♪ >> good morning and welcome to "washington journal." our first topic is health care as work continues in the senate finance committee. there is still the possibility to see a house floor vote before the august recess this week. our guest is a staff writer for a roll call, ms. jack >> to cinch. --jackie kucinich. this talks about how they are planning to wrap up their arduous multi-week talks in

coming days between the democrats and republicans. how important is the work being done right now in the senate finance committee? guest: it is extremely imported. there are two major bills coming out right now, one by the health committee, led by senator chris dodd. and this one coming out of the finance committee. they are very different. it is important in the senate to have bipartisan consensus. they have to get 60 votes. senator harry reid has pushed them to get this out the door by the recess. it will be a big victory for them at this piont. -- at this point. you had seen these recesses dialed back again and again. host: do you think covering these bills, how significant is the finance committee bill because of this bipartisan?

will it be the touchstone for all else? guest: that depends on who you talk to. the house bill is much more like the dodd bill, not the max baucus bill. the house bill has a public option. it also has the employer mandate, meaning the employers of the employee pays more than a certain number. there would have to provide their employees health care. the senate does not have that. and has more voluntary system rather than a punitive system. and the house bill if they do not, employers with a certain number of employees, there is a fine. the public option is also a huge party for the white house. because the senate bill may not,

that will be really big deal in september when the meeting of the minds comes together on this. host: this says that assuming the fragile coalition holds, the legislation would scramble the reform landscape. so, can you react to that a little bit? if something can come out of the senate finance committee, would that leave republicans facing a different political game? guest: absolute. without the public option which is then the touch-tone -- without that aspect it will be much harder for some republicans

-- there are some who are just not going to be pleased. but it will be a lot more difficult for republicans to rally against this bill if it does not include some of these issues that they say will be job-killers. host: our guest is a staff writer at raoll call. you can give us a call and talk with jackie. you can also send us a message by twitter. roll call, the issue for today, health battles turn into war, and leaders tried to beat the buzzer to get a deal. the roll-call staff is obviously working many angles on this.

where are you seeing a move that most possible this week when we talk about those two bodies? guest: in the finance committee and in the energy and commerce committee is where you see the most program. last night the blue dogs, the most conservative democrats in the house, and chairman henry waxman of the energy and commerce committee had a meeting that lasted into the evening. the broker for food. -- they broke for food, but there is no deal at this point. the most the blue dogs are satisfied they say -- unless they're satisfied, they will not go for this. they need to be on board because they are strong. right now everything is kind of stuck in the energy and commerce

committee while negotiations and -- rahm emmanuel was their last night. but there are many people horsetrading. they hope on the house side to get a bill marked up and out of this committee by the recess. the house has the recess happening this week, and for the senate it will be august 7. host: what do you hear from each party about the likelihood that of the bill getting out of the committee and going to the house floor? in some of the reporting, on the one hand speaker nancy pelosi's and the democrats have a perspective, and of course the republicans have a different perspective. it is hard to know how much is political posturing, and how much is really guessing about when this will move. guest: in the finance committee

you have a small group trying to hammer out a compromise bill. on the house side, whether it will come to the floor by september -- there is one option where henry waxman, there is a deal where he can skip the deal altogether if he can of record with the blue dogs. that said to me you still have two other committees, the education and labor, and the ways and means, that also have versions that are marked up. they must be reconciled. it will not get to the floor this week. whether it comes to the floor at all, there are many unanswered questions. nancy pelosi's seems determined. host: let's go to our first call on the lines.

bob is joining us from caller: massachusetts good morning, how are you? thank you for having me. this is probably directed at both the blue dog democrats and the republicans. they have been a very good job of confusing a good part of the public which i think is sometimes not so easy, but by repeating the phrase health care, health care, what they're really talking about is health insurance. people are so confused. the big thing is and all of this, we cannot lose sight of the fact that these health care insurance companies are making billions, billions of dollars in profit. that is billions of dollars that do not buy one penny's worth of health care.

that is profit. i understand the motivation and that we are a democracy and a belief in organizations making profits. but it is averages when you think of those billions of dollars going in someone's pocket while people in this country are being denied health care. guest: i think it is one of the things democrats are trying to solve with this public option. they said this will create competition for the insurance companies. it will perhaps take the ball from their court. it is one of the things they are trying to solve and that is in dispute in the house and senate. whether the public option will be harmful or helpful to the health care system. host: our next caller is from

pennsylvania on the republican line. caller: i am calling because i wonder why tort reform is not being addressed. here is southeastern pennsylvania where doctors pay upwards of $100,000 per year for malpractice insurance. the attorney advertising is on 24/7. this must be too expensive for the reform bill. i would also like to say that i have a 23-year-old child who was recently bumped off our policy and he would just as soon not have insurance and is willing to take the risk. but i did find him a policy in the range in cost was $115 per month up to one of a $27 per month. i thought that was reasonable. -- and $127 per month.

i think that people should go online to look at this legislation. some of the things here are very scary. all doctors will be paid the same. how will they ever afford to practice? the constraints on how many patients the doctors can see. mr. obama's statement that he will base a decision on quality outcome. how can you guarantee that a patient will go home and take their medication? guest: right now with medicare reimbursement it is based more on volume and quality of care. so, one of the mechanisms that has been talked about is having a panel to determine what exactly is the quality of care.

on another perform their turn to institute to fix the part of the system and reform health medicare reimbursement works -- welcome i hope that addresses part of your question. host: our last caller mentioned how big this legislation is. there is a story today in the style section of ". the washington"" it talks about how the legislatiolegislatures are lear- from "the washington post." they are learning from their staffers the details about the

health care bill. do you get a sense of how many legislators have really read this? when you speak with them do they do the talking points, or can the go into details? guest: it depends on how involved they have been in the process. many of our into the nitty gritty, but are focusing more on what is important to the constituents. if you are a blue dog will care more about something like the medicare reimbursement or the employer mandate than someone who is a progressive who will care about the public auctions. they are informed, but in certain areas of the bill. this is over 1000 pages. the tutorial is bringing members who would not necessarily focus on certain aspects to make sure they at least have a working knowledge of it. host: as they head into the

august recess much has been made about what those five weeks will do for this bill. as you talk to legislators are than the rest about heading over to home districts to talk about it, or eager to have home and say what they like or dislike? guest: either way, there is a lot of explaining to do. they will have to talk about it. it is big and complicated as a bill and affects many people. there is probably a little nervousness. you can see what sometimes happens in the town hall. but many are eager to get back and take away some of the exterior -- everyone is a running ad as far as the insurance companies. i think they are eager to go and explain their side of the story

to constituents. host: will most benefit to this week in making they're arguments? do democrats have a hope of convincing people that what they have done has been productive? guest: the danger is if you have members going home and they are angry. there is a chance that some of these members who have been in the washington bauble go back and really encounter angry people. that might change their -- bring them back to center ring of they would come back here with a different outlook. it can be a risk for democratic leadership to let these guys go home without a bill passed. host: republicans are talking about targeting some freshmen democrats and those in regions where perhaps john mccain be to obama in the election.

do you know how much money will be poured into this? guest: they have already begun a couple of weeks ago, really going after the more vulnerable seats. the democrats have releases daring them to cave in. they will really go after these guys and try to capitalize on the uncertainty and the risk of reforming the health-care system host: what might the democrats' counter-strategy be? guest: to explain why this would be a good thing. the good things that this bill will do, how will help people. i have seen many testimonials recently. sitting down to explain their side to their constituents. focusing on how this is helpful. host: on the independent line we're joined from bethesda, maryland.

caller: i heard you say 5 million people uninsured and i thought the number of people close to the 47 million? guest: i am sorry. i apologize. it is 50 million. you are correct. caller: i'm just thinking, healthcare is prohibitively expensive and seems to get more expensive every year. from my perspective i hear people who call themselves journalists talking around the edges of the issue, talking about the fight, politics. instead of what is in the bill and what opponents propose as an alternative. i have not really heard much of anything except from the president, his four points.

it irritates me that the discussion is about the theater instead of the substance. of course, it will be hard for our elected officials to sell it when all we're getting our buzz words. i will let you speak, thank you. guest: one of the reasons you're hearing a lot of talking about the politics, right now the politics are helping to shape the policies. the bill does not necessarily what will become law. because of that we talk a lot about the politics. that right now is what is making this bill take shape. host: president obama last week

did mention a comment where he said this could be the president's water live. it would break him if they can kill health care. -- it will be his waterloo. that also gets into the politics rather than the substance. it is that the goal the republicans have come to focus on politics? whose strategy is that? guest: a lot of leaders have said, republican leaders have said -- you are hearing that from the more, the ruby reds. but the closer to the center that you get, the more europe that we do want to fix this. but this is not the way we would fix it. would it be helpful to them if this fails? absolute. politically this would benefit

the republican party. -- absolutely. it would be analogous to george bush and social security. if the other party fails there are winners. right now i do not think that is what they are selling because people are sick of politics and the posturing. the republicans are definitely not focusing on that as a parting message. host: on the democrats' line, from connecticut. caller: good morning, i have a question and a strong talking point in favor of the bill. we hear all the time that anyone can go to the hospital and get treated regardless of whether you have insurance, regardless of whether or not you can pay for it. has anyone tried to calculate the cost of it to society?

now, somebody is making that money. what is the cost to the rest of us that we must make up these dollars these people cannot pay? is it coming from tax dollars, where? guest: take medicare reimbursement. when doctors, when medicare person comes into the emergency room they are treated. then the doctor bills the government. but he also factors in the cost of people will come to the emergency room who do not have insurance. that is one way.

it is factored into billing the government for medicare/medicaid. they are trying to figure out how to solve that problem. host: we had a comment on twitter from sasha. so, let's talk substance. what is really happening in the senate finance committee? do we have a sense of the talking points? how does that compare to what is being done in the house? guest: the two main points that are different -- the public option and employer mandates. those are the two things, the big things, that are not in the senate bill.

it is in the chris dodd bill, but not in the health care committee in the senate. it means that the public option, that is the alternative -- that is the plan that would create competition for the insurance companies. then with the employer mandates, that is the provision that would require that employers who have more than a certain number of employees, must ensure the mall. in the house if they do not they are taxed. in the senate and the finance committee bill if they do not, it is not punitive. there are incentives to cooperate, but there will not suffer for it.

both of those are very important to the president, the employer mandates and the public option. the public option would cover all but 2% of the 50 million people uninsured. host: take us even further as to what republicans would like to see? obviously, not the public option. is there something even different that they want to see a different than what may have come from the senate finance committee? guest: some of their things focus on tax cuts. it has been nebulous thing of the has not been a solid bill yet from republicans. indeed it has been a nebulous thing. there has not been a solid billion from republicans.

