employer-covered health insurance. why do i say that, because there's some people who think this is a grand conspiracy to get all these employers to let go of their employees and put them into this other plan. there are penalties for doing that, and then there are other economic reasons employers aren't going to want to do that, but the fact of the matter is the cbo when they looked at this conclude that in 2019 you'll@@@ 30 million americans will be part of this exchange. that sounds like a reasonable estimate of the people who don't have insurance today will be covered. they figure 30 million americans will be in the exchange. of those 30 million, they are figuring that 20 million will choose the private insurance options and that 10 million will offer -- will opt for the public

option. this notion that it is going to swallow of the insurance market is this proven by the analysis of the nonpartisan congressional budget office. . . non-partisan congressional budget office. now, let me say a word about medicare. medicare as all of you know under part "d" prescription drug program has what we call the doughnut hole, that you pay premiums on a regular basis but premiums on a regular basis but after you are by a couple thousand dollars you go in a doughnut hole where you're essentially on your own for the cost of drugs until you get to the other end of the doughnut hole at about $5,000 or up where essentially your coverage kicks in again. the white house working with actually in this case the

association dealing with the pharmaceutical industry came up with some savings and other parts of the prescription drug coverage and came up with a method which we expanded on in the house to fill the doughnut hole so over a period of time under this bill, the bills in the house, the doughnut hole will be closed. in the short term it will be about halfway closed, but over a period of years it will then be closed. the house bill also increases the reimbursement rate for providers, for doctors, you know, family physicians as well as other doctors. why is that important, because as many of you know, and i'm sure you hear it from some of your health care providers and doctors, they say that they can't afford to provide health care under current reimbursement rates, so those are increased as part of the overall package here. how is this paid for?

it's paid for in two parts. one is these negotiations that took place at the white house looking for areas where you could find savings through efficiencies and other areas within the provider network in the medicare program, and let me give you a very good example, hospitals. hospitals are today provided a money, especially hospitals in lower income areas for uncompensated care. makes sense because what happens? someone shows up at the hospital room. they can't pay for it. we still want to make sure that they get care. it is, as i say, the last line of defense for most people but it's the first line of defense, of course, for people who don't have coverage, and so there's -- there are funds -- currently some funds in medicare to compensate hospitals for those costs because otherwise they

might just turn everybody away at the door or they are actually required not to and we don't want them to have to be providing free care. under the new system those people who are uninsured will now have coverage so that when they come, first of all, they won't come to the hospital as the first line of defense, but when they do come to the hospital they will be paying. they have insurance, and so that means that they are obviously savings in that part of the system because of changes in the other parts of the system so that's part of it. the other part of this is paid for by increasing and putting the surcharge on families with incomes over $350,000 a year. it is a group that did very well from a tax perspective during the bush years. they had tax cuts that disproportionately benefited people at very high end, and for people earning $3350,000 and up

there will be about a 1.5% surcharge on the income that exceeds $350,000. you pay your current rates on your income below $3350,000. for every additional dollar above you pay an additional $1.5% to contribute to to overall national effort. it goes up a little bit for people who have family incomes over $500,000 and up a little bit more over a million but that's the other component to cover the cost. that's the architecture of this. now i -- i left out one important piece. what that is paying more, what those funds are paying for, as i said, is to fill that big gap in the system. we're going to require -- individuals are required to take some responsibility for their health care, so people are going to have to buy health care in this new system because right now we have a system where we're

all paying for those individuals who are not covered. we're just paying for it in a very inefficient way. i mentioned the uncompensated care at hospitals for people. where does that come from? it comes from medicare? where does medicare funding come from? comes from all of us. in the private insurance market when somebody who is not on medicare but doesn't have health insurance shows up at the hospital and the hospital gets the doctor and they treat the patient and they have to do big surgery, you think the hospital just swallows all that cost? they and the insurance companies pass it on. it's estimated that in the private insurance market individuals pay over on average $1,100 a year for all the people who are not insured in the system and pay for it in a very inefficient way because they are not getting the preventive care up front. they have to wait until the problem gets worse because they can't go to the doctor's office because what does the doctor office say when you call them up. what's your insurance number? i don't have one so it gets worse and worse and worse and

they show up at the hospital, much more expensive. who pays for it, all of us through our insurance and medicare through the system so we're saying people have to shoulder that responsibility now, but you can't say to somebody who earns $25,000 a year that you've got to pick up the entire tab. in the medicare system, us a all know, it's funded by everybody. people regardless of their age are paying on their payroll tax for medicare. that's part "a." part "b" 75%, of course, is covered through general revenue so what we're saying for these individuals is you have to put in something based on what you can afford based on your income, but the government will provide what we call affordability credit, almost like a voucher, that you can take depending on your income. it phases out, it phases out of a family of four 88,000. by that time people get nothing.

most of that goes to people who are in the most needy income areas. it gets phased out very quickly. it's on a sliding scale. it's not like everybody up to the phase-out point gets the same subsidy. it gets smaller and smaller and smaller as you go up, and that is what some of those funds go for that i talked about in terms of paying for it, and under that system the idea is finally we will have everybody included. they will be able to get preventive health care. they will be able to call their doctor and when the doctor says do you have a number they can get a number and go and get it checked out. they don't have to wait until they get sick and go to the hospital and cost us a lot more money. it's also the right thing i think to do and also the smart thing to do in a system where costs are increasing dramatically, so that's the overall architecture of this bill. now there are legitimate questions obviously, and we can have a great debate, but there's

been a lot of misinformation. i appreciate the opportunity to come here and just talk a little bit about what our intent is and what we hope to do. thank you for being so engaged in this debate, and i would be happy to try and answer any of your questions. >> okay. we will be taking questions. i want you to please be civil and respectful. we want this to be a productive event, and in order to accommodate as many residents as possible please keep your remarks or questions to one minute so congressman van hollen can answer and go on to the next resident. i think we all should be thoughtful of the other residents that also have questions. okay. does anybody have questions?

>> my name is joan guberman and thank you very much for coming here today. i was wondering how are you going to stop cherry picking by the insurance companies, especially because then people will get forced into the public option? public option premiums will go up and it will become another cycle where people can't afford the premiums. i notice that the insurance companies can discriminate based on geographic location. they can decide everyone in a certain zip code or everyone who lives at leisure world is not eligible for insurance. that's my question. >> that's a very good question. i'll repeat it for those of you o didn't hear it. the fundamental question is how is this reform going to prevent insurance companies from cherry picking where they go out and select people for them to cover who are the healthiest and then deny people who are unhealthy and those people then have to go into some other plan?

the bill essentially outlaws cherry picking and it outlaws denying people based on pre-existing conditions. you as an insurance company under this bill cannot deny health coverage to somebody who asks for it under your plan. in other words, you'll have your plan out there. if you're offering that insurance and i come and say i'm going to pay that amount for that benefit and that coverage, you have to take me, and that is essentially community rating. that, of course, is what inshurns is all about. the whole idea of insurance as we know is we're one big rusk pool and we're sharing our risks. we're paying our insurance premiums to protect ourselves against a time when we will really need the costs, and there are some people, god willing, who will not use up through the health care system the amount they put in through peopleuals. that's the whole idea. the whole idea is to people the

risk, and when inshurns companies cherry pick they undermine the fundamental notion behind insurance which is why that's going to be prohibited under this legislation. i should also point out that insurance companies spend a lot of money. people talk about costs to the health care system. insurance companies spend a lot of money trying to figure out who they should insure and who they shouldn't because they want to find those people who aren't going to need it. that makes sense. for you shareholders what you want to do if you are really good with the insurance company you get all healthy people and take all the premiums and you never have to pay out and your shareholders are happy, so -- but it does undermine the fundamental idea behind insurance so it's a very important part of this bill. >> me name is josh logan.

i have a question for you. what is your position on medicare for all, also known as single-payer plan, and if against it why? >> i agree with the president that if we were starting from scratch that that would be a port -- a way to go, if we were starting from scratch. as you know, our system evolved really into somewhat historically accidental fashion during world war ii when the government put a freeze on wages and to control prices and then employers decided to help compensate their employees in part by providing health insurance. we now have a system where the majority of people would are not on medicare get their insurance through the private market and through their -- excuse me, through their employer and the private market, and i agree with

the president that it would be a mistake to -- and too disruptive to change that system, and so i think that what he has proposed and what is being proposed in the congress right now is a practical alternative that is a huge improvement on the current system. >> thank you. i agree with the notion that nobody should be without health no one should be without health insurance. i wonder if they system like this would work. when a child is born, he gets his social security number, and at the same time that child is given a government health

insurance policy which the parents can decline if they wish to. otherwise, every kid that is born did say social security number and a government health insurance policy which at any time in your life you can opt out of. >> that proposal is very similar to the single-payer proposal. i again, given where our system is today, i agree with what the president has said, which is let's build upon the blocks that are already out there. we have medicare that is working well for 45 million americans. we have our frustrations with parts of it, but it is a solid program. we have children's health plan. under the children's health insurance plan, our children are

covered for those at the lower income scales. rather than essentially take all of that out and substitute a whole new architecture, what we're trying to do is designed the system to fill in that big hole that does exist without reinventing the whole system. there are lots of good alternative proposals out there. this is one that we think can work. hopefully get a majority united states congress at one point. at some point. >> the lady with the green shirt. >> i'm barbara cassidy. my question deals with the lobbyists. when and how are we going to make it become illegal for the

medical and pharmaceutical lobbyists to influence federal senators and representatives in health care plan reform? >> well, let me start by agreeing with the premise of your question which is that -- which is that lobbyists and the people they represent spend a whole lot of money trying to influence the process and they do it to protect financial interests of their clients, and what many of us -- there are constitutional issues here, first of all, people's right to petition the government so what we've done with respect to lobbying is over a period of time and i've been working very hard on this is to try to increase the transparency and the accountability of lobbying both in terms of the lobbying that they are doing, and they have to file, and anyone can go on the internet and find out who is lobbying for who and what

they are paying for which is one of the reasons as we all know right now how much is being spent and we can see what they are doing both in terms of how much money they are spending, the company may be spending to pay their lobbyists and how much they may be spending in terms of campaign finance and contributions, and with need to make sure that that process is totally transparent and my view is when it comes to campaign finance we need to reform the system, and there are a number of measures that support and are pursuing in order to deal with the campaign finance piece. this, of course, relates not just do -- we're talking about health care now so those -- but within every issue that comes up whether it's energy policy or health care policy or even education policy there are, of course, a whole lot of interests that have a stake in the outcome and it's the job of the members of congress to always keep the public interest in mind knowing that got all these individuals out there who are being paid a lot of money to try to influence

the process in a certain way so we need to ensure that kind of transparency, and i think as we go through this debate it is very important that people ask themselves when they see, for example, advertising on tv, and you can't -- you can't say people can't advertise on tv. i mean, there are all sorts of way people can spend their money in order to try to influence the process. sometimes they try and maybe do it directly but a lot of times they try to do it indirectly. they put an ad on tv an constituents watch and call up a member of congress and my idea is transparents set best policy because if everybody is educated about what's happening and what interests are doing what they can make their own judgments about what's happening here, bu it comes to the health care debate, there are a whole lot of interests that are raised against it. and i mentioned one, with respect to the public option, which is that there are a lot of -- in the insurance industry that don't want the competition. it does provide consumers more choice. there's no doubt about it.

