forces involved in working through the crime issue in new orleans. but much of that is sort of localized in neighborhoods. the fact is, many, many people live in new orleans and are very safe. despite what you might hear, there's a lot of opportunity there. there's a lot of optimism there. your question about the schools, i would ask you to go to the recovery school district web site, look at it, make phone calls. there gentleman there and the ladies that would love to talk to you about relocating there. go to the greater new orleans inc website. you can make a phone call to several other organizations in new orleans. megyn kelly about the positives that are occurring. host: as a reminder, we have those was as on our website, c- span.org. one more call from illinois. caller: the rate of the coast

decline due to having things like drenched the river and the missing with the ecosystem in new orleans, they anticipate that the actual gulf coast will be right up to the edge of the city within the next 90 years. i was wondering what you are doing to address that because those buffers that exist right there, right now in this field prevent a lot of flood waters from getting up against the flood protection. if that is gone at the rate of two football fields per hour, the premises for the future in terms of having a category three or four hurricane hits the city direct again, i want you to address that. guest: that is a good question. there's three levels of protection. we have our coastal protection

restoration program, and the head of that work in environmental public works committee. he is very aggressive about making sure that we have the first line of defense. we're spending a lot of money on coastal protection and restoration. the next piece is the levy system. the corps of engineers is working on it. the third piece is extremely important. it is what we can do internally. good, strong drainage programs, elevating homes, carvin homes, and we're finding the largest television program in the history of the country right now. it goes beyond that as well. the senator has talked about water management and has gone to the netherlands. we have sent staff to look to their water management program. the fact is we need to figure out smarter ways to live with water. their ways to do it, as we as seen in other parts of the world. we need to look as some of those

principles and figure out things we can adopt the work. but we can survive storms. during ike and gustav in cameron parish in louisiana, and hospital was elevated after rita. the storm surge in ike was to the beat fire -- feet higher and the hospital survived. we can do this. we're one of the greatest countries in the world. i think americans can figure out how to survive storms and how to survive floods through smart and effective ways of rebuilding. host: our guest is the executive director of the louisiana recovery authority, paul rainwater, joining us this morning. thank you for being on. .

>> a live picture from the center for american progress. a moment or two away from the start of a forum on the challenges facing labor. we will hear from richard trumka, tended to become the next president of the afl-cio -- today to become the next president of the afl-cio. -- candidate to become the next president of the afl-cio. ilive coverage on c-span. >> good morning, everyone.

welcome to the center for american progress action fund. i'm executive vice president here. it is my great pleasure to welcome you all to the first that of our new series called "perspectives on the future of the american labor movement." is hosted by the center for american progress's american worker project, which conducts research on how we can increase the wages, benefits, and security of all american workers, and promotes their rights at work and make sure that the american worker perspective is central to all work at the center for american progress, whether it is that the economy, in government, health care, and host of other issues. -- economy, environment, health care and a host of other issues. today's discussion comes at a pivotal time for our countries workers. in the midst of the rate recession, with job loss and an unemployment at near record

levels, and even worse, before this recession, the economy was working -- not working very well for many workers. the underpinnings of our economy were really unraveling. it was working for only a few. we needed even before the economic collapse to begin to make it work for everyone. one reason why the american middle class was not as strong as it should be is because of the declining strength of the labor movement, which represents 13% of american workers, down from a high of about 1/3. this is a great moment to rebuild the foundations of our economy, and with us is someone who will play a major role in shaping the future but we are pleased to have with us today as the initial speaker of this series richard trumka, the secretary-treasurer of the afl- cio. we are pleased to have with us today not just because in september he is largely expected

to be elected president of the afl-cio and to lead the federation of 56 national and international labor unions representing 11 million members, including 2.5 million in working america, its new community of elliot, but we're also pleased and you'll enjoy today because he is a passionate advocate for workers and a charismatic leader. having his energy and enthusiasm and vision here is a great way for us to kick off this important speaker series for us. if any of you saw his 2008 speech to the united steelworkers challenging racism in the presidential election, which more than 5000 americans watched on youtube, you know what i'm talking about. he has a fire that burns strong and bright, but he also has a reputation as a builder of bridges between competing interests. these two attributes make him a leader worth listening to. i look forward to hearing his thoughts on how to revitalize organize labor, the countries

middle class, and the economy. after his remarks, we look forward to a dialogue with you that david will moderate. please join me at a welcoming richard trumka. [applause] >> i want to thank cerrone for those very kind words -- thank sarah for those very kind words, but more importantly, for all that you do to respond to the challenges that this country is up against. i am convinced that the kids of now, what the historians look back at these -- decades from now, when historians look back at these last eight years, it will not only to see it as a time when the countries leaders lost their way, but will see it as a time when progressive found our voices. the work of the center has been fundamental to making that happen. you ought to take a great deal of pride. everybody that works here, all the staff here, the leadership here.

it was a tremendous thing that you have been doing. it goes without saying that with the passing of ted kennedy, these last few days have been sad ones. not only for those of us who have had the opportunity to work with them, but i actually think for everyone in this country. we have all read a lot about how he was a great legislator, and of course, he was, he really was. the reason why is that he has always -- he was always guided by his values, progressive values, our values. i remember last year at the democratic convention in denver, he said there is a new wave of change all around us, and if we set our compass true we will reach our destination. not merely a victory for our party, but renewal for our nation. i've been thinking a lot about that the last several weeks.

this is also an era of change for workers and era of change for unions. we had the chance to make a time of renewal for the american labor movement as well. this is what labor movement's moment, and together, we can build a labor movement that i think we need to create and the kind that we need to build to get the america that we want and deserve. and america where young people are not robbed of the opportunity to go to college, an america where older men and women never have to fear that they will live their lives in poverty, an america where you do not have to worry about whether the health insurance you have is going to pay for the health care that you need, an america where every job is a port with the the middle-class. that is the kind of america that we want.

it is up to this generation of trade unionists to build a labor movement that can make it happen. quite frankly, we do not have a moment to spare, not a single moment. the truth is that the middle- class in this country is not being squeezed. we are being crushed. women and men, working parents who ought to be living the american dream, are instead of losing their health care, losing their pensions, losing their jobs, losing their homes, and losing their patience. today there are nearly six times as many people looking for jobs as there our jobs to filtered for all the construction workers who lost their jobs, just since last november, stood side-by-side, he would have a line stretching from washington to new york and back. it's not just the private sector. there's always that means that

some out -- that somehow, public employees are immune from recession. just one month into the new fiscal year, 13 states are looking a budget shortfalls of $26 billion. who is going to pay for it? well, the same people who have been paying all along, the men and women that provide public services that all of us depend on. it was not the uaw or the machinists or the teachers or any other union that was calling the shots at bear stearns and lehman brothers or aig and goldman sachs. i can tell you for a fact that no one at the fed with the treasury department ever picked up the phone and called the afl- cio or any of the trade union for our advice and opinion.

even though it was not organized labor that got us into this mess, we will lead america out of this mess. there is no other way. the bottom line is that you cannot rebuild this economy and thus you raise workers' wages, and the fastest and surest and most effective mechanism for raising workers' wages is the collective bargaining process. increasing productivity only raises wages when workers have bargaining power. take bargaining power out of the equation, and you still generate wealth, but it will not get into the hands of the people who created it, or who really must have it, in order to grow the economy. that is what has been happening over these last 30 years. john maynard keynes understood

the dangers of the ravages of free-market fundamentalism. i am convinced that the president and most of the house and many in the senate understand it, too. that is why they are backing the employee free choice act. that is why the center for american press -- center for american progress was one of the first organizations to endorse it. just as a growing labor movement build the first american middle- class, unions can build on the middle class today. that is why our messages don't support the free choice act because it is in labor's interested supported because it is in your interest. support it because it is in your children's interest, support it because it is in your neighbors in trust, supports the employee free choice act because it is in america's interest.