their proposals do not, it is not the radical changes. you would not seek as much. host: we will hear later in the program from congressman roy blunt. we will also hear from the democratic congressman. we will hear from them exactly what they're like to see come from legislation. one thing talk about in the senate finance committee is a non-profit co-op situation that could give competition to private insurers. it is different from the public option. guest: they are small, regional- based insurance companies, based on a public electric system. they are more tailored to the region. it would not be a blanket.

it would be specific to where it is. many conservative democrats, more moderate republicans like this because it is not the one- sized it's all or a scary. -- as scary as a public option to them. the co-op tends to be more popular with the moderate pace. host: camilla causes on the republican line from long island, new york. caller: and concerned about the health bill. he is making it socialized medicine. that is just like canada. i have lots of relatives and montreal and toronto who wait months for doctors and tests. the canadians come over here for help. we do not go there. we are not a socialist country,

but obama is making as like that more and more. who is he to say that when you are over 50 or 70 that you cannot thata hip or leg operation? how dare he? abraham lincoln freed the slaves and might contribute someone has to tell him he does not have the right to dictate that. host: let's talk a little about how singers are responding to the president's proposals. yesterday he went to an a r p town hall meeting where people could ask questions -- to an aarp town meeting. there is a question about how the bills coming out what effect singers and people in that 50-64 age bracket who have a harder time getting insurance right now. maybe you can tell us what some

of the fears are about the president's plan, and also about some of the realities of it. the caller is concerned about people not been able to get hip replacements after a certain age. do you hear people have been concerned about that? guest: there are always concerns about pre-existing conditions. the bill would bar insurance companies from excluding people do to these pre-existing conditions. there are real fears about changing medicare and medicaid. they want to pull a savings from the current system and that means cuts. people are scared they will see their coverage disappear.

that concerns a lot of the peers with prescription drugs that i think the henry waxman bill is trying to fix. making sure that seniors, low income seniors can get their prescriptions and have low costs. but the money has to come from somewhere. host: here in "the wall street journal close-" -- seniors air doubts to obama. aarp has been a vocal supporter. then, it says the health bills

would bar insurance companies from denying people if the have a pre-existing condition and curve ventures ability to deny coverage. it seems that both parties want to take care of some of those problems. that is on all sides. guest: yes, absolutely, and there are many things they agree on in this bill. but you see a lot of disagreement around the focal point. you'd be hard-pressed to find anyone who says that we do not need to reform health care. but it is these new the gritty things. the ideology is completely different. host: yesterday the president also talked from his personal experiences about his mother and grandmother. he said -- this piece is from "the washington post" -- my mother when she contracted cancer, the insurance companies

decided they should consider whether was a pre-existing condition. ultimately, they gave then, but she had had to spend weeks fighting with the health care insurance companies what she was in hospital. we hear that from a lot of people. guest: yes, democrats have been talking about taking power away from insurance companies. you hear nancy pelosi talk about that all the time. you see a lot of head-butting on that over ideology. host: the next call is from dayton, ohio. caller: hey, what jackie just said is true. it is a contest between the profit margins of the insurance companies and what the american public want.

62% of the people want the public option, yet many republicans who are so-called christians, yet they could care less about the 50 million people who are uninsured. i know this may not be a personal feeling of yours, but you used the word radical in regards to the public option. i think it is far more radical that 50 million people are uninsured, the president of a used these two terms during the speech -- he said take out the profit margin, and he said insurance companies have had record-breaking profits while the american public is hammered. i admired he was willing to do that. on thursday there is a march, a health-care now march in washington, d.c. and i'm hoping the media including c-span covers it. i keep thinking that may beat the march should be held in iran that we get 24/7 coverage. i'm a single-payer advocate.

on the other side is leaving it and that insurance companies' hands. do you think there is any chance the public option could not end up on a bill this fall? guest: there is definitely a chance. what i meant by radical is that it is very different from what we have. yes, there is definitely a chance that the public option will not be in the final bill. that would be to the dismay of the president and the speaker of the house. and to a lot of your more liberal, left-leaning democrats. it is such a divisive piece of the bill. you not see many republicans vote for that. in the senate that is a huge problem. host: how flexible do we see the president been on that issue? guest: he has been holding his

fire. house and senate leaders know that he wants it. since we have not seen the bill from the senate finance committee -- the white house has said it they are working through process. i think we will seek more out of them if that becomes the bill. but right now from at least the outside they're just watching. speaking to quickly, members of congress do not like to be told what to do. host: something that roll-call has reported and talk about is the difference between the clinton health-care plan and how the clintons went and was something more concrete on paper, whereas the obama administration is working with

congress and letting congress take the lead. is that a savvy move? is there concern in the white house that it may backfire? guest: this white house has already seen that congress does not necessarily, regardless of the fact that the house and senate are controlled by democrats, they do not necessarily always fall in line with what he wants. there is definitely a risk, but at the same time the clinton health-care plan did not pass. they had to try a different approach. may as well give it a shot this way. host: from tennessee on the republican line, good morning, dave. caller: i was interested that the democrats decided they needed to have a tutorial. they did not do with tarp or the cap and trade bill -- those are awful.

there would destroy the american economy. i suspect this will too. the insurance company's early on said they had an easy way to fix the problem. just mandate that everyone must have health insurance and just as we have to have automobile insurance. we will lower the rates, will not eliminate anybody. it is simple. guest: i think what the democrats are concerned about is investing the insurance companies with more power. they are trying to move the ball into the government's court on that. so, you not see that this is surely coming from this congress because of the unwillingness of democrats to invest insurance companies with more host: power good morning to

detroit. caller: i am 74 and have had cancer for seven years. when i found the cancer that doctors were so great. i found it within a week i had my surgery. i have a very aggressive form. i had excellent care. under this program it appears as though because of my age i have been told to go see the doctor every five years to discuss the end of life. treatment like i received would not be available to me. when i have called my congressman are my two senators, in most cases all they want to know is if you're for it or against it. i think it they would take care of the illegal immigration, tort

reform, and put themselves on the program -- but you never get an answer. in most cases when you call your representatives. they are just tallying one way or the other. they are not concerned about your concerns. one other thing. one of my doctors said that he is getting to the point where he is having more canadians as patients the americans. we are right across the river from windsor. guest: that reflects a lot of concerns that seniors have. that you will not be able to see doctors. there will not be able to operate as they have for years.

that is something members of congress will hear about over the recess. host: how the democrats dealing with those concerns? guest: yes, they have a counter- argument. they're trying to address not being able to turn people away. there are many worries about the number of people who will be in line for care. they are working to dispel those kinds of concerns. host: there is a piece today in "the new york times" which talks about tax on health care and how that may have to be a reality in

the debate. an unpopular rises up in washington. members of congress have come up with one idea after the other to cover the uninsured, but they have still not put together legislation that could pass. that is largely because most of those ideas have a basic flaw. then it talks about health health costs are growing more quickly. one solution is to put a tax on health care and that would essentially be tax the health benefits americans received through their employers. is that getting traction in the senate finance committee? is this something that we may see? guest: republicans did not like the idea of taxing the health care benefits you already have. people are already so strained with their finances.

hillary clinton discussed that during the campaign. conservatives and people who do not believe that should happen really do not like it. it is a visceral reaction. host: the article says that the fact that these benefits are not taxed as and mit specialist noted, says it is nothing more than an arbitrary and mr. decision made 60 years ago. there is that idea that if it is not done it is not politically popular. who is it palatable to? do we hear that from some democrats? guest: yes, we do your that from some democrats, especially the idea of taxing some top earners. republicans said that could lead into small-business owners. that does not sit well with blue dog democrats or with

republicans because their contention is that it kills jobs. business owners will cut back. host: on the line for democrats from huntington, n.y.. caller: i am amazed by the amount of misinformation you are putting out today. i'm surprised you really do not know what you're talking about. first of all, during the campaign for the president it was the republicans who are putting forth the idea of taxing insurance benefits. therefore, saying it is the democrats were trying to do that turns it around, doesn't it? suddenly, when the woman called and was talking about socialized medicine and get the that people would not be put to get certain procedures done and would be told it was the end of their lives -- you never answered that question at all. he never accounted for the fact that there is no such provision in any such bill. -- you never accounted for that.

nor did you give the answer to an important question as to how much money is presently spent in the system to cover people who are not covered because the go into the hospital. how much money is put out because those people need intervention that would not have been nearly as expensive had they been capable of seeing a doctor normally? these are the questions people want answered. they want the canards stricken out from both sides. please tell us the truth. host: michael does bring up the point about preventative care. who is talking about that? guest: that is talked about a lot on the committee level.

one of the things the republicans, want to see worked out that people need to take care of themselves. but it is not something i believe is in the bill. people doing everything to keep themselves healthy. i do not know how you would legislate that, frankly. yes, these are real concerns. as far as the statistics, and not have them in front of me as to how many people and how much a costs to care for those to come into an emergency room. but that will not change. it is a lot that if you walk into an emergency room that you will be cared for even if you do not have health insurance. it will not change. host: next is from cleveland,

ohio on the republican line. caller: have a quick comment and question. it seems that obama made comments on the speech he gave that he would give c-span exclusive behind the scenes access to the closed door meetings for the health care legislation. i was wondering if you have gotten that. if your guest knows if there are in the media outlets allowed to sit in on these meetings? is anyone allowed to know who is allowed to attend these meetings? you said it the democrats had a meeting to hone their bill. it is only so they get their talking points and line for when they go on recess. people give them hell when they get home. that is why they want to get the

public's opinion before they pass the bill because they have enough democrats to pass the bill if they wanted to. they have a majority in both the house and senate. they could push it through, but i think they're scared of the way it is formed now. guest: you are right. they have a 47-seat cushion and the house. but the blue dogs said it will not vote for the bill and its current form. i think you'll see that hammered out over the next couple of days. as far as who attends meetings, i am not sure. the reporters are not allowed into the discussions at the house and senate. host: how much do you hear as far as insider information from those meetings? guest: sometimes members will

talk about it. the senate finance committee has kept everything close to the chest. some details have come out. but you really only know what the members tell you. if it is members only, it is who will hold the keys to the intermission. host: we have a break from a wisconsin joining us on the independent line. caller: when we have these comments about those in canada been denied treatment, we have lots of people who are insured privately who are also denied treatment and died as a result of insurance companies putting profits over health care. my question is, we have france who has the number one health care ranked system in the world, yet pays half as much per capita as we do here. we are ranked no. 37. wouldn't it make sense to look

at a system that is the best and try to copy it rather than this garbage that the congress is putting together which is catering to the insurance industry? if we are all mandated to have coverage it means the insurance companies have captive audiences and continue to make profits. i hope this bill goes on. they are trying to cater to every one, what they think everyone happy rather than following a system that works. i would like your comments as to why we pay twice as much per person when we are no. 37 and france is no. 1. guest: i am not as familiar with the help your system in france as i should be. there is worry about their that

the public auctions will take over, that concern by republicans. when we see the final product either these will be amplified or business. host: is anyone now looking to places like france or canada as a potential model? mike moore a couple of years ago look at foreign countries and how they're health system could be a model, but it seems like a lot is against what happens abroad when people talk about having a public option. guest: many people are holding of canada as a bad system. they are really focusing on how we can change it here in the united states rather than using those examples. because with that you also have

all the problems with those systems as well. so, right now they're focusing on with the can do here. host: online for democrats johnny is gone from jackson, mississippi. caller: good morning, either your guest is poorly informed or she is republican. i think that the latter is the case because she described the public option first as radical, then she came back and described it as divisive. every industrialized country in the world other than the united states has some form of at least a public option. why is that radical? then she describes it as divisive when 72% of the people in this country favor a public option.