it provides more choice. it also provides more competition. so that's just one example. but i think that the best approach, and again, is to try and get the information to the public about which interests are doing what. because there are a whole lot of people that are spending a lot of money in direct lobbying, but also through indirect methods. they call it astroturf methods. that's different than grass roots. astroturf is like fake grass roots. and so -- but no, there are companies, i just want to make this clear, that specialize in trying to generate at the local level letters to their members of congress that somehow go very far in misrepresenting the position. i don't know if you read recently as part of the energy debate, one of my colleagues in virginia is getting this mail from a group, i believe of

ministers. it was a public interest group. i don't want to -- it turned out that they were actually total forgeries. so, i mean, that obviously goes way across the line. i only mention that, because lobbying takes many forms. people imagine it's only people lobbying their members of congress. but lobbyists' techniques have gotten a lot more sophisticated. now what they try to do is try to influence all of you, so you call us. so you have to -- we all have a responsibility to sort through that information. and figure out who's giving it to us, and what their angle on it may be. >> i'm sometimes accused of having a built-in microphone. congressman, one of the major faults, if not the major fault found in the present health care bill is its size. people say, over 1,000 pages.

who can possibly read and comprehend this. and we all know how complex our other insurance policies are. our homeowners, our auto insurance. don't you think it would be a good idea to have somebody on these committees in the house of representatives and the senate responsible for simplicity and reducing the size of our proposed bill? [ applause ] >> well, there are a number of issues there, right? one is the size of the bill. and the other major issue is whether or not people have taken the time to understand what's in the bill. and i must say that i am pleased that the congress did not -- the house did not take a vote in the full house before we took this break. because i was one of the people who argued that it was important for us to go back and talk to all of our constituents and all of you before we took that step.

now, i should say, members of congress are taking this issue extremely seriously. as are their constituents, as evidenced by all of you. and people have taken the time to educate themselves on this bill. now, health care reform obviously is a major issue. it's a comprehensive issue. you could have a narrow -- a smaller bill, but a smaller bill would also lead to potential huge misunderstandings if you don't take time to make it clear what you mean. and you don't want to have a situation where you pass a law and then subject to multiple interpretations. so sometimes you have to pin down the meanings of things in order to avoid misinterpretation and misunderstanding. and let me give you one example. we're going to put in this bill -- there was a great article in either the "washington post" or norm "times" the other day in using plain english. requiring insurance companies to

use plain english. now, i think we should use more plain english in these bills. it's a lot of lawyering in these bills. [ applause ] because what your doing in hess bills is amending different parts of the code. if you can't do it in the bill, what i hope we will put together is a fairly good explanation. we call it the secti by section analysis. it's not the legal language itself, it's an explanation in plain english as to what it's about. so there is going to be a section -- there is a section by section analysis of the bill that comes out of the house. we haven't yet, as i said, brought these three bills together, so there's not a section by section analysis of the unified bill because it's still subject to debate and change. but the plain english language, in order to require plain english, you've got to write that in the bill, too. you're going to ask insurance companies to put these policies out. i can tell you, i mean, i think

you can be a ph.d. in linguistics and not understand some of the gobbledygook on your insurance policy. we want to write that in the bill. but again, the more things that you want to put in the bill and would agree would be in the bill, the longer it gets. i wouldn't measure the bill by just the length. i would measure it by what it accomplishes and whether or not you think that it hangs together and touches the pieces. because anytime you're dealing with a comprehensive issue like health care, it's going to touch multiple parts of the existing law and you're going to have to amend multiple parts of the existing law. but members are taking this very seriously, and they are reading it. i was fortunate in that i serve on the ways and means committee. we spent day after day after day after day going through this bill. and i would encourage all of you to not only look at the bill, which is on the website. i mean, all these bills are available for public

examination. as well as the section by section. yes, all of them. it's all on the internet. the internet is a great tool. it's all out there. >> the lady in the orange. >> my name is doris howard. and there's a lot said about this bill being socialized medicine. could you speak briefly? because a lot of people i don't think understand what socialized medicine is. so could you speak briefly to the difference between the bill that is in congress and socialized medicine? >> yes. i'm glad you asked that question. and i had a book that i was going to bring with me to read from regarding the medicare debate. because as i said, socialized medicine was the charge that was leveled against medicare as a reason to be opposed to

medicare. again, it was a communist plot, it was socialized medicine. this bill relies on the -- on private doctors, and private providers to deliver health care. it's not a system, as you do have in some countries, where the government is running health care, and health delivery. we're not paying the doctors. we're not paying the emergency room. what we are doing is paying the -- under the private plans, we're not paying the salaries of the doctors. what we're providing is the care to the -- first of all, under the employer network, the employer sponsored network, that remains the same. but with respect to the exchange, going back to the federal employee health benefit plan model, you have private insurers out there that are

going to be offering their plans that you can buy into. then you would have a public option that is the same sort of thing that medicare. where -- and so that's -- and people will charge fee for service, or under whatever other paying arrangement they have. it's a fee for service type arrangement, not a government salary type arrangement. >> we're going to take a few more questions, because it's after 11:00. okay? >> it's up to you. but i can do another. >> baseball cap. >> i'd like to raise a question. you mentioned the numbers of -- [ inaudible ] i think studies have shown many of those 20

million -- [ inaudible ]. you did not mention illegal aliens. will it provide for any kind of protection against people coming in, getting health care, who are an illegal alien. number two, you talk about the medicare bill of 1965. part of that argument was it [ inaudible ]. that bill was estimated to be $11 billion by 1990. in fact, in 1990, it was $117 billion. right now medicare and social security have unfunded pub lib indications of $48 trillion. i am more upset about what all these bills are doing to the fiscal stability of this nation from here on out. to what extent is the congress, are you looking at this issue from the long range, and also considering all the other bills that are in the hopper, stimulus

bill and all these. thank you. [ applause ] >> now, that's a very, very good question. and as you know, the congressional budget office has been looking at this, and they came out with some estimates on the cost which we're going to have to take into account and make revisions. and some revisions have already been made. and other revisions will have to be made to address the cost issues that you just raised. let me start with the illegal@@m as bill is not the forum for this in the terms of there is nothing in this bill. it changes that one way or another. -- there is nothing in this bill that changes that one way or another. we will have a debate. we have a lot of big issues on the plate. i want to make it clear that in

the 45 million, there are an estimated 11 million people who are here illegally. to what extent that is included, i do not know. there are a lot of american citizens who do not have coverage today. even if you back that out, you still would have 32 million. whatever that is. this does not. as it is written in the bill, that does not provide health coverage to those that are not here legally. medicare, that's a very good point. you're right, in 1965, when medicare was passed, people had certain cost projections for it. it turned out it was a lot more expensive than originally projected. and so the congress has had to come back now twice to make revisions to medicare to keep it solid. and we're going to have to address that as part of this reform. because as i mentioned, both in

the government insurance area, which is medicare and medicaid, as well as the private insurance area, medical inflation is going through the roof. and as the president has rightly said, it is the number one driver of the deficit in the out years. social security is a piece of it. but it's about a fifth of what medicare is. and we have to fix both. but within the health care debate context, we're going to have to bend that cost curve. and i think that some of the initial bills that came out of the congress, you work on these bills and the cbo gives you an estimate. clearly the cost piece has got to be dealt with better than in some of the original proposals out there. now, the house bill -- the house bill, during the, you know, the ten-year window that is projected under our budget, is paid for through the means i talked about. it's paid for by taking some

savings through efficiencies in the medicare under the other part of the plan. that means you don't have to pay, as i said, the grants for uncompensated care to hospitals, because they'll be compensated on the other part. and we're going to debate about it, but we have a revenue thing. it is paid for. it is paid for by -- in the house bill. i'm not talking about the senate bill. the senate does not -- one of the reasons, you know, the senate has two committees. former senator kennedy's committee, and the finance committee. it's the finance committee that has to come up with the method of paying for it. which is one of the reasons they're still working. seriously. that's their job. they have to figure out how to pay for it. in the house we bit the bullet. we can have an argument about how to pay for it. but we did pay for it, during that ten-year window. now, there is still an issue beyond that ten-year window in

the trends of medical inflation, which are there today, and while they're bent slightly, i don't think they're bent enough. you know, bending the cost curve is the dry term. but i agree with you that that has to be part of it. but again, the house bill is deficit-neutral, as scored by the cbo. the current house bill, there's -- there is another provision -- there's the provision with respect to doctors' compensation that is part of the carryover from the bush days that's already built into the budget. and i will agree with you that we have to deal with that and pay for as well. you're absolutely right that the deficit issues have got to be dealt with. we can have a longer conversation about the economic recovery bill, and i think the number one priority of the president had to be to get the

economy out of total free-fall and turned around. because in addition to throwing millions of americans out of work when you have a fast dropping economy headed toward depression, in addition to the problems of, you know, in the economy, obviously you also have less revenue generated. the fastest way you can deal with the deficit in the short term is to try and get things back on track. but you need to have a long-term plan in place. and i agree with you on that. yeah. >> in the back with the glasses. >> good morning. i think it is still morning. i have a question about long-term health care policies.