but the challenges facing unions is not just to change the way labor law works right now. it is, quite frankly, to change the way we work. it is to reconfigure ourselves to respond to the needs of a new generation of working americans. today -- well, tomorrow, the afl-cio is releasing a new study that we completed on the crisis facing young workers the dead. -- don workers today. what it will show is that every measurement, a young americans are in an economic freefall. one example -- men and women under the age of the five earning less than $30,000 a year -- under the age of 35 earning less than $30,000 a year, 52% of them are living in their parents' homes right now. younger workers ought to have health care, they ought to have

paid sick leave, ought to have a vacation. they ought to have pensions. and it ought to have union representation. but when they lifted unions, too often what they see is a remnant -- when they look at unions, too often what they see is a remnant of the parents economy, and not a path to succeed on their own. this is an issue doubled aside the future of the american labor movement. while we hear a lot about unions coming back into the afl-cio, and quite frankly, that is a personal priority of mine, but ultimately, it will not matter how many units are in the afl- cio if we fail to capture the imagination of the millenn ials. we ought to be clearer. the problem is not that they have some deep-seated hatred of unions. they don't. earlier this year, a study was done at for the sunday -- for

the center for american progress pointed out that the support for unions is higher among young americans than it is for any other age group. the problem is that -- not that they dislike unions. they think we do a lot of good things. we do a lot of good things for our members and for others. the problem is that they do not think we have enough to offer them. that is not the way that it has to be. a few years back, there was another center study that was done by a friend of mine. it found that young workers, white collar workers, who did not want much to do with the labor movement, sat up and took notice when they heard about unions winning protection for telecommuters, bargaining for affordable health care, standing up to protect professional standards. when we talked about the

problems facing contingent workers, they really listened, and for good reason. after all, a man or a woman working as a temp or a free lancer today-will be walking -- a cap or a free-lancer today might as well be walking a tight rope without a net. did not think that unions fit the way that they work. you cannot blame them. we of now refocus on the way that they work. -- we have not really focus of the way that they work. we have to change our approach to unionism to meet their needs. one union that is pioneering us in this area is the communication workers. they have an affiliate that began as a grass-roots movement of times working at microsoft in

seattle. thanks to the internet, and has members from boston to silicon valley, and is evolving into a dynamic new union tech workers dealing with problems ranging from job security and health care to offshore outsourcing and visas. but you know that we cannot only address their needs where they work. we need to address the fact that a lot of young people going to college today are drowning in a sea of debt by the time that they come out of college. there is a story that the writer has posted on our block about a young man -- our blog about a young man named robert bowman in new york. he grew up in foster care and work his way through community college and college and law

school. he survived two accidents. one that nearly cost him his leg. all along, he took out 32 separate student loans. over that for years, is that sort -- his debt soared to a little over $4,000. five appellate judges said that he cannot join it new york bar because he is not done enough to pay off his debts, his loans. that is just one example. there are literally tens of thousands of other examples. young people studying to be nurses and teachers and social workers and engineers. going to college with dreams of both careers and graduating into near bankruptcy. paying off loans the rest of their lives. now fighting to make college

affordable made not a traditional union issue. but if we care about the economic security of young workers, it really has to become one of our concerns and one of our issues. that, quite frankly, is just one piece of the equation. i am not suggesting that the labor movement ought to abandon all of its traditions. what i am saying is this also for the past is really -- is that nostalgia for the past is no strategy for the future. this is a critical moment for american workers, and we need to seize it. that does not mean just speaking to the interest of young workers. we need a labor movement that tells american workers in no uncertain terms that racism, any kind of bigotry, may serve somebody's interest, but it

sure as hell is not our interest. in 2009, 30 years after the death of a philip randolph, labor is still haunted by the legacy of jim crow. that is why after the employee free choice act becomes law, our first priority has to be launching a drive aimed at the countries 5 million poverty-wage african-american workers, and other minority workers, and the women that the economy is left behind. there is more. we need a labor movement that is ready to partner with every employer who respects workers. and understands that their employees are an asset to be invested in, not an expense to be cut. we also need to be ready to push back against any ceo who thinks that he or she has the right to earn a good living, but their

employees don't. in short, we need a labor movement with the strength to compel every company to live up to the responsibility of corporate citizenship. in that regard, i can tell you that i know the center has been working to bring wal-mart around on some health care reform. but there should be no mistake on this point, ninone -- wal-mat will never be a friend of workers so long as it denies its own employees the right and the strength and dignity that can only come with the usw contract -- the ufcw contract. that is not all. we need a labor movement that is mobilizing as never before to speak out for workers, whether it is at the courthouse, the state house, or the white house.

today more than ever we need the labor movement that stance by our friends, punishes its enemies, and challenges all of those who cannot quite seem to decide which side they are on. i'm talking about the politicians who want to turn out our members for every vote, make phone calls, door locks -- door knocks, but somehow they seem to forget workers when the votes are counted. for example, legislators to do not understand that their job is not to make insurance companies happy, it is to make americans healthy. legislators who say they are all for health care reform but refused to stand up for a public system that puts people for profits -- people before profits. to hear some of them, you think the objective is not to come up with a health care plan that

works, it is to write a bill that republicans will vote for. they think -- i think they need to understand that you can have a bill that guarantees quality, affordable health care for all americans, or you can have a bill that the republicans will vote for. but you cannot have both. we in the labor movement -- well, we keep our promises. and we damn well the man and expect that people we elect -- demand and expect that the people we elect keep their promises as well. what kind of labor movement does america need? indeed a movement that makes sense to a new generation of workers, a movement that challenges all bigotries, a movement with the strength to hold corporate america accountable, a movement guided by the progress of the values that understand that if you fight for those values, you may

not always been, but if you refuse to fight, you are always certain to lose. i know that we have some time and we want to at some time for discussion. but i began my remarks and i mentioned ted kennedy. well, there is another kennedy that also touched my life. it was his brother bobby. it was a rather time the first one in and volunteered in his campaign. some of you may recall that all through that year, he what often quote george bernard shaw and said some things -- some in d.c.'s things as they are -- some men see things as they are and ask why di. i dream of things and ask why not.

that is us in the labor movement. we dream of jobs where people are treated with respect and are paid what they actually earn. got spli -- jobs that they look forward to going to every morning, not ones that they can wait to get away from -- they cannot wait to get away from. here in our america, we think everybody ought to have a seat at the table and a chance to sit back and -- jets to stand at the winners table every once in awhile. we look forward to parents telling their children that if they study and work hard, they can achieve anything. that is the america that we dream of. quite frankly, this is our moment to ask why not. thank you. [applause]

>> i would like to ask mr. trumka to join us. i'm director of the american worker project, and i'm thrilled to have reaich here joining us. i'm going to moderate a discussion with the audience, but as the moderator, i will take the opportunity to ask the first question. you talk to -- you mentioned the importance of the labor movement and how it needs to grow and have strength to be able to represent more workers and at the powers of the workers have better wages. you talked about a major strategy of doing that is focusing on young workers. you lay out your mission for attracting young workers.