and she calls a divisive? then when the caller called and talked about the end of life choices and was very misinformed about it, your guest just went along with it as if that were the case. president obama explained clearly yesterday that that would not commit that counseling at the end of life would not be mandatory. that it would be an option. that he and michelle obama have a living will. that is what he is talking about, but she did nothing to shed light on that. host: let me jump on what you are saying in reference back to this article where president obama was speaking yesterday in to talk about the living will that he and the first lady have. he talked about what happened with his grandmother. its says one woman asked obama about rumors that under the proposed legislation every american over 65 would be visited by a government worker and told to decide how they wish

to die. first, obama joked that there are not enough government workers to undertake such a task. then he mentioned that his grandmother who died last year had a medical directive. he said it gave her some control ahead of time. she could say if she had a terminal illness did she want extraordinary measures, or did she want to be left alone? it gave her decision making process of the powe-- a day forn the decision-making process. -- it gave her that. guest: i am sorry that you misunderstood. it is divisive among members of congress. their members who do not want this because it is a deal logically opposite of what they believe in. in congress there is a lot of thdiscussion as to whether

this is the best way to do with health care. another thing discussed in the senate is a trigger system. if the insurance companies do not abide by reform it would then trigger the public option. that is another way this could happen without being initially in the bill. i am sorry if you misunderstood, but it is divisive in congress. host: it has been the most intense point throughout this process. we will see where it goes next week and when congress returns from the august recess. the next is on the republican line from maryland. caller: good morning, i am a small businessmen for 34 years. i just renewed my health insurance for my employees and i had it 25.5% increase in it. what bothers me as i have kept

good track of the discussions for the last two months. no one is bringing up that as far as medicare and medicaid, in maryland thrifts are set by the state government -- the rates are set by the statement, there set by age and no pre-existing conditions are allowed. there is a set fee will pay to any insurance company if you are at a set age group. six quotes are all within a few dollars of each other. the reason i have had these increases for the last eight years -- before that there were marginal for the first 20 years -- is that 21% of the medicaid payments the federal government reimburses the states are below what hospitals, doctors and primary physicians are paid through medicaid. the state test to subsidize

those. these costs are factored into the rates that i have to pay. when they talk about cutting medicare and medicaid payments by $400 billion, though be charged back to the private sector by the states. it will raise the private sector rates by campaign. it will bankrupt the private sector. that is what will make people go to a public option. host: let's get a response. guest: the senate is proposing tax cuts for small businesses. the other thing is that they are trying to work with the regional disparity. the medicare payments that doctors -- i'm sorry, the medicare reimbursements are different depending on the region.

they're working on that in the house bill right now. host: the independent line from atlanta caller: good morning. real quick, i have noticed that many very important questions that have been asked my people are getting cut off as opposed to completing their questions. jackie, thank you for being there to answer the questions to the best of your ability. even congress does not have all the answers in of that brings me to a couple questions. even your name, and we have a house representative named dennis cook spinach and i would like to know first of all, if you are related to him? secondly, i would like also to say that with a lot of the debate going on between

republicans and democrats, and if we should ensure all people who live in the united states legally. because i also hear about illegal people who are covered also. i also hear about the caps on the malpractices on doctors. we do have some doctors and our great nation to do not really know what they're doing who are working with the insurance companies. the insurance companies work with the pharmaceutical companies to put a lot of medicine out there that causes a lot of the problems. they say if you have a pre- existing problem -- can you answer this question? hell is it in the time to where many people are losing their

jobs, -- how is it, losing their benefits -- host: can get your question? caller: ok, the people were losing their benefits and being put on these drugs, and in the drugs are recall by fda who did not even approved the drugs in the first place, and then the take insurance -- how is that working? host: he brought up some significant points although i did not get the last one. guest: i think his concern about what is going on with the economy with people losing jobs. i think that is one of the reasons why democrats are trying to rush this through -- i mean, i'm sorry, pushed this through quickly. host: thanks for being with us.

our guest has been jackie kucinich. coming next, congressman roy blunt and also frank pallone. now a news update. >> it is almost 8:00 a.m. eastern. defense secretary robert gates says he sees some chance of a modest acceleration and the pace of troop withdrawals from iraq. he said that the top u.s. general in the country tells them the security situation in iraq is better than expected. secretary gates has been torn iraq and tells reporters that perhaps one combat brigade would leave ahead of schedule. president obama has announced plans to withdraw combat forces by august 2010. today the president travels to north carolina and tennessee for town hall meetings on health care reform.

you can hear those events later on c-span radio. congress will be in session today. work on health care continues. other measures are also considered including a bill on texting while driving. it will be unveiled by a democrat chuck schumer and would require states to ban driving while texting or face the loss of highway funds. 14 states already to ban the practice. on wall street stock futures are pointing lower, and head of the latest assessment of business conditions around the nation and the report on durable-goods orders. those are some of the latest headlines. . .

watch live coverage on c-span2. the supreme court, and this fall, on c-span. host: congressman roy blount joins us right now. you are on the energy and commerce committee. tell us about where things are with health care, as we look at what may happen in the house? >> i do not think much is likely to happen in the house. we have moved through the process of amending these bills,

seeing them. the truth is, no one knows what is in the bill because the than the ones that we have seen get changed. i am also chairing a health care resolutions group. i am working with the leading republican on the work force committee, on the ways and means committee. we are trying to make sure that we are heard in this debate. the frustration has been pretty great for us. i think, and i think most people in the congress believe, this system need to changes in it, and we could have broad agreement on a lot of those changes and we are down to a few obstacles and we cannot figure out how to get them out of the way to make those changes that will make the system better.

to understand where we are in the congress, there are people in the congress who do not want to do anything, and that is not true. accessibility and affordability can be addressed in other ways. host: what are some of your top goals? guest: we have the mechanisms in place for accessibility. the mechanisms need to be expanded a bit to make those risk pools work. access for everyone. and making the system of affordable for everyone. there are some system dynamics right now, but it is not based on competition. when we dealt with medicare -- prescription drugs on medicare, we looked at the system and

decided it was much more competitive and had more customer satisfaction and price satisfaction built into it rather than just saying this is what the government will pay for. host: blue dog democrats are being horded by the administration. have you been meeting with them? >> yes, we have and others on the board have as well. their leaders would clearly prefer that they not talk about this. the desire of republicans to make changes, the willingness of certain democrats to not go down in dramatically different road that the administration has proposed has slowed this up. i hope that we can come back in the fall and get something done.

host: how on-line are you with the blue dog democrats, -- aligned are you with the blue dog democrats, and what are they saying? >guest: they have not been overly specific. i suspect i am more inclined to have more competition, more marketplace dynamics, where they are inclined to have a government organization set up the price. maybe somewhere in the middle there is room for compromise, but they keep on talking about an outside group to establish prices. that doesn't always meet the health care needs of the country. one of the previous callers talked about his insurance going up dramatically, and that is because government planned to

not pay for health care -- plans do not pay for health care. what happens if there is no plan to offset the government plan? host: what about the idea of the co-ops? >> i aguest: i am from missouri, so we know what they are all about. we have some electric co-ops, and they are great, but they do not compete with anybody. what they were trying to compete with another company trying to provide power to our customers? eventually, one would go out of business. i am not immediately put off by the idea of a coo-op, but if it

is just another name for a government-run program, let us talk about what we are really talking about. i think that would be a mistake. host: is there a way to provide competition with private insurers? guest: i think so. i have advocated since january with others to look at this competitive method. if we look at this again in 36 months, 48 months, and see if the competitive marketplace has developed. again, going back to adding prescription drugs to medicare. the people who said there would not be enough competition then are saying that there will not be enough competition now.

some even said there would be too many competitors. neither of those turned out to be true. we need to look back and see if we have a true competitive marketplace and see if people have more choices than before, and if those choices are leading to better quality and lower price. host: our first phone caller is on the republican line from brookhaven, mississippi. caller: i would like ask -- i do not know if he knows or not, but held bills are written in the committee and house. why do these senators and

congressmen come on tv when they cannot even understand what they are reading? why can't they just make things in english so that people can understand. what is the purpose of them putting all of this in there, to the point where even the people voting on the bill cannot even understand it? and just so confused. it does not make sense. -- i am just so confused. guest: i think a lot of that is not being said by many members of congress, but what people are saying is they do not have time to see the bill. twice already with the energy tax and cap and trade, the

stimulus package, both were huge bills that were not available even 24 hours before they were voted on. even if they were, try to read your favorite 1000-page novel in one night and see how that works. we are talking about not only 18 percent of the economy here, but we are talking about the thing that people need to have ultimate confidence in. when everyone in your family is well, you have lots of problems. when someone is sick, you only have one problem. surely, this is worth taking the time. even in a good economy when you are not worried about it restructuring 16% of the economic activity, there, it would be important to do it right.

but in our economy, we need to make sure that we have really improved the health care system in the most efficient way, in terms of people's access to care, and in terms of what you're spending. it is not that people cannot understand the bill, it is just that we are not getting enough time. we have seen two costly examples of that already. i do not believe the energy bill will become law. host: on the democrat line, georgia. caller: i would like to ask a few questions.

when the wright brothers got the airplane to fly, everyone was skeptical before. this health care bill, if it is so bad, why do the people in congress have it? the money that we are spending in the war, the you know how much money we could have gotten in insurance for that? and we are still spending billions and billions of dollars. but nobody is talking about that. when it comes to health care, they do not want that. guest: the right brothers did fine. the hindenburg was not so good, so we do not want that to happen.