>> yeah. >> will these are scrutinized at all, addressed at all as part of health reform? >> yeah. this is, of course, a big issue, long-term health care policies in the country. and there are issues in the bill regarding payment structures for long-term care facilities, nursing facilities. it has not been the central part of this bill. but it is something that we are going to be looking at as part -- in other words, as you know, medicare right now covers certain things, but it does not cover the long-term costs, which is why we're really going to have to focus as a country on a couple things, including increasing our personal savings, as well as i think creating some more incentives for people to save. because while the government can pick up some of the costs as it

currently does under the system, going back to the previous question from the gentleman, there's obviously a limit to how much we can ask the treasury to pay in a fiscally disciplined way. so there are some provisions here regarding long-term care. but again, it is not the -- certainly not the focus of the bill. >> i had a question about what president obama meant when he said to the woman that talked about 100-year-old grandmother, saying just give her a pill. and i would like to know what pill he meant and what he was talking about. [ applause ] >> i'd have to go back. this was, i believe, a part of a

statement at a press -- >> it was in a conference. >> a conference? there have been a lot of town hall meetings. i've been trying to follow them. i, frankly -- there was a question in the press conference where the president made an analogy regarding choices. and how you would be given choices under this bill for different insurance coverage plans under the exchange. and you'd be able to make decisions based on information. so i'm sorry, i'm just not familiar with it. i can't speak for him. >> back there. >> one of the fastest growing costs is associated with pharmaceuticals. i believe the va has the power to negotiate pharmaceuticals. there's a rumor that that will not be in the bill when it's

finally presented. do you know where we stand so that some of these exorbitant costs compared to what other countries pay for the same pharmaceuticals produced in this country, so that it could be negotiated? i know they argue that the preparation, et cetera, is to be paid for. but i think that the profit motive has exceeded the necessary costs for being in the forefront of development. >> yes. i mean, it's another -- the question had to do with giving the federal government negotiating authority with respect to prescription drugs. in other words, when part "d" was passed, the prescription drug bill was passed, there was a provision written into the bill, and i should say i opposed having the provision in the bill. the provision in the bill actually prohibited the federal

government from negotiating a price with the drug companies. it said that had to be done entirely through a private sector structure, and that the government would not be able to negotiate a price, even though the government as a big purchaser, just like a large insurer, obviously has some bargaining power, because it has lots of members. as the gentleman pointed out in the veterans administration, the veterans administration does have the power to negotiate prices. and that's one of the reasons for veterans that the price of drugs is lower than it is for so many others. and so many of us believe that we could now, now. the short answer is, this is an issue that will continue to be debated as part of the bill. as i said, the bill's got a long way to go. and there may be some things that are added to it, and that is something that is certainly in the mix to give -- again,

this is under part "d" prescription drug -- to give the government the ability to negotiate directly for price in order to help bring down the costs. obviously the pharmaceutical companies oppose this. i should say that the drug prices under part "d" are lower than the cbo originally projected. that there has been more negotiation and competition among some of the private covers through these pdms and others, that have driven down the costs. so that the actual costs of prescription drug part "d" is lower than the cbo projected. now, we're going to -- we under our rules live by the cbo numbers. and i -- and they're a nonpartisan organization. they do good work.

it's very difficult for people to project into the future on some of these costs. i grant that. so all of us know, you get ten economists in the room and you're going to get ten different opinions. there was an article in "the new york times" the other day that indicated that the cbo takes a very conservative approach, conservative little c, not a political sense, they take a conservative approach, as they should, and that in -- with respect to medicare part "d" as well as the two other revisions that we talked about in medicare, because medicare costs were going up and changes were made, that the savings generated to the taxpayer to the treasury from changes that were made, the savings were dramatically underestimated by cbo. in other words, cbo in those cases projected much higher costs than ultimately occurred. that having been said, we operate with the cbo analysis. and i'm not saying they're wrong, and that's under our rules. we in the house have adopted what we call a pay-for rule.

meaning that we have to pay as you go. and this bill will come up subject to those rules. and we will live with the cbo analysis. but i got a little bit off on a tangent. but the prescription drug part "d," yes, i think we can get more savings from, if you give the government the negotiating power, but it may not be as much as the people had previously thought. >> we're going to be taking the last question. over here. >> good morning. i'm richard cornell. and we want to welcome you here. >> thank you. >> hello? got it. yes.

the press has reported over the last two were three months that there is a division among members of the democratic majority in the house over certain provisions in the bill. as i recall, the blue dog democrats have some resistance to the public auction. i wonder if you could talk a little bit about this -- these differences, and to what extent the myth that passage -- passage of the bill in the house that includes the public auction. >> i do not know if everyone heard the question. the related to a discussion on the house side with the blue dog democrats who are democrats -- let me back up. in the house, there are lots of

them -- of different caucuses. the blue dog, the democrats, the new democrats. in the interest of full confession, i did not sign up for a caucus. i am a democrat. i am not part of any of these groups. the blue dog democrats are more conservative, moderate democrats, and they have been concerned about a number of issues within the bill. they raise concerns about the public auction. one of the issue is an issue we agreed with, i do need to make sure -- there's some people opposed to the public auction. for those who agree we have some public option, we need to make changes in the accommodations. you want to make sure that there is an even playing field. you are now trying to create a system where the public auction swallows up all of the other private -- public option

swallows up all the other private plans. a cannot go to the federal government if its premiums are running too low, it cannot go get a loan that nobody else is allowed to get. they have to repay the initial money advanced by the treasury, just like a private insurance company would have to deal with the loans that it took out when it set itself up. it has to go out and negotiate with providers. the major issue that came up is the rate of reimbursement that would be offered to providers by the public auction. they said the public auction would propose to reimburse providers and doctors reimbursepublic o- -- public option would propose to reimburse providers and doctors

at +5. a lot of folks did not like that, even though in order to deal with some of their concerns we are raising their reimbursement on the medicare side. there was an issue as to whether those rate should be set or negotiated. the blue dogs wanted to have this subject to negotiation. that was a change made in the legislation. as things stand now, the blue dogs with the changes that are made to the bill, the majority of them on the committees of jurisdiction that have passed the bill have supported that. some of them are against the bill and some have opposed the bill and now the bill goes to the full house. i think they are going to come back just like all the other members of congress have to talk about these issues with their constituents and talk about the best way to proceed.

again, all three house bills contain a public auction -- public option. the bill that goes to the house for a vote will have a public auction -- public option. [applause] >> i would like to thank the congressman for coming. >> thank you very much. [applause] >> wait a minute. excuse me. also, if you have a q >> if you have questions that were not answered, you can write your question down. put your address and telephone on that. make sure that i will get them and i will give them to the office. also, there is a health care from aarp on the table for disbursement.

and an update from senator biden and delegate roger manno. is session. >> i think this time has been very useful to the process. a lot of back-and-forth. >> bring something through -- >> i do not know what the senate is going to do, but the house has moved deliberately. we're going to go back and talk to people. >> put together the bill. not this thing which is a monstrosity.

>> i think we are making good progress here. >> affordable. just a financial database. that infringes on civil liberties of americans. >> this is based off of tax returns. >> it is establishing -- >> if you do not want this subsidy, you can always say in no. i am serious. >> thank you so much for coming. i have to say i do not support the government -- >> thank you very much. >> i am just wondering -- car insurance, it is affordable. millions of companies do that. why can we not do that with health insurance?

>> let me turn this off. [inaudible] x tonight, three doctors from the va hospital center in arlington, va. talk about treating patients and their views on health care legislation before congress. we will hear from stephanie on the cost of mastectomy operations. >> the charges anywhere from $1,800 up to $2,000 and the payment is usually a medicare reimbursement and is usually between $650.700 $50. >> also the issues surrounding patient care. >> patients have a tendency when they have they sent them to go

to the internet and try to figure out what is wrong with them without the medical background and the grounding and experience that we have. they always get it wrong. usually think they have some terrible disease of -- some horrible disease. if there is anything, patients should not be trying to make their diagnoses on the internet. >> join us with all three doctors from the va hospital center in virginia as they share their stories about treating patients. that begins at 8:00 p.m. eastern on c-span. >> in addition to tonight's program featuring three doctors at the hospital center, we will have interviews with the president and ceo james cole and the chief of cardiac surgery, hospital care will be affected by health care legislation and an up close look at the va hospital on tuesday and

wednesday on "washington journal." we will talk about washington finances with emergency care from the intensive care unit. "washington journal" airs every day. >> as the debate over health care continues, the health care hub is a key resource. go on line to get the latest week's. share the latest thoughts on the issue. including video from any talk -- any town halls to have gone too. there is more at c-span.org/ healthcare. >> coincide the supreme court is the public places and rarely seen spaces and hear from the justices as they provide their insight about the building. the supreme court -- the highest court, the first sunday in

october on c-span. >> three republican senators and three house members hosted a health care town hall meeting last week in louisiana. we will hear from tom and john, who are both physicians. we are loot -- we are joined by david vider. this about 90 minutes. >> thank you for being here. >> welcome to our forum. nancy pelosi may consider you an american law but i am delighted to see you -- an un- american mob but i am delighted to see you. i am delighted to be joined by four other members of congress,

one of my colleagues from the senate and three u.s. members representing the louisiana. let me introduce them. first of all, senator john barroso was elected in 2008 after having been appointed to fill vacancy in 2007. he is known as wyoming's doctor. he was an orthopedic surgeon and served as president of the wyoming medical society and was named the wyoming physician of the year. he also served as a medical director bringing low-cost health screening exams to people all around the cowboys stayed. he also represented a county in the wyoming state senate for five years. please welcome senator john barroso. >> thank you.

[applause] >> next, we are delighted to have rodney alexander from the six congressional districts. prior to be elected -- to being elected, he was chair of the welfare committee in the louisiana legislature. he shepherded through the louisiana children's health insurance program, which was a republican initiative initially. although he believes that there are areas we can and should improve our health care system, he opposes the current health care bill because it sets the tone in washington for a government takeover of the health-care system. welcome, rodney alexander.

congressman steve scolice represents the first congressional district, many of you. >> before being elected, he served 12 years in the legislature. it has jurisdiction over the largest part of health care legislation. he has taken the position that individual should be charged -- should be in charge of their health care decisions, not bureaucrats. [applause]

last but certainly not least as congressman and dr. john fleming, who represents louisiana's fourth congressional district. he has spent his career as a family physician. he was named the louisiana family doctor of the year in 2007. john and i have both introduced legislation requiring that all members of the u.s. house and all members of the u.s. senate are put in any government option that may be passed. welcome, dr. john flemming. [applause]

why don't we get started in the right frame of mind and the right frame of heart by standing up again if you can for a prayer? please, remained standing immediately following the prayer. we will have the pledge of allegiance to the flag. first, we will be led in player -- in prayer by the pastor of the living water church of louisiana. >> heads bowed and eyes closed. father, forgive us for a sense of omission and commission, give us the strength to release jealousy, hatred, and help us to forgive one another for we know that you will not forgive us unless we forgive one another. we pray for your presence today. that will impact all of america.

we prayed that to lead our leaders in the right direction. the heart of the king is in the hand of the lord and you turn it where you will. we pray that this discourse will be healthy, informative, positive, and peaceful. let us remember why you have given the instruments of healing to man -- the healing of man is still in your hands. .

