deal. as i said earlier, we do not know how it is going to play out, but in the report to have been reading in the press about disarray among his people and other factions manubrium -- maneuvering because there were sort of like an independent subsidiary of al qaeda. some of the area's work this on afghanistan. everyone was thrashing around. there are unconfirmed reports of a shoe that during a leadership meeting. this is very good news for all of us. equally important, the pakistani people are converging on a consensus on the importance of this. i think this will pave the way for the doubled efforts.

. . great experts on this, he lived in pakistan for years and has a network of friends that there -- that is extraordinary, to add additional comments that this. >> it's no longer enough to just think of this as a sanctuary contributing to fattah. fattah. fattah is still a very locale for afghan taliban as well as pakistan taliban. the zone of taliban operation rups much farther east and south and north. and what we are seeing is that to bring pakistani and afghan and american interests into alignment to deal with what is now a much broader regional problem, so what we're seeing is the pakistanis have engaged and the ultimate conclusion of this fight against the pakistani taliban will have to

have a resolution of the fattah problem. so we are seeing much more of the hammer and anvil approach and in ard to succeed we'll have to maintain that kind of a relationship and cooperation with pakistan. >> robert, last question. >> good morning. i'm bob dreyfuss from the nation magazine. do you think when you are involved in all this do you have in mind that there's a domestic political clock here in which americans could look at this and as you said know it when they see it and decide that this isn't succeeding? and also do you think that al qaeda's comments about negotiating with the taliban leadership were helpful and constructive? >> whose comments? >> the u.n. did, kaida. >> oh, yeah. >> that we should start talking to the top leadership of the

taliban rather than trying to peel away the local people? >> on the second question i haven't seen the full text. in the contempt -- context i saw them in they seemed to be consistent with our positions and those of everyone else. on your first question, i can't answer your question. no one can. but i can tell you that we all feel the impatience and pressure of the american public and the congress, which legitimately wants to see progress. that's an absolutely legitimate thing and we have spent a great deal of time talking to members of congress and reaching out to groups, never in this configuration, this is unique for us, but to talk about this and so far it seems to me that people understand how critically important is this is. do we need to show progress in of course. we can't make these investments

without making some demonstration that they have results. that's why i said earlier i don't want to confuse input and out putt. we've answered your questions about what's going on on the ground but we're very mindful of the fact we need to show that all these programs talked about today, frankly unveiled in this context for the first time, have to produce results. make john can invite us back in a year and you can hold us to act. i'll leave that to him. that is an open invitation. let me close by noting that when richard began his remarks he noted he was aught our launch event for the center for american progress. he said he hadn't been invited back. i reminded himj#u we had invite him back many times nor private consultations but it's sometimes dangerous to give him a microphone. but the real reason was we were

waiting for a tremendous encore event and i want to thank he -- him and his colleagues for presenting the many components going into the strategy here. it's a very challenging context in which to work and we loork -- look forward to seeing what happens next week during the elections. you have a standing invitation to come back and report on how we're operating against the metrics and objectives that you laid out today. so thank you very much for being here. thank you, john. [applause] >> coming up at 2:00 eastern, we will have live coverage as defense secretary robert gates and joint chiefs of staff vice-

chairman james cartwright brief reporters at the pentagon. >> bill clinton kicks off the 2009 netroots nation bloggers convention. tomorrow, panels on health care reform, with howard dean, pennsylvania politics with center of the inspector -- with senator arlen specter, making change happen, reshaping the supreme court. british voters are expected to go the polls in national elections next spring. this weekend, a conservative party leader david cameron on how a tory government would change domestic policies. this fall, and to the home to america's highest court, from the grand public places to those only accessible by the nine justices. the supreme court, coming the first sunday of october on c- span. >> president obama goes back on the road tomorrow to talk about health care.

he will be in belgrade, montana, to talk about his plan to overhaul the nation's health- care system. on saturday, the first family plans to spend part of the day in yellowstone. afterward, president obama has to another forum in grand junction, colorado. white house officials have said that the trip is partly aimed at encouraging people to visit national parks, as well as to get out the message on health care. this morning, "washington journal" asked to be worse if the message is indeed getting out. we will show you as much as we can -- a view is if the message is indeed getting out. we will show you as much as we can. have the health care protests changed your mind? beginning with a call from sun city, fla. on the independent line. what is your thinking as an independent? caller: thanks for taking my call. it has changed my mind a bit.

i think the american people would benefit by being a self- insured group, and i think it is nice that obama it is given a choice. what i would like to impress everyone with and this is very important -- on ofe the things we must do is lower costs, the matter which way the vote goes. -- one of the things we must do. cancer is one of the most expensive things to treat and people need to be educated by it. vitamin deficiency caused scurvy and it took hundreds of years for people to realize it was not caused by a virus. when the people sailing on long

they knew what the answer was. now, there is a vitamin that does prevent cancer. host: need to be quick read what is it? caller: please, people, read "world without cancer." host: wisconsin, republican line. this is proper. good morning to you on this thursday. caller: thank you for taking my call. host: as you are watching the protests and town hall meetings, have you changed your mind on all this? caller: i guess it opened my eyes more to not so much that it changed my mind, but that the reaction from the president, nancy pelosi, robert gibbs' statement, like its american not to agree with -- un-american to

not agree with the proposed plan. i do not agree with the anchor and being out of hand, but i do not agree with it being unamerican. a lot of the same ones making these comments, with the proposal that the bush administration proposed, they attacked with malice upon him. now they are doing the opposite, and it will change a lot of people's minds, and it is coming out right now that is changing people's minds, the way they are attacking just for voicing their opinion. host: your comments lead to a question asked in the "usa today"-gallup poll. the light gray is democracy, dark green is of use. -- is abuse. people in this poll asked if these actions were democracy or abuse.

51% say it is democracy, angry attacks against the builder doing members of congress, a 47%, abuse. shutting down supporters of the bill, 59% said it was abuse. next up is tony in washington, d.c., democrats line. caller: people really need to get the politics out of this. this is seriously too important. i agree with obama when he says what is the consequences if we don't do anything about it? people have to get well informed. they need to get information from more than one source. does issue has to be taking care of -- this issue has to be taking care of. if we bring politics back to this, it will go back to 1992 and nothing will be done. the insurance companies will be business as usual, making billions of dollars while hard- working people are no better with health care than they

deserve. we have to go back and really had a very serious debate -- have a serious debate and get information from multiple sources. don't get information from one source. whatever view people are putting forward, they have special interests. we need to get information from multiple sources and let's move forward. host: austin, arkansas, republican line. caller: good morning, susan. my question that i would like to bring up is just where in the constitution doesn't say that the president of the united states -- does it say that the president of the united states and congress have the authority to take taxpayers' money and spend on health care? i would like to see you ask a question based on fact and not just opinion di. you listen to c-span for 10 minutes and you find out what a

poor job of educating the public is done. ask a question based on facts and not opinion. host: thank you. "washington times" has a story about the public opinion the effect of the town halls. they have put that story on page a9. inside "the washington post," david broder's column has a different tack on it. he looks to history and suggest that the could be a backlash among voters looking at the angry outpouring of the town halls. he looked to the lyndon johnson era for this, and he writes, "in 1960, just a few days before the presidential election, he was part of a crowd of several hundred people, the first republican congressman elected to texas in the modern area --

era, was one of several hundred people who surrounded lyndon johnson and his wife, lady bird. many of the demonstrators carried signs calling the texas senator judas. the johnsons were engulfed by the crowd and for more than half an hour they were reviled and jostled. johnson refused offers of police assistance, telling an aide that if the time has come that i cannot walk with my daddy across the lobby of the hotel i will know it. the seed in the adult was outraged thousands of texans and southerners. senator richard russell of georgia, who had not campaigned for his party's national ticket since 1944, telephone and johnson that evening to offer his services." let us go to the next phone call, a shreveport, louisiana,

independent line. caller: yes, ma'am. nobody has read this bill, it seems to me. all these so-called congressman won't take the time to read the bill. they get out your to these town hall meetings and the people that go to these meetings, they read the bill on the don't like it. the shutdown our throat, just like the bailout -- they shut it down our throat, just like the bailout. democrats and republicans, they have been bribed, blackmailed, intimidated, what are the other. -- one or the other. mary landrieu is sitting there and saying it is a wonderful thing. i don't think she has read it. this is communism at its best, as far as i'm concerned. i sit here and watch this and it just amazes me. they have done to the people down so much -- dumbed the

people down some much that if they put the drugs and the trash can, maybe it would understand what is going on in the country. i know people are hurting for insurance and everything, but they need to pick themselves up and quit waiting on the government to do it for them. it is a shame. it really is. host: thank you. next is new haven, connecticut. this is mike on the republican line. caller: i don't believe that these protests are going to do any good. town halls started in new england. all these protests, and yelling at senators and congressman, that is not doing any good. there is four different bills. just procedures that are going to get to the bill. i went to a town hall meeting with the congressman in milford, connecticut, and i did not see anything like that, believe me.

there were republicans there, democrats, independents. i agree with david broder. there is going to be a backlash against these protesters, because i'm a republican, susan, but we need to reform health care. i saw senator grassley on fox news yesterday saying that they want to kill granny. that is an awful like, susan, and everybody knows that. you go to a factcheck.org, and that is a lie. thank you, susan reed have a nice day. host: next up, scott, you are on. caller: thank you, c-span. they don't persuade me one bit. they make me more sure that the system needs to be changed. i don't understand why it is just not changed for the simpler.

if you have an automobile and you have collision coverage, there is a deductible, and you know what your deductible is. if you crash your car, it is going to cost you $250 or $1,000. my deductible, through my employer, which i have no control of, is $10,000 a year in the hmo. and the health-care industry, corporations, and billions of dollars every year, so the argument that they cannot afford to cover all of these myriad of exclusions is not correct. there are so many exclusions in my health care policy, when i read over, that it is mind- boggling. what i will be and the hook for to pay out of pocket, when i call my health care insurance company, they will not discuss with me what the actual costs are. i pay in full of my employer for my health care, and i believe

that they are actually profiting from my health care, so again, very quickly, if there was a simple deductible where we could rely on, even if it is $2,000 or $3,000, and we could rely on a cold eye and not have to deal -- on a copay and not have to deal with the myriad of exclusions. host: thank you for watching. the front page of "the new york times" today, "obama taking an active role in health talks. contrary to the public image of the president presenting himself as aloof from the legislative affright, merely offering broad principles, behind the scenes, mr. obama and his advisers have been quite active, sometimes negotiating deals with a degree of coal called -- cold-eyed political realism potentially at

odds with the president's rhetoric." louisiana, republican line, you are on the air. are you there? yes, you are on the air. caller: i am sorry, susan thank you for c-span. you have a wonderful show. the protests -- nothing could change my mind. i wish there was some way we could do it all on c-span, civil, where everybody could find out the truth. you listen to one channel and it will give you 15 different situations, the next channel will have it just the opposite, the third channel has some white in the middle. who are we to believe in all of this? the only way where people can enjoy it and make up their minds sensibly is if it was done solely on c-span. thank you. host: atlanta, independent line. caller: thank you for taking my

call. i am a senior citizen. i do get medicare. it seems to me that a lot of people out there forget that medicare is a government run program. in their view, it is socialism. all those people who are collecting medicare and social security, i don't know what they are arguing about. we have the same argument with the republicans fighting against medicare. if we could take care of our older citizens, why can't we take care of the younger ones? thank you very much. host: georgia, and jack on the republican line. caller: hello. good morning. i had a flawed -- had a thought,

with the white house and the democrats telling us what we're thinking, instead of listening to us -- why don't we have a super tuesday vote on this? that way they would have to bring it all out to the american people about the bill. that way everybody knows about it, and the american people could get the vote on it. better than having somebody tell us what we want. host: don't you think your representatives in congress are charged with that? caller: ma'am? host: are mature representatives charged with bringing a point of view to washington? caller: i did not elect officials to tell me what i want. it seems like it is a hard time right now when they are not really listening to us and they have a low approval rating. i figure a super tuesday's vote which everybody what everybody

wants. host: jack is calling for a public referendum. "the washington times" has a story of aarp wielding power in the debate over health care. we will be talking with the government relations senior vice president of the aarp, who would be with us for 40 minutes beginning at 9:00 eastern time this morning. next from call is from detroit, aned on the democrats' line. caller: a couple of points. one is that i work in the health-care field. i see both the patient perspective, the physician perspective, understanding the insurance industry. i think there are two issues that are being overlooked here. one is that these are not grass- roots protests. these are being sponsored by professional organizations, and these are not the interested

citizens that are just showing up. what i find interesting is that one of your callers talked about the facts, the concern that the government seems to be forcing "government-run health care" down the throats of the american citizens. but what no one seems to want to answer is that the medicare program, if i recall, is a government-run program, and any time at these town hall meetings an individual is asked you are on medicare, they are like, the gap, we do not want the government touching our medicare. medicare is a government program. secondly, the fact of the matter is that these individuals, in terms of their approach, are just basically making statements that are -- like these that the statements -- i think it will have -- like these

death statements -- i think it will have a backlash. if it is truly a town hall meeting, there is supposed the opportunity to have a diverse views. the approach that these people are taking, 50% shutting down individuals, that is not going to produce results. if you want of a discussion about the debate in america -- one last point is as pertains to this administration forcing down something the american people did not want, one thing people fell -- fail to forget is that the prescription part deprogram from the bush administration forced to that and push that piece of legislation and misrepresented the entire program. no one seems to have an issue with that. that cost seniors twice as much. host: two different front pages -- "the philadelphia inquirer"

talk about health plan backers filling the need -- senate candidates joe sestak, who would very much like to have arlen specter's job in the state. "the baltimore sun" as a store, "two dialects, one thorny idea. most say that the bill would hurt care unburden the nation." -- and bird in the nation. -- burden the nation at." let's hear from rich in south bend, indiana. caller: these protesters have not changed my mind. the system is broken. our entire health care payments is based on a prior -- prayer that every employer in the

country will offer employees the health care and pick up 80% of the bill. the very second one employer says i am not point to do it -- i am not going to do it, the system breaks down. we have 50 million americans without health insurance, and it is costing us money. a person that does not have insurance does not have money to see a doctor, is in the emergency room, getting routine stuff done -- a broken arm, and your infection -- and suddenly there is a $1,500 bill. what happens? the hospital is not going to wait four years for the guide to pay him $5 a week. and they will say, "you know what? you don't call me any money." this the reason you got a hospital and your wife is having a baby, you are having a gallbladder, whatever, they give

you an aspirin and charge you $500. it is costing us more money. i run a small business. >> "washington journal," life every day at 7:00 a.m. eastern. we go now to the white house and today's briefing. >> let me make just one short announcement before the questions today. president obama will attend the 17th asia-pacific economic cooperation leaders' meeting in singapore november 14 through the 15th. it takes an important forum that brings together the dynamic economies of the pacific rim. singapore is an important partner on a range of regional and global issues.

president obama will discuss open trade and investment, support economic recovery and sustainable development, and address the challenges facing the region and the world. the president expects to visit other countries during his trip to the region. for the announcements would be forthcoming -- further announcements will be forthcoming when those announce -- those plants -- i don't buy tickets based on any assumption. >> you cannot go to one of those countries without going to all three of them. >> the president expects to go to other countries during his trip to the region, and further announcements will be made when those plans are in need finalized. let us go alphabetically. that is because you finished the crossword puzzle. >> can you say whether this would be a link the trip?