things work in america and things do not. there are too many examples of government-on systems that do not work. we had a meeting where we had two people from canada, a cancer doctor from the u.k. telling us what happens in the system. you can often find out what is wrong about you, but you cannot do anything about it. the people who would be most concerned about us nationalizing health care would be the canadians. this is not going to make things better. in fact, i think our ideas of more competition, access to a large pool that will give you an option beyond that which you can get at work. they have lots of choices, but they pay money for those choices. i hate to use the term, but you

could get a bluecross blueshield-type of policy that covers everything, or not pay very much and have a health savings account. government employees understand that they do not want a government-run system. we want the system to be better. i am absolutely not a defender of the system as it is now, but i want to move in the right direction that produces more choices, more doctors, and more competition. competition plus a choice equals quality and price. government-run health care = some sort of standing in line and rationing -- equals some sort of standing in line and rationing, like every other

country who has it. host: next phone call. caller: i have a question about health care. i worked in a large corporation for three years. we had a great health care plan until i turned 45. i was paying about $200 a month. when i was 53, i went to the doctor -- the only time that i used my policy -- and i was diagnosed with diabetes. the policyholder to is to pay the claim -- chose to pay the claim, but it ended up tripling. it went up about $450 a month. i filed a claim myself without a lawyer to the insurance company.

after six months, my employer kept on calling me into the office and asked me, why are you doing this? you are going to make my injured go up. in the meantime, -- insurance go up. in the meantime, my company fired me. host: i think we get the gist of your story. guest: i think your story explained the problem and i was talking about earlier. the current system grew up accidentally after world war ii. the war was over, the government decided that things could go a

lot of control pretty quickly, so we needed wage controls. the wage and price control person decided that health care benefits could not be taxable and not included under these price controls. then people started to offer these benefits at work. when you do not have those options or controls at work, that i think the system would benefit from, i am all for keeping your plan if you like it, but i am also forgiving choice to the individual. this policy no longer meets my needs, i'm going to take the tax benefits, and i am going to go into this bigger pool, and maybe i can get something similar to plans that federal employees get.

if you do not hold existing greek -- preconditions, you can be out there and shopping around. and these are two big reforms in the system that i think would make it work much better and equal higher quality and lower cost. host: we have a comment from joan from connecticut -- guest: well, tort reform would have an impact on health care costs. in every state, like missouri and others who have done this, it has made a difference. it attracts doctors, it makes

access better. medical liability insurance goes down. i think it is hard for the congressional budget -- congressional budget office to score something like the savings that would be in the system. one would be a lawsuit reform, more health i.t. we all know that electronic records would help over time. they also mention more transparency. cbo would say that they would not know how much money that saved, but i think doctors and health-care providers need to say what they charge for pacific -- specific procedures, and what the results are. there was a study on hospitals and how quickly the resuscitate someone who has a heart attack in the hospital. no surprise, and they do better if you can resuscitate them quickly.

that is the kind of information that people want to have when they are looking at two hospitals in town, they have a predisposition with their heart, and one of them has a great record. it is pretty easy to decide where to go. it is not about charging more and getting more, or charging less and getting less. the scoring of this bill does not include the currently uninsured people in the country and the cbo evaluation has had a lot of impact on this debate because all of a sudden people saw a program that would cost over $200 billion every year with no clear way to pay for it. host: we mentioned in your chair

the republicans healthcare solutions group. even though you are looking at reform in a different model than what democrats are looking for, it still needs to be paid for. how do you see the health care reform being paid for? guest: we need to make sure people have access they can afford. for people who are above the medicare and medicaid coverage numbers -- and we are also talking about people under 65 -- we need a sliding scale where the person who barely qualifies for government health care but could pay a few dollars every month to their health care is asked to do that. our bill includes an end danceable refundable tax credit. that means you would not have to pay taxes to get that tax

credit. it just mean that you would not have to wait until the end of the year. it would be able to help you at the end of each month when you pay your premiums. we do not agree with everything that tom daschle and bob dole are suggesting, but this was right from the republican proposal, which is this advancement of tax credits. nothing like the amount of money the majority is talking about spending. host: next on the democrat line, chattahoochee, fla. caller: i do not want to be disrespectful, but you keep saying 36 months, 48 months. i know you are aware in the early 1990's republicans shot it

down when the clintons were trying to get health care. it seems like you want something that is watered down. all you are doing is delaying the process -- guest: no, that is not the case. and i believe there will be plenty of competition to provide health care in a more competitive marketplace and we have now. and you may know that probably before you even signed up. when we went to medicare part b, it was 24 months before the program started and there was more competition than anyone imagined. the cost of the program was 40% less than any estimates. if there is not competition, we need to make sure that there is.

maybe there is one area in the country where we would have to do something like medicare party. -- part d. most of the money will not be spent for five years. when you are spending $1 trillion in the second five years, that is a different story. i am just saying we can always revisit the idea of having more choices. host: we have a message from sean on twitter -- guest: i know quite a bit about the british and canadian system. as a group, i heard one of your callers say that the europeans had one of the best systems in the world. in cancer survival, there is no country that has higher cancer

survival rates than we do. i think all lot of that is we are driven by a process where you do not have as many specialists, options, and i believe that applies to the french system as well. i know that doctors occasionally go on strike in france, so there has to be some dissatisfaction. host: do you see anything in the canadian system that you like that is being held up as a criticism? people can get prescription drugs they're pretty cheaply, for example. guest: if you have health insurance here, you can get prescription drugs for the cheapest price in the world. we sort of stopped this discussion with canada and mexico because we decidefiguredt how to make the system more

competitive. i believe the government systems have some focus on the initiatives. we need people going to see their doctors not to the emergency room. my understanding is most of these government-run systems in europe and canada is you can find out what is wrong with you, it just takes forever to do anything about it. early detection of cancer. we had a conference with four cancer survivors, talking about the various early detection processes. you have a much better chance of survival in the u.s. than you do in any other european country, certainly compared to canada and great britain, because we have more specialists, we have more individual treatment, because there is no bureaucrat deciding what you have to do to treat your cancer.

host: from new jersey on the republican line, frank. caller: good morning. i am so glad i get to talk to you because i do not want to talk to the fellow that comes after you because he does, ascribe to my beliefs. the health-care system is a complicated thing in this country and i am sure you are aware, but people do not seem to understand -- i want to make a couple of quick points. number one, we have a major problem in the country, and what is driving the cost of health care about is we have a lot of illegal immigrants and people in the country who go to our health care system, and nobody is getting paid for it. who is going to pay for it? the people will end up paying for it because health care

people are not getting recouped on their services. number two, get rid of the fraud, waste, and corruption, and streamline the health-care system to make it run more efficient and better. number three, maybe the federal government can go to the drug manufacturers and pharmaceutical companies -- i know there is a lot of money in research and development and medications because of illnesses, but maybe you can go to them and get them to release a major medications, bring them down to a generic level quicker. right now it takes a long time for good medication to become generic. guest: people illegal in the

country -- that is the biggest majority of people in this bill who would not be covered. there are other things of concern in the bill because he cannot ask for proof of residency. -- you cannot ask for proof of residency. i heard members of congress the other day talking about one person in your house will qualify for coverage, then everyone in the household could qualify. the cbo says about half of the 17 million people they say still would not be insured would be people who are the legal in the country. there is a legitimate debate going on over whether or not people illegal in the country are covered under this bill, were easily get under the cover. you do not hear much fraud about

non-government programs. the focus is always on medicare and medicaid. if you put another 100 million people from the private insurance system into a medicare-like system, i think all you would do is increase the likelihood for fraud, rather than reform the system you have got. i was in a town hall meeting last night with one of my colleagues from missouri and two people said that medicare was already in trouble. why would the government not try to get medicare solidified and take on another group? in terms of medicare, it is a legitimate question to figure out the minimum amount of time a drug company can have access to their work product and still incur ridge the development of these new drugs which has made a difference in health care and longevity, but not let them have

excessive access to that property rights that they develop so that it gets into the system as quick as it legitimately can. what you would not want to have is not have the innovative system of drug development that we have had in this country in the last generation. 25, 30 years ago, when medicare started, you probably had some discussion about taking drugs with your doctor. that was just 1965. there was not a whole lot to talk about beyond penicillin and aspirin. now we are living longer lines and we have other options. all those are legitimate point that we need to be talking about. host: roy blunt representing the seven district of missouri.

thank you for being with us. coming up next, a democrat from new jersey, frank pallone. we will be talking about health care. >> senate foreign galatians committee john kerry talked about climate change. hpv to the climate change summit in copenhagen. -- a preview to the climate change summit in copenhagen. that is 1:00 eastern. and the house committee examines psychological stress in the military. next week, the full senate begins debate on the nomination of sonia sotomayor as a supreme court justice.

and for the home to america's highest courts. the supreme court, this fall. >> in 1968, lbj phone calls with his secretary of state. richard nixon and evangelist billy graham. saturday at 10:00 eastern on c- span radio. >> join the conversation with civil rights with juan williams, sunday, noon eastern. host: congressman frank alone from new jersey, thank you for being with us -- alone from new jersey, thank you for being -- pallone, thank you for being with us. where is legislation on health care going right now? guest: we are trying to get

agreement with the conservative blue dog democrats and getting consensus to move forward on the markup in the committee. we started the markup last week but we have not completed it. host: what do you hope to see before recess? guest: i would like to see the bill completed in marked up, but if that is not possible, at least come to a consensus with the conservative democrats so that we can move forward. host: what are you discussing with the blue dogs? guest: there are a lot of issues. you know they are not in favor of the public plan, but if it is a fair playing field, and i think they would be willing to support it. they are also concerned about cost. they want to make sure it does not cost too much. of course, it is hard to say what that is, but that is another issue.

host: what is the process of these discussions? what could you be compromising on? guest: it is everything. there have been one-on-one meetings with the blue dogs, meetings with the entire caucus and energy committee. it varies. host: how necessary are the blue dog democrats to and pension legislation? maybe you could give us a sense of the numbers. guest: they are important both in terms of the committee because you need some of them to pass a bill, but also on the floor because they are a large group of the democratic caucus. in theory, if we can get them to be supportive in committee, they will also be supportive on the floor. host: so the hard work being done now will pay off.

guest: exactly, and you have to think about how this will dovetail the senate. host: what do you have in mind with health care? guest: mainly to cover the uninsured and to bring down the cost for people who currently have it, or could be in danger of losing it, and guaranteeing insurance. you should not have to worry about making life decisions about jobs and other things without knowing that you have a guaranteed health care policy. host: public option? how strongly argue attached to that. guest: [cell phone ringing] i apologize for that. right now with insurance in the

private sector mostly, there is not a lot of competition. if you had a public auctionoptit would increase competition and bring down costs. host: if you want to join the conversation, democrats, 202- 737-0002. republicans, 202-737-0001. independents, 202-628-0205. you can also e-mail us or twitter. our next phone call is from riverdale, ga.. on the independent line. caller: i am a veteran and i am also in the army reserves. thank goodness i have that evil socialized medicine that i am quite pleased with. there was a poll that showed 72%

of the poor people take the public auction. obama's said private insurance would also be offered as well. what are we al-amin the republicans and conservatives to say that only the public option would be offered and the private option could only compete? we need to get that message out better. guest: that is an important point. what we are establishing with this exchange is where private insurers could come in, and as long as they provide a basic passage -- package, they could compete. i think you are right, that most people would opt for the private option because there would be more options. the emphasis on the public option is a bit misplaced.