>> we ask your blessings on the state of louisiana, the united states of america, that we will remain one nation under god, indivisible, with liberty and justice for all. before the name whom every knee shall bowel, our lord and savior jesus christ. amen. >> and now we will be let in the pledge of allegiance to the flag out -- by our host, the mayor of kenner. >> thank you, senator. thank you for all the good things that you have done for us. i pledge allegience to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all.

[applause] >> thank you, mayor, for all of your help in hosting us here in the center. i want to thank the police chief as well who has been enormously helpful and the entire city of kenner. this is how the program is going to work. we're going have some very brief introductory comments from senator and dr. barasso. he has been working specifically with the only other end in the u.s. senate, tom coburn, trying to explain the health care bill before the senate and alternatives to it. john will give some of his overview and thoughts and then we will go directly to the part of the program which are your comments and your questions and

your concerns. if you have not already, please use one of these simple pieces of paper we are handing out to jot down your name or comments and questions, and please pass them to staff. then we will cut into absolutely as many comments and questions as possible. -- we will go through absolutely as many comments and questions as possible. if you could move to the microphone in the aisle, and be ready for our conversation. we certainly want to follow up on the conversation. let's get started. welcome, dr. john barasso. >> 90. -- thank you. i want to thank all of you for joining me along with senate term vitter who is a great american. we went to afghanistan to visit the troops of last easter. it is a privilege for me to serve with him in the united states senate.

[applause] we have such respect for our military. i like before we start, if we can ask all of those who are with us here today who have served our nation to please stand and let us thank you. [applause] [cheers and applause] i have had that chance as one of only two physicians who serve in the senate to talk about the issues we are facing. these are vital issues, personal issues, issues that affect all of us. health care is such a personal thing that will affect, no matter what they do, every person in this room, every person in america, and it is one

sixth of our economy and it is something that we must all take very seriously. i can tell you, ladies and gentlemen, we do. i walked out with his briefcase because i wanted to show you some of the bill. people say, had you read the bill? this is house bill 3200. i held this up at a town hall meeting on monday night, and someone in the front row yelled, burn it. [applause] and then they say, what about the senate bill? this is just part of it. a paper clip was only big enough for this one. this is the help committee bill and the senate.

-- in the senate. one minute. [laughter] and then in wyoming, i held us up, and they said, start a bonfire! [applause] and tom coburn and i have been traveling the country with our senate doctor show, we were in omaha, neb., we were in northwestern arkansas, and we're getting crowds of people like this one saying this is not what we want. there is a member of the house of representatives from michigan and asked him -- they asked him when he would read the bill. he said it would take two days in two lawyers to explain to him. if it takes that, we should not be passing such a bill and

nobody should vote for that kind of a bill. [cheers and applause] i don't know how many of you watched fox news on television. [cheers and applause] i had the opportunity to be on there this morning bemegan kelly on "morning show." we were talking about these bills. i will tell you, we are at a time when our nation is spending too much money, borrowing too much money, and there are too many government takeovers, and we have to stop it. [applause] now there are folks who actually believe and nancy pelosi is one of them, she actually believes -- barass[booing]

she thinks that people are coming here because it is contrived. we are trying to protect our freedom. [applause] i could go on and on but david has a whole list of questions that are your question. it is better for us to hear from you before -- the venue hearing from me. thank you for coming here today to hear me and my friend david vitter. >> thank you, john. let's get to the heart of the program, your comments and concerns and questions. our first comes from married, if you could find your way to the floor, and let me mention the next three up in the lineup. charlotte, lanny, and donald.

if you could make your way to the floor. mary asks how can you make health care for all without financially destroy in the nation? >> we have another physician and other members of house if they want to jump in. it is an excellent question. especially in these economic times. is there enough money in the system? you can debate whether there is are not but we are spending one sixth of all the money in america and we know that medicare is a system that helps people who are seniors and friends, but there is more what, -- waste, fraud, and abuse in that program than any other program. drug dealers and in florida are getting out of drug dealing and getting in the medicare because it is more profitable, less chance of being caught, and if

you get caught, the punishment is less. there are things that we can do to improve the system. what the president is trying to do is expand coverage because he said up 47 million americans, 11 million of these people are not americans to begin with. many of them have come here illegally. [applause] we can do more with prevention and we can get into a discussion of all of these things. but any economic times, when the president says he wants to do it without increasing expenses, but then the price tag on one bill is $1 trillion, and that bill that i've just brought that is not bound together yet, the telephone book version? it passed along partisan lines with all the democrats voting for it in the health committee and all the republicans voting against it -- the help

committee, and all the republicans voting against it. they do not want to put the price tag on it. what i am saying is that this is a trojan horse, and we cannot do the way -- to hit the way that the president promises. he promises one thing and there is a gap between the president's rhetoric and reality of what is printed in these pages. these pages are what i am opposed to. [applause] >> anyone want to comment on cost? >> as he pointed out, according to the congressional budget office, you don't need to listen to what one member or the other says, the congressional budget office says that h.r. 3200 will

have $239 billion in increased national debt, and will add to our additional debt in additional to new taxes that is in the bill. $800 million in new taxes, and it is still 100 -- $239 billion in new expenses as well. >> a follow-up? >> i had a comment. you answered that question. those numbers -- for the sake of my family and the future prosperity, i cannot be up -- cai cannot afford to be ideologically blinded and more. but i think that they are promoting america's suicide. [applause] the most powerful weapons against america are not guns or missiles or terrorists, but

ignorance see and complacency. we are close to losing our liberty. we are patriotic but had almost forgotten why. we have this moment in history to stop suicide. i am here to tell you, david, congress, and president obama, you were never given the right to destroy this great nation. thank you. >> thank you, mary. thank you very much. [applause] charlotte -- will the senate be covered by the same law that they enact for us? i find it reprehensible that a senate committee rejected that amendment that said just that. charlotte, you are very right about that. as i mentioned, dr. fleming and

i both author that provision. on the senate side, that is going to be my first amendment on the senate floor. if there is any government of gen in the bill, anything like that, then every house member, every senator, all of their immediate family have to be in that government option, no other choices. [cheers and applause] no special attending physician at the capitol, no special privileges at military hospitals, nothing else. the government option. charlotte, anything else to add? >> that is all i wanted to hear. thank you. >> john has authored the same thing on the house side. >> thank you, david. house resolution 615, summoned

you maybe aware of, simply says that if you vote for a government-run health care system, you -- you are willing to forgo the waiver in this bill and you are willing to sign up yourself. david pointed out that he offered the senate commission. we have over 5000 americans who have signed a petition to encourage their representative in washington to do the same. we have 73 congressmen, including the gentleman behind me, who are also co-authors, and not yet one democrat has been willing to sign for it. >> i would like to say, i represent the fifth congressional district, the district that lies to the north of baton rouge. i am a co-sponsor of dr.

fleming's legislation. i personally believe that if any of these bills lying on the floor pass, it really will not be relevant anyway. i think we will all be under one plan. i think that is the goal, to put everyone under one plan. i think it is even more misleading to have leaders, especially the president during his campaign, often saying, i want to make sure that everyone has access to the same type of quality health care that members of congress have access to. well, i want to tell you, my wife and i had been married 42 years. my wife was a school teacher for over 30 years. i have been a member of the louisiana state group benefits plan. i still am today. i do not have access to any more quality health care than the spouse of any other school teacher or state employees in

the state of louisiana. the employees that we have had to pick and choose from the cafeteria plans. some of the employees that i have are covered by blue cross blue shield. if i got off of the group benefits plan, i would probably have to sign up on blue cross blue shield. but we have to pay for the insurance that we have a. we do not have this type in the sky plan that many -- to believe that we have. >> and charlotte, you are exactly right. this very amendment you were talking about was proposed in house committee. the problem is the proponents of the bill defeated that amendment, killed that amendment, including one louisiana congressman voting against that amendment. [booing] lanny, where are you? what did you doing to defeat

this bill, and can reconciliation succeed? one thing dr. barasso is doing, is joining with the only other physician in the senate, dr. tom coburn, and they are doing an enormous amount of outrage about this issue because of their medical background. he is doing a lot -- opt-out utreach about this issue because of their medical background. >> very few know as much about the roles as david vitter. i don't know if you have ever been to a reconciliation fight. at the time of the revolution, benjamin franklin said that 33% of the people were tories. they favored what the british were doing. 33% were timid, and 33% were true blue. and that is what you get in this audience. [applause]

in franklin said that the battle is for the timid, to get to the people who have not made up their minds yet. that is what i am trying to do. trying to making sure that the voice of the american people is heard and that the knowledge is there said that people will come to the santa clara -- the same conclusions that we do, that this is not what we want for america's future or for our children. >> lanny, did you have a follow- up? >> it looks like we are losing all war in the media. what can we do to solve that problem? >> i understand your concerns. but i don't care how the media covers us. in august we have been winning the war and we can go on and win the war if we keep at it. [applause] not to me, the big question is this -- are we going to keep at

it as active, involved citizens? are we going to stake passionate and keep in every phase, every member of congress, in october, in november, however long it takes? [applause] ok, as we gutted donald preston, let me give the rest of the batting order coming up. jean, and joan. first, donald preston. president obama said at a town meeting that medicare advantage plans do not work. i have had people choice 65 for years and it does work for me. $0 charge for hospital stays and doctors is an example. donald, i agree with you. that is why i am opposed to

cutting that out. let me just say, one of the specific proposals from the proponents of this bill in terms of how to pay for it of $500 billion cut to medicare. medicare it manages at top of that list. please know that. -- medicare advantage is that the top of that list. >> the president has been doing town halls, and he says if you have a program that you like, you can keep it. and then he says they are going to eliminate medicare advantage, 10 million american citizens. i am sure their people like you right here today. we have only 3000 in wyoming. when they put that program into place, it was intended for people in cities and people in rural communities.