i was wondering if you could go a little more to death -- more into depth and talk about how to work targeting young workers, are there new strategies to do that? thank you. >> first, we are going to bring young workers into the labor movement. we have lost touch with an entire generation and you are seeing them pay the price. we will bring young workers, union and nonunion workers, into the afl-cio to have a right of a conversation with me at the officers of the executive board so that we can begin to communicate with one another. i want to know that when i say something, what they hear. i won enough that when they say something, i'm understanding what they -- i want to know that when they say something, i'm understanding what they have to say. and then to have them help us decide -- designed a way to be able to reach out to them. we want them to know that there is an entree into the labor

movement. too frequently in the past, there is not been that on trade. over the last several years, we are opening up ladders for them to be able to come into the labor movement, but we need to do more than that. we need to help place them as well. you see this more on college campuses talking to people. i tried to get people interested in the labor movement, to come in and know that their careers, no matter what you studied in college, there is a place for you in the labor movement. we need professionals, economists, organizers, social conscience, a little bit of everything, i.t. people. we want to know that it is the place to, but we will be the place to be in and with the action is that -- action is at over the next several years. >> look forward to seeing his but that action. i will start first with the

members of the media. we have 15 or 20 minutes or so for many questions. raise your hand and i will start with you. gentlemen right there on the aisle. >> dow jones newswires. this strategy targeting young workers seems like a move to keep the various issues alive, particularly in africa, and this comes after the discussion of survival. give me a comment on that and how concerned are you regarding that. >> it is not just about that, it is about the future of the country. when we released the study tomorrow, people will be astounded. we did the same study in 1999, and 10 years later, young people are far worse off. it is almost a lost decade for young people. they need to get involved and collective bargaining will help them. let's talk about the employee

free choice act and its employees -- and its importance. it's not just a union issue. it is the stimulus issue, an economic recovery issue. from 1946 to 1973, productivity in this country double, and so did wages. the largest distribution of wealth that the world has ever seen. the most interesting part of that time is that the people in the bottom quartile, their wages were rising -- their wages were rising faster than the people the top. the wage that was closing. from dented today, productivity has gone up but wages have stagnated. workers have gone through for five different strategies to compete. we work more hours, said more people into the workforce, got a second or third job, and then the 1990's came and we borrowed on our 401ks and let us to

embark on our houses. reproved over time that -- we proved over time that you cannot drive an economy with debt- financed consumer spending. we need a new engine. the only way to do that is to put money into people's hands so that consumers can try and grow the economy in a real sense. that is what the employee free choice act is intended to do. it is not the only solution, but it is an interesting and important part of the solution. that is why we approaching it. we feel very confident that we are going to get it passed. we feel that we said from the beginning that we needed three things -- one, and ability for workers to join a union without being harassed, intimidated, or fired, greater penalties, because the employers simply violated the law and paid a fine that was so paltry as a business cost. we need a larger penalties that act as a deterrent.

three, we need to resolve disputes with a drop dead date, no fault excuse. so that people cannot just surface parking their way out -- surface-pardon their way out and deny employees the right to collective bargaining. i am certain that we will get all three of those goals met and we will get it done quickly and hopefully before the end of this year. >> gentleman against the wall. >> i guess my relevant affiliation will be author of "state of the unions," a book about how labor can revitalize itself. i talk about a charismatic labor leader named richard trumka who is the kind of person that the labor movement ought to put out front to deliver its message. i'm glad that afl-cio is finally following up on that advice. [laughter] >> you have demonstrated you have great wisdom. >> it seems to me that labor's

agenda is somewhat languishing right now in congress and in other venues. doesn't this really points at the need for a slightly different political approach by the labor movement's to, instead of spending all of its time and resources selecting specific individuals, that in addition to that, the labor possibly needs to get more of its agenda and the values anto be part of the political dialogue and on people's mind when they both said that after an election, labor has a mandate for its values and its agenda and its issues and labor is not completely dependent upon the priorities that legislators and other political leaders choose to enact? >> it is an interesting point you made, i will get back to an eighth grade teacher who said that every time you point the finger at somebody, there are

always three. back at you. -- always 3 pointing back at you. some of it is our fault. you'll see us take a very clear- cut issues and to stand beside them and defend them. when you look at a couple of issues, when we did that with the employee free choice act, the workers' control the process. when we cede that to somebody else come up the process gets muddied. i'm hesitant to call it that, but it will be our version of the contract of america but it will be what we think is necessary to create an economy that will work for everyone. you will see us doing that.

you'll see us taking sharper edge to positions, where we say that this is where we stand sometimes i think our friends need to go back and take collective bargaining 101, because you cannot put out a proposal and have the other side say no and say, "if you don't like this, try this," and they say no, and you say "try this." you do not bargain with yourself, and frequently you see that. you will see us try to stop that from happening. you will see as helping the president and congress do what they wanted it in their hearts and hands but need the political nudging to get done. we will be there nudging them from this point on. >> i will take a question over there d. >> press associates' senior news.

-- price associates union news. you mentioned one of your target is organizing minorities, specifically african-americans. can you give us nuts and bolts? are there other minorities that you want to organize? >> i think i included other minorities as well. and i also said women, because i think they have been left behind in large part because of the economy, getting paid less on the dollar than anybody else. you will see is looking at low wage groups, you will see us coming up with a strategy for that, and trying to bring more and more people into the middle class, try to provide a ladder or those who have heretofore been left behind action to get a chance to get into the middle class. that is something that all this can be proud of. >> any last immediate questions before i go to the general -- it looks like there is one woman there by the tv screen.

>> i'm with a japanese newspaper. it seemed like organized labor to do pretty well with the old gm fallout in the auto industry. i was wondering if you could comment on that and the effect it might have on the labor over the medium term. >> i did not hear the first part of your question, i'm sorry. >> is this on? just thinking about -- it seems like there was a positive payout to labor from the gm and on a restructuring over the first half of the year. i was wondering if you could comment on that and whether that is seen as a big victory, and what it might have in terms of an effect over the medium term. thanks. >> you know, american workers, particularly automobile workers, were not responsible for

designing cars. in fact, the law as it is currently constituted prevents us from having any input in this decisions. we end up, workers end up paying the price for bad management. if you look at the number of automobile workers who are losing their jobs, if you look at their standard of living, he would have to say that they paid a pretty heavy price. we are saving as many jobs as we can, and autoworkers are working as hard as they can to preserve the most for that. it is tough to call that a victory for either the autoworkers' or for america. we keep producing less and less and less. there are two economies out there. there is the real economy, and there is the financial economy the financial economy was originally designed to help the real economy do things.

somewhere along the line, over the last 25 to 30 years, those lines have gotten blurry. the financial economy thinks it is a mandate in and of itself. i guess the the people of the very top, it is, and they have done exceptionally well. but our country, each of the states, all the counties, all the municipalities, all the workers, all the retired people and all of the children, have paid a heavy price for that. it is up to us to turn that around, all of us, and to try to start to produce things again. try to create good paying jobs. the question that i think we need to ask time and time and time again -- when somebody says let's stimulate the economy, ask them, to what end? if all we are going to do is create the same economy we had before, the same result will

flow from it -- less manufacturing, lower wages for workers, people of the top doing better. ask them what will be the new driver, all will be the new driver for an economy? an economy 70% driven by consumer spending cannot have debt-financed consumer spending as the driver. ask them, all of them -- ask us as well, what is going to be the new driver? if you do not have won, we will do the same thing over and over again and everybody will pay the price, and his last generation of workers -- when you see the study to mark, it is heart wrenching what has happened to them. they cannot pay their bills, cannot live alone. the debt it will pay the rest of their lives. we can do better than this. we are the richest nation on the face of the earth.