maybe because it is new. most people do not have that now. people fear something new. but it really is not that different. we already have medicare, medicaid, the veterans system. all of that is public. host: we have russell from michigan on the democrat line. good morning, welcome to the program. caller: i would like to ask the congressman, what it looks like to me is that most of these conservative democrats, when you look at all of these different news programs, they continue to show how much money they are lining their pockets with, with

insurance companies and pharmaceutical companies, and they are behind all of this propaganda. i am on medicare and i pay approximately an extra $100 a month to be on the supplemental plan. quite honestly, it is run very well. the main thing that i see is the money that these people are receiving. guest: you make a good point that medicare has a very low administrative overhead. that is why a public auction could compete because it is not for profit. -- option if could compete because it is not for profit. however, the insurance industry has been supportive of this health reform plan, and that the pharmaceutical industry has been supportive as well.

i do not want to play up to much the opposition from insurers to the public corruptiooption. both have been generally supportive of legislation. host: we have a question on twitter -- guest: it does not seem that way, but in the senate finance committee, it does not seem clear that they will have a public option. the president has been supportive of it, but he feels, as i do, that we need a bill. in the sense that we can work around the options but still address these concerns about a fair playing field, we are open to compromise, but we would prefer to at least half the

public auctiooption. host: what do you think about not for profit, what systems? guest: i think they are good, but they should be in addition. if we can have that, as well as the public option, that would be the way to go. host: next phone call from arkansas. caller: my main issue with this whole thing is the fact that we are being forced to do it in the first place. this is totally outrageous. and the fact that congress will not be partaking in what they are forcing the rest of the country to do. that tells me that there is something wrong.

guest: when you say "force" i think you are referring to the idea of an individual mandate. it would be similar to auto insurance. i know most people are forced to have auto insurance. the principle is the same. if everybody is not part of it, then the cost goes up for those who are. insurance operates like a big pool. if you do not have a lot of people, then the cost for everyone goes up. the people not in the pool still get health care because if they go to an emergency room, we have to accept them, and those costs are passed on to the people that have insurance. it is not fair to these people who say they do not want coverage and expect to get coverage when they get sick from the emergency room. as far as congress is

concerned, we are saying if you like your health insurance plan, you can keep it. if you work for a company and you like your health insurance, you should be able to keep it, the same thing with the federal government. what we are working on with this public exchange is for people who do not have insurance, or for people who would like to move there because they think it is better. to say that you have to take a public plan, we are not forcing anyone else to do that, so why would we force congress or federal employees to do it? host: talk about the negotiations are occurring. we talked about the blue dogs, but what kind of messages are you getting from leadership, steny hoyer, nancy pelosi, and how involved are they in the

discussion? guest: very involved. ultimately, we want to meet this august deadline. that means passing both houses and out of committee by august, but that is not really possible anymore. hopefully, finishing in committee by this week or next. that would be great. if not, at least to the wood to build consensus, so that we cut -- the able to build consensus, so that when we come back, we can go to work. host: what will members of your party see when they go home? do you see in as an opportunity to get momentum, or perhaps will it be a tough time? guest: i do not think that it will be hard to work on when we come back. this will be an opportunity to come back and talk to your constituents. i am sure the leadership is

encouraging members to go back and have forums, talk to their constituents as much as possible. i know that a lot of members will do that. host: how organized bill the democratic party be about creating a message and helping members get support? since you are a key player in this bill, are you having discussions with people about what they should go home with? guest: we are having discussions about the principles that the president articulated it in the past six months. we want everyone covered, we want to reduce costs, we do not want to have you worry about health insurance when you take a particular job. also eliminating discrimination in every legislation in the bill. insurance companies cannot discriminate because of preconditions, women compared to

men, other discriminatory -- discriminatory practices. basically, what the president has been saying for the last couple of years. host: we have another comment from order -- tewitter -- twitter -- the business as usual for the last 100 years. guest: the bottom line is the status quo does not work. the reason i say that is because more and more people lack health insurance. costs keep going up, above the rate of inflation, and we know that we spend more on health care as a proportion of our gdp than any other developed nation. clearly, if this continues for

another 10 years, the health- care system will not be sustainable in the sense that it will make it difficult for the economy to grow. this is essentially an economic issue because it impacts our ability to continue to grow and create jobs. i agree that we need change. everyone does. host: on the independent line, ronald from danville, va. caller: good morning. i am on a fixed income. if we cannot get health insurance, we are going to be penalized, but that is not right because i cannot afford health care. it is not right to do that. especially with the energy bill,

it is not right by us. guest: i think what we are trying to do here is provide affordable insurance. if you do not have insurance now, you might be eligible under expanded medicaid programs, because there is a lot of we are moving in that respect to make people eligible. if not, you could go into this health exchange and purchase and inexpensive policy, depending on your income, because we would provide subsidies for duke. you might even be eligible for medicaid where you pay almost nothing. if you are going into the health exchange, you could pay on a sliding scale, based on your income. the whole idea is to provide affordable insurance for people who cannot afford it now. host: our guest is frank alone.

you represent the sixth district 3 -- pallone. you represent the sixth district in new jersey. our next phone call is from leesburg, va. caller: ina moral and fiscal conservative, however, apart from the conservatives on the fiscal agenda. i believe that our founding fathers call for it, and i have written a proposal that is two pages that gives a brief outline of the health care system that could reduce costs, cover everyone, and the market driven. i am confident it will work. i in 51 years old, i have my own consulting business. i want to get this to people who have authority. it will take two minutes to read

it. how could i do this? i have tried to contact obama, your committee, but i know that you are inundated with information. guest: i can give you my office phone number, and you can call or mail it. my office in d.c. is 202-205- 4651. we will make sure that we get it. host: next phone call from cross plains, wisconsin, on the independent line. caller: thank you for allowing us to have this discussion. what happened was, when everyone went to pay for their own

insurance, not everyone could afford it, so we provided a system of insurance where everyone would put their money into a pool so that the government could not go bankrupt. that led to a lot of money going into health care and developing the system that we have which is quite superior to the rest of the world. unfortunately, insurance companies got more and more competitive with each other and stopped picking whether or not they wanted to ensure you or not. the best way to deal with that is to look at the german program. everyone is automatically enrolled. there is this big pool of people who are already insured. that is the best way to bring the price down. guest: i think you make a good point, and that is the point of this health the change we are setting up.

-- exchange we are setting up. employers often set up a group plan, and that is why they are able to get a better price, compared to an individual. what we're doing with this help exchange is targeting people who do not have insurance so that they can get a policy, and also people who have insurance -- purchased insurance in the private market, they can join this exchange and essentially get into a larger pool. also, small businesses may have a small group policy, but it is expensive, so if they go into this larger group, they can get a much cheaper price. essentially, the government is setting up a large insurance pool for anywhere between 40

million and 80 million people who are either on the individual market or have a small group plan. then you would be able to buy private or go to a public option and you would bring prices down considerably. depending on your income, we would give you a subsidy for purchasing the insurance through this large insurance pool. you bring prices down first by bringing all these people into a large insurance pool. secondly, by providing them with a subsidy. also, by the competition between the public and private options within this exchange. host: there was talk about bringing this bill to the floor and skipping the energy committee. is that an option? guest: i think so, but not

something that will be exercised. when you look at those groups that are hesitant, and blue dog, they are both on the committee and on the floor. it makes sense to work this out in regular order and the committee, and then those same people would support it on the floor. host: next phone call on the democratic line from texas. caller: i want to share in the appearance of private pay interest. we are a family of three with a 10-year-old daughter. we were turned down by bluecross blueshield, aetna, humana. after an appeals process, humana excepted me and my daughter, but not my husband. he has a heart device that regulates him. the price that me and my daughter play, we are afraid to

use our insurance even though we still pay the larger percentage when we visit a doctor. my husband is in the texas health pool, so he does still pay a premium, but he has guaranteed health care. my husband is a millionaire in this health pool. my next-door neighbor has absolute -- epilepsy and need medicine control. they are guaranteed their health care. i would so much pay my private premiums and the largest percentage of the bill that i pay at the doctor's toward a more socialized, guaranteed

health plan. guest: i do not want to use the word "socialized." the one thing i keep on stressing is this is not like canada, france, or great britain. in other words, britain is probably the best example, where the doctors, hospitals, everyone is on the government tolerate. we are nothing like that. -- salary. all we are talking about is providing insurance. one of the major differences we are talking about relates to health conditions. it to you by your insurance through this health exchange, which the government would organize, the energy go for private or public, nor preconditions' cannot be a basis on whether or not you are

accepted or, if you are charged. -- how much you are charged. they will not be charged different rates because of their preconditions. this is the one way to make sure it does not matter who you are, that you can get a guaranteed health care. it does not matter what job you are in. that is an important distinction that i went like to call your attention to. host: on the republican line, a kansakansas. caller: i have a question. i am concerned about this health care being forced on individuals. i know that you say it is an option, but other countries who

are on this program, it seems to me, it was never intended to be a total government-run program. now in canada it is. they were going to have private providers as well. private insurers dropped out because they could not compete. then you ended up with a strictly government-run health care plan. those people are waiting years. if you have a tumor and you have to wait two years to get medical care, there is a problem. many of those people die or they come to the u.s. for medical care. guest: all i can do is keep stressing that there is nothing in the legislation that makes this like the canadian system. right now 65% of americans get

their insurance through employers. that would not change. in fact, we estimate more people would get their insurance through their employer wants this new health care plan was in place. for those who do not, if they have individual policies, and they are buying their insurance on the open market, or if on medicare because they are a senior, or if they are on medicaid below a certain income, none of that changes. .