that is louisiana. i had the privilege today toward the newly opened louisiana state university medical lab area. incredible state of the art, doctors all around the country and around the world are going to come here to learn how to do with computer simulations surgery. i'm an orthopedic surgeon. it is beautiful what they have there. cardiologists learn happenstance into art. -- learn how to put stints in two parts. it is absolutely incredible. and they also have a program to help train physicians to train to practice in rural louisiana. help for their tuition so maybe they will stay in the family physicians, pediatricians, obstetricians, the primary-care doctors that we need in this country and in all our rural areas. i think medicare advantage is very important. we also had a privilege to take

a look at the community health center that tulane has. we toward 25 different groups together. it is a labor of love by these physicians and nurses, helping your community. it talks about that type of people in this community. with tomorrow being the fourth anniversary of the tragedy of hurricane katrina, to see what these folks have done and what they started with -- i can ride after the hurricane, and now they are moving into an all stakeouts, all designed to help people in the community. this community reaches out, one person helps another. the community should be very proud of it. if you do it right, both of the universities have been doing remarkable. but getting back to medicare advantage, it means a lot for 10 million people. for the president to eliminated, as a surgeon i take care of a lot people. i will tell you, people on

medicare and vanish -- medicare and manage, it helps coordinate your care, and medicare does not do a good job that. medicare advantage does a better job. could do a better job? sure, but to eliminated, i think that is in a mistake. -- short, but to eliminate it, i think that that is a mistake. >> explain the vote in house committee. steve -- steve scalise was there. i will put it to steve. >> in that committee, we have many amendments. i co-sponsored a number, including the amendment that would forestall members of congress to join the public plan, even though i do not like

the idea of the plan. but germany where your mouth is. if you think it is a good plan, joining. and they all voted against that, every member who voted for the bill voted against that. but we did have an amendment on abortion. that was one built by one congressman to mandate abortion in the bill. there is a lot of dispute on whether abortion is in the bill. don't believe any politician in washington. the national right to life's expressed a strong opposition to h.r. 3200. it would predictably result in the greatest expansion of abortion since roe v. wade. we brought up an amendment to ban abortion in the bill. we actually passed it on a very close vote. unfortunately, they turned around an hour and a half later, and there was arm- twisting and a lot of games that

were played, and you can go watch the tape on c-span, henry waxman brought it back up again and it did our amendment using a procedural trick. unfortunately, many budget with henry waxman to allow them to bring it back up again and killed our amendment that an abortion in the bill. it reverted back to the form that it was in, which according to national right to life, would result in the greatest expansion of abortion. there was a record vote, we forced that vote, and we would be happy to get you copies of those votes. but they did occur and unfortunately they defeated the amendment. they allow abortion in their bill. >> do you have a follow-up? >> i would like to mention that i am very disappointed that the people south of louisiana, who are actually some of our most flavorful and well respected people, are blinded by their

representative and his liberal views. he is a good old boy. [applause] >> joan ingram, where is the republican health care plan? democrats keep saying that republicans just say no. do republicans have a plan? >> we have about five different plans. when we did the senate doctor show, tom coburn talks about his plan. i encourage you to come to all our web site and watch the show, twice a week, it is that republican -- is that republican -- it is at republican.senate.gov.

it is with the pre-existing conditions that people have. it is designed to let people who buy health insurance to take this same opportunities as the big companies. these have been written about often but not really cover that often in the press. yesterday, as we were doing our senate doctor show, we had an interview with cnn and dr. coburn was asked about it. what republicans have a plan? he went on about things that are in the republican options. why are we getting the press on that? well -- [inaudible] you will be happy now that c- span is right behind you and they are going to play at this weekend. see the guy right here there?

he just waved his hand. [applause] there he is. bernanke. >> any follow-up? >> i wanted to thank you, david. i think you are one of the most maligned at centers in washington, but you stand up for yourself and stand-up arrest. i appreciate that so much and so do all of us. [applause] as we go to barbara bailey, i want to announce that next batting order. >> the question that john had was an important one. there are a few house bills as well as the senate bill that you are talking about. there are competing proposals. h.r. 3200, this is the bill that passed a house committee that i post. but in the house, there are two and others, which is h.r. 3400,

one that we put on our web site. we have 20 co-sponsors. rodney alexander is a co- sponsor. we have more co-sponsors on our bill than they have on their bill, h.r. 3200. they only have seven co-sponsors and yet there are 20 members of congress, including four medical doctors that have co-sponsored this. it has pulling together pooling -- pooling togetherr. estimates are that you to save $100 billion a year just by common sense medical liability reform and redress for pre- existing conditions. you could get all of our problem -- a lower prices without getting the government involved.

>> as we go to barbara, i like to ask the following folks to start making your way to the aisle. allan ross, and cecil bailey. barbara ask, would you vote no on health care plan and no on cap-and-trade? my response to that is, ditto and ditto, absolutely. [cheers and applause] these house members have already voted no on cap-and- trade. i think everyone on the stage agrees on both of those issues. barbara, any follow-up? >> i sit next to him on the environment and public works committee. when barbara boxer glares at our side of the table, i am not sure if she is a glaring at him or glaring at me. we're going to continue the

fight against this program that will cripple our economy, crippled our energy, and make a mark -- make us more dependent on foreign sources of energy, and undermine our national security. thank you. [applause] >> that is all i wanted to know. >> you understand, we each want to be the cause of the g lare. we fight about there. is there any hope for tort reform in this congress? [applause] i will give you my honest answer. in this congress, i think the answer is no. i don't think this congress will ever consider meaningful tort reform. but let me just remind you of the first rule of politics, which i think is relevant there, particularly as we think about

the next election. in politics, it is a lot easier to change bodies and to change hearts and minds. so keep that in mind. -- and to change hearts and minds. -- than to change hearts and minds. >> you heard howard dean only a couple of days ago in a candid moments say, well, the reason why we cannot put it in the bills because it will never pass, because of our trial our constituents. -- trial lawyer constituents. >> give him an a for honesty. >> who is more important, but trial lawyers or the american people? i think you know the answer to that. [applause] and it is fascinating to me, because someone who is practiced medicine, my wife is a breast

cancer survivor, we see it from both sides. practicing medicine, i will tell you absolutely every physician, have you ever ordered a test that cost the patient money but ashley did not help them get better, because of defensive medicine, you are afraid what happened? every doctor will tell you that they have done it. that costs all of us a lot of money. ending you say, i see that past president of the medical association, president obama was at the ama meeting, he said that we need to do something about lawsuit abuse. everyone just cheered. i don't mean capps. he kept a completely out of every bill in congress and it is just wrong. when it passed for reform in texas, the rates went way down, and a lot of physicians went

there to practice. you're trying to deal with underserved communities. they found that the numbers of these tests that were done with defensive medicine went way down. to wonder million-dollar this is spent each year in defensive medicine that does not help anybody. -- $200 million is spent each year in defense of medicine at the not help anybody. if you take your kid to a hospital, you get responsible parents i sheet of paper to take on, make sure that their eyes are focusing. you cannot do that anymore. every one of those young people now get a cat scan or mri to make] sure that there is not bleeding going on to make sure that they are not one in a million. it is not only the financial cost, but all of these people that are getting the radiation

now. we do not want that to continue to build up, either. we absolutely need to do something about -- the other thing is about 60% of all the money in the system does not get to the injured person. if there is an injury, the person ought to get something to help them for the loss. 60% of the money goes to the system. that could lead the lawyers, the expert witnesses, and it takes too long. it could take five years. if you want to find a better way to make sure that someone is injured, and to make sure that the money gets to the person that is injured in a timely way -- but as congress does not seem have that interest which you and i know is critical, something that can really help drive down the cost of health care for all americans. >> doctor, do you have a follow- up? alan ross is a retired marine,

served his country for years. [applause] he served his country at a reduced rate to earn retirement and health benefits. what about that versus just giving the stuff away through nonproductive people -- to nonproductive people? would you like to elaborate? [inaudible] >> i spent 20 years in the marine corps. the two benefits is military pay after 20 years, if you can get out and do something else. you get medical benefits for life. those of the two big things. i can see right now if this

passes, just the ordinary person that sat on the couch his entire life and has the same benefits that i earned at a reduced rate, you do not have to do anything for it. [applause] where you going to do to the hundreds of thousands of retirees that are in the same vote as me -- in the same boat as mean? >> i hear you. yet a bill like the obama plan passes -- get a bill by the obama bill passes -- if a bill but like the obama bill passes, what deficits and debt that are already skyrocketing in terms of the federal government, you don't think that that is going to squeeze everything in the budget, including what we have for our soldiers and military retirees? of course it will. of course it is going to squeeze all of that.

any follow-up? thank you. thank you for your service. [applause] john flemming was a military doctor and you saw that first hand. >> i just visited with the va up in shreveport. this issue came up. how will it impact active military duty and their families? as far as i'm concerned, no one deserves the best that this country can give than those who were the uniform of the united states of america. [cheers and applause] so why should we give free health care for people who do

not belong in this country and deprive it of those people who have given the ultimate sacrifice? [cheers and applause] >> that is a good set way to learn next question. if they pass this health care reform, will it cover illegal aliens? cecil, i will give you my answer. there is nothing in the bill that says it covers illegal aliens. under the four corners of the bills, it does not. but there is nothing in all of these other benefit programs that says that he does to illegals either, and in practice it absolutely does. it always does. it always does. furthermore, when the other side talks about 45 million

uninsured, a full 25% of that figure are illegal aliens. i will be honest with you. i think that is a problem, but a law enforcement one, not health care one. [applause] cecil? >> i was just wondering why in god's name are we responsible for somebody's help that is not supposed to be here to begin with? -- somebody's health that is not supposed to be here to begin with? >> every one of iraq agrees with you. part of the motivation is of the amnesty program they can make those folks voters and tip the balance in terms of every future election in this country. [booing]

let me give you the next batting order. mary, carolyn, and robert. mary asks, thank you for standing up for life. we all did the same. [applause] was an end and would you put in the bill that will ensure that taxpayer funds will not be used to fund abortions, since the hyde amendment is not a permanent provision? >> they are trying to do that in the health committee -- help committee bill. there was amendment about how money would be spent. the republican sam -- said that it sounds like it might pay for abortion. the republicans brought an amendment that said, just make

it clear, no money in this bill will be used to pay for abortions. that was our amendment. and that amendment lost. all the republicans voted for the amendment as well as one democrat, casey from pennsylvania. but when you have 13 democrats, 10 republicans on the committee, they can always let one go to vote on our side. the vote was 12 against, 11 for our amendment, so the amendment failed. it says to me that they plan to use federal money to pay for abortions, although it does not actually say that in the words. it looks that way because they defeated our amendment that says no money will be used. we're going to try to say -- do the same with the bill that is in the finance committee. we will continue to try and make sure that federal money does not go to pay for abortions. right now it looks to me like it does. >> do you have a follow-up?