-- lengthy trip? >> some of that will depend on a number of factors. obviously, scheduling, where we are in any of the legislative calendar, what have you. the reason we wanted to get this out -- we have advance teams that are going relatively shortly to singapore, and as we get more definitive plans, we will certainly let you guys know. obviously, there are a couple of other possible countries, but i think at this point, getting into trying to look into the crystal ball would be hard. [unintelligible] that is not on my sheet. no, hopefully, it is not long after. >> can you talk about what the president is doing over the next couple of weeks on health care,

other than the town halls? what kind of role is he taking in terms of talks with lawmakers, negotiations? what is his game plan? >> obviously, i know you ask me in addition to or other than the town halls. i note that we are doing goes over the next couple of days. we will do some of dense not yet announced -- events not yet announced over the course of the next day after that. i expect that throughout both the congressional break as well as the time he gets to spend with his family that there will also be calls with different lawmakers about plans for what happens for when we called -- for me come back in the fall. >> they are on a pretty tight schedule.

they come back from the recess and there is a september 15 deadline to take a day like today, when there is nothing on the schedule and it is quite publicly. -- quite publicly it is making calls to lawmakers -- >> he has met with staff on health care. i've not seen any notification about calls. he will get a chance -- as we said yesterday, senator baucus will be in attendance at tomorrow's town hall. i'm sure there will be a chance to talk about the progress, the talks that he is having with members of the finance committee. as i said, i know those calls will continue over his and their brakes. >> he told "time" magazine that he was spending a portion of the day every day on health care. i cannot remember what quantity he put on it. is that still true over the next

couple of weeks? >> look, we will segment out for his benefit that as he is on vacation, he will concentrate on being on vacation. i do, though assume -- not assume, that is the wrong word -- i know that he will continue to talk to lawmakers on that. it probably will not be as much as when congress is in town, but there is no doubt that you continue to talk -- he will continue to talk. >> with these town halls, does he feel like he is winning converts? >> i think he feels strongly that it is important to address misconceptions or misimpressions that have been left out there about the bills. i do believe that the president feels strongly that when he

makes his case, it helps the case for overall health care reform. he felt very satisfied with what happened in new hampshire. he was able to address concerns that people had. i think he was able to take on, as i said, the misconceptions that have been out there in the legislation. i think he feels like we have made progress. >> will the reform of the generally the same? >> it has largely been the same for several years. your question, raise your hand. -- if you have a question, raise your hand. [unintelligible] he has been going girl-boy -- >> it is a falsehood. he then went boy-girl. >> i think he did a sort of rain man thing and counted more men

than women and hedged with boy- girl rather than roll-boy. [unintelligible] we don't segment town hall meetings based on party ideology. he asked for a show of hands at the meeting of those who had concerns about the legislation. again, i do not think we would ask people to stand up. the point of this is not to send people by political party or political ideology -- segment people by political party or political ideology, but to address their concerns. you can be of any number of political said -- political persuasions, and still have questions to ask the president . [unintelligible] there's no question in new hampshire, what he addressed the most has been addressed by some of the last few days, this

notion of some call them in death panels. i think what senator mccaskill in alaska said very clearly -- senator murkowski addressed very clearly as well. >> polls indicate that many people are not with the president on health care reform. he is obviously trying to change that. >> i don't want to quibble with -- >> a majority of american people are not with the president on the legislation he is trying to get through congress. >> well, i think if you look at -- not to mix networks here, but if you -- your poll -- >> more people disapprove of the president's handling than approve. >> ok, clarify the question, because the reason i was scribbling -- not to get into

the freezing appalling, but if you ask just straight up, here is what it yet, here is what it costs, the number was 58-38, something like that. >> theoretically, they are with what you say you are pushing, but -- >> go ahead. >> the polls are not we wanted to become a would you quibble with that? -- wanted them to be. would you quibble with that? >> on some of those, i would not quibble with that. >> if the press -- if the public is with you on something that if people -- >> i think there are misconceptions. people have questions. the president has been out doing town hall meetings not just for his health. i think he understands that there is a need to address

concerns or misconceptions out there. i think, again, that the president, whether it is the nbc poll, certainly other polling would demonstrate that people want to see health care reform this year, they want to see legislation that cuts costs, they want to see legislation that provides accessibility of coverage, that has insurance reforms, and that is what the president will continue to talk about. >> the fact that the american people are not with the president right now -- does that indicate that the push back, whether it is the bible e-mail discussed today, the reality -- viral e-mail you discussed today, the reality check, does it indicate that the push back its fleet? -- push baack is late?

>> i don't think so. your question is based on polling. polling is a snapshot in time. the debate continues, and we will see whether the numbers move or change as a result of a continued debate. >> doesn't the fact that you started cutting back indicate that you realize that the initiative is in trouble? >> one of the reasons we pushed back is because of the misconceptions. some of them contributed to the poll numbers, i don't doubt that. but at the same time, there is a little cause and effect here, but we are not produced, pushing back on the misconceptions -- we are not going to stop pushing back on the misconceptions with are not the polling shows one thing or another. the president strongly believes, and has for years, and that is better to address what people's concerns are and take them head on.

>> one more question, sorry. the farm ideal -- pharma deal -- there are perceptions about what the white house has agreed to. can you clear up what exactly the white house signed off on, and whether the senate finance committee and senator baucus were up front with you on what he agreed to, and whatever deal this was, was this keeping the transparency that the then- candidate obama promised? >> yes, let me take the last part of that. the question a few days ago something similar to this, we discussed bringing people to the table. making sure that pickel was involved in health care -- making sure that stakeholders involved in health care are part of an agreement. he will not get health care legislation without involving the hospitals, those that provide medications, without

talking to groups that represent doctors or patients or seniors, nurses, what have you. we've talked a little bit about the pharama deal. the finance committee in pharma agreed to $80 billion in cost savings, part of which goes to fill the doughnut hole for seniors as part of medicare part b, which i think we all know -- medicare part d, which i think we all know is that a certain point, the purchase of those drugs stops until you reach a catastrophic level on the coverage kicks back in. some of the additional savings would be used for health care. >> what the white house agreed

to come up bypassing most members of congress, did you agree to impose the importation of drugs, did you oppose a repeal of non-interference, opening of medicare part b? that is what some lobbyists are saying the white house has agreed to. >> the same article that it knows that as the nile from both -- has denials from both pharma oand us on that. >> but the president in portsmouth said that maybe you could get more. >> i do not believe the president that we could take in $80 billion agreement and make it 95. i have been fairly clear on that from here. i think as a result of the change of health care, you can see health care costs driven down.

>> you are denying -- i am denying -- >> i'm reassuring to the mild that it is in the story you are referring to -- reissuing the denial that is in the story you're referring to on our half and pharma's past. >> what is the present hearing about lawmakers in this town halls? is there a sense of frustration? >> i have not seen a list of calls that he had made recently. staff has talked to a number of offices. i hate to break it to you, but i do not think all the town halls are what you're seeing on tv. >> tell us what the town halls

alike, then. >> people are having very good conversations about what is in the legislation, what people would like to see, what options they want to have, why they think it is important. i said this yesterday and i will say again -- while i appreciate that you all have decided that every town hall meeting ends in pushing and shoving and yelling, i don't think -- i don't know how many town halls you all have been to -- they are not completely in the give up what is going on in america. >> can you give us a list of lawmakers -- you have a broader span of knowledge -- >> i don't have as many sources as "the new york times." >> but you are obviously

collecting information -- >> we had this conversation yesterday. i do not know what your plans are this week. >> my plans are traveling with the president. >> excellent. >> until 2010, what is taking place in preparation of jumping into this next year? >> i think the president discussed in mexico a more formal legislative timetable, understanding, though, that that does not mean that work does not continue. use of secretary napolitano -- you saw secretary napolitano work on aspects of comprehensive immigration reform. she will continue to do that and me with stakeholders -- meets with stakeholders, and discuss along different border communities the challenges and

opportunities, and what has to be done in order to make comprehensive immigration reform possible. >> are the groups being brought in to ship whatever is -- >> i think there will be meetings soon all of that. >> back on the pharma deal, all we to believe that they did not get anything in return from the white house, any promises, wings, knots, whatever? are we to believe nothing was promised? >> i sent it was responding to a question about the memo -- >> can you answer that question -- can you say for sure that they were promised nothing in return? >> i can assure you that we have come to an agreement to seek some savings from the pharmaceutical industry as part of comrades of health care reform. >-- comprehensive health care

reform. >> at what point will you release the facts of the deal? >> i think some of this will be written into legislation -- >> why not release it now? >> some of those agreements are with the finance committee. >> speaking of the finance committee, chuck grassley was at town hall yesterday. what has the white house reached out to him and asked him why -- to his comments jeopardize the bipartisanship that you're trying to get? did you see his comments? >> i watched your newscast. >> your reaction to those comments?

>> i would have him talk to senator murkowski. it was not on your newscast, but "it does us no good to say that there are these end-of-life provisions, the step panels. i am so offended by the terminology, because it absolutely is not in the bill. there is no reason to gin up here in the american public by imagining things that are not in the bill." >> would you say that to senator grassley -- >> i think that what she said -- >> does this surprise bipartisanship? >> note. obviously, the president is talking to lawmakers. >> besides the town hall, what else is he doing tomorrow in montana? >> i hope he will be enjoying big sky country. >> hiking, fishing?

>> i do not have any announcements on that today. at least i could lean on that side of it. >> robert, i wonder follow up on what chuck was asking about senator grassley. he is the top senator on the senate finance committee. senator grassley came out and said no public plan option, no way, know how. yesterday, he had a chance to qualify the death panel thing, and he said that people had a right to be afraid of it. can you still count seriously talk grassley as an ally in getting your health care bill passed? >> i still think there's the possibility of getting bipartisan agreement through the finance committee in order to make progress on a piece of

legislation that can pass the senate. >> does the senate -- as senator grassley supported in particular? >> senator grassley, senator and he, senator snowe. -- senator enzi, senator snowe. they will hopefully quell the perceptions felt even by people in the senate about what the bill is and what the bill is not. we continue to hope they make progress. >> he seems to be playing rope- a-dope with the white house. >> i guess we will see about that. >> senator grassley did yesterday specifically asked the white house or the president to say he is willing to sign a bill that does not at a public option. is that something the present

in -- something the president is willing to say? >> the president is willing and wants to sign a bill that has adequate choice and competition for those that enter the private insurance market. understand the concept of this option was to provide exactly that. an option in an otherwise closed private insurance market that in some areas and parts of the country are dominated by -- might be dominated by only a couple or in some instances only one insurance company that is offering the ability for coverage on the private insurance market. the option of an additional plan is to simply provide some choice and competition to a group of people that can only get insurance that way, because their employer does not provided, they don't work, what

have you. >> so you are saying there needs to be a public option. >> i am saying there needs to be a mechanism that appropriately institute's choice and competition in the private insurance market that is normally or can be at times very narrowly closed in order for those concepts to impact people's ability to buy quality health insurance. >> do you know if the president has ever consulted on health care with rahm's brothers? >> zeke has talked to staff and others about health care. >> you mentioned that some of it would be written into the senate finance legislation -- did i understand correctly? >> again, that is the panel, if

you are talking about getting different cost savings into the bill on the senate side, that is the committee of jurisdiction. >> that agreement, the $80 billion, is not binding in congress. >> is not binding on all of congress? >> all of congress. >> that depends on what comes out of the senate and what is agreed to in the conference committee agreed that is projecting a tad ahead ourselves. it is an agreement they entered into. >> robert, a couple of things on the public option. in the e-mail that david axelrod said today defining principle goals -- principal goals of health care reform.

by my reading, i did not see a mention of a public option. are there other priorities that take precedence other than a public option? >> let me be clear -- this is an option that provides a choice and competition in an otherwise narrow or closed insurance market. that is the president's goal. to ensure that if you did not get your health insurance or your employer did not have those types of options, you would have something that might compete with the only game in town. i think that is in david's e- mail, trees of competition. -- choice and competition. >> speaking of the e-mail, how is the list of who will receive it determined? >> people who signed up to receiver on the white house. >> i have received e-mail for

people who of not seek any communications -- who have not seek any communications from the white house -- let might finish my question -- >> you have done this a couple of times, major, and i would be clear -- don't look funny -- ofa has nothing to do with and never has anything to do with -- if you sign up through whitehouse.gov to receive e-mail -- the reason i interrupt is right when you rephrase your question that does not continue to assume that somebody is violating -- >> never ever sign up for anything related to this white house, senator obama as a candidate or anything, and have received e-mail from david axelrod. how could that be? >> i would have to look at who you said got the e-mail. >> other pieces of information

of people who might be curious about health care outside of people who ask for e-mail? to you in anyway seat databases or information about people who might be interested in health care? >> i will certainly check. i would do not have that information. i would be interested to see who you got that e-mail from, and whether or not they are on the list. >> may i follow up politely -- >> let me finish dealing with major. >> you are telling me that you need to give me the e-mail us to see if they are on a list. i'm just asking. >> you are asking if they are on a list. >> they are telling me that they cannot be on a list because they never asked for in e-mail from the white house. >> what i am saying is that i would have to look and see -- >> you do not have an explanation for how someone who

never signed up gets the e-mail -- >> i hesitate to give you an answer because he might into the motives of the answer. -- you might impugn the motives of the answer to a with a cap on it some clarity on -- >> you do not have to include anything. i am telling you what i of god. -- i have got. >> let me go to someplace else that might be constructive. >> senator grassley put out a statement a while ago saying that the finance committee dropped the consideration entirely because of the way it could be misinterpreted and implemented correctly. what the president's support a bill that does not have these end-of-life provisions? >> i have not asked him about that.