it builds on the existing system. it isn't that different other than what we are talking about -- they cannot charge you more or not accept you do to a health condition or difference in agenda for other things that are used now for a rate setting. and, of course, it will be affordable because you will have a large group plan, there will be a subsidy and competition between the public plan and the private sector. but this competition only exists within the health exchange which, again, is not addressing those people that have insurance through their employer or through medicare or any of the other ways we operate. so, i think that the comparison with canada it is just misplaced. i don't want to argue that, but

it is just not the case. host: one last call for congressman pallone -- richard from georgia. caller: good morning. the government-run health care program that you are talking about will be a disaster. i don't think congress or the government is concerned about health care at all. what they are concerned about is controlling 1/6 of the economy. just look at programs the government injected itself -- look at the educational system. we have schools all over the country where high school graduates cannot pass a ninth grade equivalency test. how about the housing market? the government got involved -- they will give people a house without paying for it. they ruined not only the housing market but almost destroyed our economy. guest: again, i can only stress of this is not government-run

health care. it is just the government trying to help people get a more affordable policy. the government is not running the hospitals, the government is not hiring the doctors, the government does not really doing anything to control health care system geared all they are doing is trying to make it possible for people to buy insurance -- doing anything to control the health-care system. all they are doing is trying to make it possible for people to buy insurance. i don't know how to ride insurance for all the people who cannot -- all i know is the private insurance system has not given options that are affordable for millions and millions of americans. if we don't step in and try to provide insurance for these people, then they will end up without insurance, going to the emergency room, getting sicker and costing the government and you with private insurance more money in the long run. again, i don't know what else i

can say other than to say this is not the government stepping into the health care system at all, other than trying to provide more affordable insurance options which are not available now. >> congressman frank pallone represents new jersey's sixth district. >> the commerce department is reporting that orders for durable goods fell 2.5% last month a much larger than the 0.6% decline economists expected. it was the biggest setback since january. much of the weakness reflects 40% decline for orders and commercial aircraft. "the wall street journal" reports homeland security secretary outlines of the obama administration's domestic approach for preventing attacks. the speech is expected to emphasize the concern for civil liberties. following the address the secretary adds to ground zero, her first visit to the site of

the september 11 attacks. more on health care reform from bloomberg news -- democratic senator john kerry says momentum is building for this plan to tax insurers and employers who offer the costliest health-care plans. he speaks today at the national press club. hear his remarks live at 1:00 p.m. eastern on c-span radio. and an update on the mortgage discounts received by senators chris dodd and kent conrad. the two democrats said they knew they got low mortgage rate deals in a vip program but thought the special treatment was a courtesy, like the same as frequent-flier discounts. turning to guantanamo bay, the irish justice minister says his country will resettle two inmates being freed soon. it comes after a meeting today with new u.s. ambassador. the president recently announced his administration needs at least six more months to devise

a long-term plan for the guantanamo detainees. human space flight to the moon and mars will be the focus of a public hearing today in alabama. the review committee, charged with reviewing nasa's feature plans, will consider the constellation program. this is the current framework for sending astronauts back to the moon and beyond. the obama administration asked for the review to assess the nasa's plans for spacecraft after it retires the shuttle. those are the latest headlines on c-span radio. >> "washington journal" continues. host: our question for you is, has the housing market turned the corner? we will take your calls for the next half an hour or so. this piece in "the wall street

journal" this morning -- home prices rise across the u.s. bargain hunting and low rate to drive the first gain in three years, doubled it still possible. the piece says home prices read the first monthly gain in nearly three years according to a new report that provided fresh evidence that the severe downturn could be easing. standard and poor's case shiller index rose half a percent for the three months ending in may. it marked the first increase after 34 straight months of decline and came after a variety of housing indicators have shown glimmers of hope for the past several months. however, home prices remained down about 17% from a year earlier, according to the index. what do you think? has the housing market turned the corner? does it have implications for what is happening in the economy

of the country as a whole? "usa today" has housing prices rounded the corner, as one of the top stories. the piece says the comes on the heel of other promising signs that the market is stabilizing, including a smaller inventory of homes for sale and a continuing rise in home sales. after 16 consecutive months of record year over year price declines beginning in october 2007 and ending in january 2009, the index has shown four consecutive months of smaller annual declines. which cities are striving and struggling -- still struggling on it -- is phoenix, where home sales down 34%, loss vegas, down 32% and san francisco prices in may were 26.1% below a year air -- a year earlier. among the best are dallas and denver.

glen joins us on the republican line from seattle. caller: i would like to comment what i think is happening. i don't own a home but i do have a perspective because i see the signs going up and i do pay attention. but can i comment quickly on the last second for 15 seconds? host: 15 seconds. caller: these people are statists. the medical thing is just a hammer. they will pick up any tool. these people want absolute control over us. host: moving on to the topic at hand. caller: the commercial part of it has not even begun. the commercial market a real estate, which they say is bigger in dollars. that is starting to fall out and it will continue to fall out. i have heard economists talking

about this for three years. i don't own a home. i am in a position where i am not losing but i feel the pain. signs have begun to go up more than they were initially. that is my perspective. i think there is propaganda from the leftist media that love this president. host: "usa today" articles say signs the housing market may be hitting bottom could it mean a more optimistic outlook for the economy, since it was the nose dive in home values that help launch the recession. economists said the big question now is whether the promising signs will encourage homeowners to result in more consumer spending. do you think it will result in more consumer spending? christine on the democrat line from connecticut. caller: i really believe people need to have to look at the losses that have been incurred by folks who own their own

homes, the value of their homes, and the fact that economists from both sides of the spectrum have been saying we have not reached the bottom of this mortgage market yet. i agree with the previous gentleman, although we have different political persuasions, that the commercial real-estate market has not yet figured into this. i am seeing and the store fronts all of the place. the people who own -- i am seeing empty storefronts all over the place. the people who own the buildings will certainly run into trouble when they are owning commercial buildings that are not occupied. i really think that we have yet -- they're maybe a slight blip here -- caused by people who do have money and still have money who are doing profit-taking and buying properties that are far below the cost that it would be to build them. but i hate to be a pessimist, but i really think people need to be prepared for the long haul.

on the previous subjects, i have a request of c-span. i would like you to get one or two people from different sides of the health-care spectrum, if you like, on the air to talk about the economics of health care. i would like people to understand the fact that people talk about it being 17% of the economy. i would like people to see where that 17% travels through the economic system of the country. it is not just the doctors and hospitals who are benefiting or who actually have control of these moneys once they are paid out by the insurance companies. the bank's largely figure into this as well. i would like somebody to come on and explain why there is such a huge resistance to a single payer plan when, in fact, the future resistance is coming from large money management and this company. host: thank you for the call. i would just move on so we can stay on topic.

has the housing market turned the corner? jack is on the independent line from savannah, georgia. caller: the housing market was never down that bad in my area. i think it has leveled off. also the previous topic -- host: act's limit a stick with this one. -- actually, let's stick with this one. thanks for the call. "u.s. steel posts loss, offers brighter outlook." in one of the first signs that key markets of the battered steel industry have bottomed out, u.s. steel this month we called about 800 workers at its huge flat-rolling mill. it goes on to say it also plans to restart a minnesota operation that makes iron ore pellets. does it have implications on where the economy is going?

of the republican line from montgomery, alabama. good morning. caller: good morning. you said republican, i am an independent. host: elwell, thank you for calling. -- well, thank you for calling. caller: the big problem started with fannie mae and freddie mac, and it was designed to help poor people, which is good. however, there were too many people involved which ended up in the banking system. and the pressure put on the sales people in real estate nationwide, and that brought on by the turmoil. in other words, the contract of poor people received were so difficult to read, it was like reading an insurance policy. and can i talk about health care

sometime? host: why don't you call back when we have health care as a topic on the air? missouri, good morning. caller: thank you for c-span. i want to comment on housing. in a small town, this is here where we belong to is running for senate -- i say 20% of the housing is for sale -- where roy blunt is running. most of the businesses there, like a casket factory that employs 400 people, all went to mexico. host: ok, thank you for your call. david from atlanta, georgia. caller: how are you doing? i think the greatest source of that turnaround -- male men like myself in this areas where they are building new homes --

mailmen. if you talked a realtor, they will always give you a positive perspective to drive sales. for me personally, i see all of the new starts -- people are starting to buy them up. but the other factor is, the only way the house and market will turn is to keep the illegals in our country. the housing market is largely based on how many people come into this country legally and illegally. as long as they must be factored into that equation, we will always have problems. host: of another financial store, also in "the wall street journal." chinese convey concern on growing u.s. debt. had a joint meeting geithner

plays down worries, saying both need to maintain stimulus spending -- at a joint meeting. the chinese looking at our situation here. let us go to harry on the republican line from minnesota. caller: good morning. host: has it turned the corner? what are you seeing? caller: pressure being put on banks to borrow, but at this point that they probably are not comfortable with it because there is regulations. one thing that crosses my mind is we hear that houses are living -- leveling out, the markets are looking better. at that point, how many houses are being bought by investors, by companies that have the money to do that, hoping to gain from that purchase? i guess we don't hear about that often, so when we look at statistics they can be falsified by the fact that there are large investors making purchases of

these homes now at a lower rate. host: ok. michael on the democrats' line from new orleans, louisiana. caller: i guess i don't want to be a deadbeat downer, but it seems like we are so eager to hear something good, about the economy that maybe this seems a little too mature. i am not quite sure i can honestly believe that there is anything positive going on in the housing market right now. host: do you think that is particular to your part of the country or a trend you are hearing all over? caller: definitely the part of my country. we are rebuilding after katrina. there is still relief efforts that need to be done. but i keep hearing the same things all over about people really eager to buy houses but not being able to quite afford them.

host: ok, thanks for your call. let us look at some of the headlines coming to us courtesy of the newseum. hear, a story about tanning beds. the cancer risks puts the device in the category of tobacco and hepatitis virus. let us look at "the pittsburgh post-gazette," committee approves sotomayor. she made it through the senate judiciary committee yesterday. moving on to one of the other newspapers, this one from overseas -- "the guardian." crack down on side bends -- sunbeds. and a piece on michael phelps. he was defeated for the first time in four years at the swimming world championships. but his rival was wearing a

controversial polyurethane suit that is to be banned. our next caller is on the independent line. on a cut thank you for taking my call. c-span, the voice of the people. i have a couple of things. the first thing is the market will not rebound as long as banks are not lending. 80% of the banks are not lending. but i see that housing prices are going down, and the rest of the i saw the commercial on tv where they were selling a house for -- yesterday i saw a commercial on tv where they were selling a house for $1. the greed is calling all the problems. last year the $700 billion bailout was supposed to fix it. you know what? it would have only taken, say, $70 billion, and that is a high

estimate. $70 billion to buy out all of the homes. it is all about fraud, corruption, and greed. the same problem with health care. they have fraud, corruption, and greed. if they could get that out of the system we could have everything right. and another thing is -- and i will let you go. we're spending billions and billions of dollars on destroying life and taking life and we could be -- if we would spend half a -- as much on preserving life as we would on destroying life and the destructive methods we use, we would be all right. thank you. host: later in this hour we will be talking with andrew pekosz of the johns hopkins school of public health about h1n1 swine flu. but now our question is, has the housing market turned the corner? tony on the republican line from north hills, california.

