the small business owners and employees there and those who started to look at this realize the bill payer here is going to be overwhelmingly placed in the

hands of small business. you gave some good testimony. what would you say from a small business perspective? . . that allows small-business owners to pool as a group and

leverage their numbers of the can negotiate better prices and have more choice of plans. there are tax credits that can be offered to individuals and business owners. the tax code can be fixed with the self-employed with respect to tax parity. we can open of the health- insurance market on nationwide basis. çsmall-business owners in some states are just walked into the insurance market and it is very expensive in some states, in new york and new jersey and places where they have excess of mandates. that is a barrier to manage -- a barrier to coverage for many businesses owners. i think that makes total sense, more choice, more competition. and i think just some very simple, targeted reforms without

taking over the whole system and make small business owners pay for it. >> you sound just like a member of the republican health care solution group. those are exactly the discussions we have been having. thank you all very much. i yield back. >> skews mean, these are government run my greece -- microphone systems. [laughter] thank you for your patience. we just received a very real analysis of the bill we are probably voting on next week. the analysis shows that in about three years, 103.9 million will be beginning their coverage to the plant. private insurance will decrease by $30.4 million, about 38%. medicaid will increase by about 12.6 million people. that is just in a few years. clearly, the trajectory here is

squarely toward the public plan option eventually becoming the government -- government plan monopoly. mr. baker, i want to rescue a question -- is it mr. or doctor? >> mr. >> what mr. nad works in canada without -- walked me through what happens in canada with respect to reimbursements and not just the waiting lines and the accused, -- thew queues, but we have already created this institution of confederate -- competitive which gold is to decide the treatment that can be given to patients. how does this work in canada? >> it works in canada in this fashion, not only is access to

medical care rationed, but access to the medications and the techniques involved in that care are russian. we will go back to my client, surely he lee, and we said to bellingham, washington for a blocked artery. had she had that surgery in canada she would have had an arterial bypass. she was the macy bid. and she was debilitated. her surgeon told her that had she gone the surgery in canada she likely would not have survived it. when she went to bellingham, she had a standing procedure, far less invasive, far safer. why is it not offered in canada? because a stint, which is a little thing that looks like a chinese thing reposal costs, i do know, $1,000. it is cheaper to do the bypass procedure. that is one way that the customized system is effective.

another excellent example is access to drugs. there are evidently 25 pharmaceuticals which are deemed to be effective for treating cancer. and given the on which province you live in in canada you may or may not have access to them. in british columbia we have access to 23 of the 25. hopefully, if you come back with -- come down with the cantor, your particular type is receptive to one of those 23. the but what if you live in prince edward island, the smallest province? they only approve one of the 25. you have to be very lucky to have cancer that was treatable by that one drug. what if you have cancer that required one of the other 24? he would be out of luck. >> that is a duck the what our concern is, which is, physicians ought to be able to -- that is

our concern is, which is, the russians ought to be able to cater to their care of each individual patient -- physicians ought to be able to cater to the care of each individual patient. if we set standards as a government body, it is cookie cutter based thmedicine. and you're saying is based on cost. it is not necessarily even best practices. what is the best way to treat stage three of varying cancer? as my 5 and atop already? iç guess i've been gabbled. -- gaveled. >> dr. kingery? ? gingry?

>> hello? testing? there we are. i wanted to direct my first question ought to the doctor, but to the gentleman mr. baker, who was just speaking -- you made a comment, mr. baker. you said, who cannot succeed in business if they're only competition is the government? and i think that was in reference to the fact that you were not worried about competing with the government for your business and your business model and your plan and your onta for your ship and how well you're doing. -- your entrepreneurship and how well you are doing. and we commend you for that. that is an american success story. but i can tell you who would not be able to succeed in this country competing with the federal government. no insurance company, no private insurance company that offered

a health care product could succeed against the federal government if they were not only competing, but also setting the rules. there were on the playing field, but there were also the referee. that is a real problem with this situation with a public plan, a government-run the fall plan. i'm sure my colleagues have talked about that in the time that i had to be away from the panel. but you may want to comment on that. regarding your patient, shirley hughley, you may that anecdote and talked about the need for the extent and -- for the stint and going through what you called rationing. we had our first marketing energy and commerce the other night with regard to h.r. 3200, the american forum --

affordable act of 2009. i asked my colleagues if they worked as concerned as i was about the possibility of the government making medical decisions and literally with all of this comparative effectiveness research council, taking the decision out of the hands of the position, taking the art not just the science, but the yard away from the practitioner of that art. what i want to ask you is, if we go to this system as those 1100 pages now describe without some significant changes and that becomes law in this country, what do you see for your business in regard to trying to get them access to care and out of that long queues and not be rationed out of the health care system.

>> there are other countries to offer health care. there is not a week that goes by that we do not talk about hospitals in india and pakistan and bangladesh and i want. i do not want to send my patients offshore. there are risks in traveling to these countries. i will not get into that. i have faith, however, -- and i hope it's not misplaced -- that while we canadians tend to go to the end of the line patiently and without grumbling, i do not see americans doing that. i have a higher regard for the american resistance to being pushed around. i remain confident that there is going to be away -- a way if people want timely delivery that they will work better with the doctors. i do not know that is correct, but i would like to think the american spirit is less willing

to roll over and play dead as the canadians do. >> let me reclaim my time and we are getting short of time. if i could just expand on your answer a little bit. you certainly will not be able to send them to the united states anymore if we adopt the system. the same kind of problems they're trying to get away from they will inherit when they get to our shores. >> i agree with that. >> if we have a second round, ms. kerrigan, i have a small business question for you. >>.net thank you, mr. chairman, and thank you for your line of questioning, dr.ç gingry, we appreciate that. i would like to ask a question of ms. kerrigan. we know there is a massive cost shift between government and entitlement programs like medicare and medicaid and private insurance plans. private insurance plans are set

-- are essentially subsidized -- have essentially subsidized the underpayments of government. this cost should result in people with private insurance paying an average of 1007 and drove $88 more -- $1,788 more out of pocket per year. using this would change under the government plan option proposed by the -- do you think this would change under the government plan option proposed by the house bill? using this would put more pressure on private insurers, leading to even more and more people drop in private coverage to select a government run? >> in short, yes. with respect to the government auctioned, you know, the government is going to -- to --

option, the government is going to set the rules of the game. there will give themselves a competitive advantage and give themselves a regulatory advantage. it will crowd out private insurance. there will be fewer choices, more insurance companies will leave the market. more individuals will end up in the government plan. if government sets the rules of the game, the competitive game, it is going to be to their dad did. what that means is that there are going to be fewer insurers and more people going into the government auction. . option. >> i share your concern and your appraisal of what i see happening. it is not like we don't know that it will be government run. we just heard from mr. baker about canada and we have similar

stories from the u.k. and europe. ms. holmes, i know that you have similar concerns. again, i thank you. the good news is that the american people and the american voters are becoming more and more aware of what is being overnight in these 1100 page document health care plans that no one is able to read and we do not even have a final price tag on before we are voting on them, and more are becoming aware that more and more have concerns. thank you for participating. i yield back. >> thank you, mr. chairman. i want to thank you all for being here and for your comments. my concern is obviously, how

chilling that testimony, mr. baker, was about the waiting list and the effect on people and their health. my question is about the kind of innovation that is necessary to continue to deliver the highest quality care to patients. if dr. secours is still listening i would like to hear your comment as well. how you see in the u.k. -- and then maybe we will go to mr. baker in canada -- the ability to use new therapies for cancer, for example, obviously, they are more expensive because they are new and untested. how do you see a national plan affecting the ability of physicians to try these new treatment techniques, use the higher cost -- particularly with regard to cancer and comparing the survival rates of cancer between the u.k. and u.s.?

>> there are been some very good comparison of drug use across the european countries just after january this year. it was very clear. a drug that comes available to a patient through rationing -- we are falling way behind in the last three years of our european colleagues on the mainland. the real issue is how you can get things moving. my generation of doctors has felled -- has felt that control over their destinies and, indeed, the destinies of their patience has gone down. -- their patients has gone down.

the other problem that you end up with this regional variations, as in canada. even on a very small scale. one person on one side of the street will go down and have access to certain drugs and treatments and on the other side of the street, you may get down a different route and not get them. that is where a geographic inequity comes into it. there's a lack of any incentive to move forward to embrace innovation, which is something that your country has really done with health technology. >> thank you. mr. baker, a uc innovation with new ways to cure disease? >> i got a call from a gentleman in newfoundland. if his father was a blood condition and he needs a bone

marrow transplant. this is impossible in newfoundland. but this is what would save his life. alternatively he is having we keep -- weekly blood transfusions and this has been going on a year. the doctors recently told his son, you know, we're going to have to stop these transfusions and he said, well, wouldn't my father died and they said, yes, ultimately he will. they said they could not continue to pay for them forever and they do not have the money to pay for him to go to boston as bone marrow transplant center. people in the system become hardened. they become immune to these sympathetic stories that normally, you and i would feel so sorry for people.

and they have learned to say, no, it is not available and move on to the next person. i have not had to do that in my own business because i have access to the u.s. that the medicines that might be available to you are dependent on your zip code, where you live? is that correct? >> that is correct. each department has their own budget and of the budget is gone, there is no other way to cut money than to cut off access to more expensive procedures and medicines. >> doctor, just last year i lost my has been to pancreatic cancer. i became very much involved in cancer treatments i know you

have an independent cancer facility. how many cancer facilities are there in great britain? >> altogether, 61 cancer centers in the u.k., all of them within the and a chess -- within the nhs. we're just creating the centers for radiation therapy and chemotherapy. the concern is that the generation before wanted to get competition between the independent sector and the nhs and they pushed through under tony blair a way to drive pavillion out of the service. now it is sort of half and half. i suspect that whatever happens in our next election -- the

british public loved the nhs. it does deliver to many very good care, but the difficulty is innovation. in cancer, there's not been much but is new over the past decade. -- much that is newt over the past decade. but the speed in this -- we still of great delays in diagnosis because of lack of imaging capacity and a lack of an ability to do this. >> there was a study in done in brussels and i brought this to the attention of our oncologist and he made sure that the -- i have been unnecessary combination of drugs. it was too late for him,ç but a

patient comes to you having discovered the formulary that works, that has been proven through clinical trials, are you -- if you were in the nhs, would you be free to use the system? >> not unless it has been approved. i can get special example -- exemptions from the primary payers of care. we have 152 pct's that make decisions. obviously, they're going to come to different decisions. that is the basis of the the code prescribing. -- zip code prescribing cured they do not understand when they go to their doctor and they say, can i have this and they

say, we cannot pay for it. and of how long could it take for the doctor to approve a drug? >> up to three years after it has become available. it takes a long time. if you look at their website and the drug analyses that they have done for cancer is very thorough, but very time consuming. they seemed pretty mean quite a lot of the time. it is a matter of how you prioritize. you prioritize on behalf of individual patients. >> dr., as you know, being an oncologist three years with many forms of cancer -- in an oncologist, three years with many forms of cancer is a death sentence. many americans do not want that for themselves, their loved

ones. that is not what an american held this system should be about. -- health care system should be about. thank you doctor. >> ms. baker? -- ms. tigert? >> my question is for dr. secours. i have a daughter and her family that lived in london for 11 years and they love it. i asked them a couple of questions about the health care system there and i ask if you have any information on this. number one, she gave me a website, a cancer postcode lottery and explain the fact that if they're in a zip code were they have run out of cancer drugs, even though they might

have been three blocks away in another as a code, people that live there cannot have access to those drugs. is that true? >> it is not quite that they've run out. it is because there are 152 primary care decision makers, certain drugs have not been approved essentially. it is up to each of them to approve a drug or not. whether they approve it or not, they ought to have money in the budget and there may be some other aspect. it is the vagaries of the system. >> and then we see that for example, breast cancer, the rate of curious about 60% vs. -- we have a much higher rate here in the united states. >> doctor, is that your impression?

our numbers would indicate that if you have early detection of cancer in the united states -- >> absolutely. >> you have any percentages on that? >> iyer the detection is greater in the u.s. than in europe. -- the early detection is greater in the u.s. than in europe. our breast screening program is a population based screening program based on call and recall. 90% of the population come forward for that. that is a tremendous achievement and it can only be done as a government service. and that is great. but they're not great at delivery of care. >> there was another question. the expectation of getting these drugs, experimental drugs in particular with cancer, a patient decides that they want

to have a private doctor in the u.k. they can get access to these experimental drugs, they pay forç them, and then they cannot go back into the public sector to get just the regular drugs, is that true? >> that has changed slightly. last year, there was a review of the top of payments. it was exactly that, the regular government drugs and then you have what are called the top of drugs. that has just been approved. the government did a u-turn during the autumn of last year and agreed that would be, the case because there was an outcry on the people that what the topic up. they pay for that. they pay their taxes, so why not let them have topped up. -- top up? >> i think that was a good idea and it shows the power of

objecting to things like that. >> exactly. >> the other oneness -- the other one is, with having to go to private doctors, you can go to the public sector and get an appointment if you have, let's say, a rash on your arm purity -- on your arm. and they say, yes, you need to see a specialist and we will refer you. it could be up to 18 months before they get the of four men with the dermatologist. >> there are huge delays. if a lady has a breast lump, clearly, she will be seen and truman will be started within two to three weeks. but unfortunately -- she will be seen and treatment will be started within two to three weeks. but unfortunately, many things could take up to a year. if that is the case with a melanoma, then you will delay a cancer diagnosis.

>> she also referred me to a website that showed a hip replacement was a year, and the replacement was 10 months and for a slip to this id was five months. there must have been a lot of hits because now it has been taken off. >> the wait list now, the target is 18 weeks. 90 percent of the population waiting for surjit populate -- operations get treated within 18 weeks. -- waiting for surgical operations get treated within 18 weeks. >> we are and impatient people, but we also want to be -- we are used to our health care system as working and we are used to being taken care of. >> mr. jackson?