>> is it something he feels strongly about that is necessary? >> i would talk to him specifically about that. >> you talked about the town halls and how people sign up for them. i'm wondering if you could give us more information. how many people do try to get in? how far in advance to you put a sign up list on the web site? how does it work, if i were a citizen wanting to come to a town hall? >> obviously, the size is determined by the venue and capacity with which the then you can fill. -- the venue can fill. i do not know how in advanced parts with one was. -- how far in advance the portsmouth want was a lot of it done -- was done with local media. >> do they find that there are many more people who want to get in and it is random?

is it that way always? >> a different sign-up for different populations, but that is generally the way it is done. >> is that the way it will be done this weekend? >> i do not have clarity on how it is done this weekend. [unintelligible] >> a lot of our editors and producers want an answer for, can you give us clarity on how the montana -- >> and the grand junction as well? >> one on israel and afghanistan. a lot of people are asking the president to make more -- put more pressure -- do these have an effect on policy? >> i do not know if the president has seen the letter. you cannot have comprehensive middle east peace without asking

both sides for -- to live up to their responsibilities. without having seen the letter, it is hard for me to comment. but some -- efficient safe to say -- safe to say that the president, in talking with leaders throughout the region, had asked for -- -- for them to live up to different responsibilities. this is not a one-way street. .

obviously that is an encouraging development. in terms of the overall security situation in the country, my view, and i believe the view of most of our military commanders is that american at mixed picture. in some parts of afghanistan the taliban have clearly established a presence. the operations under way now and those being considered for the coming months are designed to roll back the taliban and establish a lasting security and government presence. its presence that can get the afghan people confidence that they will be protected from intimidation and retribution. an absolutely critical factor in the success of this mission is reducing civilian casualties from military operations, and i believe the rules of engagement changes are making a real difference. we still have more work to do in this area.

these military operations are but one component of a multi- faceted strategy for afghanistan and pakistan announced by the president 4.5 months ago. at this time, general mcchrystal is assessing the security situation in the context of the president's goals and strategies and will submit his submission -- and will submit this by early september. that assessment will not include specific recommendations or request for more forces. however, we have made clear that he is free to ask for what he needs to complete the important mission that he has been given. though there has been a good deal of reported recently about what general mcchrystal may ask for, i can tell you it is premature to speculate on that. any future resource request will be considered separately and subsequently as a result of the security situation. we will be happy to take your question. >> how long do you think

american combat forces will be fighting this war in afghanistan? >> i think that is -- in the intelligence business we always used to categorize information into two ways, secrets and mysteries. the secrets or things that were ultimately knowable. mysteries were too many variables to predict. i think that how long u.s. forces will be in afghanistan is in the area. i think we're certainly hoping to see progress within a year. in terms of the president's new strategy in general mcchrystal is new strategy and tactics and certainly it would be our hope, assuming we are moving in the right direction, that we would see a situation that we have seen an iraq where more and more

of the security responsibility will slow from the international security forces -- will flow from the international security forces to afghan security forces. we all see a significant pacing factor here to be the speed with which we can accelerate the growth. we have a lot of money in the budget to do that for the fiscal year 2010. so i think that it is just not possible to predict specific periods of time when you're in a conflict like this where the enemy has a vote and where there are so many variables, but i think, like i have said from the very beginning, i think we need to be in a position to be able to show progress within a year.

being in a position where we could completely be where we are in iraq depends a lot on the political environment inside afghanistan and also on the afghan national security forces. thank you. >> i will stick with the mystery construct. things that i would look for that would tell us if we're moving in the right direction would be when we can start to turn over certain areas of responsibility to the afghan national army for the afghan national police for security. when the security is an equal interest of us and the people there and they acknowledge it and contribute it. when you start to see that attitude change, then you start to have a sense that things are or to move in a direction that would be towards the end it of

the violent side of this equation, which is what i think you are asking about, and then more towards the stability of the holding side. >> clearly what you're hoping to achieve in afghanistan, rebuilding institutions, rebuilding the sides of the forces, the economy, it will take many years. david richards says that british troops will be committed there for about 30 to 40 years. does that sound right? >> i do not agree with that. first of all, i think you have to deceit -- you have to differentiate between economic development and defeating the taliban on the other. i think the latter can be accomplished with all of the considerations that i just described in a few years.

the larger part of it, economic development, and institution building probably is a decade- long enterprise in a country that has been through 30 years of war and has high electricity -- and has such a height you literacy rate. -- high illiteracy rate. we are committed to that side of the equation for an indefinite amount of time. that is what we do all of the world in developing countries, and said that is a long-term prospects, but in terms of the security situation, i'd been for looking at a much shorter time frame. >> [inaudible] >> i said it is unpredictable, perhaps in a few years. on grass over the next few years. >> can you give us an update on

the correct operation. is it accomplishing what he set out to do? -- is it accomplishing what you set out to do? the desired time when for this kind of operation, or couldn't something along the same lines been done something sooner without days to spare before the election? >> on the first count, with the work that is going on, we're seeing positive signs. i think that commanders believe they are making progress. if the election is the time when we're looking at, the metric is, are more people able to come out and avail themselves of the democratic process of voting, yes? s. are we stable? have attained all of the objectives we intended to obtain? and not yet. we have a lot of work to do there yet. my sense is back to the original question, that will take us some

time. we have certainly, i think, from the standpoint of the marines and strikers, have established a situation in an environment where the elections are to be better off than they were before. >> i think the answer to your second part of your question forward. the forces were not available to said in until pretty recently. we got them in there as fast as we could. >> congress is away for recess and you can't keep building -- and you can keep building doorcase for budget deficits. the house wants to build a said in june, the senate does not -- the house wants to build a second engine, the senate does not. does this cost growth undercut your case for keeping one

producer of the engine for the pentagon's largest weapons program? >> there is always cause growth associated with the developmental aircraft. it was true of the f-22. there are often development program -- problems. it is one of the reasons we have over $4 billion in the budget to reduce program risk to allow for more engineers, more testing time, more testing, and obviously the engines are part of this. we think that fixing the problems that we have encountered, the challenges we face with the engine, is something that is quite manageable, doable, and we do not think it is the best use of

our money to fund a second engine. >> there is more than one way to manage the risk. two engines might be one, but the path that we're on is to manage it with technical expertise, making sure we are working off any issues that we can see that technically might be a risk, and from a standpoint of a larger decision, there were a lot of decisions why we went to the single engine. they still stand valid. >> are you in favor of fixed price contracts so that the taxpayer does not get nailed with cost? >> i think that is something we would have to look at. i think once the production begins, congress clearly likes that idea. i am certainly open to it, but i think we have to get through the development part of the program first. >> you have expect -- expressed

reluctance to send more troops to afghanistan. are you changing your mind in response to the belgian meeting? >> i have expressed my concern in the past about the size of the footprint of international forces. i think general mcchrystal makes the very valid points that how those forces behavior toward its the afghans -- toward the afghans is clearly an important element of that. so far, i think most afghan css there to help them and their partner. -- most afghans see us there to help them and their partner. i think we need to work with the afghans in the afghan government.

it is still a concern for me, but i would say also that the availability of forces is still a challenge as well. >> what is your view of the resources? >> right now we have a new strategy. we are resources that strategy. the forces have not all been sent out. as general mcchrystal goes through his assessment, it is an understanding that he is still receiving forces. what he is assessing is, have i got it laid down right? is it appropriate? is the resources laid down our corporate for the problem that is actually their? key will come back to us and talk more about -- he will come back to us and talk more about, and i going to be able to do the job that i was given?

it is a question of the strategy resource mix, and is it in fact executable as we go forward? remember, the forces that are moving to the theater on this updated strategy are not all there yet. >> what could 4.5 months of the -- one of the things we do not hear you talk about anymore is osama bin laden. you look at this and you are so busy with this, administration- wise, to what extent did osama bin laden become less of a priority on a scale of one to 10 basically? >> i think we're still very interested in getting rid of the leadership of al qaeda, and i can tell you that the effort against al qaeda, not just in

afghanistan, but in other parts of africa and the middle east goes on. i think that our view, my view, is that what we need to do -- i think we have done some real damage over time to the al qaeda organization leadership. i think they still have capabilities. they are still the most dangerous terrorist organization in the world with respect to this country and a lot of our allies. they remain a very high priority. by the same token, that does not mean that we cannot resource the effort in afghanistan either. >> with respect -- i understand about the leadership. can so many americans remain deeply interested.

the president, while he was campaigning for office, talked about capturing or killing him. can you tell americans if you have had any good leads in recent months? does this administration still look for him every day? what is the priority on trying to get him? >> i would say that the united states and allies and partners continue to have the hunt for al qaeda very high on our priority list. i will leave it for that. >> this trust agreement with columbia has caused a lot of concerns among some american countries. do you feel like this is worth the political price? what guarantees can you give that the u.s. will actually not deviate from the mission there in said colombian borders? >> let me start and then ask

general cartwright to pitch in. virtually all of the counter narcotics efforts that we pursue in latin america are in partnership with other countries. these are not unilateral actions on our part. we hope to continue these partnerships. clearly the need for reconnaissance or being able to find laboratories, we bring some assets to this, but our allies -- our allies welcomed this. that is really what it is all about, how we work more effectively with our partners in the region to go after these narcotics cartels. >> as you may know, this is talking about seven phases in particular. the intent here, what we're doing, is going in first and we use these basis to provide capability to the colombians.

it is going in and assessing the basis for safety and security in the ability to give us fuel, part, and wait. of the runways, things like that. the intent, at the strategic intent is in fact to be able to provide to the colombians that what they need in order to continue to prosecute their efforts against the internal threats that they have. this is a bilateral relationship with colombians. >> [inaudible] >> i think we need to do a better job of explaining to them what we're doing in making it as transparent as possible. anyone's concerns are valid. if they have concerns, we need to do a better job of describing about what we're doing to make sure that we take care of the current sense to the best of our ability. >> there has been more flighty

-- fighting on the border. there was a report on pakistan public opinion. it said only 9% of palestinians see the u.s. as a partner. how do you react to that news? what is the role in changing that public opinion? do you see a need to go to pakistan, have you been there recently this year? >> i think that, first of all, one of the reasons that the pakistani have concerns about us is we walked away from them twice. we have walked away from them after the soviets left

afghanistan, and we walked away from them through the 1990's. that was because of the amendment. our military relations were significantly interrupted, and so i think the pakistani people questioned our -- question how long we are prepared to stay there. is the only reason we are interested in working with them is because of the war in afghanistan where do we value them as a partner and ally, independent of the war in afghanistan? the latter is the case. i think the bills on the hill to provide assistance to pakistan manifest that. i think it will take time to rebuild confidence of the pakistani people that we are long-term friend and ally of pakistan.

by the same token, i think the tolls -- polls that are more meaningful in this context is the strong support that the pakistani people seem to have given to their government in terms of the activities in western pakistan. there there seems to be more combat than any one of us would have expected a broad political support for what the pakistani military is doing in the west. i think this change of attitude and the success of the pakistani forces clearly serves our interests, as well as it serves the interest of the pakistani people. my hope is that over time we will be able to demonstrate to the pakistani people that we are a reliable ally that they can count on for the long-term. as i look at my travel schedule over the next six or eight months, one of the places that i

am thinking about going is back to pakistan because that has been awhile. admiral when has developed a good relationship and has made a dozen trips over the past 15 months. it probably is time for me to return. >> [inaudible] >> the only thing i would say is that is what the admiral has testified with and that is we are comfortable with the level

of security. >> you have called for 22,000 increase in the army, but that will take time. do you have the force is to get to general mcchrystal in the short term and say i need more into next year? should the president agree with it? to go as far as i know, people have not started to look into the availability of forces. -- >> as far as i know, people have not started to look into the availability of forces. until the drawdown in iraq begins after the elections there, that it will be a challenge for us, and particularly as we seek to increase time at home for our forces. it will be looked at, but it will depend on what he proposes. >> does this come after

providing forces for afghanistan? >> i think you have to balance these things. >> you mentioned that there was a potential -- is it safe to assume that this is still on the table? with that likely be done going to afghanistan? >> i would say that we had a video conference with general odierno earlier this week and i think he is feeling pretty positive about the way things are going into iraq. so i would say that despite the uptick, which is clearly one of the things that he made clear is a positive development, is that the shiite clearly recognize that this is al qaeda trying to

restock secretary of violence. this is not the sudanese coming after the shiite. this is al qaeda. -- this is not the sunnis coming after the shiite. i raise it as a possibility. i think that is a decision, whether or not to do with a comment that he will make probably several months from now. >> back to the troops issue. in your opening statement you said mcchrystal success as that will not include a request for more it forces that he is free to ask what he needs. has he been told not to ask for more forces? is it more forces that he needs, are you willing to put a cap on that number? >> first of all, we will both answer that. general mcchrystal has been told very directly by both the chairman and bite me -- by me

that we wanted to ask for what he thinks he needs. i think you have to allow your commanders that freedom, and then the chain of command, general petraeus, the joint chiefs, we will all look at that and decide what to recommend. so we're not talking about caps. we are waiting for its. and then to see what options he assessment as we move forward. as general cartwright said, the reality is he still has another full great to have come in. these forces are still flowing that have already been made available by the president. he needs time and we need time to see what the impact of all of that is. >> the only other piece i would add is that as we have watched

and you have watched what is going on in afghanistan the ied site is pretty lethal. that is one area we will have to focus in on, whether it is an adjustment in our tactics, additional resources, we agreed to have to take a serious look at them. we will have to do that soon. >> given what you said about the need to roll back the taliban and general mcchrystal comments this week about meeting to secure populations and possibly deploy troops, is there some trade-off between taking the fight to the taliban and protecting the population, given the limited resources and the terrain? >> my view is that if you tonight the taliban access to the people -- if you deny the taliban access to the people, you are starting what nourishes them. the key as general mark

cartwright said, the key is the afghans themselves becoming a part of the security force. it is not just their security forces, it is ordinary afghans turning in talabani'ns. we saw this happen in iraq, and it is clear that when people see a sense of security, then they began to look towards the long- term future and become the allies and other government and the international forces there to help them. >> does this mean you will protect the people rather than fight the taliban? >> i suspect that will be addressed in the assessment. >> [inaudible]

what kind of results are you expecting and the improvement from the syrian government? >> i have not received a readout on the meeting or heard anything about the results, but the reason they are there is that when foreign fighters crossed the syrian-iraqi border, they target american troops more often than not. my expectation is that syrians need to do more in terms of stopping those foreign facilitators and foreign fighters. >> i have a question on afghanistan. d.c. any evidence that al qaeda is playing a role in the recent fighting? is there any correlation between al qaeda and taliban? at the second one is on somalia. do you think the level of assistance given to the interim

government? and do you need to stand for more assistance and technical support to see a change? >> with respect to the latter, with secretary clayton just having been in africa -- secretary clinton just having been in africa, i am interested in her evaluation whether we recommend to the president that we do more to help transition government in somalia. i am waiting for secretary clinton on that one. i think what we have seen in afghanistan over the past, more than a year, is several different elements engaged in the fight against the government of afghanistan. al qaeda is one element.

the taliban is obviously a major element. there have been some others as well. these are the major players if you will. i think it is fair to say that they are mutually supportive and at times they collaborate. i have not seen any information that suggests that they are a unified fighting force or that they are following al qaeda's direction. they all had their own independent agenda. but in their view the you have a common foe. clearly al qaeda is in touch with these different elements, and probably different elements help provide protection for al qaeda, but i do not think that they are firm allies or have a common agenda. >> one more.