we can do better than this. no one will convince me that we cannot. a sort of have a real soft spot in may for all those workers that gave every day of their life to do a good job and tried to create a quality product. and now they have lost their jobs, and it was not their fault. maybe we can work together to put some of them back to work in good paying jobs the will recreate the middle class and form a real ladder so that those at the bottom can walk back into the middle class. >> i see a couple more press questions towards the back. >> my name is steve brown, and i've been an attorney for about five years now. i'm just here with myself. i've not had health insurance for the last -- i've had health

insurance for one year of the last 12 years. i know that a lot of unions and people in the in support universal health care plan. do you find that the businesses also support this because it would lower their costs and is there any way to motivate any of the politicians that are friendly to us to actually get, if we cannot get single payer anymore, that to get a public plan to make sure that this kind of thing happens so that we can lower costs for everybody, including people like myself? >> you know, that is a great question, and i empathize with you and sympathize with you. you are in this a position as millions of americans without health care -- the same position as millions of americans without health care could do any business people support that? yes. even large businesses. we used to have a regular conversation with 12 of the largest ceo's in the country,

and i will not tell you who they are because they want to remain anonymous and have deniability. a week met once a month, and they wanted helped -- but we met once a month, and they want health care change dramatically. they went back to the business roundtable on the national association of manufacturers and the chamber of commerce and they beat them to death, saying, "you cannot do this, you cannot do this." they did not come out publicly supported. how can the and not support a health-care bill that would cover -- how can gm not support a health-care bill the recover everybody? how can any metal manufacturer not do it? they are getting creamed. small business people want to, it just cannot afford it. there is a lot of support for it. hopefully we will be able to drag some of it out. when it comes to the public

option, 94% of the insurance markets out there right now are highly concentrated. which means that a few companies dominate them, and they keep the price up. they can charge whatever they want and you cannot walk away or do anything. that is what the public option is so important. for the secretary of hhs to be able to negotiate good grades with everybody on health care, on drugs, and be able to create competition so that if the company gets a little out of hand, you have somewhere to block to and go to to the public plan -- to walk to and go to for the public plan. the point that i find disingenuous is the other side saying that we do not want a health plan, and some people saying "i am on medicare, i do not want the government-one plan. don't touch my medicare." probably 50% of the people in the country right now are

covered by a government plan. if you include government employees, medicare, medicaid, social security, and the military, probably half the people are covered by a government plan, and they say to keep their hands off of it. here is the one bit of hypocrisy that i just laugh at -- whenever we talk about having a public option or even a single payer plan, the pharmaceuticals at hospitals started screaming that if we allow the government to negotiate those types of prices, it would put them out of business. on the one hand, they say that you cannot have a government plan because you do not want them controlling health care, and it is sloppy, and government cannot do anything. on the other hand, they say don't let them do that, because if they do, they will put us out of business. the government plan is sloppily run and it will put them out of

business, then what does it say about them? [laughter] in the last seven or eight years, health-care profits of got up for insurance companies 1000%, and prices have gone up for you 300-something percent. it is time for us to start asking questions, time for us to give all our friends on both sides of the aisle a little bit of backbone. and say, "don't let this small minority of people stop what the vast majority of the american public wants, needs, and demands." >> gentleman in the very back left. >> hi, i have a question about efca as it was originally introduced compared to efca as it may emerge from the capitol

hill compromise negotiations. do you believe that the majority sign a provision will be in the compromise bill? how do you see the arbitration provision changing in the compromise bill? >> i decide to you that -- i just said to you that sometimes our friends failed bargaining 101. i think i will talk to you about where we are willing to compromise or where we are not right now the bill says it is a card check bill. we are pushing for that and we think you'll get a bill passed that will satisfy the three goals and talked to you about. >> we have a question at the far left over here. can you wait for the microphone? thank you. >> i wanted to identify with the comment that was made earlier, that is when you were president of the mine workers, you showed

that kind of vision that you of referenced, and the ability to talk to people that did not think they need it to participate or be involved in a union. i've been traveling recently, and in this travels, i have monitored some of the town hall meetings, and i've noticed -- it is not scientific, but it was pretty accurate, in my opinion, that a lot of the people were young people, a lot of the board you need people out or retire -- a lot of them were union people that are retired, and they had not put the cost and affect together. they were against things that were for their benefit. given the dominance today in the internet and talk radio and a lot of the publications, how do you plan to put in place and effective way of communicating with these people so that they understand what their needs are

and what are the solutions for their concerns? >> thank you for the question. i think in the past we have been to focus on the top of the labor movement. that is where all the fun stories get written. you talk about the big split in the labor movement. the story was -- the story that was not written was that 80% of the locals for the unions that left, state affiliated with the afl-cio. they were much more in solidarity at the local level. we focus too much on the top, and we have not focused on creating a seamless operation of the federal to the state to the local effort. we are going to be much more grass roots-oriented, coming out was something that we can organize around and educate around. the components of what i told you it would take to create an economy that does work for every working people, and we will work through a process to come up with that. it will not be dictated by a

couple policy people sitting in the afl-cio. we will meet with our affiliate's and meet with people on the ground and will meet with young people and meet with seniors to come up with a real program that meets their needs. and then we'll start agitating and educating and organizing around that. and we will put that out in the election. it is not a -- somebody said this earlier, and i may not have entered this part of the question about what are you going to do to get these things done about your agenda. we are going to organize around that. we are going to have a little sharper edge around that, and we are going to do a lot of education are routed. and we are going to use the central labor council and the local unions and the state fed to try to do a lot of that. whenever election time comes up, they will have a couple of things on their hands. they will have an understanding of what kind of the economy it

takes, and what the components are so that they can begin to ask people who want their support, which of these components do you support? it will then be able to hold accountable afterwards. the other thing we have done is that the day after election day, we dismantled our operation, and we put together this great operation to get people elected, and then we dismantled of the operation. by focusing on at the grass- roots level, we can keep that operation in effect 365 days a year, and not only educate, but hold people accountable, and that is where we want to go with it. >> we have time for one last question. there is a man upfront in white. raise your hand. >> hi, rich. i would like you to say something about trade, trade policy, and how it affects

american workers. >> trade policy has had, along with tax policy, has had a devastating effect on american workers. it has been a one-way policy. let me start off by saying this -- every time to talk about trade policy, they jump and they say that you are protectionist, as if there is nothing between no rules and an absolute wall around the country. they do not want to talk about what is in the middle. about a country using trade to help its own economic well- being. everybody else around the world does that. we don't. let me give you one example -- when we tried to pass the buy american provision in the stimulus program, people screamed about that, particularly the europeans. "oh, this is outrageous, they are being protectionist."

we were trying to stimulate our economy, and if we did not stimulate our economy, helping the country that has an economy the size of rhode island does not really help in lot of ways. if you take just the windmills -- if you bought a windmill in the united states, it stimulates the economy, if you bought it from offshore, six 2 cents out of every dollar when offshore -- 62 cents out of every dollar went offshore and it did not stimulate our economy. europe is screened about it, and you know what they exclude in their franchise? this is what the european union excludes -- no u.s. company or anybody else can bid on these, right? anything dealing with drinking water, anything dealing with telecommunications, anything dealing with transportation, and the fourth one slips me right now, but i will get back to you

if it is important, if that is not enough -- that those are all excluded from what we can bid on, but not they can bid on. we need to start looking at trade as economic policy and not foreign policy. over the last eight years, the trade laws, feeble as they are, have not been enforced. have not been. as a result, we have sustained a trade deficit that is astronomical and unsustainable. china's was $250 billion and growing. the overall deficit was 800. it will be down a little bit because of the recession and people stop buying and the dollar dropped a little bit, but it will still be substantial, and as soon as things get better, it will start to grow unless we change the trade laws. we have created incentives for people to produce things off shore, and we have given them with the trade agreements a

guaranteed market back here. it did not go to guatemala before, because they were not sure if they were in guatemala, the products could flow back. now they have, with the straight loss, could actually do that. we need to take a look at them take a look at what works and what does not work, and said that if we are going to create an economy that is sustainable, we have to do something about the deficit, and the tax laws that go along with it. we have a long way to go, to enforce what we have and take inventory about what works and what does not work, and start negotiating trade agreements that actually work for the american economy and the american people. we have not seen that for a number of years. >> thank you very much. i want to give the opportunity for the audience to thank our guest, richard trumka. [applause] we are thrilled to have you, and we very much look forward to working with the afl-cio, your

vision and leadership will really help american workers for the future. thank you. >> i want to just thank the center, because you've done a tremendous job. we are tremendous allies and i look forward to working with you for a long time for a better, more progress of america. >> sounds good. [applause]