>> i got help from my aid over here. we're here today because our goal is to get every american in this country acts of to help insurance. however, i think everyone would agree that not all health insurance is created equal. based on what we are today, health insurance does not equal access to health care. the health care bill currently before the house creates a government-run health care plan at that studies show will force over 100 million people into -- from their health care coverage currently based on the -- from their current health care coverage. based on the conversations of our witnesses, i think that we need to decide what kind of service that would be. i think it is a disservice to the american people if we talk about getting more health insurance without discussing what type of insurance will be forcing them into. ms. holmes, i appreciate you coming here today.

your experience with the canadian health-care system, you stayed over 5 million people in ontario -- you state over 5 million people in ontario do not have access to a doctor. is the family doctor a fading breed of there? and number two, i've heard that some town lotteries in canada and give the lottery winner at access to a position? is that true? why is it so hard for people to get access to a doctor? >> it is about 500 million people all over canada. it is about 800,000 people in the province of ontario. there are different shortages of family doctors. family doctors are your gateway to any specialist, any testing. you cannot get anything without the family doctor. this is why people will say that patients are overusing or misusing the emergency room. but if you go into a walk-in

clinic or something like that, you can often get referrals to where you need to go. that is why they end up in emergency rooms. >> if they go to emergency rooms, does that give them access to a specialist? >> not necessarily. they will treat whatever the instant i think is, or you will sit there for 12-15 hours. because of course, is triage. and rightly so, it should be. there is a patient responsibility not to misuse the emergency rooms, but unfortunately, these people have no choice. and definitely, we do have lotteries run and we also have a system where family doctors come in and they can interview you. you have to go in for an interview and they can decide whether or not they want you as a patient. there was a very upsetting article in my opinion done in a magazine in toronto by dr. and he laid out how to be a really

good patient and to get accepted by a family doctor. the number one thing was to be nice. and quite often, you tell your friends, like, can you see my friend because he is really nice? quite often when you are sick, you are not the nicest person if you are on a wait list. i will try to get myself that i am a nice person, but i thought that was very sad. the other thing is, there were shortages within them that you may only get a physical once every two years. when the going to get that physical, you have to decide if you're going to get the top half-dozen or the bottom half done because you cannot do both. when you walk through that door, you're really trying to get the most out of that thing. a lot of doctors will say one complaint per visit because they only get paid for that one visit. so you cannot say, i've got a headache and in iraq. you have to be very specific or

else -- a headache and an earache. you ought to be very specific. the other thing, too, if you are one of the fortunate ones that have a family doctor and something happens after-hours or you cannot make a dime -- a daytime appointment, if you go to a clinic, some doctors will make you signed a piece of paper that you just go once, they can drop you as a patient. >> you said a top five or lower house -- a top half or a lower half. is that at the belt line? >> this has been a very hard thing for me. this whole thing has put a tremendous pressure between myself and my family member who is a family doctor. everyone will lay blame on who did or did not do the right thing.

the plot -- the backlash i'm getting from the committee is about being here speaking out is that i am not an embarrassment and that i am anti canadian. i think it is sad because canadians should be embarrassed that i have to be here talking. i think even if one person from parliament from ohip, for many place a position, the doctors that let me down, an apology from one of them would go a long, long way. >> we are having trouble getting family doctors here in this country, too. dr. secours, as a health-care provider that has practiced in the national health service for 37 years, i've heard many stories about government-run health program in england. when i was stationed there in the air force, my son got sick and we walked into a waiting room with twice the number of people that are in this room and i walked to the counter and they said, are you paying, and i said, yes, and they said, come

right in. i saw the doctor and i wonder how many doctors are taking advantage of private pay over there, if it is still an option yeaand yet, even with the privae option available, it seems like the statistics it are that cancer is worse over there than it is over here. >> i think that the past nhs has a a separate system has than the private system on the whole. on the whole, the private system is kept separate bendy nhs. doctors then maybe three days a week in the nhs and two days a week in the private sector. that was allowed from the very beginning in 1948. problem now is that we worked in teams.

that is not just a lone doctor treating cancer or doing his replacement. it is 1818a team. the problem governments how is this inability -- the problem government run system some of his inability to mqcá innovation had on. the waiting time is going up and you're trying to fight those problems and a the same time, you have new technology. those in the nhs spend their time in the here in now because the pressure is on the mediacy. that is a major problem. >> mr. chairman? can you hear me now?

thank you for holding this. i serve on the energy and commerce committee and we have not heard testimony of anything like this in that committee and i think it is vitally important that the american people hear the facts that are being brought out at this hearing and understand them before we make, quite frankly, drastic, shocking changes to our current system. i want to thank all of the witnesses. i think you're doing a great service. i think you are doing a service not only for the people of the u.s., but also for those of you are not americans, dr. secours in england and the two of you cure that are canadians, you may be criticized back home but we can improve all of these systems. the canadian system is looking at improvement and your testimony here is vitally important. ms. holmes, i want to thank you for coming -- my friend from minnesota wanted to say this, but a deshawn.

i wanted to go to the mayo clinic in arizona. they were deeply concerned about this level of reform. as you know, they have not spoken out and said that the american system needs reform, but this is not what we need. there's a failure diagnosis under a state-run system and getting the diagnosis is that you need. >> what happened to me, and this is why i feel my particular case is so genuine. i took three stabs at the system for the same problem. i could not get diagnosed, so i did not know what i had. i just knew i had sent arms. quite often when you have a tumor and cited you do not know what is going on. -- a tumor inside you do not know what is or not. the most serious thing with my eyesight. when i traveled down to the u.s.

i got all the diagnosis. the thing i found so remarkable about the mayo clinic, and i cannot say enough about the treatment that they give, was that the cooperation they were prepared -- they were prepared to work hand-in-hand with canada. the amount that they were prepared to go in order to send me home for treatment and to stick their necks out to try to get the hell back home. i came home, i had that diagnosis. i think it was more to their shock than anyone else that i was back on their door to read a letter saying, we need to do this, let's go. they never looked at my bank account. they never said, can you afford this? let's do a credit check. absolutely nothing. i think that is important. >> i appreciate it. i assume in your capacity, you are an advocate on health care

and have been for many years, i assume you have read a substantial portions of the house bill. i was shocked last night. the president said a number of things in his remarks. i do not think that he address the real concerns. one of the things he said was that the reform we are proposing will keep the government out of health care decisions. is that an accurate or fair or even reasonable characterization of the house bill? >>, nou. -- um, no. [laughter] if you just look at what is being set up from the federal government perspective in terms of all of the different departments, all the different offices. the new health care tauruses commissioner, you know -- the health care choices commissioner, the amount of regulations, just the specific regulations that will make decisions in the system is

quite extraordinary in terms of the level of intrusiveness, and also in terms of the level of intrusiveness on small business. >> dr. secours, i would like to conclude with you. the cancer statistics are pretty stunning. i have looked at them. if you look at the five-year cancer survival rates in the u.s., if you get breast cancer, prostate cancer, or cancer in general, in all three categories have five-year survival rates, the u.s. beat canada quite dramatically. it beats europe overallç by an even wider margin and it beats in good by an even wider margin than not -- and it beat england by an even wider margin than that. this study for breast cancer shows the united states are rate is 83.9%. the european the survival rate is 73.1%.

the survival rate in the u.k. is 61.7%. in earlier tests 20 i think used the words, of "falling way beyond." i think i heard you say it is, in part, because of the system both because of delay and delay in access to drugs or treatment. could you expand on that? >> i have been studying this for the last 25 years looking at why we are behind. there are many factors. the interesting thing about our statistics, if you look up a common cancer, the foremost, being breast, lung, prostate -- a rare cancers are the kenya, the tichenor cancer, we are not falling behind. -- leukemia, testicular cancer, we're not falling behind.

we need to have access to imaging or access to specialists. about all takes time. and you need access to precision radiotherapy and could keep own therapy. -- good chemotherapy and. it is a total system problems your -- a total system problem. we have the knowledge, but it does not allow ourselves -- our patients to come in a timely manner through the system. >> thank you very much. i hope the american people get to know those facts before we are forced to vote. the speaker of the house is going to pull the bill from the commerce committee in order to get a vote next week. i do not want to rush to judgment, but i want to thank you and all of the witnesses. these are the facts that we need

to know before we vote on this kind of legislation. >> dr. burgess? >> this is, i guess, the only active hearing on the house side that is going on even though we are right now being told we are under a tight timeline. i've heard your testimony before and it is always moving. i do not think i have ever heard quite that wrapup you gave about no one down here checking your bank account. and last night the president called us out as doctors and said we were not seeing sick people. that is just flat wrong. america's doctors and nurses have been doing the right thing in spite of medicaid, in spite of the abysmal reimbursement rates that are there in the public sector. thank you for saying that. i did not intend to do that, but you force me, and i'm glad you did. dr. secours, could i ask a question? the german as a tight gaveled here, i know of. -- the chairman has a tight

cavell, i know. could you discuss the differences between your medical system and ours? >> it is regionally organize and still allows for very little choice. the go to a general practitioner who goes to down the route of a primary care. >> but as far as someone gets in trouble and there is a bad outcome and there is a lawsuit that results, how is a different in the u.k. than the united states? >> we have much lower levels of a vacation. patients are much more -- and there is very little louder realism. -- collateralateralism. patients do not feel that they have a different pathway. >> is there consistency in the way things are done there rather than in the united states?

>> medical litigation here is going up considerably. the courts we are glad to export it to you. -- >> we're glad to export it to you. but me ask you another question you talked briefly about the ability to read innovation. you said not much has happened in a decade cancer of the pancreas. are there other areas of medicine where you see a stagnation of research? >> i think any area that has innovation, the obvious one is angioplasty. it is a coronary artery disease. after someone suffering from a heart attack, instead of the lake, youç go into the angioplasty and the patient is out to his letter and the problem is solved for at least a few years. -- two days later and the promise of for a peace if you years. the introduction of that is --

has been enormously slow and our system. they do not want to go to a place where they cannot get that innovation. that is was in competition and that is what this is lacking in a government run system. gratz we are being accused of of realizing a -- >> we are being accused of over utilizing that. when we are compared with canada, a canadian system is on a budget. and when the budget is spent, the budget is spent. our public system, and we have a much larger public system than you do, it is -- you send us the bill and we will pay it no matter what. we may reduce the amount, but there is no upper limit on the system. we just take whatever comes across the counter. could you speak to that for a moment? >> each hospital has a block budget at the beginning of the year. they are given, let's say, $6 million. is your respective of how many people come -- is regardless of

how many people, or security of their problems. you must treat everybody within this budget. we do not care how you do it, just do it. that is an impossible task. how can you set a budget without knowing how many patients you will have or what their complaints will be? it is an unworkable system and we have seen it is not working. >> is there a candida's the pool of funds at a hospital can go to a patient -- a contingency pool of funds that a hospital can go to? >> i am not an expert on budgets. i know that people do not get turned away if they have urgent conditions, normally. but i will tell you that there are some conditions which you and i would say are urgent, such as urgent a spinal surgeries in the town of edmonton, alberta. you cannot get an elective spinal surgery because they do not have funds to pay it.

the only way to get a spinal surgery is to go to the emergency ward. if you come to the emergency ward and you have soiled your underwear, you will get service. otherwise, you do not get it. >> thank you, dr. burgess. thanks to our panel. dr. secours kaman thank you for being with us from the uk. thanks for your efforts to be your from canada. and thanks for your efforts in small business and entrepreneurship. we have worked hard to come up with alternatives that we think would make the system work better. dr. secours said repeatedly era -- a phrase that we have been using. i do not know if i have as concise as he did when he consistently said competition and choice drive value. we want more of market factors in the system, more choices,

more opportunities for you to choose your doctor, more opportunities for you and your doctor to choose your health care determinations. we think we're going to have a system where people have many more choices than they have now. karen kerrigan talked about that. small-business owners have been working for years to open of the system where you have all the choices you have now, but also a choices beyond that. and inside the system itself, things like medical liability, health care reform, more medical transparency kamal saving money there as well. we want to see more americans getting health care and a price they feel better about because it is driven by competition and choice. what we do not want to see is the elimination of choice and to come to the kind of government run system we have seen discussed here today. and not just in canada or the u.k., but in any system that is

rationed. they all have lines and they all have developed this two-tier credit system. that is not what america wants. we need to solve these problems. my comments to my colleagues impatience and stayed with those two votes and microphone challenges, and particularly to our panelists and those who travel or stay up later in the evening in great britain to be with us, we are grateful to you. >> thank you, doctor, we're going to hang up the phone. thanks for your patience. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] ç>> the health care bill likely will not see action soon in the

senate or majority leader harry reid says his chamber will not debating health care bill until the fall. but it is possible the house could consider a bill before leaving town for the summer recess. house democratic caucus chairman john larsen plans told a meeting tomorrow starting at 4:00 p.m. eastern to go to the health care measures section by section. according to a cq article, congressman larsen said the meeting will go as long as necessary to answer every question members have. today, alaska governor sarah palin officially steps down. she will turn over power at a ceremony in fairbanks and lt. gov. john parshall will be sworn in. we will show their speeches and the ceremony tonight at 10:00 p.m. eastern here on c-span. >> iraqi prime minister nouri al melichar spoke thursday at a

u.s. institute of species -- nouri al maliki spoke thursday at the u.s. institute of peace. we will hear opening remarks from former assistant secretary of state richard solomon, now president of the u.s. institute of peace. this is about an hour. >> let me just say how pleased we are that all of your here in the room with us this morning. we have an overflow room for obvious reasons, given our distinguished guests. and we are webcast in this event this morning. anybody around the world who has got a computer and knows our web address will be watching this event as well. i think many of you know that the institute of peace has been working on the ground in iraq since 2004.

our programs are designed to promote reconciliation, to facilitate the reconstruction of the situation in iraq, and are -- our work focuses on training iraqi leaders, promoting rural dialogue and interfaith dialogue to transition from the war time frame to a very robust activity of peace building. it is in that context that we are honored to have our special guest this morning. entry introduce him, i want to bring to the podium of the chairman of the board of the u.s. institute of peace, robyn west. >> thank you, ambassador solomon. i'm very pleased to read knowledge the ambassador who is with me, my colleague and friend and vice chairman of the u.s. ip and the other members of the board here on the front row. on behalf of the board of directors of the institute of

peace, we are very honored to welcome his excellency, the prime minister of iraq, nouri al maliki, to speak today about the situation in iraq. i understand the prime minister will take questions after his speech and the q&a will be moderated by dan silver, our vice president for confidence stability operations, was in very active in iraq. mr. prime minister? [applause] >> in the name of god, most merciful, the most compassionate, i welcome all.

and i would like to speak about an experience related to iraq. iraq that went through its leadership in the past and all the stages to today. and major things to place since then. all of these changes really took place now. we're going through constitutional and organizational states. all of the challenges that we have faced.