>> roughly how much of afghanistan to you consider to be under taliban control right now, and how can you convince so many afghans that it is safe to gvote when the marines are showing up in their village seven days before the election? to go first of all, it is a pretty big country. i would make the point that first of all, based on everything that i have heard, we are looking at an election in which there will perhaps be 1300 for 1400 more pulling cases -- more polling places and there were in 2004. they are obviously holding an election in adverse circumstances, but i think these considerations are important. they have significantly larger

numbers of afghan observers for these polling places. there is a tiered security arrangement. i think the potential is there for a quite credible election. i think general mcchrystal's you would be -- view would be that there is more activity in the west and north but there are individual provinces and districts where there has been an uptick in activity, but for the most part they are not too bad. the challenges regional command south and east. i think that most of us here believe there is ample opportunity for a quite credible election.

ok. >> if you walk or move around the country the other thing you see now is candidates making speeches and having rallies, posters all over the place. rallies advocating one candidate or the other. so the openness of the activity right now is substantially different than anything we have seen in the past. that is just a judgment on their part that the security is sufficient that they are going to go out and do that. it is also a reflection of the confidence in the security. it is not the same everywhere, absolutely not, but by and large u.s. seen so much activity up there that you associate with a political campaign, a democratic election. it is really startling when you walk around and watch this. could that be interrupted by violence? sure. but right now it is very shocking, at least having seen it before, how much openness

there is in this campaign. >> ok. thank you. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> bill clinton kicks off the bloggers convention. coverage starts tonight live at 8:00 eastern on c-span. tonight, pennsylvania politics with arlen specter. making change have been increased shaping the supreme court. -- making change happen in reshaping the supreme court. 40 years ago this weekend 1/2 million people gathered for woodstock. michael lang excess behind the scenes this saturday at 9:00 eastern. -- takes us behind the scenes this saturday at 9:00 eastern.

>> president obama had to westmark to talk about health care. he will be in belgrade, montana, to talk about his plan to overhaul the nation's health- care system. on saturday, the first family plans to spend part of the day in yellowstone of four heading to grand junction, colorado for another health care forum. the trip is partly encouraged that encouraging people to visit national parks as well as getting out his message on national health care. now we get a look at health care messages from other groups. >> if i had relied on the government for health care, i would be dead. i am a canadian citizen. if my brain tumor got worse, my government system told me i had to wait six months to see a specialist. in six months i would have died. >> government run health care in

canada, care is delayed or denied. delays that can be deadly. many drugs and treatments are not available because the government says patients are not worth it. >> i am here today because i was able to travel to the u.s. where i received world-class treatment. >> now, washington wants to bring canadian-style health care to the west. government should never come between your family and your doctor. >> my advice to americans, as patients, it is your care. do not give up your rights. >> what if we stripped away the $13 billion in profits. the $119 million anin ceo pay. that is the president's plan. keep the coverage you have now come origins -- or choose from a

route range of plants. -- or choose from a range of plans. >> members of congress are holding a town hall meetings. we recently went to texas where kevin brady talked to constituents in livingston, texas. this is an hour. >> good afternoon, everyone. i want to thank all of you for coming out here. we really appreciate this. i want to thank you for bearing with us. this is about the largest room we have in the hospital.

please bear with us with the space requirement. out of respect for everyone's time, everyone i know is very busy, i want to get started with this health care discussion today with congressman kevin brady. he was elected to a seventh term representing the eight district of texas in congress. this runs from montgomery county to trinity county and then eased over to the louisiana border and down to orange county. he is a member of the house ways and means committee, which writes many of the tax policies impacting health care in america. also, she has jurisdiction over much of the medicare program. he also serves as deputy whip. he has become very active on health care issues during his last three years. having launched a grass-roots effort called "50 ideas to improve health care."

this is ongoing debate throughout southeast texas to find out how they would improve health care in america. kevin lives in the woodlands with his wife kathy and their two sons, will come at him, and sean. please welcome the -- please join me in welcoming him. [applause] >> thank you for hosting us for another town hall meeting. i think i have done about 11 of them. we will do 40 in august. we keep adding them because there is never a more critical time for the americans to weigh in on health care today. there is a lot about this bill that we do not know. it is time you are able to talk to lawmakers about that and ask

questions. here is the bill, 1018 pages. it was given to us at 3 minutes before midnight. we were asked to vote on it at 9:00 the next morning. 1000 pages. no pricetag to leit. what really brought it home to me was that two weeks ago we met with the leaders of the texas medical center leaders, at the c 160,000 patients per day, some of the brightest minds in our country, and their message to us was, we have no idea what is in this bill. we do not know how it will affect our patience, and no one has even ask our opinion how to make health care better. you have to wonder if some of the best minds in the country, those who are delivering health

care do not know what is in this bill, who is writing this bill, and what do we need to know? we are going to talk today about this bill and answer questions. let me just say something. we are hearing and reading a lot today about all of the mobs of the town hall meetings. here you are into are a fine looking mob. -- and you are a fine looking mob. [applause] how're you doing? we have great ideas. these are sick of -- we use examples from the livingston town hall of the time. i have been anxious to do this for a long time. today i read an editorial that said, from the speaker of the house, that said it was un- american to challenge or

lawmakers about this bill and what is in it. i will tell you, what i think is an american -- and american -- un-american is to encourage people to go against washington. it is almost as if, how dare you challenge our bill? how dare you asked to read this legislation? the truth of the matter is, we all loved ones -- we all have loved ones who fought in wars to make sure we are able to be here with the freedom to ask questions. i am thrilled you are here. we ask because no one in america knows what this bill does. we asked the joint economic committee, asked are economists and health care people to go through this bill, a provision by provision and tell us how it works. tell the american public how

this health care bill works. this is how it works. [laughter] this is a flow chart of the democratic health care plan in the house. every color box, everything colored on this chart is a new federal agency, commission, or mandate. 31 new federal agencies to you and your doctor. what patient in their right mind would let control of their health-care decision go to this bureaucracy? by the way, this is not in place of health care today, this is on top of health care regulation today. it will be even costlier. it really starts here in this blue box. if there are people that want to sit down or need to sit down, come back and join us on this bench.

as long as you don't not make faces, i am happy to have you back here. [laughter] we have a lot of czars in washington these days. this person that we do not know who it will be is so will imports into this whole plan they are mentioned almost 200 times in this health care bill. this person will ultimately decide, we do not know who it is, ultimately decide what doctors you can choose, what treatments they think you deserve, and what medicines you receive. this person will decide that, mainly because so much of this chart close down into the health czar. they manage what types of insurance plans we have. the health insurance exchange, you hear the president and others talk about it, they basically say this is just a shopping mall for health care.

but when you dig deep into this bill, it is much different than that. the first thing they do is trade a government-run health-care program, modeled after england and canada to compete against private health-care plans. i did not know about you, but the government never competes fairly with private business. when you can print money, when you do not have to pay taxes, at the end they say we will not subsidize the tax dollars -- how many of you believe that? [laughter] that is like when they say the tax increase is just temporary. this public health care plan will do real damage to the health care plan you have in america today. in fact, because it will not play by the same rules and will not reimburse doctors as private plans do, because they can print money and it does not have to break even, it will end up

squeezing out a lot of people who have private plans today. in fact, the best estimate we have from independent groups that look at this bill was that over half, about 56%, of those with plans today that they have from work or individual plants will end up being pushed into the government-run health-care plan. for example, we have 18 million americans who get their health care not at work, but they buy it themselves as individuals. under this plan they strangle those plans. they go away because they say no new people can enroll in them. when that happens, that group gets older and more costly. pretty soon it will go away. medicare advantage, which is the no. 1 choice for seniors in rural areas, minorities, and the poor, it goes away under this bill. in texas, 1 million seniors will

have to choose a different health care plan than the choice they really want. those of you that health health savings accounts, some of you may, almost 50 million americans have those, those types of health care basically they will start restricting those. they start by saying you cannot use our help savings account to buy over-the-counter medicine. because some bureaucrat somewhere decided to run as far enough so we will tell you how you can use your health care dollars. so when the president says if you like your health care plan, you can keep it, that is not true. we're going to lose a lot of good coverage for a lot of good people in this plan. as i go through it you will see even more reasons why that is the case. see these boxes here? these baby blue boxes? that is what i call the rationing bureaucracy.

this is a group called the comparative of effectiveness research group that will grow to ration health care in america of. the reason we know this is because that is exactly what has happened in other countries that have tried to do this, that have done national health care. the premise is a pretty fair one. let's look at health care today. let's compare with treatments. let's compare with medicines and surgeries and outcomes and circumstances. let's do the research, which by the way we need to do. that makes sense. the problem is everyone of these commissions, whether it is the nice group in england, whether it is the canadian group, ultimately they end up playing cost effectiveness. what is cost-effective to the government? they start making decisions usually too late citizens --

senior citizens. in england it is so long that people actually die waiting to just get basic care. in canada, one at of every eight people do not have a family physician that can see them. -- one out of every eight people do not have the family physician that can see them. i had our professional staff of the joint economic committee go through the world and look at government-run plants and other countries and compared them to america. the reason i did that is because i think thi 3e theee three seris words in english dictionary is if you have cancer. -- you have cancer.

the survival rates are so much better in america when you compare the government-run plants. the british system. you are 50% more likely to not survive the first five years and other government-run plan then you do it in america today. women had had less chance of surviving breast cancer. if you are a man with prostate cancer, you are twice as likely to die under the english system than you are in america today. i offered an amendment that said if this work -- if this comes down to the public health care plan, if the wait time, at if cancer care is second class care, if you suspend those plans and you let people get the plan that actually can help them. they've voted those amendments down. they said it was too inconvenient to keep track of wheat time in cancer care in that provision. tell you what, if it is you or loved one that needs care for

cancer, that is inconvenient. one other reasons that worries me so much about how this can next to us in real america is that under this health insurance exchange, after five years, all plants in america basically have to look like the government-run plan. you have to have a government seal of approval, to meet the federal standards. instead of having more choices for people, we will actually have fewer choices. we will come down our health care system that basically looks the same no matter what. -- we will dumb down our health care system that basically looks the same no matter what. this past week and is at a rotary club and there was a gentleman there, a friend who works really hard on the interests -- on veterans'

issues, he told me about his uncle brian. he was raised in sussex, england. his uncle brian needed a hip replacement because he had had polio as a young child. he was denied because it was not cost effective to giving him one at net advanced age of 72. seven years later they did it surgery through the system. they finally got it right the second time, but by then his uncle had alzheimer's. his last 10 years of life as quality years, instead he spent it in paint, fighting a system he could not win and ultimately did not win. that is the type of health care system i do not think we want for america today. at the end of the day, under this program, when you and i get sick, today we ask ourselves some pretty basic questions.

how sick and mike? how long will it take to get well? -- how sick am i? under this lady will have to ask yourself another question, will i be a winner or loser when the government starts picking? and that is what we do not want. look across this whole board right here. all of this is new regulation on our health care system. doctors, hospitals, home health, hospice. america, that is part of the problem today. three at of every $10 be spent in health care does not go to the patient. it is siphoned off into red tape and overhead and regulations. one of the reasons we pay more and get less for health care than a lot of countries do adding this new regulation will not give more quality care.

this area, we're going to talk about. this is all new taxes and mandates. new taxes on small businesses. new taxes on professionals. there will be taxes on small businesses and new mandates. this will be very damaging to small businesses. in the end, we're going to end up pushing health care from your work and into the government plan. i visited with a small business owner wednesday who has three small businesses and he says if this goes through, we're going to drop our health care. we're gonna to push our workers to the government-run plan because it is cheaper to do that. we're going to keep pushing people in that direction.

with the small business increases, tax increases, you're going to see job loss as well. i know you hear from washington that we're just going to tax the wealthy. half of all small business income are job creation, creation for america, half of that income will be taxed, these are in the tax areas they are focusing on. the people who create jobs for our economy are the ones that will be targeted. the best estimate we have is that we will lose a little over 4.5 million small business jobs if this goes through. 4.5 million jobs. maybe we should not have end up like counseling in this bill, maybe we should have end of the job counseling in this bill. this targets professionals, people who stay in school a

little bit longer. this target small business people who took that a second mortgage, ran the credit cards up to the hilt. spent weekends, evenings, their whole lives are risking to start a business and build it up for the years. they are the ones that they're going to bear the brunt of the new tax increases. in washington, i live here in texas and commute to washington. one of the things that i am only -- i am always looking at are tipping point. tipping points are a number of americans that do not pay any federal income tax whatsoever. onlver 40% and growing larger.