. . >> the payment is usually reimbursable. it is usually under $750. >> and in turn this talks about patience and patient care. >> there is a case where people go to the internet to figure out what is wrong with them.

without the grounding and experience we have, there will always get it wrong. they usually think i have some horrible disease. i would say that patients should not try to make diagnoses of the internet. >> watch all three doctors tonight share their personal stories about treating patients. it begins at 8:00 p.m. eastern on c-span. >> this week, "washington journal" is live to examine the american health care system. we will re-air conversation from this morning with a chief of cardiac surgery tonight at 8:45. on tuesday, the chief financial officer talk about hospital

appliances appear -- talk about hospital finances. on wednesday, the icu director will be live at 9:00 a.m. eastern. the health care coverage continues now. this is about an hour. of a new book on senator mitch mcconnell. first, here are comments as president obama traveled to mexico for the summit meeting. he was asked questions about the canadian health-care system. here is part of what the president said earlier this month. >> i have said that the canadian model works for canada. it would not work for the united states. simply because we have evolved differently, in part. we have an employer-based system and a private-based health-care system that stand side-by-side with medicare and medicaid and our veterans administration health care.

so, we have to develop a uniquely american approach. this, by the way, is a problem all countries will have to deal with at some level because if medical inflation continues at this pace, everyone's budgets will be put under strain. we are trying to make sure we have a sensible plan that provides coverage for everyone, that continues the role of the private marketplace, but provides people without health insurance who are falling through cracks a realistic and many got. option we have to do it in a way that also changes the delivery system so we're not engaged in the kind of wasteful, an inefficient spending. i suspect we will have continued vigorous debate. i suspect you canadians will continue to get dragged in by those who oppose reform even though i have said nothing about canadian health care reform.

i do not find canadians particularly scary. but i guess some opponents of reform think they make a good bogyman. i think that is a mistake. once we get into the fall and people look at the actual legislation being proposed, that more sensible and reasoned journal" continues. host: joining us is the former president of the canadian medical thank you very much for joining us here on c-span. guest: good morning. host: let me begin by asking how the canadian system works? guest: it is mostly publicly funded. the funding comes from income tax. everyone is covered. this is the main feature of our system.

it is universal. everyone is covered. no one must pay anything to see a doctor or go to the hospital. it is a system that covers everyone, basically. host: how is it funded? guest: by the income tax. you pay the income tax. we have to understand that there are about 14 systems in canada because we have provinces, and other government structures. it is not a premium of insurance that is paid. in some provinces there is a premium, but mostly it is an income tax. host: you delivered a speech as you left your position and alluded to a couple of points. first of all, in areas of how

canada can do better you wrote, waiting 15 hours in an emergency room is unacceptable. within four hours in a doctor's office to renew a prescription is electable. within six months or more for his replacement is unacceptable. -- is unacceptable to wait so long and a doctor's office for a prescription. is that standard? guest: is not like that everywhere, but these examples exist. in quebec right now the average wait for an emergency ward is 15 hours. i give the example of four hours for the prescription in the doctor's office -- this was my cabdriver's expense. it may not be the rule, but it exists. the six month wait time for a hip replacement -- that is our target. if we compare it to other countries this target is very remote from what should be. host: so, how do you fix it?

guest: the biggest problem in canada is the wait time. we are looking at what other countries have done. european countries where they have a universal system -- we want to keep it like that. their system does not cost more, but they don't have those we times. we need to improve. we need to avoid the weight tons. this is the biggest problem in canada -- we need to avoid those wait times. host: it is not a single system, but varies by province. can you dig into some details to explain how would work if you live in montreal compared to toronto, or in the western part of the country? guest: basically, is the same system but would variation. it is based on five principles. what is included, universality, meaning that everyone is covered

and no one pays for services, accessibility, public administration -- the system is publicly administrative, and these principles are the basis of our system. portability is the last one, meaning that you can go from one province to the other and are still covered. the difference in the services that can be provided from one province to another -- some include a few extra, and some exclude the same. the biggest difference is about pharmaceutical care. in quebec it is a universal program. that is different in some other provinces. host: some background information on canada for our viewers here in the u.s. we'll also show you phone numbers. canada is come to over 31

million residents. the average life expectancy is 78 for men, 83 for women. that is comparable to ours here in the u.s. 8.6% unemployment, slightly less than here. with issue to prescription drugs or medical equipment you need, is that all covered under the canadian system? guest: well, for the equipment, the care, if you go to the hospital or to see a doctor everything is covered from the first dollar. for pharmaceutical care is different. depending on the province there is a part you must pay. we pay about 30% out of pocket. 70% is covered by the state. this part of the money is for

dental care, pharmaceutical care, or ambulance, or long term care. the rest comes from the government. host: so, is medical bankruptcy even an option in canada if you face high bills without insurance? guest: this is not something we see frequently compared to what you see in your country. the police usually do not get bankrupt in canada because we're cover. there could be expenses if you have too many drugs to take in some provinces. -- the people usually do not give bankrupt in canada. we are covered. if you do not have the money to pay premiums, the government will pay it for you. so, there is no bankruptcy in canada because of health care. this is a very different system in the u.s. host: our guest joins us from

montreal. we have a line for canadians listening. we want to share an excellent of an interview we did for an upcoming interview. the author has a book about health care. he outlines the evolution of the canadian system. it began in the 1940's. >> you read my chapter about canada. what happened is one province, saskatchewan which is a lot like colorado, have planes and half mountains -- half plains -- elected a left-wing governor who

decided everyone in the province should have health care. he's set up a state-run single- payer system in 1944. his name was tommy douglas. he called the medicare and it work. everyone in that province had medicare. many doctors came there because they knew that they would get paid. the other provinces saw it and gradually they copied it. they saw it was working. by 1961 it was so popular that the people of canada demanded that the federal government established it coast to coast. it began in one state with tommy douglas. in 2004 the canadian broadcasting company did a poll -- millions of voters. the candidates included alexander randall, there'd jfk, -- the >> green, and others --

the >> and the one was tommy douglas. host: could you elaborate on that? guest: yes, it is important to know that the healthcare system is imported for canadians. you want to keep our system because it is important for everyone. everyone. we want to improve our system . we want to keep the universal access for everyone. this is the basic principle of our system and we want to keep it. host: our line for viewers -- we're talking with we're talkingouelett. if

you do not have insurance and you need medical care, quite often you go to the emergency room. that absorbs the cost absorbed by those who are uninsured. what type of procedures are involved in canada? guest: if you go to the emergency ward in canada, you will not have to pay anything. if you have any kind of surgery, you will not have to pay anything. you do not have to pay out of your pocket. this is covered. you will not be denied in the procedure if you do not have money. we want to keep it like that. it is important to us to give access to everyone. it is the factor that is not working well. we have to wait a little bit to do these procedures.