çand as you may know, the terrorism came to iraq and reoccupied iraq in the sense of making it busy and in order to put iraq backwards. and we have fierce confrontation. and we have fears confrontation with the terrorism and of laws -- our laws.

and when the terrorism took over because iraq was destroyed from the past, and based on this, they found a good forum for them to work in iraq. . .

>> in all sectors, nationalism is respected in iraq. >> we have had four major elections in iraq.

we have the power of the process of rebuilding iraq and the parliament system. the democracy in iraq is unique in the region. the democracy conference's of your rejection from the region in iraq and the regional states.

in order to protect the democratic process, we have to build professional systems. we are building the army. as we were fighting terrorism, we were campaigning to rally all people in iraq to side with the system.

as we were building security in the region, we were rallying the people of iraq into building unions, rallying the tribes in iraq and we have all the iraqi people to integrate as one system. in order to have peace and security, and to avoid sectarian violence, we have had the national reconciliation. it is a strategic opinion toward

building iraq. this is a continuous process. [unintelligible] the national reconciliation found, put the foundation for the harmony of the iraqis. part of that is returning more than 100,000 troops.

and reenforcing more than [unintelligible] we addressed all the issues relative to the ministries and one of them is the media ministry. also reconstructed the army service to the civilian service.

as we were reconstructing of that, more than 96,000. >> and large group of them has joined the police and army and the other portion is joining the ministry and other agencies. [inaudible]

>> national reconciliation has achieved the most of the foundation of what is needed [unintelligible] one of the challenges facing us while rebuilding the state's is the reform [unintelligible]

we are now -- we're headed toward a national reconciliation that can promote the political process.

>> what would be success is the ability of the security forces to have control over security.

the implementation would not have been possible without reconciliation. because of the cooperation between u.s. forces and iraqi forces, it is also a force that could be on standby if iraqi forces need further assistance. we have inherited a country that was loaded with [unintelligible] because of the previous regime -- loaded with corruption because of the previous regime. this was one of the places where we have achieved a great victory

at that level. we have fought a battle against financial corruption and political corruption. by political corruption, i mean interference, regional and international in the affairs of iraq. or by people trying to implement agendas that cannot go along for the national interests. what helps is the national awareness among iraqis of the need to do so.

that success was seen in the latest election when we put forward the national platform as a substitute for any sectarian [unintelligible] the iraqi citizen has proved far demonstrated here she is with the national platform. >> there for the election at the beginning of next year would be based on an international platform that would be along the national tendency as opposed to any sectarian tendencies.

>> our success in the national project is to fight corruption and also restore the forces. >> therefore, our state should be based on security on the basis of security, economy, and services. political systems will be based on the constitution and we will have these foundations to move forward today modern time in iraq.

>> one of the challenges we are facing is the financial crisis. with this, we are facing challenges with developing the economy and providing services to our citizens. >> nevertheless, we have had success in providing services for the iraqi citizens. the average income was $500 and today it has reached an average of four thousand dollars. from a budget that was in 2005 or around $34 billion, today it is that to $79 billion.

with electricity sector, that was an issue in iraq. today is that 22%. >> we have inherited the infrastructure of electricity and sewage system and water, all of this was destroyed because of the adventure and wars. in 2008, however, we were able to boost that and [unintelligible]

>> we have tried to further improve infrastructure in 2009 and tried to improve services and the economic sector. however, we were affected by the global financial crisis because of the drop in oil prices in general. you know that oil has been our sole income in iraq because of the previous regime and policies put into place.

>> we have worked on trying to use the iraqi oil income and we have fought to further contracts, to increase the production of oil and provide the state with further resources. we have sought contracts with various countries and companies in order to boost the construction of infrastructure and find a way to pay off long- term at that level.

>> previously, iraq was known as the land of fire, if you will. nevertheless, with these efforts, iraq is a country where many officials come to visit and had to companies and had said monday capitals come to iraq. this is a country today that is dealing with its regional and international surroundings as a state capable of interacting politically and other levels. one of the transformations is that the international community today has confidence in iraq and has opened up toward iraq.

the return and the reopening of embassies that closed. the visits of senior officials and people through iraq. we have international and regional conference is taking place in iraq and we will have a conference on the international compact that will take place in iraq. delegations from international major companies come to iraq to discuss further cooperation.

iraq was in the past place that was seen to be a place of disturbance and argument. today it is somewhere where people meet to discuss privatization. because our policy is a policy of opening and dialogue toward all countries of the world. we are determined to find a resolution to all issues based on dialogue and mutual interests. to stay away with -- to stay with from other people's businesses and not allow interference in other

businesses. all these achievements highlight what we are today -- a strong country based on the constitution. we would like to think the international community and they countries that have cooperated and helped iraq. >> it was a successful experience that the international community has embraced this country that was torn apart by sectarianism and dictatorship. what you were working on today is furthering the openness toward the international

community and various other entities. we ask for supporting a democratic new experience of iraq. it benefits both peace and stability in the world. >> iraq has become an important factor in peace and security in the world. today, iraq is a peaceful and democratic country that lies -- relies on democratic institutions.

>> our war on terrorism has given us a great experience and we hope the international community will benefit from our experience. we hope it will cooperate but thus on training resources and the rules of financing for terrorism. we hope they will join us in fighting terror. >> we can help prove fighting terrorism, we can remove [unintelligible] we also asked in a special committee to help us in that effort and help with the perspective irresolution pertaining to iraq and move us out of chapter 7.

of course these are transformations taking place in iraq. i do not want paint a rosy picture and say we don't have challenges. we do still have challenges to face. what we can say is we are back in the position where we can face these challenges. we are now moving forward toward solid steps in the future. of course, we still have a long road ahead of us. on the remnants of a dictatorship and infrastructure that is still needs to be

enhanced, it is a challenge. nevertheless, the whole world can see and witness our achievements. we have achieved great strides at the democratic level with respect to pluralism in our country. >> the election has been a great indicator that we have succeeded as a democratic state. we are moving forward.

>> we are at a stage in the history of iraq we -- where the will of our people is clearly demonstrated and our people want a democratic life. they want to be good citizens and fight terrorism. thank you very much and now i open the floor to questions. [applause] >> thank you very much, mr. prime minister. we will take questions from the two microphones and i see people are already lined up. you emphasized in your opening remarks your commitment to a national program for iraq. could you give us an idea of

what that will mean for improving relations between [unintelligible] and baghdad. >> this is a problem that has been inherited from a dictatorship. perhaps it is one of the most dangerous issues that has been a concern for all iraqis. many -- many weapons and -- i am suggesting the kurdish people

[unintelligible] >> if you want to talk about [unintelligible] it has to be away from any sectarian affiliation or [unintelligible] >> the relationship between the kurds and iraqis in general have seen some [unintelligible] and it needs to be resolved.

perhaps there were many concerns more than what the reality was. nevertheless, the stability of the institutions of the states in iraq, these aspirations would not be as much as before. the solutions we found our institutional and foundations for all components of the iraqi population.

>> these are still problems that remain in a mass assault on the basis of the constitution and cannot be solved by force, whether by the american government -- by the iraqi government or the kurdish region government. we will see in kurdistan as we try to resolve the issue is based on dialogue and based on the constitution. >> i am confident we will be able to resolve these issues, not only with kurdistan, but other provinces and we will see

some hope along the way. >> let me move along to the questioners. please be brief. >> i am the editor of the "middle east *." you said in your address that democracy in iraq faces serious opposition. could you explain where the opposition is coming from? >> in reality, democracy and it's true definition is not a system the region was accustomed to.

because democracy is a sound solution in the system that is composed of various components. >> all the countries of the region have various components and i would say that the level of ethnicity and various religious components. we feel that the mechanism is in place -- the mechanism in these countries have not reached the level we have in iraq for

democracy whether the election level or by legislating a constitution and putting forth in a constitution that prohibits discrimination in iraq. >> perhaps will would be the most serious opposition against democracy are those who have been accustomed all along to dictatorship. within our own society, some of the components in the iraqi society. >> nevertheless, this opposition

that was strong at the outset is not as strong as before because democracy has given a strong image of itself, whether in how the state is managed or with respect to equality among all citizens. >> i was wondering, mr. prime minister, what you think the u.s.-iraqi security relationship ought to be after 2011 should there be any form of residual u.s. military presence in iraq. do you foresee a situation where the status of forces agreement may need to be renegotiated?

>> the relation between the u.s. and iraqis is a relationship based on cooperation and all the foundations and rules put forth in the agreement. pursuant to the agreement in 2011, the presence of the americans will [unintelligible] >> nevertheless, iraqi forces require more training, we shall examine this at that time based

on the needs of iraq. i am sure the prospect and desires of such cooperation is found among both parties. nevertheless, the nature of their relationship and the amount of forces will then be discussed and be examined then. >> i'm a senior fellow at the institute of peace and a reporter on leave from the "new york times." there was concern couple of years ago that the prime minister might need to week --

might be too weak and now there is consideration that he may be too strong. there are detentions that may have occurred on the basis of political calculation more than security calculation. they're being targeted because they are opposed to the other -- opposed to the government. what are your concerns and as iraq moves into the election process, what steps to you intend to impose the rule law? >> [unintelligible] iraqis have confidence in us because we have done things

based on the law and not anything based on any ethnic or sectarian background. >> we take into consideration and move along the political process, but for those who are killing people, we will not stop in implementing due process against them. we do have a good judicial system and in modern judicial system for those who commit violations of law in iraq.

>> you are talking about imprisonment, yes there would be violations against the law and against the people. >> the problem is those who are affiliated with political parties are not willing to recognize there committing crimes against other citizens. >> what is a source of concern is once apolitical or sectarian

group was targeted, but this is accountability and holding up those committing violation to the law, this is not of concern to us even if there are political voices that are heard at this time. what is a source of concern to us is those who have caused women to be widowed and cost children to be orphans. these people need to be subject to accountability. [unintelligible]

>> this operation is happening away from any politicization or sectarian calculation. what we have proved so far in iraq is we have done everything without such consideration. >> [speaking by iraqi]

>> the question from the bbc reporter is falling -- the iraqi government intends to send a letter to the u.s. embassy requesting clarification about a protocol that has to do with the holding of talks between rep from the u.s. government and those in opposition in iraq. we have considered this to be as interference in the affairs in iraq and have discussed the issue with president obama? >> [unintelligible]

>> the u.s. government and president obama [unintelligible] against those who killed soldiers and citizens. there will not be negotiations

by the government with those killers. there may be some issues here and there, but we have opened communication with the americans and we continue to talk to them about other issues. >> for those who have committed wrong actions or have been involved in similar activities, we will look into this in the national reconciliation process. we want to that process to find solutions to many of the problems. for those who are involved in spilling blood, they will have to be referred to the judicial

system for the judicial system to give its opinion. >> we are hoping that you have a couple more minutes. three questions. we will take them all together. >> i am from the "philadelphia inquirer." to follow up on the nature of your thinking of relations between the united states and iraq in the future, you talked of a victory when the u.s. troops pulled back from the cities. it seems this relationship is delicate in your mind. in the long term, can you say you want and openly close relationship with the u.s., civilian and military, or does the history in iraq require you to distance yourself from the u.s.?

> [unintelligible] >> in that withdrawal from the cities, the iraqi forces and the american forces, we have defeated al qaeda and the other gangs. later on, the iraqi army itself will return to its own camps and

you only see them on the streets in iraq. >> after all the achievements we have had, we are gain toward success at the political framework achievement at all levels. we want and seek a very strong, solid relationship that is open with the americans and there is no internal politics that prohibits us from having such a solid relationship with a great and solid country like the united states.