>> i think it is so important because most people in our country are pro-life, and i think it is important that u.s. senators and congressmen, that you stand for life, make sure that you get something into the law that says that our taxpayer money will not kill unborn children. thank you. god bless you. >> absolutely. [applause] and again, i want to underscore what john and steve have said about this, because it is so important. the proponents of the bill say, this is not about abortion. the abortion word is not in this bill. it is not there. many conservatives say, ok, but we want to make sure, so here is an amendment that specifically, clearly says, no taxpayer funds in this bill for abortion, and

in the same proponents of the bill kill the amendment. what is going on? it is a clear conclusion to reach that that is a very valid threat. ok, how is the panel that would make decisions on treatments selected, and what are their specialties and qualifications? that level of detail is not in these bills, but there is clearly a move toward that. going back to the stimulus bill earlier this year, there was a panel set up, so-called comparative health outcomes panel, many of us fear that it is leading exactly in this direction, which is exactly what they have in the national health care system in great britain. >> and india's committees, that

will lead is the president on where they should spend the money and use the money. comparative spending, likely approved by the president, and it gets down to the point that you just made. kathleen sebelius, the head of europe -- health and human services -- [booing] i was on cnn with her a week ago, and what she said is, don't be distracted by the details. [laughter] well, the american people are focused on the details. we care about the details. that is what this is all about. is very personal. it affects everyone of us very personally. let's do a show of hands, how many people think that you are personally out of your pockets will be paying more for health

care than you are paying right now? look at that. every hand is going up. how many people here in the audience thinks that your health care is going to be worse than it is right now? every hand goes up. so the details matter to everyone in this room and we're going to fight over the details. [applause] >> carolyn nixon. the president said that if we like what we have, we can keep it. one way that he will pay for his plan is to cut medicare advantage. how can he say both? [laughter] >> i have heard him say both many times. at the same times, he says we can keep the doctors and keep

the plan that we like. we have medicare advantage through our social security, we have humana and we have been very place. my husband was pretty much save to buy it. >> that is a great point. -- was pretty much saved by it. >> you are exactly right. he has said both of those things. both of those things are completely contradictory. so -- sure. >> at this question about medicare has come up a couple of times. i have practiced for 30 years. this is something, dated day economics that doctors are involved in. medicare is a beautiful house on a very weak foundation. you need to understand that. by now doctors -- right now dr.

reimbursement has been cut to the bond. if a doctor has too many medicare patients and not enough private insurance patients to offset that cost, he will go out of business. many of them have. as a result of this, if you expand medicare and the single payer opsin idea, and you pull more of that private insurance that subsidize medicare, the whole system will cave in. that is the whole problem. that is why people on private insurance will not be on private insurance five years from now. it is like a black hole. and if nothing is done to medicare in terms of damage to it, it is going to run out of money in eight years, ok? it's heading for a train wreck. the president is going to take out $190 billion to eliminate 25% who are in medicare

advantage. that leaves another $300 billion. a president says that it will not come from services but out of the providers. ok, our heart surgeon today is paid 33% of what he was paid just a few years ago. an eye surgeon is paid the same thing for cataract as he was in 1964. if you take $300 billion at that system, was the chance it will, of services? extremely high. if anyone should be concerned about going to government-run health care, you in medicare should be the most concerned, in my opinion. [applause] >> this is been a very important point. if you like what you have, you can keep it. i strongly believe in that. but some going around talking

have rendered -- h.r. 3200 -- but in their bill, right on page 15, a health benefits plan shall not be a qualified health benefits plan under this provision unless the plan meets the applicable requirements. do you know what this does? the health care czar -- we need to be rid of all of these czars. we do not need to have another czar. [cheers and applause] it sounds like some of you may have read that section. if you look at this section right here, this gets the health care czar the ability to take away your plan even if you like it. we tried to remove this from the bill. not one member who voted for the

bill would vote with us to remember it. they will be able to take it away and it is not right. >> james? james bruce, let's go this quickly. it is my understanding that a cornwall acorn -- acorn will be participating in the national census. right now they are unofficial partner with the u.s. department of commerce -- an official partner with the u.s. department of commerce in the u.s. census. [booing] i had specific amendments on the senate for the bar that. both times they were defeated by i near party-line vote. two democrats, every other democrat voting know. we need to change that sort of mode outcome.

-- vote outcome. two points -- tort reform and caps on pain and suffering, and a crackdown on fraudulent health care -- what do we think about that? >> tort reform is critical. we have to get that part under control. if you want to get cost of care down, if you have to get rid of all lot of unnecessary procedures, defensive medicine. $200 billion that we can save the system. [unintelligible] talking to doctors there, is 30% cheaper than if you are in iowa. but the things that you mentioned, the other ways to do that, as opposed to iowa, delivering a baby there is 30% more.

it all has to do with all laws and we need to make sure that we did that. you talked about this long bill and we could dissect all the pages. that trickery, the financial trickery in these bills is something. to try to keep the cost -- the first question about the cost. to try to get the cost to $1 trillion. these are astonishing figures. they are going to collect tax money for this for nine years. they are only going to pay for services for six years. you have not heard that before, probably. but those of the details of the bill. -- those are the but that -- those are the details of the bill. but costs are going to go beyond that. yet this does not break our country, that absolutely well. we need to know more about the specifics about the details that are in this horrible bill. >> any follow-up?

>> i have a message that i would like you to give nancy pelosi on my behalf. [laughter] not only did nobody bride you to come here -- nobody bright me to come here bribe -- nobody bribed me to come here, i had to give up overtime pay. if they do not stop driving us to socialism, it is going to be nasty. that is the message. >> thank you. [applause] i can tell you that we will help deliver that, but all of you can deliver it much more effectively. you are doing that, so keep at it. [applause]

okay, next batting order, and this may have to be the wrapup. brian, armand, william, and glen. bryan says, we cannot afford another $1 trillion bill. how can we defeat this madness? i hate to tell you the real cost estimate. i think the best cost estimate is $2.20 trillion to $2.40 trillion over tend years for full implementation. he goes up from there. the nonpartisan cbo says that costs is a huge issue. instead of ending the cost curve down, it has been in the cost curb up and making it worse. this is a cbo -- i non-partisan body, and the head of the cbo is appointed by nancy pelosi. brian, do you want to follow up?

>> thank you, senator. and i thank you for holding all these town hall meetings. unlike the so-called declared opponents who seem to be afraid to even hold one meeting. i want to thank you for coming here today and been so forthright. -- and being so forthright. [applause] >> this is 19 and counting as mom and -- this month. we will keep going on so it will not end. do not worry. [applause] >> what can you all do? you have two of united states senator, and one of them are going to vote against this. it is up to all of you to make sure your other united states senator votes against this bill. [cheers and applause]

>> why isn't anyone asking the question about trashing this bill and starting over, writing it so people can understand the bill? armand, a manner -- i agree with you completely. any 1000 page bill, no matter what the topic and who writes it, is likely to be really dangerous and really full of foolishness. in terms of process, i would much rather have three or four or five focused 30-page bills that deal with specific problems, like pre-existing conditions, like associated health plans, like tort reform. [applause] there are absolutely problems to

fix and we need to fix them. but we need to use a scalpel, not a sledgehammer. follow-up? >> when you represent a lot of people in your district a five- page bill is enough. you don't need all these pages. i would want my constituents to tell me, here is the bill, e- mail me and call me and tell me what you think. that is the way i would vote. >> absolutely, thank you. william? is there anything the republicans can do to prevent the democrats from passing the 1000-page bill in the senate with only 51 votes? that is a great question. he goes back to this issue that was brought up earlier called

reconciliation. in the senate, where john and i work, almost everything has to pass by 60 votes. not a simple majority, 60 beds. i came to the senate after the 2004 election and i was actually part of a big republican freshman class that put us at 55 republicans. i thought that this 60-vote roh was absolutely ridiculous. but it had been growing on me since then. .

i'll give you my real broad-brush impression, which is maybe half of their entire plan could be passed in some way through a simple majority but the other half could not. so it's a very imperfect tool to do everything they want to do. i don't know if you want to follow up. >> i'm just concerned if this thousand-page bill passes that's so complicated they'll be able to interpret it any way they want. and if they do, they'll have total control over our lives. >> right, right. you're right because even in a

thousand pages a lot of this language is very broad and a lot of this language gives authority to new bureaucracies to write the details. you know what, the devil's in the details and we need to know the details before it becomes law. glen gardner, is there any way to get an alternative bill on the floor that would reform health care through the free enterprise system by allowing trade and professional associations to receive national group medical plans across state lines. and number two, what can we do to convince congress to approve the government -- let's see, to oppose the government option which would result in socialized medicine. two great questions. >> in terms of the rules to be used, we are going to continue to offer amendments, continue to bring bills, continue to put out these issues.

then in the two years that barack obama was in the united states senate, he voted against allowing people to buy insurance across state lines, against giving those opportunities for people to have more choices. he voted against individuals having a right to write off tax it is they pay for that. he voted against allowing you to use your health service savings account cans, item after item we think is so crucial the president voted against those when he was in the senate and continues to work that way. the numbers are against us right now but we have vision and values we believe in and what we'll continue to fight for and use every technique we can but mostly, we need the help of the american people. we need the help of every one of you in this room to talk to your friends in other states, get to other folks, get to their elected representatives so the rest of america sees the danger for the future of this country, if either of these bills or approaches is adopted into law. this is breaking the glass that you're not going to be able to

put back together. we cannot have this for america. it will change our country forever in a way that no one in this room wants and is not going to be good for our nation. >> and glen, these house members have already been pushing alternatives, have already been pushing amendments to take out the government option. maybe rodney, steve, you have any thoughts? >> by the way, you probably have heard on tv there are members of the congress that have not read the bill. i've read the bill. and we'll be glad -- [applause] >> we'll be glad to leave you a copy this afternoon if you'd like to go over it. there will be moves to try to take the option out of the bill. i think when we go back to

washington the day after labor day, the dialogue has already taken place that to get anything passed they're going to have to remove the public option. that's my opinion. and i think -- [applause] i don't know if there is a specific bill yet that's been introduced but i think we will be asked to vote on some type of health care plan between now and the end of the year and don't think it will include public option. >> even if you take the public option, the so-called government option, even if you take that out there's a lot of things in this bill that won't be good for our country. >> you know, i think the last couple of weeks we've seen an incredible citizen movement

across this country, people who are fortunately reading the bill and expressing their concerns about it, but as some people who are for this bill are going back now and they're hearing from people saying oh, no, i'll take out the public option and do a co-op. none of them are telling you what a co-op is. first of all, the co-op is just like the public option. but one thing you have not heard, one of the proponents of this bill say, you have not heard one person saying they would be willing to take out the $800 billion on new taxes on american families and small businesses. you haven't heard one of them say they'll be willing to take up the rationing and mandate of abortion and things like that out of the bill, too. let's scrap this bill and go to some of these comments that fix the problems without breaking the things that work. >> and let me underscore that --

[chanting from the crowd] >> let me underscore your very point. in the u.s. senate in particular, there's always a big push to deep pocket bipartisan and agree to some compromise. and you know what, and you know what, a lot of times that means the following, you have an absolutely horrible bill and we pass an amendment so now it's merely a really, really, really bad bill and then we should pass it. well, i can tell you that's not going to be my test.