at some point we will have more people who get government that actually pay and. under this tax increase, in most states in america, 39, people in this tax brackets, more than 50% of their income will go to state income tax. think about that a minute. for those people, the tipping point is the federal government and state government will have a greater claim over their earnings than they do. that is a tipping point. for every dollar you work, every hour you work, the government will have a greater claim over wages and earnings than you do. that is a tipping point we can't go to in my view. on this chart, let me just say if you look at the bottom line of this health care plan, a simple question, will it lower

health-care costs? that is one of the biggest concerns we have in america today. the answer is no. the congressional budget office, independent group, takes a look at the plan. they said it will not lower health-care costs. in fact, it will increase health care costs, just as it did in massachusetts. will it break even? will it save money for the government or add to the deficit? this answer is it will add tens of money to our growing in scary in dangerous deficit today. they say about a quarter of a million dollars more to the deficit in the first five years. for the first four years nothing much happens except the tax increase. then it goes up like this. it shoots straight up. when they say over the first 10 years we will only run this far into the deficit, they are

really being misleading, because what that looks like is an adjustable rate mortgage. for one of those credit cards, zero interest for so long. the question is, how much will it cost when it's fully into gear? the estimates are so low that we are going to create another medicare where you have over promised, is nearly bankrupt, 2016, right now it is an unfunded liability stretching out generations that will never be able to be paid for. we're looking at adding another entitlement, and other health care plan we cannot afford either. . .

sort of like shooting for the moon. you know, if you get off course of the beginning, it can go wild and a big way. so they took our spending and deficits and budgets and looked out in the future. until 2080, they literally cannot find a scenario where we balance the budget during that time. think about that. a child born today can go nearly their whole life and never see a balanced budget in america again. yet, we're going to add another plan that we cannot afford. it should make us nervous. i offered one, and a congressman

from nevada offered another amendment you might be interested in. i offered an amendment that said members of congress have to certify that they had read the bill before the vote on it. they told us that that was a bad idea. [laughter] it is true. you may have watched it on c- span that night. a congressman on our ways and means committee said this public health care plan is so good that members of congress should have to enroll in it. [applause] that the defeated, too, because they said it was important that members of congress have choices. by the way, i offered an amendment to strike all those small business taxes because i think that is the wrong way to go. they told us we need to tax small businesses more because they have had it so easy all these years. that is what they said.

the question is not, do we need health care reform in america? we do. we need to make things better. there are a lot of areas. we have about 200 good ideas on how to make health care better. the question is, is this the right plan for me? i do not think so. here is what i would do. we have republicans and those of us to work on health care and number of years, and we have put together some proposals, about five republicans in all. one was offered by the head of our ways and means on the republicans' side. there is a plan from another congressman. there's several plans that range from step by step improvements to bold reforms. i do not know if we will ever get a chance to offer them.

as you know from your civics class is, when one party has the white house and the vote margin and filibuster-proof, we cannot stop it. but if we get a chance, if the american public speaks out in august and says we want to hear other ideas on health care, then we will have a chance. i think rather than going back to the 1960's and looking at england and canada, we should come up with a 21st century health care plan for america. let's pick care back in health care. coverage is a key. some people already qualify for government plans. some people are here illegally. some college kids might the coverage if they do not think they are invincible at that age. but let's focus on the truly uninsured. they work for small businesses that cannot afford the health care.

they're changing jobs. there in between jobs, sometimes because the recession. other times because americans do not work for the same company 40 years in a row anymore. they moved from town to town and a job to job. and then those with pre-existing illnesses. we have to focus on the coverage. let's focus on the truly uninsured. let's create incentives to small businesses so they can afford health care for their workers. let's create, for those who want to be mobile in america, but give them the option of a worker backpack where they can choose the health care plan that is right for the family. they can do the same types of benefits and the support as businesses get. and they can put it in a backpack and a ticket with them through their lifetime. from job to job. my wife worked at a local bank and is home raising their boys,

and she will be going back to work so we can afford college. everything we go through in life, let's create backpacks and options so people can take their health care with them. for the people with pre-existing illnesses, you know, you could expand these state pools that cover those illnesses. that is in that plan. i think a better way to do it would be rather than take those who this health-care costs when it will be high and isolate them together were that gets more costly, why don't we insist insurance companies cover those with pre-existing illnesses? and then, like they do in some other countries, led seven independent board that watches over them and let the insurance companies swap dollars to cover that care. in effect, which changes insurance committees do not profit by who they exclude. they profit on how well the cover those they have.

i think there are some great ideas on coverage. affordability -- you ask anyone in america about what concerns them most, and it is that health care is just too expensive. that is it. there are frivolous lawsuits. lawyers the sue doctors and hospitals. the drive up costs in america. about $200 billion of our health care dollars kids siphoned off into either defensive medicine or into this frivolous lawsuits. let's see lawsuit reform the federal level like we have done in texas. in texas, the legislature did it in 2001 because we sell these doctors fleeing our state. they put in common sense limitations on what happened. we now have a backlog of doctors' waiting to come to texas. not just in to the wealthy areas

but into the valley and rural texas. a great example is, i was checking the texas medical center in houston before toward reform -- before tort reform and a lawsuit reform. they had one pediatric neurosurgeon, one and baby bring dr., for 500 people in this region. we now have almost six reforms on lawsuits, and they do not just cover houston. they are available for communities like ours in rural areas. lawsuit abuse has stopped if we're going to get the most affordable health care. second, that red tape i talked about, we cannot keep putting $3 at a $10 into a bureaucratic system. that money needs to get the patient care. the of the plan does not do much to help this. then there is research. i am worried that other countries are starting to figure out how to get ahead of us when it comes to creating those life-

saving breakthroughs, those new medicines, those new treatments, new surgeries'. so we have got to up and make permanent our research and development tax credit. as i have gone through these town hall meetings, i have realized that it should stand for responsibility as well. i am not sure we can never reform health care in america until we tie people's behavior is to their health care costs. that does not happen today. especially for young people but for a lot of americans, the two questions we ask our, what is the copayment, what is my deductible? but for us to get quality care, we will have to ask much more than that. i want to be about to give people incentives but along with their lifestyle, the choices they make. uc great examples. there is one just north of orange, texas where a paper mill

and a steel worker unions worked together to come up with a plan that is so basic and so remarkable, but it is tied to your dollars actually -- your health care dollars. safeway is a great example. it is a big company decided that the health care costs were going through the roof, so they are going to tackle diabetes and a chronic care. they create incentives to their workers to dramatically lower obesity and chronic illnesses. they have lowered their health care costs. but they give incentives. they actually reward workers with the dollars for doing that, for exercising, for taking their doctor's orders. they actually have a stake in it. safeway cannot do more of that because federal law prevents them and state law prevents them from doing that, from offering more incentives. so research of the responsibility have got to be a key. part of that, and some in the

medical community may not like this, but if we want informed consumers, we are going to have to pull back a curtain of mystery on medical pricing. you know, why can we not go on line and compare the drug prices of every pharmacy in our community? why can we not go online to figure with the test costs are in your clinic and what the infection rates we have our? it is hard to tread. but why can we not this could be more engaged in our health care? we'll have to transition to that. finally, efficiency. that is getting more bang for your buck. the government really created a fractured health care system. we basically pay physicians and others, hospitals, check the box, do this, get paid. do that. doctors want to keep the care going in between doctors' visits. really focus, patient. it is hard for them to do. why don't we change the way we do things in health care so that

we reward doctors, hospitals, other providers for aligning for the patient? instead of having doctors verses' hospitals vs. insurance vs. lawyers verses regulators, why do not align the mall for the patient and reward quality health care? you know, not on what boxes get checked. there is so much we can do on efficiency that is not in the bill today that makes common sense. i am hopeful we will get a chance to sit down in washington to come up with better ideas and then the government-run plan. a lot of that depends upon august and how you speak out as americans. with that, let's start taking questions and comments. yes, sir? >> you opened a can of worms. you brought up pharmacies and prescription prices. i am carries. one of the things this does not bring up, and all my friends who

are vehemently against it are surprised that it did not take the position of being so much against this, but we need to clean up the act in the first place. in 2001, and new zealand began a campaign to make direct-to- consumer pharmaceutical advertising illegal. everybody in this room, every night, is the loose with what is a $4 billion campaign by the u.s. pharmaceutical industry. two years ago, new zealand allotted. as it stands now, the united states is the only country in the world that permits director- consumer advertising of the pharmaceutical products. according to odyssey on the internet, 80% of the doctors or more are against it. why do we have it? i am a retired government annuity. i paid $356 a month to blue cross.

in their ever so cleverly worded contract, i did a very limited results. my seven prescriptions i paid for, my doctor appointment to go to sometimes, i end of averaging $1,000 a month out of my pocket for this same great insurance product that the congressional people have, i suspect. last year, walgreen's, according to a statement i have come of it paid almost $12,000 to a pharmaceutical companies on me, my behalf. multiplied at times everybody standing in line at walgreen's. why, and and they have a big business background so you may not receive this, why do we have to continue to sustain $4 ian in overhead pricing for pharmaceutical products? if you want to stop in the lower the costs, listed at first. why do we have to see hospitals

-- every night on the houston news, advertising? why do hospitals advertise? the hunts will paper, i saw it about a month ago with a full- page advertisement of a hospital administrator sitting at her desk. who pays for that and why? i further ask the question when last things giving my son was visiting from out of state and got bitten. he went to the emergency room for a dog bite. he sold his hand in solution for about 30 minutes. the know how much the cost? $1,500. i do not know what this hospital here charges for emergency room care. i have an extra neighbor that is an attorney -- >> let's do this. we have so many questions. is that ok if we focus on the

first one? >> ok. >> look, there is a lot of advertising for prescription drugs. i do not get to stay home very often, but after a night of watching tv, i am convinced i have six new illnesses just from watching the advertisements. really. it is so vague. and then the side effects. do not get as going on that, ok. you know, i do think we spend too much on advertising. i do think that given a choice between less information to consumers and more information, i always choose more information. i wish they would do less. i would like every dollar they can pump into research and development and for the next breakthrough drug. i think part of the problem we have is that american bears the cost of research for all these

breakthrough drugs. the bulk of it is here in the united states, and when we sell to other countries, they have price controls and other things that limit that. that needs to be addressed. i have to tell you, i really worry about this plan from the standpoint of, the goal is a national health-care plan, a single-payer health care system. people often say, let's get the problems of health care. but i will tell you, a lot of the best parts of health care, including all new innovation, comes from people knowing that they can have a profit if they come up with that new products or come up with a better way to treat patients. i want to limit the cost of medicines. the increases are dramatic. we need to use more generics.

i think we need to be able to buy medicines from around the world for cheaper if we can do it safely. but i also want to be very careful. this is my only point. i want to be very careful they do not go overboard in this sort of shut down that research valve that ends up with that next life-saving breakthrough. i think there is a balance between lower costs and keeping those coming in the pipeline. >> i have a print out here on a few things that i think are in the bill. i passed one of your press secretary today. i think there is a manifesto in this thing for the overcoming of freedom in america. and we have some things that are listed in here this a we're going to have to give up some of our private information, financial information. we're going to be told some

things we can or cannot do. we're going to have to pay the put people into health care. they're wanting to take control of the people that are pushing this thing or not looking at health care alone. i believe we're looking at a manifesto for the overcoming of america, aka hugo chavez and fidel castro. [applause] >> there was a lot in that. thank you for being here. i think the goal of this plan is very simple. the government-run health care plan, one pair for every one american. and of the president has been very clear about that in the past. >> he lies a lot. >> well, he wants that on this. congressman barney frank said the other day -- [boos]

>> he said whether you call it a public auction or a co-op, at the end of the day, both lead to a single payer system, national health care system. what seems so strange is that this is a country where we're looking for an american model, not an english or canadian model, so why are we taking those 1900's example of health care instead of creating a 21st century model for us? do you know what they mean? it does not make sense at all. [applause] >> i have a comment about the pharmaceuticals. if you look how they develop drugs, research and development is less than 25% of the cost of the drug. more than that, a good deal more is spent on the marketing of the drug. the rest of the costs that you pay for is what their board of director decides the want to make on that medicine. i have to agree that there's nothing wrong with profit. but profiteering is bad.

that is what you want to eliminate. you can come back to profit and a still have a pretty healthy bottom line and allow for research and development. we are subsidizing all the drugs everywhere else. that is the reason we can pay half the costs of the bill in canada as we do for the same dreg here. it is coming off the same conveyor belt. it is made here. it is shipped to canada, yet we cannot go by our medicines there. if i give a prescription to someone in my practice and ask them to go to canada to get it filled, i am guilty of the federal drug crime. i could be put in prison with the same consequences if i was selling cocaine in the office. there is something wrong with the basic concept. >> what is your thought overall of the plan? >> well, medicare and the most insurance companies, for that matter, purposely are

bureaucratic to the point that we just about cannot use them now. this is going to make medicare look like child's play. and this is so inefficient by its very concept that it will not be workable. and like you say, why are we going to base our future health care on plans we know do not work very well? in britain, they're offering tax incentives now for people to get out of the national health system and go buy private insurance because it is bankrupting their country. the only way they can control costs is to deny access so that above a certain age, you do not the coronary bypass. above a certain age, you do not get a transplant or dialysis. it is not that high. we're talking about age 65. we're not talking about the elderly or extreme elderly.

not all rationing is bad. it is based on outcomes research, but we do not have those numbers for most things. that is not available anywhere in the world. medicine is getting this sort of information now. i am in neurologist. every couple of months i have a new practice based on what the best available evidence for a given the treatment of a given disease is. we have not been through 5% of the neurological diagnoses yet. spread the to the of the specialties, and we do not have the information to make those kind of rationing decisions right now. and be rational and correct in it. we're just going to make decisions based on what costs are look like. there is good cost-benefit ratios. it actually may save you money to do things that are not

allowed rainout. i am weasley dr., and i can tell you that the reasons insurance companies in the medicare have now decided to pay for sleep apnea diagnoses and treatment is that the medical costs actually go down about 50%. i am is another treatments out there do the same thing. if you want to make these kind of russian decisions, that is the information you need but is not there yet. >> doctor, i think, for me, and we of two young boy is, family growing up, mom is on medicare -- i want my family to make those decisions about those treatments. i do know the government making those decisions for me. i do not want to lose control. most people i speak to, that is what worries them the most. >> i am pediatrician and have been here over 10 years. since i work with kids, i am very simple. if i have a child and we trade three's times and do something

right and come up with the devore plant, i say to fix what you are already have. we have an american product for a long time, and a lot of things could be corrected. i remember the money embezzlement and that is where the costs are going. this is very complicated. this will make me get out of business. this makes me question why give up my life and family for years to achieve my goal, so i can pay more taxes? i should have stayed as in years. there is no incentive for me to work. i think it would rather quit now, take unemployment, and sit home and watch tv. i am tired. >> well, we cannot afford to have you do that. a lot of doctors say if you want to make improvements, fix medicare first before you buy it. >> you cannot fix the veterans. they have already given so much. veteran health care is in terrible shape. i only work with parents and children, but the sense of entitlement as some of these people have -- they do not want

to pay our be a participant. they want everything given to the. yet, they want me to work and pay the taxes on that. now you're going to tax people 50% more because it wants to start a new business? there is a small minority in this country making money to support everybody else. if that is the way it is going to be, i am going to quit and get on the other side. >> banks, doctor. -- thanks. >> realistically, what early odds of defeating this monstrosity? >> what are the odds of defeating this bill? she is a monstrosity, but i am trying to be fair. [laughter] the answer is, it all depends on you. there has been in such a rush to get this bill to the president's desk, we were fighting hard just to give you a chance to see this bill before god voted on.

but now, in august, until you that in the time i have been in congress, this is the first time i have seen the american public actually get a chance to change the course in the direction of the bill. i think if americans speak out on this legislation before lawmakers go back at labor day, we have a chance to stop this and a to say wait a minute, go back to the drawing board. both parties, go back there. come up with some real forms that this country can support. there are some great ideas out there. i just do not know for will get a chance. it depends upon town hall meetings like this in taxes and every state and community across the nation. >> i, congressmen and he says "amen, brother."