>> i'm from the "washington times." last month, [unintelligible] was released from custody. your government was quoted as saying it was part of something agreed to in 2007. is this correct? >> we're going to finish with margaret warner. >> i'm from the "news hour" on pbs. u.s. commanders say iraq has imposed tight restrictionss on u.s. troop movements since the hand over. that prevents them from conducting raids with time sensitive intelligence. even when the safety of u.s. troops is at stake. my question is, did president obama raised this with you and can you guarantee u.s. forces will never be prevented from

defending themselves in whatever manner and their judgment is most effective? >> >> with respect to the release of the prisoner, this is --

there were not negotiations and this was not a deal. this happened within the code of national reconciliation. others were released within at national reconciliation. with respect to the question on a restriction, i am surprised by the media rages -- by the media raises such questions. there is a security agreement between the two parties and this has been agreed on. everything was put in place. >> the agreement is for u.s.

forces to defend themselves. cooperation and coordination is still found at all levels. teams of supporter found side by side with iraqi forces. at any moment when iraqi forces need the help and support of u.s. forces, this will happen at that moment. >> if there's anything arises that is partial or urgent, that does not mean something is not right with the agreement. it does not mean there is a

question for u.s. personnel. >> mr. prime minister, which you allow one more? >> thank you very much. >> i allowed a because she is iraqi. >> the question is from the u.s.

institute for peace and it pertains to political reform in iraq. mr. prime minister, you have talked about this and said that in iraq there should be a particular presidential system in iraq. some of the consensus formula with in the governance there is perhaps it may not be the best. can you give us your perspective on reform in iraq? >> we may need an entire lecture to talk about reform in iraq.

but it is to build a strong united states that is unified, strong, based on the constitution, but that does not mean there is not some particular issue about the vocabulary in the constitution. that may need to look at further. >> we have noticed that the consensus-based system or the parliamentary system may need to fertilize some of the process of the state. >> if we reject a consensus-

based system, that is not suggesting we need to prevent blocks and alliances among different factions in the government. >> nevertheless, let the parliamentary system in iraq, we have found that when it stipulates all those who enter elections must be involved in the formation of the government, we saw -- we thought this may not be helpful much. partnership is needed, nevertheless a consensus-based system might mean that in iraq, a quota system, if you will. a quota system is a system that

might breed sectarianism and other considerations. >> when i talk about this issue, i see that whoever is elected by the people would be there and strong. this might happen with a modification to the constitution. nevertheless, if this does not happen, we will go with the parliamentary system that is in place until we can have some reform.

>> there is a document for political reform in place and i invite the heads of the parliamentary blog this every two weeks to meet and go forward to weaken discuss reform and have it in place if it is necessary for iraq to be a strong country and for iraq to gain more democratic momentum. >> the secret service has asked me to ask you to stay in receipts for a moment while the prime minister and his delegation leave. but before he does that, i think we all owe him an enormous vote of thanks for an extraordinary presentation about iraq today. we wish you well in your future

endeavors. [applause] >> no, i look back at last week's news and what is ahead for this week with a republican and democratic strategist. this is from this morning's "washington journal." madden. when do you are on your way coming over after we saw your tweet. [laughter] steve, what kind of a week as the president had? callerguest: he has had the kinf week when he is the dog that call bus. you have heard that old metaphor?

he is seen what the challenges are of being the president of the u.s. his offhanded been marked gates situation created a furor he did not intend. it took him off his agenda of health care reform for the week. having said that, he is beginning to weigh in on health care reform. he will have to leave the congress through the spring and he still has a very good chance to get it passed. guest: i like that analogy and would agree. to me it was a week where he had an unfulfilled expectations. that is an emerging trend that is, has his poll numbers under assault. by announcing last friday it would do a press conference to hit the reset button and take cannot provide momentum to healthcare by having a press conference on wednesday night, and it was essentially newsless

and resulted on thursday as senate leaders say there would senate leaders say there would not get a health-care bill by the time recess began just showed the president set a very high bar and did not reach it. that has been apparent. this week petered out for the president and congress. guest: there are many people who think as peter doeas kevin doest the press conference was newsless, but with focus groups around the country, many americans out there understand that health care reform understand it to be a party for the white house. they understand what is in it for the 18% of americans who do not have health coverage. but they do not understand what is in it for them. this news conference explained

what is in it for them even if they already have coverage or are a small business owner. that is what people need to here to get behind it more fully. you could see support for health-care reform slipping in polls, especially for independents. people did not understand what it meant for them other than more money to the federal government and through taxes. so it was imported. maybe not newsworthy, but to americans who wonder what is in it for me, there was information. guest: i would agree. it has been interesting to watch the way he talks about health care as a body. it is new to debate. for 25 years now washington has only talked about it as a spending issue. he has talked about it as a principle he hopes to achieve. ultimately, at the end of the day the reason he called a press

conference was to leverage what he believes is this enormous reservoir of personal goodwill that he has with the american public. the more the public learns about the specifics the worst this healthcare plan does. guest: i do not think that is right. host: here is obama's six-month report card. jimmy carter had a 75% approval rating early on. there are many stories this month the bell president jimmy carter's speech. there are some parallels as to whether president obama could go down the same path. are there parallels or is that a false analogy? guest: i think it is a false analogy. the circumstances now are so much different from that. when carter became president

health care costs were not consuming 17% of gdp which they are today. the dicit was not at the level of today. there was not an economic meltdown going on. if you think about what president obama inherited an walked into, he walked into a circumstance that was far, far worse. if you look at where obama is approval ratings are, kevin is right, his turn to leverage approval ratings on two policy. that is what a president must do. he has done that on two or three occasions on big issues whether stimulus package or climate change. that is what being president is all about even if it take a toll after some time. the people in washington understand that. host: your former boss ran against this man.

the peace by edward kennedy co- written by his longtime speechwriter. has his absence been noticed on this issue? guest: i think so. both republicans and democrats would admit that someone who is as deep in the policy of health care over the past 30 years as edward kennedy, that there is an incredible void. you look at governor admit romney's achievement of universal care in massachusetts, it could not have been done without kennedy's help both federally and to guide many democratic members of the legislature in massachusetts to agree. there might have been greater progress in the senate if there were a ted committee up there right now. guest: my former boss and someone who has fought for health care reform his entire

life -- i think it would be different. even during the years i was there and since, and i was there some time ago -- republicans and the senate when polled about the most effective u.s. and the tears always a ted committee to the top of list. it is not because they agree with him, but because he is very effective for his state and effective in the legislature as bringing people together. chris dodd and orin hatch have noted that his absence has been felt. host: he has been there before. caller: he once told me in 1979 when he was fighting for national health insurance, jimmy carter offered catastrophic health insurance for every american.

senator kennedy made a choice which was that that did not go far enough. here we are 30 years later and he has regretted that choice to some degree. guest: as a conservative republican i do not agree with his policies on health care, but there is no doubt he has an incredible amount of experience and deep-seated relationships with people on the hill to get these things done. guest: having come close both times and having this too is very committed to getting this through. even as he recuperates in cape cod from the serious health situation he is engaged in the debate in a way designed to help move it forward. host: here is a photograph from april 12, 2006. in the national review the caller from-- they called rom

ney-care. that is a bad deal even by government standards, they say. guest: that is tough criticism from the national review. there are many things that people -- when it tried to draw parallels between the debate we're having now in washington and the debate he had when it put together this universal health care plan and, there are number of things missing. to take several dollars which were used as direct payments and try to leverage them in a way to create private insurance as an exchange to get people who do not have health care and to private insurance compared to having a lot of the bureaucratic costs and cost runups with carrot that is been handled just through an emergency care

situation. what is right for massachusetts does not necessarily right for everyone else. where governor met ronnie had a departure -- mitt romney -- he did not believe there is a one size fits all approach to health care. it is probably one reason that plans that are put forth here in washington are having problems. you have state-by-state markets that are unique to each other. a federal approach is not the best way. host: this is vice-present joe biden's article in "the new york times."

this came up wednesday night in the press conference. here is an excerpt. >> that and the deficit are the concerns of mine. i am very worried about federal spending. and of the steps we have taken so far have reduced the responding of the next 10 years by $2.20 trillion. it is not enough, but for us to do more we will not only have to eliminate waste in the system -- and by the way we had a big victory yesterday by eliminating all weapons program, the f-22 that the pentagon repeatedly said we do not need it -- so, there and we will have to also eliminate no-bid contracts. but we will also have to change healthcare, otherwise we cannot close that $7.10 trillion gap in the way the american people want us to change.

host: if you listen to sean hennessey or rush limbaugh, this becomes an achilles heel for critics. guest: it is another thing they try to beat the president with. but let's remember what the president inherited on his first day of office. he got a $1.30 trillion deficit. that is not an easy thing to hear. he still has the financial meltdown on wall street to do with. he did not want to come to office and fight for a stimulus package and use all the political capital for it. he did because he understood what it meant for the economy to prevent a meltdown. i'm not an economist myself. but as i read the historical accounts of what was going on just a few months ago there are many economists who believe we were on the verge of a global financial meltdown. he stopped that he stopped it at

some political cost to himself. i'm sure their rush limbaugh and sean hannity and all those who criticize him would have been even more upset if their great fortunes would have suddenly vanished which was possible. he did not have an easy choice. it was not a very good choice. he made the choice to bring the country back and he did. host: you can send us your comments by twitter. do you tweet, the way? guest: i am not a big tweeter. host: you can send us that or an e-mail, or the old fashioned way with a phone call. here kevin madden says, the white house has misread the national mood. the problem is not that they did

not bend the curve, or did not celebrate, the problem is that the national mood has changed since the president was elected. back then the mood was that changes for the good, but what altered or the full implications of the financial crash. guest: that is right. around september 2008 the country went through the idea that they wanted to hit reset, essentially challenge the status quo. they did so by electing someone with very little experience, but someone who had developed a compelling case that there were unlike anything washington had seen before. that was president obama. at that time there was a lot of anxiety about the coming. that turned into a lot of anger when you looked at many of the bailout for aig and bonuses.

now i think that the american mood has turned to cynicism. because they do not see -- they see that this president is somewhat inexperienced and has failed to to launch the status quo and has instead seemed to become a conventional democrat. he has offered almost a devotional, devoted to putting federal spending and to every problem he confronts. that has created a situation now where his numbers have gone down, and congressional democrats' numbers have gone down. even the republicans' numbers have gone down because the public has turned into an anti- washington me. host: here is a photograph of gov. schwarzenegger from a bunker at the new york times,"

and it says that the california dream is dead, or else the lead. here he is with a switchblade and his office in sacramento. guest: he is probably about to turn it on himself. he probably has the most difficult job in america right now. in california they have certain expectations. people live up there because the believe it is the land of opportunity and always has been. it has always offered a lifestyle that is very attractive to everybody who is in search of it. but they have serious problems now. if you look at numbers on education whether science, math, or reading -- california is down with states to spend far less on education. some of the southern states who are usually toward the bottom like alabama or mississippi. that is not what most in california who pay fairly hefty

tax rates expect from the government or their governor. host: we will talk about new jersey politics and not. this is our next caller on the republican line. good morning, mark. caller: good morning, i would like to ask you both a serious question concerning health-care problems. neither party wants to enter. how come no one addresses the fact of what illegal aliens have done to the health care system? these people have destroyed our medical system. 35% of our hospital bills here locally. guest: a number of republicans have addressed this. it is often part of the debate when you break down who the 47 million uninsured are. it ranges from close to 12 million who may be eligible for

medicaid and medicare but do not sign up for. you have between seven and 13 million who are here in the country illegally. you have those above $75,000 and can afford it but do not pay for health care because they believe they are healthy and do not need it. it is an added cost they would rather not have. it is often times part of the republican effort to address who exactly the 47 million people are. had we address those who deserve and need care but can i get it because of the current system. the question for those concerning illegal aliens is how we get people t-- how do we geto

those who are here legally that protect public health. we cannot deny illegal people just because they are here illegally. it is a passionate debate. those people are getting care with taxpayer dollars. many believe we must balance the risks and rewards. host: yet this piece points out that 30,000 legal immigrants were denied care because of a cutback by the massachusetts legislature. this final point, the experience in massachusetts should teach conservatives that individual and employer mandates are socialized medicine with the private facad. guest: it is "the national review -- and i am not

surprised and frankly, not persuaded. the caller is right about the costs associated with and reimbursed care, but they're not the costs associated only with those who are here illegally -- who by the way most of them pay taxes even if illegal. the do not file returns of they do not get refunds. in many instances the government profits from those people. but unreimbursed care is a serious problem that affects health care for a room. if you do not have a mandate you do not have young people bringing down the costs. they do not feel there will get sick and do not feel the need insurance and cannot fill the should pay for it. but if they're not in the pool, then the costs for old people like me and like you, steve, and younger people like kevin go way up. the only way you can get everyone in is by requiring them to be there. it is part of living in a civilized society.

if you'll provide these benefits everyone shares the expense. host: ken is on the phone. good morning. caller: i know i don't have long to talk because i'm calling on the democrat line. host: i am not sure of the connection. caller: the nisei this real quick. let me address two things. i called on the last line but you do not take the last call. -- let me address this request. the sarah palin thing, what you have the discussion i heard people calling in saying that the president is egotistical. how gates is a member of the naacp, and things like that. i do not think sarah palin is qualified i think she probably has some enduring qualities about her, but she does not have the background, even as limited

as the president's is with understanding some national topics -- host: hold on, let me ask both of our guests concerning sarah palin and her resignation. guest: you have to take her on face value. the reason she is doing this -- she has felt that the state was burdened by many of these ethics investigations. her family was personally burdened by it. she chose to step of the spotlight and choose a new forum. host: do you want to follow up? caller: let me ask this about the president. i heard another caller from north carolina say that president obama is considered. do your panelists think he is just trying to be a socialist or

that he really sees -- the medical thing has been around for a long, long time. guest: i think that he sees healthcare costs consuming 17% of our gdp. they are on their way to 20%. 47 million people do not have insurance and that does not include all the illegal aliens referred to a few moments ago. he sees a system that is unsustainable. medicaid and medicare alone, if there growth continues at this rate will bankrupt the federal government. he is trying to step in front of the problem and stop it. many americans do not think it is a serious problem. it does affect them because their premiums are higher than they should be to cover others. they pay more every day as small business people to cover

employees because not everyone is a in. this is a national problem. most other industrialized countries have addressed it. he is trying to address problems he told the american public he would. now that he is president he is trying to keep his word. it is not something many politicians do, but this president has from the beginning tried to keep his word. host: is president obama over- exposed? the guest: i think that the writer in market watch had a very important article about this. one of the amazing things that has happened in washington is that it has become the financial capital and now a cultural capital -- i am sorry, financial, political, and now a cultural capital of the world. by that committee used to be that you turned on cnn and saw the president, you turned on espn and saw baseball, and so on