[crowd chanting] >> that what i just described, that may be washington's definition of bipartisan, that's my definition of selling america down the river and we're not going to do it. glen, let me follow up. >> there was one thing i did want to share on top of what's already been said. i had a very wise stepfather who was a doctor at tulane medical center for many, many years. and i asked him once, why is it the doctors -- he did

consulting in england, too. why is it doctors in england hate their socialized medicine so much? and the answer i got totally amazed me, i never thought of it that way until he said it. he said because they have to play god. i said what do you mean, "play god?" he said because their limited financial resources and they have to make decisions who gets the medical care they really need and who doesn't, like the older people, they'll send them home with a couple of aspirin sometimes when they know they did a certain procedure and expensive surgery they could save their life. they don't like playing god. >> yeah. well, that's wrong. that's wrong. and there's one thing that's even scarier and that's government playing god. we're going to try to get to

three more people, michael gannon, january cookmore. michael says how can we be assured our tax dollars will not be used to pay for abortions? michael, i think we talked about that, if i could ask for your indulgence, i'm going to go on. jan says what will be the ramifications of obama care on home health and agencies providing those services? i've been a therapist for over 30 years. any of the doctors want to take that? >> let me first approach that more broadly and that is what we've touched on and that is any time you have a government-run health care system and all these countries we've talked about and even some states, you run into a budget limitation because it's always expanding demand. once it hits the budget you have to simply decide how you're going to allocate those resources and we've heard testimony from people from

canada and from the u.k., doctors as well, the stories we've heard were spine chilling, the delay in care, the lack of care to people who have coverage was much worse than people here who don't have coverage. now, one example was a child who needed tubes in his ears at 15 months waiting list and nine months he developed a brain infection, was brought across the border, got tubes and then lost his hearing. another was a young mother who was born with a spinal disorder, she needed surgery after years of waiting which she was partially paralyzed and had to wear diapers because of total incontinence when she asked why can't i have corrective surgery, the answer was because you haven't suffered enough. so these are the realities in a government-run health care system where resources have to be allocated. and this is even broken down into something called quality,

qualitied a justed life years that they use. so if someone is 70 and has a little illness, their life is less important than someone who is 40 who is perfectly well. so to your question specifically, those resources, as they become limited, they will be given out according to how productive and how valuable your life is. so obviously the older you are and the sicker you are, the less value you will be for the health care system and for the government to give you resources. >> and 9 % of my home health patients are medicare, and i think that is what is going to be the problem. you're going to have some job losses. >> sure, sure. you'll have huge cuts to medicare to pay for some of this stuff. absolutely. thank you, jan. tad guidry, howard dean says there will be no torte reform if a patient under a government

health care plan has a legitimate malpractice suit, will he or she be able to sue the government or just be out of luck? today he can sue a private health plan or provider. well, tab, i'll tell you my fear, and this is particularly significant to doctors and other providers. i think this proposal offers to doctors and other providers, potentially the worst of all worlds. it potentially offers them socialized medicine like in england without malpractice protection. in england doctors have that protection. that doesn't make the system good, but they have that protection. here doctors and other providers could face the worst of all worlds, and i don't think it would be government getting sued, it could still be

individual providers. >> thank you, david, for that answer. i still think, you know, it's going to be a bad bill and but thank for you taking time to come out here and being here and i don't know where tully is, maybe he's on a fact-finding mission in another country. but thank you for voting against the stimulus and thank you. >> we're going to be able to take three more quickly, bill, janet hayes, and don slezak. under any bill says under any new health plan will you support legislation that will provide military retirees with benefits similar to the ones in place? well, bill, certainly i will do

everything in my power to protect those benefits and make sure -- try to make sure a new plan doesn't erode those benefits, but i'm very concerned that a new big government plan would end up eroding those benefits or even eventually collapsing that system in to the bigger system. anybody else want to respond? any follow-up? >> david, first of all, i'm mike and thank you so very much. >> sorry. >> it's ok. i want to thank you for everything you have done. and i'm a little confused, as most of us are, a lot of us here are on fixed incomes, on social security. we have been told that social security will drop this following year because of increases in medicare and that there will be no cost of living

increases. you have to explain to me why that is because if medicare is going to increase and reduce our social security benefits, we can't sell our houses, where is our cost of living increases? >> well, you're right. and with medicare cost increases, that means you're coming at it behind, you're not even staying in the same place. so that's the great point. i want to mention another cost of living adjustment, too, though, because i have legislation about it. there is under present law an automatic pay raise virtually every year for members of congress. that's ridiculous and that's offensive. i have a bill to take that away so there's no automatic pay raise. [applause]

>> we've actually put enough public light and public pressure on that issue that we passed that through the senate. now we need to pass it through the house. [applause] >> real quickly, janet hayes, all hospitals are clogged up right now with uninsured. we're in the red. do you support the charity system and charity hospital being reopened? we need to go quickly. i support that. it's long overdue in downtown new orleans. but i himself support using a different, better model and having money follow the patient and not just follow big government institutions. and janet, i'm sorry, we need to wrap up. john slezak says what's being done about the czars, is it legal to have them with no oversight? don, i think the czars are

absolutely unconstitutional because the u.s. -- [applause] >> any big presidential advisor like that, like a cabinet secretary is supposed to come before the u.s. senate for one thing for confirmation and this is a complete run around that and i think it's unconstitutional. i'll fight that, i'm sure we'll all fight that, but quite frankly, that's not going to change until a majority in the u.s. senate says it has to change. who pays their salary? you pay their salary, we all pay their salary. yep. yep. thank you all very, very much

for being here. and please help me thank all of our colleagues. >> great to be with you. >> dr. john fleming, congressman steve scalise, congressman rodney alexander. thank you all and pleaseñi keep i.óçó up, keep it up. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009]ñiñii >> asñi theçóxd debate overñ9i+ care continues-

there's more at c-span.org slash health care. >> three hospitals in arlington, virginia tell personal stories about treating patients and offer their views on health care legislation cur&ently before congressqmñ an !murray.

>> they talk about how virginia health care may be affected by legislation making its way through congress. and our closer look continues tuesday and wednesday on "washington journal" and we'll be talking about hospital finance with the chief financial officer robin norman and emergency care with staff in the intensive care unit. "washington journal" airs every day at 7:00 a.m. eastern.

>> tonight, texas republican john culberson show how members of congress use technology to stay in touch with their constituents on "the communicate indicators" on c-span 2. >> in more than a dozen works, national book award-winner jonathan kozol has analyzed and critiqued the american public education system and sunday will take your questions live. >> topics at today's white house briefing includes an upcoming report on the situation in afghanistan from the top u.s. commander there. press secretary robert gibbs also talks about the debate over health care legislation. this is about 35 minutes.

>> good afternoon, everyone. welcome back. just one quick scheduling announcement, on tuesday, september 15, the president will address the national afl-cio convention in pittsburgh. and with that, our a.p. personnel, hold on, divert the cameras over here. yep. tuesday, september 15,>d[çóñi b wayñztoñi ask the obvious -- ca you repeat the announcement, please. >> i didn't know. you were here the whole time. fire away. >> is the president still asking israelis to stop all settlement building in the

territories? >> obviously, i think the president's views on this have been made clear, there's been no dirq and i think the -- i do think senator mitchell has had productive meetings over the past few weeks, and is going back soon to the region. >> javier solana thinks the two sides can come together during the u.n. general assembly meetings in new york coming up in september. what will be the reason for optimism the two sides are ready to come together when there's been no real -- do you guys have information about movement, progress, the reason he would be optimistic? >> we, as i've said here before, believe we'veñi seen progress, weñi continue to going to get intoñr everyñrñiñi

discussion we've had with hopeful we can continue to make progress and if that happens in new york we would be quite happy. >> is the presidency -- [inaudible] >> the report is working its way up the chain of command like it normally does. but i believe it has been delivered to the pentagon. >> how much up the chain of command does it have yet to go? u÷rymñixd petraeus,ñi petraeus, it will go to the each step[ññixdñrym alongñrñi will-qñrñrçó head their comme strategic assessment that=/%ñi general crystal has made.çóçó

>> is the president willing to consider more groups for afghanistan? >> let's read the report. >> will you get into that specifically? it might come down to this fall. >> this report is an assessment of where we are and what in his assessment needs to change, any

resource specific recommendations i'm told will be made in the coming weeks but are not a part of this report. did you have a follow-up? >> i did. we talked with the israeli president sharon perez and indicated the meeting will take place on the sidelines of the u.n. g-8 opening and also suggested there's likely to be a suspension of israeli settlement activity to facilitate the meeting. is that your understanding? >> you know, i would not contradict your interview with president perez but we're certainly hopeful progress is being made and that we can see that progress continue in the near future. >> let me ask you on another matter, the jerusalem post conducted a survey and found only 4% of jewish israelis consider president obama to be pro-israeli. does that trouble you in any way? >> i haven't seen it, paul. >> what do you say to bob dole

who has the op-ed who says he thinks the president needs to refresh the health care debate and specifically put a plan on the table? >> i think the president has outlined a series of proposals. and principles he thinks ought to be included in health care and will continue to see if we can make progress as it relates to that. >> but on the specific plan, he's saying he's not a commentator and is president of the united states and shouldn't just be commenting on what the congress is saying. others have said this in congress, maybe she take a more active role. >> he's talked with many members of the finance committee and members of congress in the house and senate. i think to characterize the roles the president is playing as inactive would be inaccurate. >> he doesn't seem to be active on health care right now. he's going to go on the campaign -- he's off right now so i --