[laughter] who do we call? we know where you stand. how do we change the minds of the other guys? it will not listen to us. >> in america, there are no shortcuts in a democracy. who prevails, those who believe the most and believe the longest. in august, i think three things. speak out in your own district. not just to me but to our senators as well. make sure your heard. second, reached out to your friends and family and co- workers who are in other congressional districts. encourage them to get to the town hall meeting. pick up the telephone, what ever, show up and ask questions about the bill. and finally, do not quit. do not quit speaking out and reaching out until this is done and a new opportunity is made available.

there are some great solutions. this is not have to be it. >> should we go to washington on mass? >> you could. but it would be better to drive over with a neighbor in another district or a friend's family in another district and speak to another member of congress. because of the end of the day, members of congress represent their communities, their neighborhoods. that is who we want to hear from. i think the white house thinks all these town hall meetings that are organized. i am republican. we cannot organize anything these days, it seems like. [laughter] the truth is, what motivates people these days are their beliefs and the beliefs that there is a better answer than this. that is what i think they're underestimating in a big way. it may seem basic what he would tell your children, but it is really up to you guys.

we're going to keep fighting on this bill. but that is sort of how you can magnify yourselves. seems basic. >> i have been on the internet for a week now, and other democrat representative said the town hall meetings and their constituents are telling them to vote no. and they have the arrogance to say they're still going to vote yes, despite with their constituents said. one representative told him he had to leave because the powers that be. the constituents ask to his superior was. he said he could not name his superior, but he was told to leave the town hall meeting. you have all this democratic constituents you're asking their representative to vote no because they are against it, but that person will go back and vote yes, despite what they say. there's a lot of party- going on there. there will come back and be in

line with obama and the democratic congress, so then they will vote against this by with their constituents as a. >> that is mined point. do not give up until they represent their districts. there is enough time. in the last two weeks, you have changed the tone of this debate in america in a dramatic way. so do not underestimate your own power is voters. do not do that. because in the day, it is not just about one and a half years from now. it is their representation every day. in every district and every state. >> who wants to go to washington? i will go with you. >> ok. let's take some more. how're you doing? >> good. how are you? good to see. as far as government-funded

health care system, the tribe held services of a government- funded health service. it is underfunded. about 50% -- we work on a 50% shortfall every year for the budget. with that, we have to go at the beginning of the year because we do have catastrophic coverage. it actually causes our funds to the plead. by the middle of the year, we have to go through what is called priority one where we can only see the doctors it is a life for the situation. that is the government-funded health care system that we live through rainout. so we've got about waiting for people to visit a doctor in canada, it is happening here in united states. and our health care costs are so high, but we do have 50% diabetes rates among tribal adult members. so our insurance rate now is

about $1,100 per month per employee. if we do not provide health insurance, they go to ihs of verse somewhere else. some of our catastrophic illnesses have made is of an economic insurance. >> so your thought, this is not the answer but we have to find one. >> when you say a government- funded health care system, you did not talk about having to raise the cost, the affordability of health care. like you sicko we provide insurance for our employees, but because we do have severe cases that one or two employees causes our rates to go to the roof, that we get turned it down. i think we asked for 10 private companies to look at our whole portfolio. only one was able to respond. >> i have been to your clinic. you do good work. >> we're proud of the ihs.

because before then, we had people not going to the doctor, and our life expensive sea was very low. there has been a change, but -- our life expectancy was very low. there has been changed, but it is still underfunded. >> thank you. >> [inaudible] i understand that the rationing of medicare was going to be immediately upon passage of the bill. where is it listed, what rationing they're talking about? >> i do not see that happening under this. but i do see, in the long run, rationing health care across the country for anyone in this public plan and others in the government-run plant. the reason is, we already have this in america today in the medicare system.

we ration the doctors' services through reimbursement. we're supposed to decide how much we reimburse doctors for being in medicare. but they did not reimburse them by saying doctor, how much more this year are you paying for staff, rent, , and more are your expenses? they estimate across medicare how much money should be spent on doctors' services. if it is above that, they just lower reimbursements. it was supposed to be 21% this year. but there's no way they can see seniors and a 20% cut in. but rationing is called when a government entity picks a budget number, and if you go above that, they just cut the health care under it. we already have rationing health care today in medicare. it is one of the reasons it is hard to find doctors to see seniors all the time. most people do not want to see that replicated across the rest of the country as well.

that is one of the fears. 's barney people in washing, especially democrats said have an original thought in their head, and do not regurgitate the party line? number two, is there any way to get nancy pelosi out of there? [laughter] [applause] >> then nancy pelosi tell you you had to vote by 9:00 the next morning when you got that at midnight? >> that was our ways and means committee that won this vote. next question. [laughter] we had a young woman back here. >> i represent in number of families in my subdivision, and most of them are retired. what kind of advice will you give me to tell them not to be so afraid of this plan? [laughter] >> be afraid. terrified is right.

>> you know, i heard the gentleman from england saturday at a town hall meeting. he had been in the health care system over there and came to america and was applying for his visas and all that and will not go back there to that health care system if his life depended on it, which it would. it reminded us of a statement from thomas jefferson from long ago who said, people afraid of its government is tyranny, and a government afraid of its people is democracy. you know? i am not talking physically fearful but respectful of what americans want for health care. tell your neighbors the there's no question we can do a lot of good things to improve health

care. but this plan, the more you look at it, the more carefully you look at it, this really is not the plan for us going forward. and encouraged them to speak out and reached out. i think there's no more important time. for all of us -- the reason people are a town hall meetings is because this is health care. this is our families and lives on the line. so we have to get a read the first time, not rush it through and then get around to fixing its sunday. it will not work that way. we know it will not work that way. what worries me, too, the things we keep discovering in this bill -- for example, there is a provision should stand on the position on hospitals under construction. that means 40 of our physician- owned hospitals will be shut down. 15,000 health-care workers go without jobs. too much of this come -- thank you. we're going to stay here so we

can answer questions. get on my e-newsletter. we have more town hall meetings. we need to get with you. thank you very much. [applause] >> thank you all for coming. we do appreciate your patience. >> members of congress are holding meetings with constituents on health care throughout the country. as 7:00 p.m. eastern, we will so you senator grassley's recent meeting. he is the top republican on the senate finance committee, one of

several committees working on health-care legislation. he is also part of an informal bipartisan group of senators working on a potential compromise health care bill. now a look of some of the health care ads that members of congress are facing during their august recess. >> for six years, i have owned this restaurant in the diaspora. last week, i got a call from my health insurance in my rates would go about 42% from last year. i cannot afford that. i told them i may have to cancel. i am going to pray my kids do not get sick. when president obama proposes a public health insurance option that would force the private insurance companies to compete and lower rates, that is exactly what my family needs. now i hear that the senator that they voted for is leading the charge to delay health reform this summer. that is exactly what they want. the health and insurance companies that have given that senator over $2 million and if

that -- and that if we can stall reform, it we can kill it. senator, whose side are you on? if you're on my said, stay at work. my family cannot wait for reform. >> democracy for america are responsible for the content of this advertisement. >> $22,750, in england, a government health officials decided that is how much six months of life is worth. under the socialist system, if the medical treatment costs more, you are out of luck. that is wrong for america. life-and-death medical decisions should be made by patients and doctors, not politicians and bureaucrats. tell your members of congress to oppose government-run health care. >> president obama goes back on the road tomorrow to talk about health care. he will be in belgrade, montana to talk about his plan for the

health care system and on saturday, the first family plans to spend part of the day in yellowstone. then president obama heads to another health care forum in grand junction, colorado. what else officials say the trip is also aimed at encouraging people to visit national parks. >> bill clinton kicks off the 2009 net reads nation bloggers convention. coverage starts tonight live 8:00 p.m. eastern on c-span. tomorrow, health care reform with howard dean. pennsylvania politics with senator arlen specter. making changeup and reshaping the supreme court. british voters are expected to go to the polls in national elections next spring. this weekend, a conservative party leader on how a torie government would change current domestic policies. but as son and then on c-span. this fall, enter the home to america's highest court. from the grand public places to those only accessible by the

nine injustices. the supreme court, coming the first sunday in october on c- span. >> now a discussion on evarts to reform the health care system in this state of massachusetts. we will hear from the state's health and human services secretary. this is part of a conference on primary health care hosted by the federal health and human services department. this is 40 minutes. >> good afternoon. i am pleased to introduce my next speaker. she will talk about the work she has been doing in massachusetts around health care reform. we have been watching with great interest and of taking counsel from your experiment. and some of the investments in the resources, the $500 million in health professions and the

fy 2010 budget at things reflects a recognition of the need to invest in primary care. we're thrilled that you can join us today. the secretary of health and human services overseas 17 state agencies, and she serves that -- on the cabinet of governor patrick. her broad range of experience as a primary care physician, prof., researcher, and health policy expert gives her unique insights into how this state can best serve the people of the commonwealth. one of the secretaries top priorities is insuring that the stay delivers high-quality and a accessible services to massachusetts residents. some program areas she oversees include health care and the state's medicaid program, child welfare, public health, disability is, of veterans affairs, and elder affairs. since her appointment, the

secretary has successfully implemented many aspects of massachusetts highly successful health care reform law. the state has adopted its first plan to address the long-term needs of elders and the persons with disabilities. she championed the creation of the office of child advocacy to improve the state's child welfare system. until her appointment, she was the medical director of community health programs at hospitals. she was also associate professor of medicine at harvard medical school and director of the school's center of excellence in women's health. prior to her appointment, she served on many boards and expert panels including the boston public health commission, the institute of medicine committee on assuring the health of the public and 21st century, the minority woman tells panel of experts. she was president of the society of general internal medicine, the only national organization representing primary care from

2003 to 2004. she holds a b.a. and grammatical doctorate. please join me in welcoming secretary bigby. thank you. [applause] >> good afternoon, everyone. thank you very much for that introduction. i also want to thank you and those here for inviting me to be here this afternoon. i am going to tell you all i have a call. i am not shaking hands or hugging. but please, bear with me as i go to my presentation because of that. this is a wonderful opportunity to be here. obviously, everybody knows that health care reform is on everybody's lips these days in ways that are surprising to some. but it is a wonderful

opportunity to tell you something about what we have done in massachusetts and to talk about the challenges and the successes that we have had. so i am going to go through and tell you what we actually have tried in massachusetts and show you a little bit of the results that we have seen, both from increasing the number of insured but also trying to give you an idea of what impact this has actually had on people. we are more than just counting the number of people with insurance. health care reform in massachusetts shows to summer is for you and would include several initiatives. number one, the government supports for low-income individuals, i would say is one of the most important aspects of health care reform in massachusetts. the way that massachusetts did those was to expand eligibility for its medicaid program.

the state also developed a new subsidized insurance plan for low-income individuals to are not eligible for medicaid. and people with incomes up to 300% of the poverty level and are eligible for the subsidized program it did not have access to affordable employer- sponsored insurance. insurance reform was also part of the reform efforts in massachusetts. the individual and small group market has emerged in an attempt to create more -- a larger risk pools for both of those groups of individuals. i think what we have seen thus far is that individuals have benefited from this more than small groups. there also expanded options for young adults to are presumably healthier, but this expanded options include allowing people to stay on their parents'

insurance policy if there were living at home and up to age 26 and some other options. there's also a fair employer contribution which we called the fair share. in this part of health care reform, if employers with more than 11 employees contribute to the coverage of their employees, they do not have to pay an assessment. but if they do not participate at a level that we defined as the fair share, then they are assessed to $295 assessment for each full-time employee. individuals in massachusetts are required to purchase insurance if they can afford it. i will tell more about our experience with defining affordability. when of the other elements of reform in massachusetts is what we call the connector authority.

it is commonly referred to as the exchange and the national debate. the connector has several functions. number one, it sets the floor for coverage. it is very important to define what minimal credible coverages given that we have an individual mandate. we did not want people to buy insurance that does not cover very much. as they try to fulfill that mandate. they also have established a seal of approval for health plans. the connector also sets the standard for affordability. remember, i said people have to have insurance if they have access to affordable coverage. and the connector authority, which is a board made up of various stakeholders, said the floor for affordability. -- set to the floor for portability. the state subsidized product is

administered in the connector authority, but it is not one of the products available on the exchange. the connector also maintains a website and information about the various products for individuals and small groups so they can compare both the packages and of the costs of these products. i will show you a little bit about what that looks like in a few slides. so here is where we are in massachusetts in terms of uninsured adults. you can see that one of the advantages that massachusetts has is that we started out with the relatively low percentage of uninsured individuals. there are some who suggest that these figures actually underestimated the percentage of the uninsured in massachusetts. and we did we design the survey tool that estimated a number of insured after we came into office.

but this gives you an idea of how we have been able to do, very quickly, decrease the number of uninsured. we estimate that this 2.6% uninsured percentage represents about 167,000 people in massachusetts. this shows you where these people are now insured. this is basically, if you look good health care reform, the bill was passed in april 2006. so this tracks the number of newly insured individuals in massachusetts starting in july 2006 through december 2008. and as of december 2008, we estimated that there were 428 ,000 people who were previously

uninsured and are now insured. the yellow bar on your slide represents the people who are in the state subsidized insurance program, which we called commonwealth care. this is 163,000 people. the dark blue bar next to that is 149,000 people who are in private employer-sponsored insurance. the 76,000 on the light blue bar the new people who enrolled in mass health which is our state medicaid program. and the last bar, 41,000, represents individuals who have purchased insurance on their own. so you can see that the very substantial percent of the newly insured individuals are in employer-sponsored insurance. this shows you the type of insurance of people had in 2008.