-- now you turn on espn and there is president obama throwing out the first pitch. you see him talking baseball. u-turn on cnn and he is talking about health care. u-turn on a channel related to popular culture and it is about him and the first lady going to see a play in new york. there is nearly and on the presence by this president. i think it was at first welcomed, but now is becoming a bit of a burden for many folks. it is almost as if they cannot escape the present. if you asked me three months ago i would say no. he had this incredible personal popularity he was leveraging to get things done in washington, but now i think it has become something for people feel they almost cannot escape it on a daily basis. host: hartford, conn., good morning.

caller: i would like to comment before i ask a question. but i have to agree with vidal that there is one corporate party with two right wings, won the republican, the other the democrat. i do not think there is real debate going on in this country at all. it is superficial at best. as far as i'm concerned, no one really wants this done. no one wants a health care plan. but you continue to spend on wars and foreign aid. perhaps you will pay for a new war and iran and get think that health care plans will happen when you are borrowing all this money for iraq and afghanistan, borrowing from china to pay for it. . .

caw where is this debate going? guest: that is a good question. they are still very intent upon

a passing legislation from the house. the folks who represent districts that used to be held by republicans. ca. there are three republicans who are very involved. senator grassley, senator snow. i think the obama administration is hopeful that this could be a bipartisan bill and not a person one. i think they are prepared to pass this on a person the vote. guest: steves comments underscore where i would agree with the caller. everybody on health care wants

health care reform. there is a huge cannon on where some republicans are and were some democrats are. you what -- to ask every member of congress if they want health care reform and they say yes. there is no reform. where i think this debate is going? i think steve is right, the fact is you have a bipartisan effort and deceit leaders like senator grassley and senator hatch all working towards proposal, offering competing ideas. it will continue that way. on the house side, there is an extreme lack of bipartisanship. speaker pelosi has said she will put a bill with a public auction whether blue dog democrats who care about the

cost or not. you know this house some say they have a problem with spending, i also disagree with the caller on that. there is not a person anywhere in washington or capitol hill where outside of washington that does not talk about the economy. they think there is an incredible amount of bail out fatigue, spending fatigue among the public. there is, i think, a gap where the perceptions about that, with every day americans. guest: there is a very large amount of bail out. i would like to point out that under the obama stimulus package there were a number of conditions that wall street did not look -- like very much. the money was accompanied by

warrants. there are banks that are now trying to return the stimulus money and buy the warrants back. the warrants generate revenue for taxpayers. this last round of stimulus could end up making taxpayers billions of dollars because of the way it was structured and the conditions attached to it. there are still some liquidity issues. they are buying their warrants back. every time they do that, the taxpayers benefit. host: corporate ridges, crumbs for the commoners, more and more profit for the oligarchy. the cover story of newsweek magazine out today, available on line. it is called, the recession is over. now we need is a new kind of recovery.

what kind of a recovery will we see. the author writes, a year ago we had a new kind of a recession by housing and finance rather than manufacturing or a weak consumer spending. now that it is over, we will need a new kind of recovery. you can read more from newsweek .com. what did you learn putting this piece together? guest: what is different about this is that the usual tool that we have to get our economy together we have used for the last 60 years, which is the federal reserve cuts interest rates, we deregulate wall street, and finance the movement of trade around the world. all those things are off the table now because we cannot use

those tools anymore. we have a trillion dollar deficit. we should not be cutting taxes. f global trade has been shrinking. instead of consumers pulling us out, they're still spending money like it's going out of style. all the things we've relied on to get us out of the last many recessions we've had, it's like those tools have been broken or blunted or dulled from excessive use. so the question is, how do we get back the growth? there's the growing consensus among economists that the contraction may be over. that's just a technical term. how do we get back to the kind of two, three, 4% growth that actually creates jobs and raises living standards. host: you said until the next big thing comes along, consumers and businesses will continue to do what they've been doing. pay down the debt, restructure, focus on survival.

which by your account doesn't lead to a robust economic recovery. guest: right. the u.s. is different than a lot of other developed mies due to our relatively high birthrate and immigration, our work force is expanding. we have to have 1 1/2 percent growth just to feel like we're standing still. we have to create 140,000 jobs a month to start making a dent in that unemployment rate. we're not there yet. if you extrapolate from the recent past going forward, if people continue to do what they've been doing, which is companies cutting back, focusing on survival, consumers saving -- we're saving at a 7% or 8% rate, versus see row% a couple years ago, that's not going to get us out. the question is, how do we get back there? there are sources of demand as consumers, consumers who are still not partiesing. businesses who are still not really participating. and of course government.

what we have right now is an immense substitution for public capital for private capital. we've seen it in the banking system, but we are seeing it if other parts of our economy as well. >> one other point from dan gross is that the obama administration strategy resting on what some might call industrial policy or excessive government intervention or even creeping socialism. guest: what i would call the last many years of orthodox, you might call them a set of dumb or blunt instruments, tax cuts, cheap money, etc. they're not saying that's not the way to go. the way to go is invest in these strategic sectors of the economy. infrastructure, broad band, health care, alternative energy, green technology. these are the areas that have been neglected, that are vital for political and economic reasons, and that have the potential to catalyze private sector investment. that is the sort of only game in town right now. and it's the big economic -- and

it's big political we because the republicans have basically -- there was not a single republican in the house that voted for the stimulus package. they are totally opposed to doing anything with health care. so this is the big economic question. it's a big political question. host: steve mcmahon? guest: i think dan articulated the view perfectly. basically all the tools we've traditionally relied on and the republican tools that have been in effect for a long, long time -- lower interest rates, wall street deregulation, look where that got us. and the sort of thing that he mentioned was tax cuts. we now have a deficit. we've got low interest rates. and our ability to do things rather limited. what we can do is invest in those growing, emerging technologies. green jobs of the future are where the world is requiring them. they demand innovation. and america needs to step up to the pleat and lead the world

because america always has. and you've got health care, as i talked about already, 17% of the economy. you've got to figure out how you're going to address that cost curve, or you're going to have an economic calamity going forward because medicare and medicaid are going to bankrupt the federal government. i think they're doing what they have to do. they basically were dealt a set of cards that started with a $1.3 trillion deficit for the year that they took office. and they're trying to figure out how they can use the tls that have been used that are blunt and don't work as well as they used to and come up with new toolthat invest in the future. because at the end of the day, america needs to invest in the future and look ahead, or india and china are going to simply pass us by guest: i think where i would disagree with the characterization that republicans don't care about health care, that's just simply not true. again, everybody on political cares about health care. there's just a difference in how we do it.

i think democrats want to stimulate the government. republicans want to stimulate the private sector in a way that creates jobs and everybody benefits. i think that was a big problem with the stimulus. everybody understood that at a certain point, this economy was on the precipice, that we were on the knife point, and we could have fallen off, and falling off that knife point either way would have been disastrous. but republicans believe that the stimulus plan dimlated the government. there was a focus on the government side and not enough of a focus on the private side. i absolutely agree with steve and i think there are many republicans that would agree, that we do need a comprehensive effort of investment and a new energy sector in this country. that was something that governor romney talked about extensively in places like michigan, a new energy sector, which is going to be sustainable growth in the economy, going to continue to

create jobs, as we look for ways to get off of the way we've always been fueling this country on the energy side, an look at new ways to help that. so i think there's agreement there. the big fundamental disagreement is whether or not we should stimulate the government versus the private sector. host: online this week is the cover story for news week. called the recession is over. now what we need is a new kind of recovery. we're talking to dan gross, who is on the phone from new york. how is westport, massachusetts, indicative of this recovery? guest: we did some reporting to try to find places where the stimulus is actually hitting home. we found a construction company that had been laying off people. they work on roads and other types of construction projects. it's been a rough two years for them. they've been on a dozen or so projects for the stimulus package. they got two. one of which is a $4 million road resurfacing project in westport, massachusetts, which

is a town sort of a few miles from the beach, about 60 miles south of boston. they've hired five new people. they have a bunch of contractors on the job. so they've been able to -- because they got these two projects, have been able to maintain all their employees, bring on five new employees with full benefits, and, you know, it's turning out to be a better year for them. to me, that is sort of a microcome. , because we are continuing to lose jobs. unemployment claims are continuing to rise. focusing on the consumer, giving people tax cuts in an environment like this, where they are hugely in debt, does not translate into new spending. it doesn't translate for consumers, doesn't translate into new spending for businesses. like it or not, the main source for now of new investment is the government. because private capital is not going to come in and build roads and their not going to build it in the factories because less

than 70% of our industrial capacity is being used now. so we saw that looking at sort of that project, that company, and this is a small victory, and this is way it's going to have to go. you know, projects, companies here and there creating a small number of jobs, and we have to hope that eventually that cat tallizes and schmo balls into something larger. host: dan gross, writes for news week, senior writer and columnist, the cover story. thank you for joining us. marie is joining us from palm springs, california. you're up awfully early this morning, marie. caller: well i had lunch yesterday with a canadian friend. lives her now, her husband was a physician. and they moved here when canada became socialized. how are we going to have health care without doctors? a lot of the doctors are not in favor of this. when you're in canada, she

personally knows people that have had cancer, have had to wait three months for treatments, hip replacement. her sister has to wait three months. it's not as good as it sounds. are we going to provide health care for illegal aliens and all the welfare recipients and we're going to punish the achievers, people that have done well and tried hard and just giving -- we're just going to have to wait in line for care and it could cause a lot of deaths. it's not a good thing. not as pretty as it sounds. also the mean-spiritedness towards sarah palin i think is over the top. they used to try to hang that title on republicans that were mean spirited. the left has it now. letterman, for instance, and all kinds of people, just because she has a different lifestyle that they don't understand, living in alaska. host: thanks for the call. tom price will be joining us later if the hour. does anyone know that interest on the $11 trillion debt, that alone could have paid for health

care for everyone. let me turn to politics for a moment and ask the same question i asked about president obama. kevin, what kind of a week have new jersey politicians had? guest: i think there's probably a lot of them now that are on phone calls just assuming that they're being bugged or tapped. i think this was a good week for any politician who was a former prosecutor against corruption running for office. so i think chris christie probably had a very good week. i think there is also a way to make a case that chris christie represents a sort of modernized republican approach in new jersey, where you put an emphasis on law and order, you put an emphasis on job creation, the economy, jobs, health care, education. and that's where a lot of voters will -- a lot of voters are going to gravitate toward a message that is pragmatic and about cleaning up a state

capital that they think has totally lost touch with the folks of ngng and is not focused on providing -- new jersey and is not focused on providing solutions. ultimately it was a pretty good week for chris christy. host: the polls show that jon corzine is down. guest: i think what he's seeing this year is what president bush saw last year. there are people in new jersey who feel like their economic condition isn't imprufinge fast enough for their case and they're ready to take a chance on something new. i think governor corzine, however, has a pretty compelling story in terms of being able to manage a fragile economy. this is something who did quite well for himself in private business, who understands the economy, who understands how to bring pressures to improve it. the economy in new jersey isn't improving as quickly as they would like, but it's not improving as quickly as most americans would like either. i think you'll see a lot of

governors, democrat or republicans, who will begin to feel the effects of an anxious and discontented public. guest: so when it comes to corzine, you guys like the private sector? guest: we like it respectively. we just finished talking to daniel, and the stimulus money, which kevin says is going to the government, is going to companies like daniel found in massachusetts that are creating jobs, investing in infrastructure. everybody who benefits, the people who get jobs, the businesses who hire workers, and the people who drive across those roads and businesses, are all benefits from the stimulus package. host: good morning, independent line, with kevin madden and steve mcmahon. caller: thank you for the opportunity to talk about health care. you quoted an average of 2,600.

i saw $20,000 for a family of three children. i don't know where this is going to go. the numbers that -- like the ladies from palm springs. if i was in canada, of course i like to move to palm springs. say the hip replacement has to wait for three months, i had insurance here and i had to wait forever for a doc. about illegal immigrants. how many illegal immigrants do we have that take care of it thelses? -- themselves. so health care needs to be reenergied.

the other day i went to the emergency services and i was not seen by a doctor. i was seen by a nurse. and i was charged as if i was seen by a doctor. host: that seems to be part of the problem. the rates that you're being charged by health care providers, hospitals, doctors, urgent care. caller: the rate is super high. we are thinking here that we live in a competent society. we are living in a society where -- host: thanks for the call. the our issue is that tort reform is not part of the democratic plan and should be? guest: that's right. if i were to sum up his frustrations right now, it's cost. costs are driving this debate right now. i think if you look at the grab between people's personal assessment of the -- of their

health care, some of them feel that it's good and they like their doctor, but they wish they could pay less, but they think that the system is broken. i think right now if they had to choose, they would look at their own costs. that is where this debate is being driven right now. i think that the fact that this bill, the proposals that the democrats have put forward on capitol hill, even according to c.b.o. sthat estimates, doesn't do anything to solve the problem. more than anything of the little inside washington bickering that we talk about on capitol hill, it's filtered back to the american public very easily, that this is a very big bill that costs a lot of money that doesn't do much to reform the current system. host: the tweets are coming in. could you republican guest send chris christie over to pennsylvania before running for governor in new jersey? guest: well, you're a pennsylvania native. my wife is a pennsylvania

native. i'm sure they would love to have somebody who is a foreminded republican in the commonwealth of pennsylvania. host: let me just ask steve mcmahon. you've been to pennsylvania. guest: yes. host: the wimes wrote a story about the race in virginia. the two states that have a statewide election this year. what's happening in virginia politics? guest: what's happening this virginia generally is it's becoming more of a democratic state. it's purple now. it used to be a very reliably and conservative republican state. it's now much more competitive. president obama carried virginia this last time. and i think what you're seeing is you've had two governors now, governor warner and governor tim kaine, who have been fiscally conservative, pragmatic and moderate, so the democratic party in virginia is actually in very, very good shape. the economy is not in particularly good shape as it is not in very good shape around the country, so in some measure,