we want to keep it accessible to people. host: pharmaceutical companies say they can spend money for research and development because of the sales of their drugs. is there such a system in canada? guest: yes. we have pharmaceutical companies that are doing research in canada. the research is funded by our system, in hospitals and universities. we have companies that are working in canada. you have to know that we have generated drugs and jim drug. companies are doing research in canada. they are making profits on drugs and reinvesting that profit. by host: and if you travel to anywhere else and needed medical care, which your system cover

it? -- would it? guest: yes, but at the price paid here. if you go to the u.s. you need supplemental insurance because the costs are not the same. the insurance in canada will pay canadian-level costs, but most of the time it is not the same amount. we need supplemental insurance to go outside the country. host: you say part of the funding comes from taxes. can you break that down? guest: well, it is a gradual income-tax. some are not paying income tax at all. the maximum you have to pay is about 46% if we compare among provinces. there is a federal and provincial income tax. the maximum is 46%, but some do

not pay income tax. even if not, they are covered by the system. it is not a premium you pay if you are working or not. if you do not have a job the government will give you. you merger will give you care. it is not related -- the government will give you care. it is not related to having a job or not. host: jacqueline is joining us from california. caller: good morning, i would like to comment on the healthcare system. i personally feel the only people who are complaining are the middle to upper class whites were feeling the financial strain of what bush has done to them. now that their leaders are beginning to get another game plan and helping people have

forgotten where this mess came from, they seem to be angry that some poor kid from a family less fortunate might receive something they say they have not earned. the white republicans and richer people have received things they have not earned all their lives. it has been on the backs and sweat of poor people who have worked hard for this country who have been underpaid and without benefits. then they were discarded like" paper. can this system is not perfect. they are admitting that and saying there will put a strong effort into improving -- canada's system is not perfect, which they admit. we should at least try to improve the care for people instead of doing the same thing we always have. host: we will get a response. guest: it is very important to have everyone covered. even if people are not paying

for income-tax, in canada we feel we have a collective, social responsibility to give service to everyone even if they do not have money. because they deserved it. it is important for us canadians that health care is covered and provided to anyone. if he has money or no money. money is not important. it is the social responsibility of the country that we have taken. this is the way we think. this is it. host: our next call is sandy from new york city. caller: yes, i would like to ask a couple of questions. you mentioned earlier that you do not have to pay anything if you went into the emergency room and you would not have to pay anything if you had heart surgery or heart transplant. i wanted to ask you about the

madison. do canadians have to buy insurance for the medicines after they have the heart surgery? that would be a lot of money. also, the police and firemen, public workers, and people serving in the armed forces in canada, are they covered under the universal health care? finally, the you think the system would work if you have a population of 340 million like the u.s.? thank you, and i will listen to your reply. guest: the first question is, everyone is covered. the workers working for the government or armed forces have the same program for everyone because everyone has a universal system. everyone is covered whether or

not he is working for the government. there is no relation between your work and the healthcare you receive. for pharmaceutical care, people pay for medication, but depending on the province the amount differs. i will give you the example of quebec for you pay about 20% of the cost because there a maximum, a deductible, and accost you share. you can have private insurance or government insurance. it works. it is compulsory to be insured, but you pay about 20% of the cost. if you must pay more, it is covered. you do not pay more out of pocket. this is for the medications outside the hospital. inside the hospital everything

is covered and paid 100%. what was the third question? host: could your system work here in the u.s.? guest: i think we explore the system -- the base of yours is different from what we have here. you need to look at what you are doing now andry to improve it. we have a good system we need to improve, but i'm not sure that it will work in the u.s. now. the starting point you have is so different from ours. i do not think you can import that. it is not about the number of people, but the way it is working. i do not think it could be imported in the u.s. many in canada will say we do not want to have the u.s. system. here in the u.s. you say we don't the canadian system.

maybe both are right. you need to improve yours and we need to improve ours. host: dr ouelett joins us from montreal and is a graduate of university of montreal. guest: i'm a radiologist. host: we have a message from twitter. what types of care are not covered based on age? guest: no, there is no -- i have seen those in the u.s.a. if you're 85 you will not receive it. that is not true. you receive the care you need. whenever your condition or age, if you need this procedure you will have it. you will not have to pay for that. this is the most important aspect of our systems. we do not select patients. we do not say no, you do not

have money, so you do not have cared. you will get the care they need. this is very important. host: we're joined from australia. what time is it there? caller: it is 25 past nine on sunday evening. i am watching your program live. host: we are thrilled to have you. what kind of system do have in australia? caller: we have a combination of a private system and a public universal system. there is universal coverage, but almost 40% also take out their own private health insurance. host: what do you do personally? caller: personally, i have a private, but for those who cannot afford it they can get free hospital care and up to 85% of the doctor's bill when they go to their general practitioner.

host: are you satisfied with your coverage and insurance? caller: yes, i think as the former head of the canadian ama said, all systems need to improve it. there is no system that is absolutely right. as i speak to people in the u.s. you have the very best of medicine, but the lack of universal coverage is the problem. also, the cost of the system there -- just a very simple statistics. the u.s. spends nearly 15% of its gdp on health. here are in australia spend nearly 10%. at the u.k. spends almost 8%. i think you can does not spend

enough, but the u.s. is spending a lot of money for a wealthy country. much of it is going into administrative costs. i'm a medical practitioner myself and my colleagues in the u.s. will talk about how they are controlled by insurance companies, about what services they can provide. we do not have those same sorts of controls here. there is administrative waste in the complexity there. the life expectancy in the west happens to be four years less than in australia, despite the greater cost. more money is spent but without a clear, improved outcome. many of the top academics in u.s. universities have been very clear looking around the world, at canada, european countries

and looking at the strengths and weaknesses in each area and seeing how that might be applied to the u.s. there is a lot of academic work i am sure it is informing the plans in your country at the moment. host: thank you for the call, john. we will get a response from our guest. guest: yes, in canada we spend about 10.7% of gdp, and you spend 15%. this is a lot compared to other countries. we went on a fact-finding mission of this year to european countries. we have seen countries not spending more in their system compared to ours. they have universal access which is the most important thing, nor significant weight time. it is possible to have a working system -- without a significant wait te.

i agree with the person on the phone that you have one of the best systems, the best care if you were going to some hospital, but the cost is very high. it is not sustainable, probably. you are paying too much. maybe you are paying too much for defensive medicine. we do not have that kind of attitude here in canada. attitude here in canada. host: nancy -- nancy smith lives in texas. what percentage of doctors belong to the association? guest: out association -- we have 70,000 members out of about 84,000 doctors in canada. we have about 85% of doctors in

our association. host: is health care air raid or a privilege. obama says health care is a civil right. guest: i think it is something that is fundamental. if you are not healthy, how can you work? how can you insure a life? this is a fundamental thing for us. health care is very important. it is something that you need. this is why we're trying to offer that to all of our citizens. what if they do not have money? we wanted to offer them health care. host: what is the number one complaint you get from your patiencts?

guest: wait times. it must be more efficient than it is right now. people are suffering from wait times. people -- you do not have to pay for them. they have to wait. this is why we are doing our study this year. we think we can still have our system with a better way to time. we have improved our wait times and we need to do more with that. we still have a good system. once people are in the system, the satisfaction level is very high. host: another tweak from a viewer who says are u.s. citizens sneaking over the border to receive canadian care? guest: we do not have that many americans coming to canada to

have care. this is not a problem that is going on in canada. they're probably going to other countries like india or thailand for medical tourism. >> one of the many ads ot issue of health care. americans for prosperity took a look at the canadian system. we'll watch it, come back, and get your reaction. >> i survived a brain tumor. but if i had relied on my government, i would be dead. i'm a canadian citizen. and as i got worse, my government health care system told me i had to wait six months to see a specialist. in six months i would have died. >> some patients wait a year for vital surgeries. delays that can be deadly. >> many drugs and treatments are not available because government says patients aren't worth it. >> i'm here today because i was able to travel to the u.s. where i received world class

treatment. government health care isn't the answer and it sure isn't free. >> now, washington wants to bring canadian style health care to the u.s. but government should never come between your family and your doctor. learn more at patients united now.com. >> my advice to americans, as patients it's your care. don't give up your rights. >> until earlier this month, u were the president of the canadian medical association. your reaction to part of the debate here in this country on health care. >> well, about that video, we have seen that. it's unfortunate. it's a sad story for that person. but it's not typical of what's happening in canada. people don't -- people are not dying on the street in canada. people don't ask to go to the united states to have health care. some of them will do that but it's a very, very small portion of people that need to do that because they wanted to have