caller: you go to american- hijacked.com -- on 9/11 we got hit and the bankers started printing money and they made money easily available and you have crooked bankers to didn't care and they may tons of money -- goldman sachs, who is now financing obama as well. it all goes back to 9/11 and our support for israel that made 9/11. you can look up what motivated the 9/11 hijackers. host: paul is on the democrats' line from clarksburg, md.. caller: thank you. first time i have gotten through. i live in the washington metropolitan area which is supposedly the best market in the worst of times in this housing market. i had my house up for sale, but we are seeing very little to no

activity. i travel north up to pennsylvania, everywhere i go i see a lot of properties for sale, a lot of land is for sale. as long as the unemployment situation is as stagnant as it is, there will most likely be very little activity. but one of the earlier callers was correct that people are buying at the low end, and that should bubble up over time. and that would make sense as people take advantage of the discounts. buying at the low end and then move upward. and what i'm hearing from real- estate agents is that at the top and people are downsizing and the baby boomers will be retiring so there is some consolidation going on there that will be happening with the next, say, 15 years. i would agree the market is slowing. there was some bounce here last

month. there is a link on the maryland state site that will show the average price houses in the washington area. the average price sells for about $450,000. host: thank you for your call. a comment from twitter -- joe rights -- there is nothing positive in the housing market? if this keeps up, poor people will soon be able to afford housing. you can send your comments -- the address is c-spanwj. we will come back in just a moment and talk about the age 1 and 1 swine flu. our guest will be andrew pekosz with john hopkins. we will be right back.

>> this afternoon, senate foreign relations committee chairman john kerry tubbs about climate change, a preview to december's summit in copenhagen. he is also expected to discuss this week's u.s.-china talks where climate change of the major topic. after that, the house armed services committee examines the psychological stresses of military service. both of those events live on c- span3 and online ad c-span.org. >> next week the full senate begins debate on the nomination of sonia sotomayor as a supreme court justice. watch live coverage here on -- on c-span2. and toward the home of the supreme court this fall on c- span -- tour the home. >> on c-span radio, lbj's phone calls.

saturday at 10:00 a.m. eastern on c-span radio. >> join the conversation on civil rights and raise relations with npr and fox news analyst juan williams, live, sunday, noon eastern on "in depth" on c- span2. >> "washington journal" continues. our next guest is dr. andrew pekosz, associate professor at johns hopkins blumberg's all of public health. great to have you with us -- bloomberg's office of public health. as we look at how people are learning about the virus ending discussed in the media. >> overall i think the media coverage has been very good. this is a virus that is a new virus, a new combination of genes and in a new host, humans.

a lot of unknowns and uncertainties. but overall it seems like a virus is behaving as we would expect the seasonal flu would normally be a. it doesn't appear to be as verlaine's -- as we would expect the seasonal flu would normally behavior. it doesn't appear to be as violent -- virulent. the public response has been measured and the program. host: let's talk about the flu vaccine beard with school preparing to come up in a month or sooner in some parts of the country, is there any way to get an inoculation? guest: of the most important thing to remember is we will have two kinds of flu vaccine. we will have but seasonal flu vaccine and also the 2009 h1n1

vaccine. there will be separate vaccines that protect against different strains. it will be important for people to understand which virus they are being vaccinated against and what the procedure is for that virus. the 2009 h1n1 vaccine appears to be on schedule. it is being scheduled right now for efficacy. we should have the results in about a month to two months. it looks like it will be ready to be distributed by the end of october. host: will be a single or double those? guest: we are testing it right now. it looks like the h1n1 will be two-dose schedule as opposed to the seasonal influences will -- which is a single inoculation. host: "the new york times" has a story that some people may not get the regular flu vaccine because they are focused on

h1n1 and writer focuses on how public experts say people should still get inoculated for the regular flu. guest: absolutely. at the centers for disease control later today or tomorrow will come out with guidance. if we looked at the summit hemisphere, which is now in the middle of its floozies and -- southern hemisphere, which is now in the middle of the season, the dominant is h1n1 but they are isolating cases of standard seasonal flow with the other designations. so, while we can't predict with absolute certainty, it is probably a good chance we will see primarily the new age 1 and 1 circulating in the northern hemisphere as well as seasonal -- the new h1n1 circulating as well as the seasonal. host: reuters reports that mark finds the first case of h1n1

resistance to tamiflu -- denmark fine is the first case. guest: we know from previous experience that this type of influence and has a propensity to develop into a viral resistance -- anti-viral resistance. we were monitoring for this and we have seen sporadic emergence of viruses that are resistant. the important thing is we have not seen the spread of tamiflu- resistant viruses either locally or across any kind of regional distances. we have seen a few cases of resistant viruses but no sustained transmission. that is what we will be monitoring carefully. host: our guest is dr. andrew pekosz, associate professor at the school of public health at johns hopkins. you can call with your questions

or comments. the topic for the rest of the hour is the h1n1 swine flu. can you take a step back and remind us what is the difference between swine flu and the regular flow that people have been getting for decades, of course -- how is it different from what we have seen in recent years? guest: the most in port indifference or the most relevant with respect to it being a new -- most important difference for the most relevant with respect to being a new human disease, generating an of bodies to proteins is what protects us from the g-8 antibodies to proteins is what permits -- protect us. it could be generated by vaccines. this 2009 h1n1 is very different

from the two anti virus strain circulated in the human population before 2009. therefore, we don't have any pre-existing community in the population to this virus. the number we most often used is 40% of the population has some degree of upset -- protection in any given year. that number may only be in the single digits, 3% or 5% of the population. therefore this virus is a concern to us because a much larger percentage of the population will be susceptible to influence and therefore we expect the full season to consist of much more cases of influenza which will bring with it more severe cases and perhaps more deaths. guest: why is the fall such a -- host: why is the fall such a crucial time? guest: influenza season particularly in the united states begins in november and

really hit the peak at the end of december and beginning of january. the vaccine needs about four weeks to six weeks before you can generate enough of an immunity to protect yourself from influenza. if you work backwards, what we are really trying to do is get as many people inoculate it with the vaccine in that september- october timeframe so when we start to see cases of influenza, a good portion of the population will not already been vaccinated and have the community needed. guhost: our first call is steve on independent line from tampa, florida. caller: i lost two great aunt in the flow from 1917-1918 and my understanding is nobody knew where it came from and where it went because it came, killed, and was gone. are there any studies being done to compare the 1917-1918 flew to

what we have with the current flu? guest: great question. yes, there are studies. your question is basically two parts. yes, we don't know where the 1918 influence came from because we don't have enough information about the influence of virus strains circulating in human and animal species from that time. we do, however, know where the virus when it appeared that 1918 h1n1 virus actually became what we have now what would cause seasonal each one and one. it continued to circulate. it lost a lot of its ability to cause very severe disease within about two to three years -- after entering the population but it continued to circulate to 1957. it then left the human population and then reemerged in 1977. the 1918 h1n1 has been with us ever since it emerged in the human population but it changed

very significantly in terms of its ability to cause disease. right now we're doing a lot of experiments using animal models and in vitro model systems to look at the ability to the swine h1n1 to cause disease as opposed to seasonal flu and 1918. host: bill on the democrats' line from burke, virginia. caller: a two-part question. well this vaccine be containing an agivant -- and any evidence this was genetically engineered? guest: the second question is easy. there is no indication of that this has been genetically engineered in any way. it appears to consist of segments we can find in viruses that are circulating in nature. it is a new combination, but certainly not something that would be considered as manmade

or engineered. with respect to the agitent question -- right now but could clinical that is put in place to look at efficacy are focusing on rexene that does not have adjutant, because that would resemble seasonal. but their well-being said is looking at that. they help stimulate the immune response and their a lot of data in the literature suggesting they can allow you to use a smaller dose of vaccine and get the same immune response. there for their use may be able to expand the number of people that can be immunized with a limited amount of h1n1 vaccine. host: the comments from a listener -- can we guaranteed that there will not be mandatory vaccination by the world health organization to ensure heard community and if we refuse? i guess the question to the de think of what comes a point

where vaccinations could be mandatory? guest: that is probably not going to happen this year. i think there are too many concerns right now about making sure that we understand about how to use the new vaccine. and i think there will be concerned about making sure there is enough vaccine to protect the vulnerable populations. i don't think mandatory vaccination is something that will come forward at least this year. who does not mandate vaccination procedures, it does not mandate any type of actions for individual countries to take. it can only make recommendations so, it is really up to the u.s. public health authorities and government to make decisions about how to best use the 2009 h1n1 vaccine to maximize the protection of the population. host: henderson, ky, diana on the republicans line.

caller: dr., what are the most severe complications -- one of the most severe complications of swine flu is pneumonia. i was wondering, would there be a benefit for people to get a pneumonia vaccine before the fall, especially older people and perhaps children? guest: great question. the caller is absolutely correct. when we talk about the very severe cases of influenza we talk about infection in the law were loans which often leads to what we call either viral pneumonia for the virus sets up an environment that could cause bacterial pneumonia. it is those types of cases that we want to minimize because those of the ones that have the highest mortality rate. the vaccine should be taken by anyone who falls into the risk groups of pneumonia, and that

those covered the elderly. the centers for disease control will release their vaccine guidelines some time today and tomorrow and will include recommendations for taking that vaccine because a lot of evidence suggesting that that vaccine affects the development of severe secondary bacterial pneumonia. host: michael is on independent line from louisiana. caller: good morning. doctor, considering baxter pharmaceutical was caught red handed approximately five months ago distributing millions of flu vaccine tainted with avian flu to 14 countries in europe, considering that our country, our government just ordered millions and millions of flu vaccines from baxter pharmaceutical, and why should we trust you to trust the

vaccine and why should we trust that this flu wasn't made in a laboratory, considering it has salons a human food, once one and one avian, which could only be designer. why should we trust you or the government or the pharmaceutical countries become this? guest: regarding the vaccine, the vaccine is being tested for safety and efficacy. so, that testing is being done by independent laboratories. out across the country so there is going to be a lot of independent verification that this is in fact what it is and that it works and can generate the opprobrium immune response. i will also mention that this is an inactivated vaccine, meaning there is no lie in the virus in it. it has been killed, partially purified to remove some of the

viral genes present there. so therefore there really will be no risk of acquiring influenza from the inactivated vaccine. the second point about the viral genome -- yes, this is a very interesting virus from a scientific standpoint because it contains genes from what we consider as human influenza come avian, as well as swine influenza. but just the fact that it has those unique combinations does not mean it is man-made. in fact, we can look back into the swine population and find many examples of swine influenza viruses that have genes from avian and human. these viruses under the right environmental conditions can affect the same host and exchange their genetic material. we have seen it many, many times in the past 2025 years. in fact, it is the way influence it generates diversity of the way we have these periodic pandemic. so, it is a very unique virus in terms of genome and combination