the democrat perhaps has a slightly more difficult time. this is a rematch of what was run four years ago for foreign general, creigh deeds against mcdonald. it is following the same kind of script. the traffic here is second only to los angeles in terms of what a mess it is. and many people in northern virginia feel like the government in richmond hasn't addressed it adequately. i think that favors the democrat. but there's no question it's going to be competitive and close and going to go down to the wire. host: just looking at it, is deeds the strongest of the three potential democratic candidates? is he the one candidate that -- guest: i think it would have been a much easier -- there would have been a greater opportunity for bob mcdonald to

draw contrast. i think that this is one of those things where many of the democrats in virginia -- the reason he closed so quickly in those days, being outspent five to one, was that many democrats saw him quite electable. can is quite odd because usually campaigns and primaries like that are where the base looks at, who represents the constituents of the party in virginia. the one really came down to electability. and i do think that steve is right, that virginia's demographics have changed. looking at northern virginia changing demographics. even parts of southeastern virginia. but what's still important to remember about virginia's electorate is that the middle is where the big battlegrounds. this is going to be essentially a race to get that growing sector, that has fall an away

from both parties and is looking for pragmatic leadership. host: we're talking about virginia politics. the story this morning available online at the wimes website. it's also front page this morning in that newspaper. rock anne is joining us from -- roxanne is joining us from cleveland. caller: i don't know why they keep saying that canada's system is so bad. i mean, we have nothing -- i am able to afford my own -- i mean, i can pay for my own insurance, but i cannot afford it. it's too expensive. republicans do nothing that helps the poor and middle class. absolutely nothing. i haven't seen their plans. they have absolutely no plan. and they are being pimped by big business. why aren't they talking about how insurance are denying people coverage every single day. they're make your lives hell. another thing i'd like to say,

obama is not any passing an insurance plan. why don't they make it where we can g across state lines and buy our own insurance. host: i just came back from a tour of canada and spoke to every canada i saw and talked to them about their health care and they loved it. guest: people say, well, canada, they have government care. england has government care. well, they have much smaller populations than the united states. we have right now, competing with private insurance and coverage in this countrying something like 253 million people. i don't think canada even approaches anywhere close to that number of people being covered now. if you were to add 47 million, assuming that that number is in there into a public system, that would dramatically change the quality, the access, and the cost of care in this country. so i think you have to remember that you have to look at the unique populations of the united

states versus places like canada and england, that have socialized medicine. i do disagree with the caller that republicans don't have a plan. if you were to look at paul ryan's plan from wisconsin, if you look at a number of folks, even a bipartisan bill up on the senate side. widen bennett. there are a number of plans that look to help state businesses or pool their resources so they can get into association health plans. there are cooperative plans, such as senator charles grassley has. all intended to help people pool their resources, lower the cost, and ease the burdens for folks so that whether it's employers or individuals so they can help bring down the cost of their health insurance premiums. guest: there are some republicans on the senate side who are trying to come up with a bipartisan solution. i just would like to say

something here about this canada conversation. because there's not a single democrat i'm aware of who's talking about the canadian health care system. what they're talking about is building on the system that we have, the american system. a system that's based fundamentally on private insurance companies delivering care, not the government delivering care. there's not going to be any government takeover of anything. there's going to be an effort to reign in costs, to make sure that everybody is covered and require businesses and individuals to have coverage so that everybody comes into the system, the system operates the way it operates new. people get to choose their doctor, they get to choose their health insurance plan, they have a choice op options in both regards, and they essentially get everything that they like about the health care system today and they address many of the things that they don't like. health care reform, for instance, the health care reform we're talking about now, would not make it possible to deny somebody coverage for preexisting condition.

everybody who wants coverage would be able to get it. and if you're sick, you wouldn't pay any more than somebody who's not sick. it would address the things that people are frustrated by. it would do it in a way that people are comfortable with in the american way. it wouldn't bring the canadian system here. it's utterly untrue. guest: well, i think you also have a lot of democrats that point to the canadian systems and other systems, whether it's germany or england, as templates for some of the changes that they want to make. guest: other industrialized countries addressing a system and the health care crisis in those countries. every one of those countries that you mentioned provide just as good of care at a much lower cost and everybody is in. and i think those are the things that the democrats that i speak to are trying to accomplish in this country, not by bringing the canadian system here, but by improving -- guest: it's not just limited to republicans who bring it up.

host: this is an aside. dick morris' book, catastrophe, stopping president obama before he transforms america into a socialist state. number three this week. guest: how is it that the conservatives write book and they shoot to the times. guest: dick morris is a conservative? machiavelli's political consultant. host: walter, last call. what's on your mind? caller: our present insurance companies will continue to exist, but they cannot exist when the government throws out the standards that they presently use and insert the government requirements of taking bad risks and covering everything. and who's to decide when a cancer cure costs $250,000 for an elderly person that prolongs

life for three months? rationing is the way they're going to save money and they don't admit it. host: thank you. let me take walter's point and ask you, we're still six months away from 2010. where do you see all this heading when we go to the next political cycle? guest: i think a lot of it depends on what the final product is. i think i'm probably in the minority of republicans who believe that there will actually be some sort of bill at the end of this year, because i think the president has indicated that he's defined a win by getting some sort of bill he can put his signature on. i think ultimately that will result in a very partisan bill because i don't think if you look at any of the comments of the public postures of harry reid and nancy pelosi, and they're indicating they're more and more likely to sign on to a partisan bill. so i think ultimately democrats will put forward a bill that has a lot of health care, a lot of spending, very little reform,

and that they'll pay a price in the 2010 elections for that. host: steve mcmahon, you get the last word. guest: i think he's wrong, how about that? i'm still hope. there will be republicans who come to table saying let's do this as americans, not democrats or plans. we have to. we simply cannot afford to do nothing. host: steve mcmahon, frequen and the state department acting inspector general on the cost of operating the u.s. embassy in iraq. u.s. policy in afghanistan with larry korb.

washington journal begins live at 7 eastern. at ninth, a look at the economic impact of obesity, the centers for disease control and prevention is releasing a report on obesity prevention and control. >> how this is been funded? >> publicly funded. >> donations may be? >> government? >> suspend its funding through federal funding, if funding -- public funding? >> america's cable companies created c-span is a public service, a private business initiative, no government mandate, no government money. >> now, remarks from rnc chairman michael steele. he spoke earlier in the week

about president obama's health care plan. this is about one hour. good morning. welcome to the national press club. i am a reporter with usa today and i am president of the national press club, were the lead -- world's leading organization for journalists. we provide informative programming and journalism education and fostering the free press worldwide. for more information, please visit our website at www.pres.org. on behalf of our members worldwide i would like to

welcome our speaker and our guest today. .. ng forward to today's speech and afterwards, i'll allow as many questions as time permits. for our broadcast audience, i'd like to explain that if you hear applause, it may be from the guests and members of the general public who attend some hour news makers and not necessarily from the working necessarily from the working press. our guest today took a twisting path to politics. at johns hopkins university in baltimore, michael steele was class president and a member of the fencing team, but nearly was expelled when his social life eclipsed his academics. he later studied forth priesthood atville know have a, before turning his attention to law at georgetown university. a corporate finance attorney by profession, mr. steele founded his own company, the steele

group, a business and legal consulting firm. formerly lieutenant governor of the blue state of maryland, he mounted a very strong challenge for the u.s. senate seat in 2006, losing out to ben cardin. in january, mr. steele was elected chairman of the republican national committee in a close-fought battle that went six rounds of balloting. he is the first african-american to hold that post. with a republican party in the political wilderness, mr. steele has jostled for a prime spot in the conservative limelight with such figures as rush limbaugh, and sarah palin. today, he has the stage to himself to talk about the republican alternative to the democratic plans of president barack obama and the party's congressional leadership regarding the critical subject of health care reform. raising the stakes of this debate, president obama has promised a health care bill by the end of the year.

the non-partisan congressional office said democratic plans do not reduce the spiraling cost of health care programs, as the president has said he wants. this wednesday, the president will be holding a primetime news conference to try to take command of the health care agenda, following criticism of his input or lack of it from democrats on capitol hill. mr. steele now has the chance to get ahead of the president and seize the agenda for republicans by putting forward an alternative to what the democrats are proposing. please join me in welcoming michael steele to the national press club. >> thank you very much. good morning. it's a real pleasure to be here and i appreciate the national press club offering this opportunity to address one of the most fundamentally important issues in generations that our country has to face. president barack obama is a good man, and cares deeply about this country, but he is determined

with an unprecedented single mindedness to transform it into something none of us would recognize. candidate obama promised change. president obama is conducting an experiment. he's conducting a dangerous experiment with our health care and with the quality of our lives. he is conducting a reckless experiment with our economy and he's conducting an unnecessary periment with our tax dollars, experiments that will transform the very way of life of our country and its citizens. the president is rushing this experiment through congress so fast, so soon, that we haven't had a moment to thousand if it would work, or worse, to think about the consequences to our nation, our economy, an our family if it doesn't work. the barack obama experiment with america is a risk our country can't afford. it's too much, too fast, too soon. surveys show that a solid majority of americans are concerned that president obama

has no strategy to reduce the deficit. perhaps that is because president obama's strategy is to increase the deficit. in only his first six months, this president's first budget has sought to take on nearly as much debt as we have had taken upon ourselves in the entire history of our country. the deficits for this year alone will be the highest in u.s. history. nearly five times as much as it was just two years ago. his economic experiments have left all of us and generations to come with a staggering bill and the obama experiments are not working. so far, the experiments in that economic laboratory called congress have simply failed or blown up. president obama told us that a stimulus package would keep unemployment under 8%. it's down at 9.5%. and now he tells us that unemployment will go well, to

12% anyway. that experiment cost us $787 billion. to 3 to understand the enorm of that number, consider this. the interest on the stimulus package, the interest alone, cost us nearly $100 million every day. president obama has committed to borrowing trillions from foreign creditors. in return, they get the lion's share of our future economic output. in short, our children will be working to improve standards of living not here in america but for our foreign creditors. let me quantify that a bit. in a typical year, the total profits for all american businesses amounts to 6% or 7% of gdp. president & 's own budget projections -- >> that means that even assuming relatively benign interest rates, which is no safe assumption with all the inflationary policies, the president has pursued, roughly

5% to 6% of our gdp will go to paying interest on our federal debt. that means, in short, capital roughly equal to all the business profits in the country, capital that historically has funded the expansion of our economy and enabled us to improve our standard of living, will go instead to our creditors, largely china and opec to expand their economy and improve their standard of living. mr. president, you're putting your party's entire big government wish list on america's credit card. but that card comes with a bill. it is more debt our children will have to pay, because this reckless administration has an unrestrainable urge to splurge. when president obama faced a credit crisis, a struggling economy, a housing bust, bankrupt auto companies, wall street failures, whatever the problem was, he re responded by

spending, spending, and more spending. and now our president is proposing more did you not, morrimore risk, more experiment. his next item is a pull at this trillion dollar experiment with our health care, including a government-run health care plan. it not only risks our economy, it risks every american's health too. president obama says he wants to reduce health care costs. well, republicans agree. health care costs waste too much. health insurance premiums have risen three times faster than wages. health insurance is costing families and businesses too much and certainly we have to fix that. but here's my question. how come the democrats' plan to save money will cost us more money? how come their plan to reduce health care costs will cost us trillions more in tax dollars. democrats boast that their plans cost only about $1 trillion. now you need to consider the

absurdity of that idea alone. but that assertion is based on a deliberate ms. reading of the date -- misreading of the data. the non-partisan congressional office, projections to which they refer, are for the next 10 years, but the democrat hes' plans are only fully implemented towards the end of that window. according to cbo's best plan, once this plan is fully implemented, it will cost hundreds of billions of dollars each year. in the case of the house bill, $202 billion in 2019 alone. and note that i said best guest. the thousand plus page house bill was not released until less than 48 hours before markup and cbo said that it still had not completed its revenue analysis. for example, cbo stated, we have not yet estimated the administrative cost to the federal government of implementing the specified policy, end quote. in other words, the staggering

costs estimated by cbo does not even include one of the biggest expenses in the bill. only washington could make saving money more expensive. it doesn't matter if your insurance charges you more through the front door in higher premiums, or whether president barack obama charges you more through the back door in higher taxes. it's the same thing. under the obama-pelosi plan, costs are going up, and you, the american people, are going to pay. let's just use common sense here. when was the last time washington ever made anything cheaper. or cost less. if you're a small business owner, you will see a tax hike on your income, your payroll, and you were investments. all of which won't help you to grow and create more jobs. if you're a senior, you face $400 billion in medicaid and medicare costs. if you're working, you face $600 billion in new taxes. and they're just getting

started, folks. some democrats are even complaining that they're not raising taxes enough. if you get health coverage at work, they actually want to tax your health insurance. but they're not finished. if you're thirsty, they're considering a 10% tax on a can of soda, and if you need a stronger drink, after hearing that bad news, i've got more bad news for you. they're thinking about raising the alcohol tax too. in addition, they're considering a new tax on employers equal to 3% of payroll, also under consideration is the value added tax, a sort of national sales tax of up to 1 1/2% or more. now foolish me, all this time i didn't know raising taxes on something actually made it cost less. that's like those commercials that promise you can eat all the cake you want and still lose weight. who knew? a good doctor though makes a thorough diagnosis and prescribes a remedy that is specifically targeted at what

ailes the patient. if you come this with a sore knee but are otherwise healthy, the doctor doesn't remove your kidney, put your arm if a sling and perform quadruple bypass surgery. and above all, for thousands of years, physicians have pledged to adhere to one principle above all others -- first, do no harm. we should approach health care reform in the same way. we must specifically target reforms at what ails our system. do no harm to what is right about it. in fact, p about our health care system is in very good shape and we should make sure those aspects are strengthsened, not eliminated. currently $250 million americans have health he insurance, the majority through private insurance and polls show they are overwhelmingly pleased with their current coverage. second, america is home to the high of the quality and most innovative health care in the world. now, you don't have to take my word for it.