faster service. but we're receiving good quality of service in canada. and i don't think that you could find people that are putting the amount of money she put i think it's $100,000 in her surgery. you don't need to do that in canada because it's available for free. >> free meaning that someone is paying. we're paying with our income tax. but for the patient it's free. so this is not a typical story of what's happening in canada. and i thk it's not fair to say that people are dying object street in canada and we don't receive high quality services in canada. it's not tru. we receive high quality. we have a problem with wait times. we know that. we want to fix that. but it's not true our system is so bad that you're dying on the street. >> this program is being sime you will cat on cpac in canada

and cheryl is joining us. are you happy with your system? caller: very happy, steve. and good morning. i was just watching the canadian medical association meeting that they have every year and my biggest concern and i am scared to death about this as much as the americans are fighting to keep public system out of their private system, i don't want private system in my public system. i feel this is going to be a very slippery slope that final thri public system will be so degraded. the problem with our wait times, and i'm 250 miles north of toronto, the problem with our wait times is we have a shortage of doctors. what we should be doing, and i think canada can do it, we should be paying the freight to educate our doctors. we pay the shot. let's pay for these doctors to go through so they won't get hung up with high, high debt

when they get through their schooling. then they will come to smaller communities. and about the wait times, i had a hip replacement four years ago. i opted to go to toronto for it. i could have gone to the city next to mine but i opted to go to toronto. i hasn't seen this surgeon in 20 years. i saw him in 30 days and in the next 30 days i had my hip replacement. then i had home care, i had fizzyo therapy at home. it was just fantastic. i had nurses come in and take care of me all at no expense to me. thank god for our system, sir. i hope we keep it and i hope we don't go down this private sector slippery slope. host: thank you for the call. guest: well, some people are receiving good care in canada. and when we're talking about wait times, some people don't have to wait that they're lucky

to have that. fortunately it's not everyone -- unfortunately, it's not everyone who has the same kind of service that she has, but it's true that many people have that kind of service that she was talking about. so nothing -- it's not everything that is bad in canada about our health care system. and people are happy. and she was talking about privatization. we don't want to privatize our system. the only thing we have said in our general meeting is, if needed, we could ask the private sector to help. but this will be paid by the public system. for giving private delivery of surgeon services. and this is not about going toward privatization of the system. it's just taking all the measures, all the possibility to give the better service to the patient. so it's one way to try to improve our system. but we're not going toward privatization of the canadian system. that's for sure.

host: another tweet from a viewer. guest: it's not for everything. it depends. and you heard that lady, she had her hip replacement within 30 days. depending on where you live, canada is a wide country. we have remote areas, we have big cities. and there's variations for wait times for surgery and wait times for medical examination like x-rays or ct scans. it's different depending on where you live. in some of the big cities you might have a better access than if you have -- if you are in a remote area. so it's not even in canada. it's depending on where you stay. host: if you just joined us, today we're taking a closer look at the canadian health care system. what we like to call as canada

health care 101, dealing with some of the basics. as part of the overall debate on health care. and tomorrow, tuesday and wednesday we'll take a look at health care through the eyes of one hospital, and during the course of the programming over the next couple weeks we'll take a closer look at the health care system in great britain. caller: good morning. i've had a few of my questions partially answered but i'm wondering, can the doctor tell us, if the difference is 6%, where 6% higher here because of our costs, it's just hard for me to believe that it's all because of defensive medicine here. how do you keep your costs down if there's no rationing? and isn't it try that there are businesses or associations up there just to help people get to the u.s. to have procedures that they either have to wait so long for or can't be taken care of there?

guest: there are some associations that are doing that, but it's a very, very small portion of people that have access to health care in the u.s. there are about one or two offices that are doing that. but, believe me, it's a very, very small portion of people that are getting in those kind of associations. so it's not a widespread phenomenon. people are saying, because they will receive good care in canada. and i believe we have a good system in canned dafplt we need to improve it but it's a good system. host: go ahead with your question. caller: good morning to everyone. good morning doctor, i'd like to know as far as the wait times are concerned, to what extent the rules that guide the doctors, the operation, the operation rooms basically. because i heard that to a certain extenlts that doctors

are allowed to operate maybe four hours a week and they are kind of frustrate bid that. but there's some kind of rule. maybe you could elaborate on that. that's my first question. number two, we are are talking about like waiting up to 15 hours in the emergency rooms but if you get there with a broken leg or a gun shot or asthma attack, you're not going to wait 15 hours. so i'd like you to comment on really the 15 hours. is it because there's a shortage of doctors and instead of going no where they just go there for their cough or for whatever reason? that's not really an energy? and my last question -- emergency. and my last question is maybe what was the ratio between the doctor and the population like back maybe 30 years ago and what is it today? thank you very much. guest: ok. first, for the doctors having one day of operating time a

week, it's about the situation in canada. and we think that doctors and surgeons think that they could operate more than that. so this is why, if they were going in the private facility paid by the public system, they could operate, they could have operating time more than what they have right now. for the wait times, 15 hours, of course. if you come in the emergency with something very urgent you won't wait for 15 hours. the wait times is for those people that they don't want to see their doctor or their doctor is not available they come to the emergency ward for something that is not that urgent. so the wait time for those patients could be 15 hours. but if you come with a cardiac arrest, don't worry, you won't wait for 15 hours. that's for sure. and the last question was about zoo the ratio between doctors

and the canada population. guest: the ratio of doctors is 2.1 right now. it has been about 1:120 years ago. we're improving. we're training more doctors. but in the 90's there was a great cut in the training spots of doctors and we're still suffering from that. this was a decision of all the provinces and the federal government to stop the funding of training doctors because they thought at that time that if we had less doctors the system will cost less. this was a big mistake and we're still suffering from that because it takes a long time to train a doctor. you could take ten years and we're improving. we're putting more spots, more training spots for doctors for residents and students but we're still have a big problem in canada of shortage of doctors. if we compare, we have 2.1

doctors compared 1,000 people. in some countries like belgium they have 4.2 so they have less of a problem of access in those countries than what we have here. host: tonight a conversation with dr. john gared, who is the chairman of the board. he is also the chief cardiologist at the virginia hospital center. and then next week, t.r. reed, the healing of america. and during the conversation comparing the canadian and the u.s. system and part of the interview includes a look at the cultural differences between our two countries. here's an excerpt of next here's an excerpt of next week's q -- i'm pretty tough on canada because they have long waiting lines. i was talking to the minister in canada. i said, you keep people waiting. you have to wait months to see a

specialist. his answer was, canadians to not mind waiting so much as long as the rich canadian and the poor canadian have to wait about the same time. that is the culture. we do not have that ethic. it is a standard in america that rich people will get better health care than poor people. host: your response. guest: i have to agree. it is a different attitude that we have. for us, it does not matter if you have money or you do not have money for health care. you will be offered the same kind of health care for everyone. this is a matter of attitude. we believe that health care is the number one priority in life

that we need to provide to our citizens. we want to keep it like that. host: we welcome mark from virginia. caller: it is unfortunate that the debate is taking place around the canadian healthcare system. this is probably the want -- no offense to your guest -- it has worked the least well in terms of dollars spent. the japanese system can do a cat scan at 1/10 of the cost than we can do them here. patients can have surgery within the week. germany and france are pretty close. the scandinavian system. having the debate of the u.s. system versus the canadian system is worthy opponents of health-care wanted it to be. it is the poorest choice.