but that in and of itself is not uncommon for us and does not suggest this is a man-made or engineered virus in any way. host: dr. andrew pekosz is our guest, associate professor at the bloomberg school of public health. i want to throw up a map that shows love flu view, from the cdc. where cases have been reported from the past week. and it talks about where there have been deaths, reports .... it looks like about half of the states reported deaths from h1n1 beard the most important being alaska with one reported there. california has had the most, which makes sense given the large population. did predictions of how the flu would spread back in april and may, have they come for -- true as we look at how it is spread, cases of it being attractive and severe elisabeth? guest: in terms of severe

illness and death, there was a lot of controversy in the beginning because initially the numbers of severe cases have been -- appeared to be very high. as the infection has spread globally and we have gotten better detecting confirmed cases, it appears the severe diseases caused by this virus are in the range of what we see with seasonal influence appeared the spread of the -- influenza. this bread is another story. we usually don't see influenza virus spreading at this time of year as extensively as we are seeing with this new h1n1 virus. we are not entirely sure what the reasons are, but it probably has to do with the fact that so many people are sensitive to viral infections. it gets back to the issue of pre-existing immunity. the population as a whole is primarily sensitive to infection with this virus and therefore

finding a lot of posts to and that during times conditions for virus spread are not ideal. and it is a concern for us because it may be telling us that when the flu season -- season does arrive, it may arrive earlier and keep earlier and we may see a larger number of cases early in the season as opposed to later, like we normally see. host: kate is calling on the democrats' line from state college, pennsylvania. caller: hi. thank you for taking my call. my question is about the seasonal flu and the h1n1 vaccine. i used to work as a public health nurse and i know from my work that the flu vaccine is made available to people who work in health and long-term care facilities. but i am disabled and i live at home.

a home care worker comes and helps me periodically. she is uninsured, although her agency offers health insurance, her income is so low that she cannot afford to buy the insurance. also a lot of people who work in day care are uninsured because well, for the same reasons. my concern is that even if i get a vaccine, it puts me at risk and a lot of people at risk if the home care and the day care workers are not immunized. i would like to know, what is the plan to get a distribution of vaccines to people who are uninsured. guest: fantastic question. the cdc will be releasing guidelines today, and they will be modified over the next few

weeks, so specifics will be coming out gradually over the next month or so. i will point out, though, that the initial guidance for vaccines is going to target certain populations -- health care workers are one of them. the are barely, compromised, pregnant women, as well as children will be the populations we will look to immunize extensively against both the seasonal and h1n1, 2009 h1n1 vaccine. and the government plan does have a place a distribution network as well as ways to deal with the costs of those vaccinations so we can ensure those populations of going to be covered. host: "the washington post" reports 5 senate pages have been quarantined. five senate pages appear to have contracted the swine flu and it may have been quarantined. how affected as quarantining and how early doesn't have to be done?

guest: to answer the question you have to understand that right now we are in a very different stage of dealing with the virus than in april. in april we were looking at quarantines, school closings, as a way to limit the number of human cases because we were trying to stop this virus from entering the human population and establish itself as a human virus. that unfortunately has happened. so right now when it comes to things like quarantines and a discussion about school closures in the fall, what we are really trying to do is limit the total number of cases. so those types of things will probably be instilled when we have situations where a very global population is at risk -- day care centers are one example, nursing homes or another, hospitals are another example. quarantine is a very difficult thing with influenza because you are usually able to spread the virus and in fact other people

anywhere from 12 hours to 24 hours before the onset of symptoms. so even if you start to feel sick and you go home to work -- from work immediately, you probably exposed people to the virus in the previous day or so. so quarantine efforts and school closings have been done very, very early and have to be very strictly enforced if they are going to work at all. host: this piece notice the senate pages have not been tested, they do not have confirmed cases, because the sergeant at arms of the senate says the test itself is uncomfortable and the results will not alter the treatment plant. how significant is it to be tested to the specifically you have h1n1? guest: again, this has changed from the beginning. at the beginning of the outbreak we were very vigilant making sure anyone with flu-like sets -- flu-like symptoms would get their test because we wanted an accurate assessment. the virus is not established in

the human populations of testing for that virus is not going to be a critical component to the response. when the flu season occurs, there will be testing going on, but for the most part the assumption will be if you have the flu there is a 90% chance it will be the 2009 h1n1 and the procedures for dealing with and treating the flu patients will probably just be universally applied. host: john is now on the republicans line calling from fort myers. caller: good morning. don't you think it is just asking for disaster because obama wants us to get out of our cars and take mass-transit. as you can see, it's a month or two to isolate the cases and by then people in the subways or any monorail systems could affect millions of people and that is where you get the pandemic. what about the older people? obama says he wants them to get

older, if they don't want to get held they should just take the pills and passed away, what about the older people? thank you. guest: it certainly is true that your risks of acquiring influenza of the greater if you are in public places, the more people you come in contact with particularly during floozies and, the greater chance to get infected. it will be part of the 2001 -- 2009 h1n1 prevention plan. avoiding close personal contact with people during the part of the year when lots of the influenza cases are being diagnosed, avoiding public places, practicing appropriate cost and sneezed etiquette to try to minimize the spread of the virus. washing your hands to make sure you are not spreading the virus to other services people will touch and come in contact with.

so this is going to be a very extensive, multi-pronged approach to try to control the 2009 h1n1 involving vaccines, anti-virus and public health methods to minimize the cases. no one is under the impression we will be able to prevent this from occurring in the fall. what we are really focusing on is trying to minimize the spread of the virus, particularly the spread to the wall will populations like the elderly. host: 1 note, president obama has not supported euthanasia. we just wanted to make that clear. if you were named jim -- if we are to receive the vaccine for weeks to six weeks before the season begins, how long will the vaccine last and will last the entire season? guest: this is a new h one -- h1n1 vaccine so i cannot give a firm answer. if it behaves like the seasonal and when the vaccine -- and there is no reason for us to think of what -- we should get a

response that should last six months to nine months. so, even if you are one of the first people to be immunized the beginning of october, you should generate an immune response to protect you for the entire season get a i will remind everybody that the influence of vaccines can only produce immune response to six months to nine months, require you to get an annual vaccination. just because you get one this year just because he got one last year does not mean you and not think about getting immunized again. host: an e-mail -- what is the mortality rate versus the seasonal flow? guest: about the same. very, very low. much, much less than 1%. so, it does not appear to be behaving very different from its seasonal influence of virus with respect to mortality and severe cases. but there is a little caveat to that, and it goes back to this idea of pre-existing immunity.

so i will remind you that the population is very sensitive to this infection beard so you will be seeing more cases of influenza. and you will see a proportionate increase in the number of severe cases and deaths. and every year healthy, young individuals do die from influence appeared so it would not be surprising if we see numbers of severe cases and deaths increase across the spectrum. it is something we are monitoring very carefully because we do want to be sure we are not seen any changes in this virus that are making a more deadly. host: mark is our next caller from the independent line from california. caller: how much is the budget of the united states government on paying for a lot of this biological research? a lot of the research seems to be creating more viruses than curing? i do not know of a single cure produced by some of this research. one of the problems with the

aids virus, the one that is probably the most damaging, is that back in the 1970's there was a great deal of research going on and a lot of the universities and hospitals were getting government money, there was a war on cancer and one of the ways you study cancer is by degrading the immune system -- sometimes chemically, but preferably, using a virus to attack the immune system so you can introduce cancer-causing viruses to allow researchers to test how powerful cause of cancer something could be. so this kind of research going on back and 1970's that led to the outbreak of aids has been covered over by the press, which receives a lot of the same money funneled to the hospitals and universities like his which by advertising in the newspaper to protect this system of money.

what the danger is that these viruses get out of control and the press put out the word that these viruses originates from africa when in fact everybody who writes about the subject in the united states fresno's the research was going on in the 1970's that this exact type of virus has been researched on the during the 1970's and that is what spread into the united states -- and anyone can get on amazon and put in the word aids and argent and find numerous books none of which say that aids originated in africa. guest: well, my answer probably will carry no weight with this collar because i'm part of that infrastructure that he is criticizing. but i will respectfully and strongly disagree with virtually everything he said. hiv is not a man-made virus. hiv can easily be traced back

to origins in africa, and we can find lots of clothes sleep- related viruses to hiv in animal populations -- closely-related viruses. host: of the democrats' line, jerry from richmond, virginia. caller: good morning. i want to ask the doctor, saying they will wash out the vaccines by the fall -- what safety precautions could you possibly test for in such a short time being they want to give these vaccines out in september and october? i heard during the 1970's pandemic or semi-pandemic they rushed the vaccines out and killed more people with the vaccines than the flu actually did. guest: in terms of the 1977 h1n1 swine outbreak i think the caller is referring to, just to

clarify, there were no deaths associated with that vaccine. there were some increase cases of adverse side effects -- one syndrome was linked to that vaccine. but even that was not completely proven because of the difficulties in terms of associating the disease with vaccination. but the core question is a good one -- how we know it is a safe vaccine? first and foremost we want to make sure the vaccine is safe. secondly, that it is efficacious, that it does what we wanted to do. we don't want to immunize the entire population with a vaccine that doesn't work and that is going to cause adverse side effects to a large percentage of the population. how do we know it is going to be safe? we are doing the studies right now. the next eight weeks are devoted to safety and efficacy studies in test population looking at various doses of the virus and how the patient responds with respect to adverse side of tax

and how well the virus works in terms of inducing an immune response. the second thing is, the vaccine that is being tested right now is basically the same kind of preparation that we have been doing for seasonal vaccines for 40 years now. so there is a lot of experience in terms of generating this type of vaccine against influence of virus we are calling on to help us optimize this test procedure. but i want to be very clear about this, that's no mass vaccination programs will begin until the pilot studies prove the vaccine is safe and it does produce the appropriate response that will protect people from the 2009 h1n1. host: jim is next caller on the republican line from texas. caller: hello. thank you for c-span. i would like to know if there have been cases of h1n1 in russia.

guest: i have not checked recently. my understanding was there have been cases diagnosed in russia. again, the who have gone away from updating its web site in terms of numbers of confirmed cases on a very frequent basis because of this movement of the virus in terms of being established in the human population. so, i can't tell you exactly how many cases where the numbers came from but they are having cases in russia. host: joe on independent line from clearwater, fla. -- joan. caller: my doctor with two young children are considering going to england for a short vacation and they have the flu -- i think practically every day.