ask the saudis receiving care at johns hopkins, the canadians at the mayo clinic or the british at mass general. or ask the committee that awards the nobel prize for medicine. over the past 25 years, the vast majority of honored researchers have been americans. so what is the diagnosis for what ails our health care system? the problem for which we must provide a remedy. in a word -- cost. we spend a colossal amount on health dare. over 15% of our gdp. the next highest industrial nations spend about 10%. and for that amount, in the aggregate, we have similar health outcomes as countries spending less, when measured by such metrics as life expectancies. our uninsured are a symptom of that cost problem, a problem senator daniel patrick moynihan once characterized as health care costs disease. for certain, some of our uninsured have the means to purchase health insurance, but unusely choose not to in the

hopes that well, they'll stay healthy and save money. others qualify for government assistance, but for various reasons, do not receive it. but for most of the uninsured, the problem is easy to diagnose. they just can't afford the insurance. yet, president obama's response is to make health care insurance even more expensive. let me throw another statistic at you. one that remarkably receives little or no coverage from the media as far as i know. according to the latest cbo estimates, under the house democrat version of the health plan, after it is implemented, the cost of insuring each additional individual would be nearly $30,000. and amount far greater than the average annual cost of insuring an entire family. in fact, according to the henry j. kaiser foundation, the average cost for a family of four is about $12,800.

to add insult to injury, every version of the democratic health plan, even after spending trillions of dollars, will leave millions still uninsured. this shifts the cost to the taxpayers, to our children, and to future generations that will have to cope with this crushing debt. by implementing huge subsidies and establishing a health-care plan. in fact, the president's plan describes the short-term pain relief instead of treating the source of the pain. he was a doctor, that would be malpractice. than the plans those americans have now. don't believe me? then believe president obama. on the town hall a few weeks back, president obama refused to pledge he would limit his family to getting the same cures and treatments his plub plan 0 would give the rest of us. now if the president doesn't have faith if his own plan for

his own family, how can we trust this plan for ours? the american health care system should not be more like the european health care system, where patients who are over 70 are told no, you're too old for cancer screening, where sick people are told you have to wait in line for this test or that medicine. no thank you, mr. president. the president tells us that he just wants the government-run health care plan as another choice to compete with health care insurance you have now. he says you won't be forced to join but his plan does exactly the opposite. in fact, the president's proposal creates yet another government czar. what are we up to, 20? who will push government run health care wile dictating to your private insurance company how they should operate, the insurance coverage they should provide and which health care services you should receive? now, we all remembered harry and louise. harry and louise helped save us

from hillary clinton's health care experiments in 1994. this year, harry and louise have been replaced by another couple, harry reid and nancy pelosi. harry and nancy aren't really doctors, they're just trying to play one on capitol hill, by experimenting with health care and insisting on a big government takeover. now say you have a job in grocery business or office store or a hardware store. imagine if the u.s. government knocked on your door and said, hi, we're opening up a business right across the street, and it will be a government-run store, we came here to compete with you. and we're going to have to lower prices a little bit cheaper than yours, because we're the government, and quite frankly, we don't have to pay our bills. we'll just leave them for your children to pay later on. how do you think your store will survive? how long do you think you will stay in business? how long would you have your job?

when big government competes, one congressman said, it's like an alligator competing for a chicken. and the health care you have now is the chicken. simply put, experts tell us president obama and the congressional democrats' run plan could lead to 119 million americans being dumped out of their private coverage into a cheaper government run health care program. that's why they're forcing members of congress to vote on legislation to reshape the economy in a fundamental way before a single member of congress has even read the bill. now, i don't know how you read let alone understand over a thousand pages of legislative text in a few hours. democrats are determined to shove this bill through without permitting any meaningful scrutiny. that's why they are cutting republicans out of the pro he is he is. -- process. the democrats have no intention to have a bipartisan bill. they never have. the president has arranged to

have nice photo ops, but that's just about it. back in 1994, when hillary clinton tried to jam a massive health care bill down congress's throat, senator bob kerry, gave a speech on the senate floor in which he flatly stated that he would not vote for a bill that would have republican support. now, i'm waiting for a democrat, any democrat, to show that sort of com courage today and please done throw up the blue dogs at me. their press releases may talk about fiscal responsibility, but in the end, they have been nancy pelosi's he is most reliable voting block. and don't tell me that republicans are unwilling to support a responsible health care reform proposal from a democrat. the very first major health care reform bill introduced this year was written by senator ron wide i don't know, not just a democrat, but a liberal one, but his bill had good ideas and has drawn as many as republican

sponsors as democrats. republican support health care reform that addresses the biggest problem in our system -- run awe way cost. we don't need to spend more money on health care, we already spend more than the rest of the industrialized world. what we need to do is spend it better, starting with a third party payment program, that limits choice, and misal indicates resources -- misallocates resources. we wants the 60 million americans that have health insurance to keep that coverage. we want people to choose their own doctors and make their own choices regarding treatment option. we want to focus on health outcomes, keeping people healthy through preventive care and promoting good fitness and nutrition. under the obama plan, the vast majority of americans will pay more to get less, it's that simple. we will spend trillions more, trillions, and the 260 million americans who now have insurance will have fewer options and

worse care. and we still won't cover all of the uninsured. this is one sixth of our economy we're talking about. if we screw this up, it could last a generation. and congress is trying to do this in the next two weeks? they want to get a bill done in the next two weeks? this is -- this reckless approach is an ill-conceived attempt to push through an experiment and all of us should be scared to death. so slow down, mr. president. we can't afford to get health care wrong. your experiment promotes -- proposes too much, too soon, too fast. your experiment with our health care could change everything we he like about our health care. and our economy as well. so it is time to stop the experiment with our economy and our health care and our future, mr. president. if you will only slow down long

enough to see a better way. a better way of helping our families and businesses get hold of and bring down health care costs. republicans stand with the growing number of americans supporting the patient-centered health care reform movement. we believe of the patient centered health care reform movement offers the best way to reduce health care costs bottom up. with patients and doctors in control, not the government. the old top down washington senate system the democrats propose is designed to grow washington's power to restrict the cures and treatments your doctor can prescribe for you. the president wants to make health care more affordable, so do we, but republicans have a completely different vision of how to do it. republicans support simple common sense fixes without the big washington experiment. obama, pelosi want to start building a colossal closed health care system where washington decides.

so, mr. president, let's talk about some common sense reforms that the american people and their doctors can trust. let's have doctors and hospitals post pricing and outcomes. in this day and age, why aren't the costs of all tests, treatments, procedures and office visits, as well as effectiveness of treatments posted openly on the internet? that will bring down costs. and how about if we make health insurance companies compete with each other with simple, understandable contracts, and minimal benefit packages, so insurance is simpler, cheaper, and fairer. just like many banks are doing with car or home loans, and why not put in place a simple, one page reimbursement form, so folks can navigate a little more easily. that will bring down costs. and let's protect doctors from frivolous expensive lawsuits, so they can work together with other doctors and patients if their communities to reduce unnecessary and expensive test

procedures and costs. i appreciate the president's very brief flirting with tort reform. we'd like to welcome you back to that tort reform table, mr. president, because that will certain brings down costs. then we change the law so you can take your health insurance with you if you have to change your job. eliminating expensive and unnecessary insurance turnover. that will bring down costs. and we cut out the washington health care middleman, reducing expensive bureaucracy to produce big health care savings. that will bring down costs. let's support new paperless computer age health care i.t. systems to reduce the cost of health care management, as well as reduce medical mistakes. that will really bring down costs. and let's make sure every american has equal opportunity to get the best value and buy the cheapest insurance, no matter where he or she lives, or horhe or she works for. let's change the law, so any

american can buy the lowest cost insurance available nationwide, not just in their state, whether from insurance companies, businesses, church groups, college alumni associations or groups like aarp, who often provide it a lot less expensively. guess what? that will bring down costs too. and don't you agree that companies like target are best suited to bring down costs than any politician in washington? so let's use consumer buying power and washington buying pour power, to bring the cost of health care down. let's support a bipartisan idea, effective prevention, wellness handy stacey management programs, because they will improve our health too. and that will also bring down costs. let's support bold new incentives for companies to develop new treatments and cures, because that is smarter than paying for a chronic, long-term illnesses we can't

cure today. that will bring down costs. every american should also get a tax credit for their health insurance premiums. certainly that will bring downs costs. but further, under current law, employees not covered by health care plan, a group which disproportionately includes the working poor, cannot deduct the cost of insurance premiums. incredibly, rather than remedying that injustice, the democrats make it illegal for anyone to purchase a new individual plan. we believe in bottom up up health care savings for the middle class and the working poor. and here's another idea. how about we give small businesses the same cost saving break big businesses get by helping them form small business health plans and small business health co-ops. guess what? that will bring down costs. then let's support tough new penalties against anybody who rips off the health care system, whether they are corrupt big insurance company executives, unethical physicians or patients

or government pen pushers. guess what? that will bring down costs too. an one more thing. no lifetime health care benefits and insurance for congressmen who leave their jobs, unless and until everyone else in the country gets to share in the same benefit. that's the right thing to do. and it brings down costs. now, i know president obama has some tough challenges to get that, we understand that, and the president tells us, he doesn't want to spend more than we have, he doesn't want the deficit to go up, he doesn't want to live off borrowed money. but he also told us, he didn't want to run an auto industry. the president has insisted every step of the wave that his health plan will not add to the deficit, but just last friday, cbo concluded that the obama-pelosi plan will add $239 billion to the deficit by 2019 and hundreds of billions of dollars there after. that means, according to cbo,

not michael steele, the obama-pelosi plan does not do either of the two things the president swore they would do -- contain costs, and not add to the deficit. president obama justifies this spending by saying the devil made him do it. he doesn't want to spend trillions we can't afford, but he says he just can't help it, even though he says he believes in less spending, he says he has no choice but to spend even more. even though washington is on fire with spending, he said he's compelled to conduct this experiment with reckless spending and pour more gasoline on an already growing fire. mr. president, the time to stand by your principles isn't just when it's easy. you need to stand by your principle with it is not easy. the time your character is tested is with doing the right thing is tough. :

>> you are important actors in this process. you should not sit on the sidelines and just wait for what happens to you. in short, yes, you can. show washington who is really in

control of america's health care. in america, we do not allow one man to roll the dice with our entire nation we do not allow one political leader to risk all health care system in ereck higher economy. we cannot allow one political group to get with the fate of generations. we have a novel -- never allowed one party to experiment with the future of our country until now. it is time to hit the pause button on this reckless experiment in our health-care system. this type of experimentation is not what america voted for and it is time to put this bill that on the shelf. experiment on the shelf. today the republican national committee is at unveiling a multi-campaign america's about the risky experience that the president is conducting on our economy and our country. we are taking our message directly to you, the voters out there, through our new website, www.dot barack obama

experiment.com your and your advertising such as the tv ad that we are launching today. so that you, average joe and jane, understand what is at stake and what this administration is about to do to you and your family and your community. we want you mobilize and we're going to mobilize voters to oppose further extermination on the economy, especially health care. voters may want health care reform, however, they don't want this kind of reform. today, we are faced with a lot of challenges. we are stymied with increased costs and burdens that some can't bear. many democrats outside of the obama pelosi reid waxman, know that voters won't stand for these kind of foolish prescription for our health care or for ourselves. we do to. that's why republicans will do everything humanly possible to

remind voters about the risky experimentation going on in washington and we all must do to keep members of the house and senate out of the laboratory. this is a time of great economic uncertainty. this is the moment when the very structure of the global economy with the depends on our economic might is being challenged. we will get through this global economic storm. but then we will have to compete and win in a new global economy that is going to grow dramatically in size and complexity in the next few decades. who is going to get all of that prosperity? america or someone else? who is going to own the new economy with more women and minority's, the middle-class expanding and the entire workforce earning bigger paychecks as we build a wealthier world? who is going to own the future, the coming era of promising, the most powerful economic and technological growth the world has ever known? who is going to lead a world where health care is transformed

into people live longer and healthier lives, building upon the most valuable resources on the planet, the human resource that transform nations and continents. who is going to settle a new global frontier of peace, prosperity and progress? i say we are. we, the american people. and i'm telling you there isn't anything before us we can't achieve, any challenge we can't overcome. so be optimistic, for the opportunity before you now dwarf the opportunities our parents had. there are numerical's of science to be found in america will find a. there are new jobs we cannot imagine and americans will create them. there are new economic frontiers to be settled, and yes, americans will compete and win them. the greatest time to be in america, and american, is before us. all of us here today have a great and noble purpose.

as our country calls upon each of us to rise to this critical moment and keep america the greatest and healthiest country in the world. thank you and god bless america. >> will go to some questions. if you have some more questions, feel free to pass them up here. mr. steele, is a morally acceptable for 30 to 40 million americans to be without health insurance?ñ?it is morally wronge future generations with a burden, a debt burden they cannot pay. it is morally wrong to stake a claim in the future in which the government controls your individuality, the choices that you make, and how you lead your lives. so i think that this question is

a very important one, with respect to the 30 or so million people who do not have health care. we as a nation have committed ourselves to doing everything possible to help them. but we have to do it in such a way that we don't hurt others along the way. and this opportunity to fix, if you will, the system to bring those 30 to 40 million people into full insurance is a great opportunity we can't miss the north mess up. and our concern is that in a rush to try to get it done, we are losing greater opportunities to secure that future so that in five, 10 or so years we are not facing something more catastrophic than just 30 million people without insurance. we're talking potentially under this plan upwards of so a hundred 19 million people are so being kicked out of the health care insurance that they currently have. and that's a moral consideration as well.