no offense teargassed. -- no offense to your guest. you, because if we compare ourselves, canada to other european countries, we're not performing well. and i agree with that. and this is why we need to make some changes in canada. this is why our association wants to transform our system to become a system much more efficient like the system we have seen in the european countries. of course we have a problem because of a shortage of doctors to do that. they have more doctors than what we have. but we have seen systems where they have universal coverage. their system doesn't cost more than our system and they don't have wait times. so it's possible to do that. and this is where we're going with the canadian -- we want to go with the canadian system. we want to improve. we don't want to change everything but we surely want to improve it. and i agree with you that we're not the best in the world, the u.s. is not the best in the

world. there are some countries performing more than we are doing rights now and this is costing less money than even we're spending on our system. host: peter from wini peg. you're next. caller good morning. i'm a resident in minnesota and do lot of work in win nipeg. first, there's a lot of misconceptions. minnesota has a state subsidized insurance program. there's a number of states that actually have some of the culture that he is talking about. they're not framed around civil rights, they're framed around the good of the economy for the state. and we have almost universal coverage in the state. in fact, the people who aren't covered probably don't know about the program. secondly, my dad's currently getting treatment at the mayo klinic for esophageal cancer. now, i don't believe the canadians are coming there because of a problem with their

system as much as it's the fact that it's the mayo clinic and it's a global hospital. my question is that a lot of the advances in treatment and a lot of the advances in pharmaceuticals come from the u.s. paying so much money. and if the u.s. creates a new type of system, how is it that those type of extremely advanced global centers, pharmaceutical developments get paid for, how do the canadian citizens pay for it when they go to the mayo clinic? so two points. i think the states might be better and share some of that culture. and second global centers the cutting edge of medicine, how will that get paid for? guest: i agree that you have institution in the united states that are top notch, that are top of the world, like mayo clinic and some of them. and you need to keep that because this is very important

for research. and you're doing some procedures, some things that we're not doing in canada. but if a canadian citizen wants to go to the mayo clinic, he has to pay out of his pocket to do that because it's not covered, or at least the part that will be covered is very small compared to the real cost. so people are paying out of their pocket if they want to to have that. but these are for very specific things that could not be done in canada. but we're doing most of the things. but you still, i believe that you still need to keep those great institutions that you have. they are world class and you need to keep that. host: larry is joining us from pittsburgh. and some more information on canada and its health care system. caller: really great program. i'm originally from pittsburgh. i've lived in germany for three years, and my wife's family comes from canada and i've seen all three systems.

and i will tell you this, i do cancer research. and if you have cancer, you want to live in canada because they have 100% coverage. their women come for their pap smears, they have the lowest incidents of cervical cancer than any country in the world. they're the best at screening women for cervical cancer. and we have these statistics. american women do not come to the doctor as often as canadian women because they don't have insurance. if you want to talk about wait times, just go to any major city, where you have people without insurance. and go to the emergency room. you'll see three, four hour wait times. i think the canadian system is much better than we have here in american's on the whole because we have too many people without coverage. and germany, you pay 7.5% of your income for excellent insurance. it's very expensive but you get great care in germany as well.

letting these people with serious diseases like cancer in this country without screening for cancer is an abomb nation and something has to be done about it. host: thank you for the call. next, montreal. caller: hi, thank you for taking my call. doctor, thank you very much for being on. i'm from montreal and i'm living in connecticut right now taking care of my mother who has leukemia. doctor, you're being very modest, and i know that you're very smart. but you're being like us good canadians who are always saying thank you even when you know we're right. i know that you do not want to be in a situation that the americans are in like the gentleman just said, the call before this call. the waiting list in canada, i have lived in three provinces,

i have lived in new brunswick, ontario, and question beck. and i have never had more than a three hour wait, maybe a four hour wait in any er room. i have three children. we have four adopted children. we have never had any long waiting period in any hospitals. i have a large family. and i want to say to the american people that they do want a system like the canadian system in comparison to what they have right now. i have complex region al pain syndrome. the canadian take care of us beautifully. that's pain 24/7. we do not have anything compared to what you're looking at without any type of medical system at all.

host: doctor. guest: well, i think she's right. we have a good system. and this is what i've been saying. she was lucky enough not to wait but i can tell you that some people are waiting. we have to look at the situation like it is for some people. some of them are luckier than others but we still have a problem with wait times. if this patient could have all those services whout wait times, thank god, that's fine. and i think that the most important thing is what she said about having access to those treatment even if you don't have money, even if you don't have to pay for that it's provide bid the state, provided -- the care is provided by the state because we believe in that. host: shirley joining us from pennsylvania. go ahead caller: good morning. thank you very much. i wanted to know, with your

health care system, is there a limit as to how many times that you would be allowed to go to the doctor, say you have something that is chronic and you're always -- say allergies, for instance. and from one time to another gets worse, gets better, gets worse and you need to make numerous calls to the doctor to try to get these problems solved. is there a limit as to how many times you're allowed to go? and if they see that you are making too many appointments, maybe they're going to say no more? i'm concerned about that because it looks like maybe we're going to be getting the same thing here in the united states and i'm truly worried about it. at my age, we're on medicare. we have a supplement. and we're very happy with what we have. now, i understand there are a lot of people here in the united states who don't have

any. host: how old are you if i may ask? caller: my husband and i are 70. and he has numerous problems. and he is back and forth all the time and has to have blood work done. and a lot of times, he couldn't wait sometimes say 15 hours or whatever, he could never wait like that. that would be absolutely terrible. host: thank you for the call. guest: well, i think that in canada you don't have that problem. even if you have a chronic disease and you need to see your doctor each week, you won't be denied. as you need care, you will have care. so this is not a problem. and no one will say, oh, you're coming too often. no. if you need that care, it's, you can come and you will receive it for free because the system is like that.

so it's available and it's there. and you won't be denied any procedure if you really need it. and you will have it. so people are not afraid about that. and so those people with chronic disease who come tuvene their doctor, they're not waiting 15 hours. we're talking about patients going to the emergency ward for something that is unexpected. but if you go to your doctor you won't wait 15 hours for that. if you have a chronic disease, you will be seen reg alreadyly by your doctor -- regularly by your doctor. and you don't have to pay for a team of say social workers and nurses. this is included in our system, and you will have the care that you need. host: to our radio audience, our conversation is with dr. wolet, former head of the canadian association. caller: good morning. i would like to ask the doctor, he's being very tactful and i

thank him for that. he said that the difference in attitudes between our two countries. but it seems to me that it's more of a difference in moral values. that is the fact here. i personally believe that every citizen should be entitled to adequate health care regardless of income or race or status in life. that's just a basic right of human beings. and it seems to me that is what canada feels. guest: well, i think you're absolutely right. this is how we feel and this is what we think. i'm not saying that you're

absolutely wrong. but i think a great country like yours should look at giving their citizens a full coverage on health care because this is fundamental. and this is what european countries have understood also, because they're giving full coverage to everyone, whether they have money or don't have money. and this is the principle that we have here in canada and we want to keep it like that. host: janet, former resident of toronto now living in indiana. go ahead. caller: it's not a question, it's more of a statement. i love the states and i love canada and i've lived in both. i came to the states for graduate school and when i came here, i did not have insurance here. i'm a student, i'm paying a lot of money to be here in school so i ended up getting injured in my dorm apartment and it became a problem where for the first time in my life i had to be debating whether to go to the hospital to get care or

whether to just stay there with it and try to figure it out on my own. that was the first time i was ever in such a predicament because it became about money and not about my health. and i remembered ending up going to a pharmacy to ask the pharmacist what ideas he had about what i could do to care for myself because i could not afford to go to the hospital. i also at the same time i have a 77-year-old mother in canada right now. for the past 25 years she's had multiple medical problems. her medical history is very complex. i thank god for the canadian system. she has been cared for thoroughly with no expense to her. what's sad to me is when someone has to lose their life savings to get health care. and i think that shouldn't be the fabulous country with fabulous people. anth