68% were in employer-sponsored insurance, 17% public, and 15% medicare. this is the entire publishing of massachusetts. so even though we estimated in 2008, the last time we did the household survey on insurance coverage, but 2.6% of the total massachusetts population was uninsured. we know that we still have some challenges in terms of seeing higher rates of uninsured people among certain populations. would you see here is about 5.4% of the individuals who have 150% or less of federal poverty, of in come at the federal poverty level. our uninsured, about 5.1%, up to 299%%%% of the federal poverty

level. you can see that as people get into the 300% to 500% range, the rate of one insurance is much lower. so low-income individuals are still much more likely to be uninsured than higher income. this slide shows uninsurance rates by race and ethnicity. as you can see, among the total population, this is comparing 2007 with 2008. what we see is, for the total population, an estimate of 5.7% compared to 2.6%. but the insurance rate went from 4.6% to 2.2%.

you can see the different races. for those who are of hispanic ethnicity, it went from 10.2% to 7.2%. while we, again, still see that there are differences by race and ethnicity, these are by far the lowest rates of uninsurance among these populations that we see in the united states. as i said, we're looking at things other than how many people are insured. this is a very complicated slide. i am not sure you can actually see everything. but i want to. at a few things about what this represents. one of the issues about health care reform in massachusetts has been the issue of affordability. and whether people really have access to affordable coverage. what this slide represents, you

see the three lines going across all of the bar graphs. they represent various levels of the affordability standard set by the connector for people at various income levels. if you look of the bottom line which has $165 next to it, that is the level where of maximum of affordability for an individual with an income of about $37,000, i believe. so $165 per month. what the various bars represents is the actual cost to an individual of the monthly premium, depending on where they get their insurance. so the first bar represents what state employees in massachusetts pay. the blue part represents the out of pocket expenditure by the state employees, about $80 per month. the total amount is about $400.

the next represents an average employer-sponsored insurance out of pocket premium for an individual, and that is about $114. then you see, in the light blue bars, those are the subsidized insurance products that we have in massachusetts for individuals, up to 300% of federal poverty level. as income goes up within that range from 100% to 300%, their share of the premium goes up. it is the maximum amount for people up to 300% and it is $116 per month. the last set of bars, the four dark bars, represent what the individual market expenditures are for people who choose to buy individual policies ranging from what we call the bronze

package to the gold package. and you can see that their costs are within the affordability standards set by the connector. so this gives you a sense of how this actually played out in terms of trying to figure out what is affordable for people. the reason this is important is because when people file their income tax returns are in massachusetts, they have to document that they have health insurance. if they do not have health insurance, they have to show that they are not able to afford what is accessible to them. and this is the standard used to measure affordability. the other thing that we have been tracking in massachusetts is, again, so what if you have health insurance, doesn't make any difference? what you see here is some of the data from reports and studies that sharon long has done in

collaboration with individuals in massachusetts to actually track what is happening to people. . you can see before health care reform, is 25%. in 2008, it was 25%. this has gone down somewhat. the next slide shows the percentage of individuals indicating they have a source of care, and this increased from 86% in 2006 to 91% 2008.

that is an important number for this audience, and it is complex to the role of primary care and what it should play. we have a challenge of primary care providers in massachusetts, but in spite of that, we still saw the percentage able to report they had a usual source of care. we also are seeing people with doctors for preventive care, and a percentage who has made a dental visit go up. the reason i'm showing this is because one of the things health care reform actually mandates is that the medicaid program cover dental benefits for itself. so we think that policy is mostly responsible for this increase in dental visits.

this next side looks at what people are saying about their experience with affordability of care. in the first line, you see the percentage reporting an unmet need for reporting health care because of costs, increasing from 17% 2006 to 11% in 2008. the % who said they have problems paying medical bills decreased from 32% before health care reform down to 24% in 2007, and up again in 2008, and this is obviously something we are concerned about. the percentage saying that they had to pay their medical bills over time decreased from 27% to 23% but then went up of the

2008. this may represent the fact that people could not have house access to health care initially found they have access, but as they continue to gain access, approved 2007. boom so who are the uninsured in massachusetts? this shows you the characteristics, and you can see that for age, the least likely to be in this group of uninsured are people between the ages of 50 and 64. whites are overwhelmingly represented, but 9.3% of blacks and 11.5% of hispanics are

percentages that are over represented compared to the general population of massachusetts, which is about 6% for blacks and 6% for hispanics. you can also see looking at educational attainment that those without a high-school diploma are least likely to be in this pool of uninsured. again, i think that represents the fact we have state- subsidized plans for low-income people. those without a degree or disproportionately represented, and we still see that there are workers who are represented among the uninsured and the highest % are workers and firms with more than 50 employees.

i want to talk about the issues related to primary care. massachusetts has the highest number of doctors for each 100,000 of population of any state in the country, and to make sure people understand, this excludes people who are researchers, residents, fellows, people who do not actually practice medicine or who are still in training. the yellow bar represents all doctors, and you can see 394 per 100,00 in massachusetts versus the u.s. average of two ordered 49 and the median state approximation of 247.

this is reflected in primary care physicians, 125 per 100,00 0 compared to 85 in the u.s. a verage. states would be happy to report figures like these. in spite of disfigures, various analyses that have been done by the departments of health, the massachusetts medical society, suggest that we do have health professional shortages in massachusetts including primary care physicians, nurse practitioners, mental health professionals, psychiatrists, dentists, and ob/gyn practitioners. this slide shows with community health practitioners have seen since the implementation of health care reform, which is a

very important analysis for this audience. in 2005, there was an estimated 431,000 patients who used community health centers in massachusetts. we have a strong network of community health centers all across the states. among the $431 to -- that for under 31,000, 6% were not insured, -- among that 431,000, 6% were not insured. in 2006, which was the year in which health care reform was just beginning to be implemented, it at the 446,000 visits -- you can see 446,000

visits. percentage of insured had already started to decline. we implemented at the third phase in october 2006, and the percentage went from 36% to 33%. the % covered by medicaid went up from 38% to 42%, and the percentage privately insured was about the same. you also see, though, in 2007, there were about 42,000 patients and community health -- 482,000 patients in community health centers in massachusetts. in 2005, it was 36%, the percentage who had medicate was 42%, and those with private insurance did not change.

5% are in the commonwealth care program. with expansion and creation of a new state-subsidized program, we were able to to note to the uninsured. massachusetts, we have what has long been called a free care pool, paying for services that uninsured individuals access at community health centers and acute care hospitals. the pool was used to fund health-care reform in massachusetts, and before, there were about $700 million in the fund.

there are between 300,000,400 million remaining in the pool, and that is the case for this 26% of uninsured in community health centers and continues to pay for the uninsured who goes to acute care hospitals. it could continue to go up her it health centers obviously require additional staffing to meet demand, so many newly in short, there was a population of

people who had not previously accessed services. many reports on leveling off somewhat, but you can imagine that this presents a significant challenge as people who are newly insured come into the system. in an effort to address the shortage, we have new initiatives. august last year, the

legislature passed and the governor signed a bill known as chapter 3 05, where there was the creation of a health care work force center with an answer council. it will be responsible for modern france in health care so we have a better handle on what the needs are. -- monitoring trends. we understand the impact of those things on retention, including whether or not the medicaid program allows nurse practitioners sufficient assistance, for example, to be paid as primary care providers. this work force center also is responsible for creating and implementing a new loan repayment program to fill in

gaps. if people are not eligible for national health service because it is not designated, or if they do not qualify for one of the other programs we have, this will try to fill in the gaps. we're also in the process of developing a statewide plan for insuring that by the year 2015 every practice will be designated as a central home. there is an initiative coordinating council, and all participating in paying for health care are at the table in this group. we are developing a consensus on what the condition is, what the new core elements should be,

what the methodology should be with report to enhanced payments and providers. also providing the type of resources necessary for transformation. as part of the vast -- evaluation, a unified set of clinical outcomes becomes transformation. we are working with 14 community health centers in massachusetts to get a jumpstart on this initiative, and we are looking forward to the goals at community health centers.

i just put this slide appear to give you a sense of how we're looking at health care reform in massachusetts. part of the difficulty with the national debate on health care reform is we do not really all speak the same language about what reform means. when we look about reform in massachusetts we recognize that we have multiple segments of the health-care system, the regulatory system, the payment system, that we have to coordinate efforts if we're going to see true reform and -- lasting effect. as we look at access, the connector authority has certain responsibilities for insuring that people at least have access to affordable insurance. the department of public health, through a determination, have a

responsibility to promote right care and the right place, and to go through the work force. we're looking at whether or not we should be more proactive with fat, with what we're doing with planning in massachusetts, expanding the role to help planning authorities. we also have a health institute responsible for implementation of medical records and an information exchange. we do have resources to help implement it, building on the federal stimulus to allow us to do this in the most efficient way.

disparities in massachusetts -- there is a statewide council looking at disparities that will make recommendations about how do we continue the process on eliminating disparities. the health-care cost council was something created with the original health care reform, 58. it has created a consumer friendly web-based site where individuals in massachusetts or anybody can go and look at whether the different grapes -- rates paid by insurers, different diagnoses, looking at outlining of the performance measures that are being provided, so we have the court made its statewide system of doing this.

we're looking at, how do we oversee governance of all of these various initiatives going on. we just had a special commission on payment suggesting we should move away to a model representing more global payments. and is continuing to come out as an issue needing reform. we do not have an answer for that yet. we're looking for ways we can get performers out in the process. we also recognize we're looking for health and wellness in the commonwealth. so we do have a statewide program to promote that. this gives you a sense of all the activities going on in massachusetts. it is not limited to health

insurance reform. we're really looking at what we need to do across various systems to figure out ways we can coordinate them and be very clear about the results we want to get and how we will get there. we have no -- dissolutions about how difficult this is and how long it will take. but we do not feel that simply making sure everyone has insurance is the answer to the problem. we have a lot of stuff going on. i think that is it.

>> i wondered how you were dealing with the issue of foreign nationals and articulate undocumented once in the program. >> hint -- none of the programs implemented in massachusetts cover undocumented individuals. it is why the free care pool will never go away. yes? >> college of dentistry. i appreciate your point about including dental coverage and health plan, because about 10%

of the population of 30 million americans visited dentists last year, but not their primary care provider. >> it was a back up slide in case somebody asked about cost. basically, what this shows you on the left-hand side of the slide is reform, before it happened, the state was paying about $1.4 billion in the free care pool and supplemental payments to various entities to

pay for individual care for those who do not have insurance. in 2007, the total cost is about 1.3 billion, and in 2008, about 1.6 or 1.7 billion, and the 2009 numbers are in red because they are not final yet. this is costing the state more than anticipated. >> why was the public auction not put in the exchange? why wasn't that part of it? >> so, quite frankly, we don't

believe that either the chip program or any program looking like medicaid should be in the exchange. by having the public auction out, and allows us to better manage the administration of that program. what we have seen over the last couple of years is that individuals actually moved from the subsidized program to the medicaid program to the free care pool based on their levels, that sort of thing, through the medicaid program. that is one reason why it would be a nightmare if we separate it out.

>> thank you. your job is quite complicated. at this point, we're going to our breakout sessions. iowa all the feedback you can give so we can improve the conference and give us your great ideas about what we can do in partnership with you. your next generation ideas are going forward. >> we're having these large turnout because of health care issues. so i wanted to bring up -- because there have been a a lot of concerns, legitimate

concerns, expressed about what might you might be and what i'm doing in washington, but i'm listening to the people iowa, those sort of things. i want to express to you that i think we have the best health- care system in the world. it does not mean it is perfect. there is something they can be improved. it is costly. health insurance is awful expensive. >> at 8 eastern, live with and the netroots conference. bill clinton addresses the conference, live in pittsburgh. >> three days of peace, love, and music. 40 years ago this weekend, half a million people gathered for woodstock.