>> why didn't the republicans when they held both houses and the white house to do something substantial to address the health care issue? >> well, i think that, you know, there were efforts along the way, certainly there was the medicare part d., regulation d., passage that the republicans did get through. there's always been a debate about that particular piece of legislation. but i think the other reality is, you know, the will to do it. and the pressures that have been mounting over the last few years have just grown so great, and i think the will is there now for the people to be involved in this, as well as others. but i just think there has been just a general lack of focus on this issue by many in both parties. i've always believed that if you're going to do health care you have to do it right. you just can't do it partially. you can't have a conversation

with just trial lawyers and insurance companies. you have to include patients and doctors. you can't have a conversation without including the pharmaceutical companies. you can't have a conversation about health care without including everyone who is touched by the issue. and in the past, that has not been the way we approached it. it's always been piecemeal. from both republicans and democrats, and i think i applaud the president with the desire to do this. my concern is the rush to do it. too fast, too much, too soon. we are not going to get this done effectively and well in the next 10 days. i don't think anyone in this room believes that and i know the people out in america don't believe it. and what will the bill look like? what kind of health or do you get for something that's done in 10 days? when it took a year and a half for them to put the medicare system in place in the 1960s. a year and a half to put medicare in place, and were going to revamp the entire nation's health care system, one fifth of our economy, in 10

days. in 10 days. amazing. and so i think we all need to stop and get serious about what we are confronting here, and stop playing this washington game of russian roulette, if you will, with the livelihood and businesses and health care of our communities. >> wasn't as all dedicated in the last election and your side lost wa? >> i don't know who got sued, in the last election. yeah, we lost the last election. i get it. we lose an election and therefore we just now sit back and let whatever happens happen? really? that's a serious question, someone asked that question? the last time i checked i was an american citizen. i didn't stop being a concerned american because i lost an election. all right? so i think the question is a

little bit silly. because i think it's important for all americans right now, regardless of who lost into one. i know a lot of democrats who won last year are right now sitting there going what the heck is this, is this a change i voted for? i know a lot of democrats who won last year who are voting against were walking out on this legislation. i know a lot of democrats who won last year who are scratching their heads going, this isn't a bargain i bargained for. are the americans? i think the r. and that's why they are concerned. so for those of us who lost we are not giving up our right to be concerned about our country. and its prospects and its history and its health care. >> when will the republicans propose the alternative legislation they have been saying since may that they have been drafting? >> there has been any numbers of effort by members of the house and the senate to put within the

president's bill effect of changes or accommodations, if you will, to the totality of this process. now, you know, the republicans can get up tomorrow and introduce its own bill, but you and i know how washington works. the bill that matters is the one that the leadership puts in place, the democrats have the leadership. but it's tough to do when you have been locked out of the process. it's tough to do with your staff is not included in the draft. it's tough to do with the leadership is not included in the discussions. and then you are given a bill at the 11th hour that says here, you guys go vote on this this afternoon. and that's not a bipartisan process. republicans have, as i mentioned in the text of my speech, have been working with democrats in the beginning of the year to put in place and crap, comprehensive bipartisan health care reform. legislation.

and they have been stymied and they have been set aside and castigated as the party of no, we have put in that position or i'm here today, we are the party of saying no to expanse of government, no to an increase in taxes and spending. that's the know we are concerned about. we want to be, we want to work with this president. we want to be at the table. we want to work with nancy and harry. but they are making it awfully difficult when they don't even include members of the leadership and staff in the process. >> do republicans still support the senator mccain's plan to tax high-cost employer coverage to finance tax credits to help the uninsured? >> that's something that the republicans and the house and senate are going to work through. i know there are different points of view on that particular issue.

i stated very clearly in my comments that the idea of taxing health insurance premiums to me is not the way to go. i just don't think taxes work in this economy. i just don't think that is how you are going to solve this particular problem. but the republican leadership in the house and senate will work through with senator mccain and others, what is an appropriate form to take. and we will see when they come out. >> do republicans support an individual requirement to get coverage? >> and individual requirement, what do you mean by individual requirement? >> to require people to get health coverage. >> do we require individuals to get health coverage? again, that is one of those areas where there's a different opinion to buy some in the house and the senate on this. look, i don't do policy. i'm not a legislator.

my point in coming here today was to begin to set a tone and a theme, if you will, and approach to addressing this issue that is centered bottom of. is centered on real people who are struggling with this issue every single day. my hope and my expectation is that the very smart people that we have elected in the house and the senate on both sides will come together and recognize exactly what the american people need and want. because they are telling them. trust me, this white house is pulling just like the dnc is going, just like the rnc is going. so everyone has their fingers on the polls after. which again, it befuddles me to why we are going down this road of more government expansion, more government taxation, more government spending, more government intrusion, when the polls and the people are saying they want as little of that as possible. so we're hoping that the folks on the hill are paying attention to the people in america who are

making very clear what it is what they want and what they don't want. >> why haven't congressional republicans united behind the single approach to oppose democratic bills? wouldn't that make your party more effective? >> again, that's a strategy that the leadership works out. i don't get to make that play call. and so i., you know, i had enough play called i got to worry about at the rnc. and so my job now is to work in close coronation with them as possible as they see fit that helps them get their message out to the american people. and they make the decision about whom, with whom and who they work with with her colleagues and with each other. >> does a president obama's health care plan represent socialism? >> yes. next question. >> in 1965, republicans said medicare would lead to socialized medicine.

how are you so sure health care overhaul will have the dire consequences you predict when your party was so wrong about medicare? >> well, i think that there is -- i think that there is a legitimate debate there about the impact that medicare and medicaid are having on the overall fabric of our economy. you look at the cause and effect that you have to keep feeding this particular engine. i think though that in this case, unlike 1965, the level of spending, the level of government control, and intrusion is far greater and much more expansive than anything we have ever seen. come on folks, you guys, you are journalists. you scrutinize this step if you are sitting here telling me that this is not unprecedented? that even you aren't shocked at

the degree to which this administration is bringing the government, not just into our lives, but into the very relationship between the doctor and patient? between the patient and the insurance company, between insurance company and the market? so i think that what we are talking about here is something far beyond anything we've seen in 1965 or since 1965. this is unprecedented government intrusion into the private sector period. and you can sween it anyway you want, but it still tastes better and i think the american people know that. >> how would your plan make the $12800 affordable to those who can't afford it? how many of the uninsured would it cover, and what cost in subsidies would you change the way doctors and hospitals are paid for patient rather than per procedure?

>> i think that's a very good, very good question and it really goes to the crux of what we have to get to, the meat of the situation. really looking at the fiscal as well as the relationship impact that's involved here. look, m not proposing any quick fixes. i don't have my head in the sand or my eye, you know, up in the sky dreaming. i know this is going to take hard work and it's going to take a real effort by both parties to come to the table can seriously talk about health care. not just in the abstract, not just in the self interest of promoting one special interest over another year but in the interest of promoting what's best for the people. so we are looking at how we are going to pay for it, how you take that $12800 cost to families, and how that is a proportioned and how that is paid out. that is a legitimate question but we haven't begun to do that dissection yet.

we are rushing to get a health care bill passed by the end of the year, by the end of the month. without that discussion. without anyone answering that question, who really need to. not michael steele. i can prolific it all day long or what we should do but it's the legislators who write the bill. they are the ones who have to put it into practice and into law. but we're not having that discussion. we can't even get in the room to ask the question of the legislators. we saw what they did on cap and trade, a 1000 page bill with a 300 page a minute which came at around four in the morning. no one read and everyone in the democratic party voted for it. how crazy is that? and what are you going to do with this bill? asked the congressman. folks out there in america, call your congressman up and ask them if they started reading the bill. can they tell you what's in it. well, they can't because they haven't seen it yet. and they will get it at the last minute and they will vote on it. and they will think they have done something. but what they have done is put

out on the road to ruin if they do that. and so i want to see us get to the table so we can address, so the people who need to seriously addressed a question like that can do it and come back to us and tell us what these costs really are and what they really mean, and how we are going to pay for it. because the bottom line for a still remains very simply, who is going to pay. and if you tax every wealthy person in this country, i don't care how you define them, you still don't cover the costs of what the president is proposing. so the 95% of you who were told last year that you were getting a tax cut, no. you're not getting a tax cut. you will get a whammy of a tax increase that's going to come in the form of a whole bunch of other taxes besides what you see coming out of your paycheck. >> so for republicans actually get to the table, do they have answers to those questions that were just supposed? what are the going to actually bring to the table? >> i just laid out, do you want me to go through them again?

i can go through them again. let's talk about portability. let's talk about tort reform. let's talk about creating networks for small businesses to co-op so they can go in the marketplace and compete for the best insurance packages for their employees. there are a host of ideas that republicans have put on the table that have quite frankly been ignored or they are not part of the discussion. so all i'm saying is, mr. presidenpresident, nancy pelosi, harry reid, let us come to the table and sit down a real bipartisan way to do this. we like coming down the white house and having a beer and watching the game, but someone is, you know, going to lose a health care opportunity here if we don't get this right. mena, the american people. and so i think that we put on. i just went through the list. i will happy to go through them again if you can get them, but i think, i've laid out in very broad terms and then there are more specific pieces of legislation that our members, house and senate, have proposed

that should be part of the bill and part of consideration. >> what will the political price for the republican party be if it succeeds in blocking health care reform? >> i'm not concerned about a political price that the republican party is going to be. i'm concerned about the price of the american people will pay if this thing passes. it's that simple. not looking at this through the rose-colored glasses of what are our political fortunes. i'm not worried about that. i'm worried about my health care for my family. i'm worried about what my 21 year old son and my 17 year-old son are going to do if they get sick or injured. i'm worried about my mother and my father, god love them, who are still living up here in dc trying to figure how to pay their health care bills. that's my concern. that's a concern of every american. certainly the concern of everyone who does what we do. i just want to do it right. i want us to get it right. and i think that the consequences will come for those

who fail here. those who sattel this econo and our people with something they can't afford, not just in this generation but in future generations. so the price to be paid is steep, but it's not a political price. it's an economic one. it's a community one. it's one that your families and your neighborhoods will, you know, really, really come to bear and i think that's a bigger consideration right now then, you know, who is up and who is down politically. >> okay. in light of the day, i have to ask this question. if we could put a man on the moon 40 years ago why can't we give health care to more than 40 million americans this year? >> bingo. i mean, that's it. that's it. and the addendum to that is why do we have to up in an entire health care system to do that when the polling, everybody's going, it doesn't matter. it's not just republican

polling, but everybody. nonpartisan and partisan on the democratic side polling show that the vast majority of americans like their health care coverage. the vast majority of americans like the quality of their health care. the vast majority of americans don't want uncle sam to judge their health care, what they are concerned about is the cost. and so if we can just deal with that issue, that will solve a lot of the opportunities that we avoided in getting those 40 some million people to the table. now, you've got to look at that number very carefully and just realized that the number may not be as big as you think it is because it includes folks in the case of some who don't qualify for health care, in the case of others who have access to health care but just haven't accessed it because they didn't know they qualified for health care, for medicaid or medicare. and those young folks who say i'm not going to get sick, i don't want to have to pay for and they just opt out altogether. but whatever the situation may

be, whether it's one american or 40 million americans, we have to do our level best to make sure that every single day they have quality health care at their fingertips. when they are ready to accept, access it, however they want to access it. and the government should have very, very little to do with that. >> okay. we are almost out of time, but before i ask the last questions we have just a couple of announcements. first of all let me remind our members, teachers beakers tomorrow, july 21, gayle mcgovern, president and ceo of the american red cross will address a luncheon. and on july 24, representative john conyers and democrat from michigan will address also the press club at luncheon, at a luncheon. also at a luncheon. and also, i would like to give you our national press club mug. but you're not quite off the hook, so here we go. the last 10 years -- we like to

make sure you don't run. the last 10 years cbo scoring for the iraq war was to .4 billion, twice the initial ten-year scoring for health care reform. argue similarly worried with the costs of the war? if so, why aren't you expressing those concerns now? >> well, the cost of the war like the cost of everything else certainly is of great concern to the american people as it is i'm sure to the administration. but i think in a real sense the costs of health care is something that is up close and right here, something that people touch. it's something people have to deal with in a real way. when they go to get their medicines, when they go to get health services. they are either paying or they are seeing what that cost is in a real way. i think that it doesn't, doesn't take away from the fact that the cost of engaging militarily is a

cost like all other costs, but when you are looking at the entire cost of health care as a proportion of our gdp, as the bottom line for our state governments. i know in the state of maryland, health care was about 48% of our budget. 30% of that budget was education. so 78% of our budget was tied up and to think that all the things we did on homeland security and, you know, national defense with respect to the military institutions that we have in our state. was a very small portion of that. so clearly, whether you are talking at a micro level or macrolevel, the cost of health care, the cost of providing that health care is a major, major piece of anyone's budget. and i think that right now this is something that's impacting our economy.

it takes up a significant portion of the dollars that we are allocating. and we need to get it under control, and our concern is that additional spending is just out of line. we are not dving this nation into debt. trillions and trillions and trillions of dollars of debt by the spending that's going on right now with the war in iraq. and afghanistan. health care is driving that never. you look at what this administration is proposing, it is astronomical amounts of cash. and we are going to have to pay that bill. and it's a bill that is related to the health care expenses that this administration wants to put in place. and so i think that, you know, the federal government, the state governments will be grappling with this issue in a real way for sometime, but we need to do so smartly. we need to do so with a sense of urgency, yes, but with the right

amount of pause to make sure that we get it right. and right now, i don't think we are getting it right. we are getting it very wrong because it's i think in the long term going to cost us more harm than good that's intended for it to do. thank you all very, very much. >> i would like to thank you all for coming today. i would also like to thank the national press club staff members who helped organize this. melinda cook, pat nelson, joanne booze and howard rothman. also thanks to the npc library for its research and npc member. the video archive of today's newsmaker is provided by the national press club broadcast operations center, our events are available for download on itunes as well as on our website. nonmembers may purchase transcripts, audio and video tapes by calling (202)662-7598, or e-mailing us

>> today, alaska gov. syrup palin officially steps down. she will turn over power in fairs