9:00 p.m. eastern. brian jennings on the new fairness doctrine -- interviewed by monica crowley on "afterwords," part of booktv weekend. this morning, "washington journal" talked to gm executives on what they were doing about alternative vehicles. this is about half an hour. our first guest from detroit. it is the line director from general motors for the chevy volt. please tell us about the volt. guest: good morning, susan, everyone. general motors is very proud of the progress made with the volt, general motors electric car

which is destined to hit the marketplace in a little more than a year. we have handled all the challenges previously associated with electric cars -- ranging, charging. it will give you for the emission-free miles, then if you want to go longer we have an on- board engine generator that allows you to go hundreds of miles more. it is a car that we believe as a chevrolet americans can follow- up with to be a primary car. host: my producer and i have been having a discussion because of that conversion long distance to the gas engine -- whether to call this an electric car or a hybrid. what is the correct terminology? guest: when you look at the department of transportation data and see how many miles people drive on a regular basis, 70% drive at your than 40 miles. for those people if they plug in only once per day will be an electric car all the time and

there will not use any gas. for an average person that probably saves about 500 gallons of gas per year. host: so, what should we call it? electric or hybrid? guest: we call it an extended range of electrical been that it becomes a battery-electric car if you take the other thing out. host: we want to take phone calls from viewers about this. we will learn more about what it might do for general motors and its health of raw. what are executive saying about the prospect of this car in restoring economic health for the company? guest: the show volt is about the future. this is a car -- the chevy volt -- it is a unique, no one else has stated that they can or will do this. we will be a technology leader. elector drive and general motors

technology will lead the way. host: what is the process from today until it shows up and share rooms? guest: we're going through painstaking means to test the battery. we will go to dedication in michigan that will be the battery-assembly plant. the car and battery pack are made in america. we are doing the finishing touches to make certain we have our production tools ready. and that we have tested the battery pack and that will last 10 years, 150,000 miles in the car. it will probably also have a life after the car. host: when will it be insurance? host: when will it be insurance? with our focus on cars, customers, and a new culture, we will expose this car to customers across the united states to get their feedback and input, to make sure certain that the car will be at the like to

them when they receive it in november 2010. we do not have exact figures, but the plant is in detroit, said that is all american workers. a battery plant is in michigan, and all of the engineers really are headquartered in the detroit area, as well as support for global resources. so it is really a jobs play as well, and when you look at the future, they will probably have an additional 2300 vehicles. we need an electric solution using u.s.-made electricity to drive the future. know what the pricing will be yet? guest: we typically priced cars a couple of months before we launch them. the wonderful thing about a the wonderful thing about a chevy @@@@@@@@@ @ @ @ @ @ @ @ @

electricity probably costs 2 cents a mile versus an equivalent gasoline car, 10 cents a mile, and we expect they want to see electric drive work and electric automobile, to be. we think a lot stakeholders will help the cost. we will get free electricity, maybe a home charging unit, etc. in the end, it will become quite a value for consumers. host: there were some questions raised, and i would like to have to answer them. suggestions of the media are that the car would possibly be priced in the area of $40,000, and concerns are about competitiveness with japanese cars coming in about $12,000 cheaper. with the company's struggling to make its way fiscally, what about competitive pricing?

the price will be reduced by $7,500 a due to the rebate. hypothetically, if the reports are correct at $40,000, it is more like $30,000 car, and probably less. there is nothing comparable with that volt. there's not a mass-market, high- volume car. even the electric battery cars have limited range and take a long time to charge. sometimes it is only a two- seater. but this is a four-seater, sold around the country, and is wonderfully fun. green cars do not have to be born. this goes from zero to 60 m.p.h. in 9 seconds. our vice-chairman likes to say that it will allow you to burn rubber, but not fuel. host: let's take your phone

calls, beginning with mike in wyoming. caller: the question i have is, in the wintertime out here in wyoming we may get 20 below zero, even 35 below zero. how good does that better redo in wintertime situations? have you tested that there really? guest: mike, that is a great question. some of our friends in canada are used to the engine block heaters. the simple answer is that if you have the capability to put it in and a standard 120 volt outlet, and it charges overnight. if you keep it plugged in, we use some of the energy that we peel off the grid and keep the battery condition. if you are not plugged in, the other beauty and the way it is designed compared to other

battery electric cars, is that we do have been in on board that in emergencies and low temperatures the engine can be started. this really is a car that we want everyone to be able to buy, not a niche car, monta $100,000 car. host: how is the moral of your team? guest: i think busy people are pretty happy, especially when you are busy on something very exciting. we have this breakthrough technology. we are quite inspired by it. we get a lot of comments from people, passers-by who are rooting for us. they believe we can do this. host: our next call comes from motor city, detroit, on the independent line. caller: good morning, i am so proud of what general motors is

doing. i am so proud of our president barack obama because i remember when president kennedy was taken up the challenge. we can meet any challenge. the challenge that general motors is meeting could in a few short months -- 200 miles for the gallon, we do not have to look for excuses. gm will go back to the top again, and with the experience and skills we have here in the detroit area, i just thinkt is a brief moment for america. the whole world is watching. thank you, sir, for your hard work. guest: george, thank you some much for your support. we're working on a card that will be a breakthrough,

transformational, really exciting. the battery is a powerful story. we developed the battery to last 10 years. this can help us capture renewable energy. let's store the energy from wind or sun and store it. we are excited host: your biography says if you have been a line director for general motors for 11 years. can you tell us how long ago the work began on volt? guest: i was lucky to get tapped on the shoulder. one of the original challenges was let's do the electric car again. we have a wonderful history. we learned a lot from a technological perspective. i have been working on this 24/7 since the beginning of 2006.

we have a spirited, dedicated team who thinks there will make a difference. host: the development of the battery, the essential ingredient, was it done all with private money, or whether government grants involved? guest: for the most part with the blood, sweat, and tears of general motors employees. recently, a vice-president joe biden came to detroit to announce that general motors was one of the recipients of the grants, specifically associated with the plant in brownstown. we have not had the technical capability in this country to the bettors. but in china, japan, korea and have developed that through funding through their government. we're pleased that our government understands the power of this battery storage. general motors has taken the

next step beyond. who better to help develop its and have it as a core competency than to motors? host: the next question comes from minnesota on the republican line. caller: hello, i have canadian grandchildren and i am concerned over in windsor help it will it affect that plant. those people were hurting, too. how will it affect the canadian side as far as that future of the electric car and the plant? guest: the chevy volt will also be sold in canada. interestingly enough we get a lot of support from an engineering firm in ontario. we have a wonderful facility also in ontario. it is awfully cold there. it relates earlier -- to the

earlier question from our friend from wyoming. we're pleased to be partners with canada for cold-testing and the like. we're hoping that the volt will create jobs not only in michigan, but beyond, from the perspective of being the hub of electrification. windsor is not far from detroit. there are so many wonderful and talented people in canada. we would like to create more jobs even for them. host: we're getting a number of questions from twitter and by e- mail. here is an example. guest: great question. much discussion about future activity around smart grid, how to manage the challenges. our grid is a patchwork. many regional grids that we must tie together and

coordinate. the volt which charges on your standard alleged charges overnight. between six and eight hours. foremost, that will occur when they are sleeping. during that time frame the grid is underutilized. we have enough capacity always to handle needs during august when it is so hot, so in the midterm is a good thing to utilize that capacity available at night. the other beautiful thing is when these batteries are all plugged in we know that we will push for other green technologies. this battery is an asset that can be used to collect that energy. you will see more in the news when some of these smart greed d.o.e. grants come out. i think that will be addressed

ahead of time. when some of this small grid money comes out. guest: it all depends on the price of your electors the plan which varies over the country. -- price of electricity which can vary. it probably would be about the fourth or fifth most consuming a plant in your house, the equivalent of an average electric water heater. we anticipate the consumption, probably increases 15% to 20%. but the off-peak rates for electricity are much less. probably a 10% increase in your letter bill.

for many people that is maybe $150 per year, compared to saving 500 gallons per gas. we're possibly talking about thousands of dollars of savings using electricity compared to a gasoline-powered host: car next is chattanooga, tenn., on the line for democrats. caller: good morning, how are you, tony? i'm wondering about the repercussions of the car and if there has been in a discussion of ad solar panels to its roof? is it a small engine like a lawn mower engine? what are we talking about here? guest: danny, both precautions.

solar cells our technology we are very bullish on. we believe they need to be part of our future. we are looking at lots of studies, one of the near-term challenges is, as you know this battery is very expensive. in the new technology, the early prices generally come down over time when you get more suppliers and competition. your engineers and scientists get smarter and execution. the solar panel is something you'll not see when it is first launched. after rob, this is a chevy and people expect that everyone can afford it. but we do see the opportunities forsolar panels elsewhere in the system. sometimes when a yourvolt is

plugged in outside, could be positioned appropriately. we have thisrange-extending future. it is different from any of the vehicle. i can go hundreds of miles more when i need to. this is a small, 1.4 liter, 4- cylinder block engine. we sell hundreds of thousands of these engines globally, so the cost is down. in the future, we anticipate some of the students in university today will come up with new ideas and create a generator that is smaller and more efficient. a stirling cycle engine, a gas turbine. as the batteries get better and better, we think we can create even more battery power and more gasoline.

host: which you are volt making the volcker announcement -- the gallon number is disingenuous, especially when trying to define fuel economy or energy use for a car that uses energy from distinct sources, energy from a grid and liquid fuels. dropped the rating altogether and give us specifics, whether the energy is written in kilowatt hours or be to use, whether it comes from the grid or from liquid fuels. do you see going to a different standard than miles. gallon? guest: that is a great question. i will take some more time to develop that further, because it is very important. for years, we have trained customers that miles a gallon is somehow a measure of goodness. with an electric car, and miles

a gallon metric becomes less and less important. we do have an exact figure on what the number is. 25 kilowatt hours. that is every 100 miles. we have to remember that this has to get customer focused metric we provide people so they compare one car to the next. 230 miles a gallon in the city cycled meets the epa testing requirements. i would not use any fuel as a gold for current requirements because they're less than 40 miles. as we discussed, if a customer drives only 20 miles a day or 30 miles a day, even at that level, more than 60% of this country drives less. it would be disingenuous if we said that the fuel economy is infinity. it takes real-world, real-

customer driving data and says there will be people who get more than230, and people who get less, but allows customers to compare a metric they are trained on for many years. this is different from a 30 mile per hour car. final point, ultimately we need to go to cost per mile. that is a customer metric everyone can understand. it is 2 cents per mile volt. the equivalent is 10 cents per month. if gas goes up, that will become an even higher number. st: west virginia, on the republican line mike. caller: first of all, i want to congratulate you on the car. the technology is great, but i have questions. what are the replacement cost for the batteries? suddenly come how will the

subdue in mountainous areas? three, why should we be on the force of the $500 if it is the panacea that you say it is? -- suddenly, how well does it do in mountainous areas? guest: that was number three, what was o #ne caller: i cant remember the area. host: we have taxpayers on the hood, the mountainous area, and what is the third? caller: basically, i am more concerned with the costar replacement for the battery? guest: that was it. let's begin with the batter one. i want to focus on what consumers need to know. chevy volt battery is designed to last in the car for 10 years

and 150,000 miles. when you see comparative battery-powered cars that is the first question you should ask. what is your battery performance target? second, what is your performance goal? it will be an eight-year warranty. the replacement cost is not something you must worry about for quite some time. it could even be beyond that at 10 years. that is longer than most of your other components. this is our level of confidence. we like to kick around and say that the battery is like a fifth passenger. we treat it so well. we not fully charge and this charge the battery which is tough on it. we do everything in our power to extend its life so that you do not have to deal with the larger

replacement cost. second question, this with the area of the tax credit. like all new technologies if you are interested in stimulating them so that people will adopt them, they require some help. some weather the plasma and screen tvs, cell phones, we see how they have changed over time. they were very expensive at first. we commend the obama administration for the jump start they have given this technology. it has existed in the past. it is not out of the ordinary. third question, mountainous areas -- remember we have both a battery pack and an engine on board. so, when you need totax the car a bit, our motor power is 111 kilowatts. that is the equivalent of a 150-horsepower engine. it is designed to be an everyday car.

host: not much time left. here are two questions, one by twitter. you have talked a lot about the advantages of city drivers. guest: one of the things really nice about the volt is that the recharge time is relatively dest. if you have a 240 volt outlet like your dryer, this is a less than 3-hour charge. general motors will do a great car. this is where we are hoping that plug-in ready communities will help out. others will help to support allowing people toplug in.

we have a wonderful innovation, the electrical grid which is going through transformation. host: the last quick question comes from brian in vancouver, british columbia. caller: good morning. i am fascinated with the volt, but i heard what i hope is just an awful rumor. that the volt will not be released to your canadian chevy dealers at the same time it is released in the states. i hope that is not true because i want my name number one on the list. i am anxious to get one. guest: well, we appreciate your interest in the car. we hear so many people who are inspired. we have to deliver on the promise. the car will come to canada. it will come to vancouver, but like a lot of introductions it has to be rolled out over time.

it will be by region. it will begin in the united states. there are 3000 different electric utility companies. as such, plugging in the car, making it reliable and giving customers confidence is very important. so, it will come to canada. but it will be in the u.s. a little before them. you need to keep an eye on the vancouver olympics. you might see a jolt from volt there. host: we are out of time, but we're getting all kinds of questions about the mechanics and other questions of the car. i am wondering if your website has a place where people can get their questions answered? guest: there are a number of different ways to do this.

our ceo fritz henderson has opened up a line of communication. . . thank you very much for telling our audience about the volt. lots of ways to find out more. we appreciate you taking our calls. >> i think we're having these large turnouts because of the health-care issue. so i wanted to bring up, because there's been a lot of concern and legitimate concern expressed

about what my views might be and what i am doing in washington, whether i'm listening to the people iowa. first of all, i want to express to you that i think we have the best health-care system and the world. it does not mean it is perfect. there are things that can be improved. in this costly, some people have a hard time getting health insurance. it is awfully expensive. >> members of congress around the country are holding meetings with constituents on health care. here's a look at some of the advertisements that they are facing during the august recess. >> for six years, and have been here in nebraska. last week, health insurance agent called, and told him i rates would go up 42% from last year. i told him i might have to

cancel coverage. i'm just going to pray that my kids do not get sick. when obama proposes a public option that would force private companies to compete, that is what my family needs. now i hear that ben nelson, the senator i voted for, is leading the charge to delay reform this summer. that is exactly what they want. the insurance companies have given the company's money, and now they think if they can install reform, they can kill it. if you are on my side, senator, stay at work. my family cannot wait for reform. >> democracy for america and progressive change committee are responsible for the content of this advertisement. >> they will not pay for my surgery. what can we do? >> funny, you cannot live this way. >> and to think that planned parenthood is included in the

plan. they are spending money on abortions, but they will not pay for my surgery. >> our greatest generation denied care. our future generation denied life. stop a government takeover. >> bill clinton kicks off the 2009 bloggers convention. coverage starts tonight at 8 eastern on c-span. tomorrow, panels on health care reform with howard dean. pennsylvania politics with arlen specter. making change happen, and restate tune -- reshaping the supreme court. voters are expected to go to the polls nationally next spring. david cameron on how a tory government would change domestic policy. british baltics, sunday night on c-span. this fall, from the grand public places to those of only accessible by the justices.

the supreme court, coming the first sunday in october, on c- span. >> now, a house hearing on regulating the bottled water industry. over the next two hours, the investigations subcommittee hears about the regulation differences between bottled water and tap water. >> the chairman and ranking member will be recognized for an opening statement. other members will be recognized for a three minute statement. i will begin. food safety is an important issue this committee has felt

the need to have nearly a dozen hearings on in the past years. time and again, we hear from individuals wanting more information to make wise decisions about what they eat and drink. my constituents are no exception. a's hearing on bottled water to its close to home. my role district has alaska, so we have a keen awareness of issues. we're also home to a facility that has not been without controversy. in 2008, americans consumed billions of dollars from bottled water. many americans think it is healthier than tap water. the foundation found nearly 56% of drinkers site