>> if he marvel with a golf ball he would be more interested in health care. >> he is golfing and going to camp david for more vacation. when is he going to get back into this debate? >> well, again, ed, the president did some meetings today that included discussions on health care. i assume he'll continue to make calls throughout the week, judging and assessing where we are. i think that just because the president might be doing something else doesn't mean he's not focused on health care. yes, sir. >> i had a couple of questions. one, just teeing off a bit, a question about health care, have you guys see this fundraising letter from senator chuck grassley in which he goes after the simple truth is i am and always have been opposed to the obama administrations plans to nationalize health care and am deeply concerned about rising health care costs but the reality is -- it just goes

after president obama and democrats. >> i have not seen it. >> it would seem to belie any indication senator grassley is actually partnered with the administration or with the senator baucus on creating a plan you guys would support. are you still firmly committed to working with the three republicans who are still at the negotiating table? >> i'll say this the president is firmly committed to working with democrats, republicans, independents, anybody that wants to see progress on health care reform. i will say this, i haven't seen the contents of that letter, certainly i think the radio address over the weekend by senator enzi repeating many of the generic republican talking points that republicans are using that have bragged about being opposed to health care are tremendously unfortunate. but in some ways illuminating.

it appears that at least in senator enzi's case, he doesn't believe there's a pathway to get bipartisan support and the president thinks that's wrong. i think senator enzi clearly turned over his cards on bipartisanship and decided it's time to walk away from the table. i think what somebody has to ask senator enzi and ask others , every member of congress is are you satisfied with the way the system is working right now. are you satisfied that premiums are doubling every nine years? are you satisfied that out-of-pocket expenses are skyrocketing? are you satisfied that small businesses are dropping their coverage? are you satisfied that every day 14,000 americans wake up and find themselves without health insurance coverage? i think many may believe that we can't afford to do anything.

i think this president believes we can't afford not to. >> let me ask you, are you satisfied with the ability that the white house is showing in getting that message out as opposed to what the opponents of health care reform are saying? >> notwithstanding ed's question about what the president is doing. >> do you think we've all now, the congressional recess has been going on and some of us have left washington, d.c., do you think you're doing a good job at getting the message out to what health care reform should be? >> i think we looked at and we discussed when we last met in here, i think the president has made progress on turning around some of the very specific, yet untrue allegations about this bill. it doesn't help -- i'll give you, jake, it doesn't help to have republicans who say they're for bipartisanship and say they're at the table to try to find a solution repeating republican party talking points about what they know is not

true in the bill. i don't think that's helpful and i think that it's unfortunate, again, it's tremendously unfortunate it looks like republicans are stepping away from seeking a bipartisan solution. i think that's -- it's bad for this town but much worse for this country. >> i wondered if you have any comment or remarks former vice president cheney made yesterday, i think it's in the preliminary review of what the c.i.a. officers broke any laws, i think it's an outrageous precedentiçó to have this kind look back at the prior administration and said it created a chilling effect at the c.i.a. and the actions are not making the country safer. >> yeah,ñi this is the same son and dance we've heard since literally the firstñrñiçóñi dy soñi i don't have -- i don'txd a lot to say. i think theñiok vice president,

you watched some of hisñr ñ somebody who you know is tasked with homeland security in the previous administration, i think -- i think what was also illuminating were senator mccain's comments yesterday about whether the impact that

these enhanced interrogation techniques that the president looked at and has now outlawed, the effect that they've had on our standing in the world in our foreign policy. i think he certainly doesn't agree with us on every issue as it relates to this. i understand that. but i thought given his experience, i think they are tremendously illuminating. i would add this, i'm not entirely sure dick cheney's predictions on foreign policy have born a whole lot of fruit over the last eight years in a way that have been either positive or best of my recollection very correct. >> if the president outlawed -- [inaudible] why does he continue retention and how does he think this can

be monitored, these thousands of miles away? >> again, i do think it's important, helen, to reiterate, as i said to jake, the president viewed -- after a review of enhanced interrogation techniques came to the very same conclusion senator mccain said yesterday. >> illuminated it when you send them to black sites. >> again, there are, based on the president's executive order, there are no american run black sites anymore. there's an outlawing of the use of enhanced interrogation techniques. we follow the geneva convention and we follow the army field manual. we're going to close guantanamo and we're going to repair the image of this country and make this country safer. >> and detainees are not sent to other places? >> detainees are not sent to

other places to be tortured, that's the policy of this country. >> interrogated. >> some may go to other countries to face charges they have in those countries, but they're not shipped in the dark of night to be tortured. >> i believe it was march when the president announced his new tragedy? afghanistan and since then things have gotten worse. this july and august i believe have been the two worst months in terms of u.s. fatalities. obviously it takes a long time to implement a military strategy, but after six months, not only are things not stabilized, they're worse, they've gotten worse in that period of time. is this an early sign his strategy is not working? >> no. we've got to resource afghanistan for the better part of a decade. >> not sending in additional troops, it's getting worse. >> not all the additional troops are there. the assessment that is coming back as part of what a new commander does when they go to a region when they're newly assigned as the president has, general mccrystal to this

region, but understand, chip, we're not -- the president, whether it's economy or health care or anything, we're not going to make -- we're not going to see the entire thing turned around in a few months after years and years of neglect. you can't underresource the most important part of our world terror. you can't underrecess that for five or six or seven years, whether it's underresourced with civilian manpower or underresourced with economic development funding and hope to snap your fingers and have that turned around in just a few months. what the president innunsated through this administration was to change our direction in afghanistan and understand it was the central focus and that in afghanistan, in the hills separating afghanistan and pakistan were those again

plotting to do us harm. and then for far too long we've ignored that with the resources that were necessary to deal with the size and the scope of the problem that existed there. >> as bad as it was when he came into office, things have become significantly worse since he announced his plan. >> it is a challenging place. we are forever indebted to the men and women who serve there, and particularly those that sacrifice, make the ultimate sacrifice. i think the generals -- we'll see the general's assessment when he gets here. the president is focused on ensuring that we meet measurable benchmarks and that we disrupt, dismabtle -- dismantle the extremist allies. it's going to take some doing and more resources which the president has dedicated to this

problem, but understand, chip, this was underresourced, under funded, undermanned and ignored for years. and that's not going to change overnight. >> is it possible simply losing control in and it's going to continue to spiral out of control? >> based on reports -- based on additional reporting i've seen on general mccrystal's report he says the situation is quite serious but the war is indeed minimum. yes, sir. >> how long does it take for this report to get to the white house? >> i don't know the answer. >> have you tracked it? >> there's no fedex tracking. >> i guess how does the report get there faster? >> i'm assuming it will be sent over by the pentagon and seakt

gates. the president has continued to do briefings with ambassador and former general iken berry -- eikenberry, with others involved, general petraeus, ambassador holbrook and others involved. what the president will want to do is review the report and then discuss and talk with all of those who have equities in it to get their viewpoints and ensure that each and every person is heard on this and that's what the president intends to do. >> going back to health care, rather than responding to dole how about responding to chris dodd who says he wants the president to come back and really frame this for us? >> i think the president will continue throughout this month to frame what's important about getting health care reform done, doing it in a way that steps in neutral and doing it in a way that improves quality of care, doing it in a way that changes the amazing amount of resources that it takes to

provide right now 46 fewer million people that need health care with something that's more expensive than any other country in the world, strapping our economy and budgets. >> so he's going to, i guess, this is something -- i mean, chris dodd is somebody who is in charge, it's his committee. >> right. >> along with senator kennedy that they got through one of these bills and he's asking -- >> he got through the bill -- >> he's asking for more presidential leadership. >> he got that bill through with over 200 republican amendments. the president will continue to work on and discuss health care. >> and that is, i mean, it's something that he will wait until he gets the finance committee bill or -- >> he'll do it. >> is it something he'll do before he gets the finance committee bill? and when do you expect the finance committee to get the bill? >> it's a good question for the finance committee and a good question for republicans. again, i haven't seen jake's letter -- senator grassley's letter. thank you.

>> "the washington post" also reported it. >> there you go. mr. fletcher thanks you for the shoutout. i do love how they put air grams on here like the plane just landed at des moines airport. maybe they've got a report. but it's a better question for those republicans that have made the type of comments that we've seen over the past couple days. >> or max baucus, he's not let you know they happen to have a bill for you september 15? >> i think his deadline, best i understand it, is september 15. >> is there any reason to think you won't seek his bill? >> it's a better question -- >> let me follow-up, there seems to be no sense of urgency on the chris dodd report. more americans are dying than at any point in this war.

>> don't misunder the fact that -- again, commip, the report has to go through -- chip, the report has to go through the chain of command and will be commented on those in the theater. >> like i want it on my desk by wednesday? >> we may have it on our desk by wednesday. i think to assume because we haven't gotten a report from the pentagon the president doesn't believe this is a serious problem, i think his -- it's an unhealthy thing to insinuate. >> on health care, senator hatch walked away from negotiations in the finance committee already. senator enzi has shown his cards and he's not interested in the bipartisan solution. what are you saying about those who are bipartisan, are republicans negotiating in good faith now? >> again, i think that's a question you should ask them, jonathan. i think, again, some of the comments that have been made, it certainly seems to suggest, i think, to anybody that reads

them that they seem to be less interested in the bipartisanship they talked about only a few weeks ago, only a few weeks ago. >> could you say what you think of the kind of gloom in the last week about the forecast for next year's election, more than a year away, in a sense that somehow the -- >> it would be like me predicting who's going to win the world series not in a few months but a year and few months. i'll let the extremely smart prognosticators that always predict with unfailing accuracy the brilliance by which americans will render their opinion in more than a year. i will leave them to their stately craft. >> robert, does the white house now believe or suspect that scott and suspects someone

because of the oil spill between the u.k. and libya? >> i don't know the answer to what caused scottish or british officials to make the decision that they did. mark, as you know, this administration weighed in repeatedly with those officials in saying that this person should serve his sentence in its entirety in the location that he was at that time, which was scotland. and we believe -- we continue to believe that's the case and continue to believe this was the wrong decision. the motivation for the british is the question for the british. >> do you know when the last time the president spoke with prime minister gordon brown since the release? >> no, they've -- i want to say it's probably been a minute or month and a half.

>> you say it's a question for the british government but is there any official -- will the u.s. government have any official trying to investigate, trying to figure out how this happened beyond just asking questions of the british government? >> don't know scottish law. i'll toss that softball to you guys. i just know what the administration did in weighing in and what the administration has continued to say about the actions. but beyond that i don't have anything for you. roger? >> on the japanese elections, japan wants closer relations with china and russia, is the u.s.-japan alliance going to change as a result? >> no, we believe we have always had a strong relationship and that

relationship will continue regardless of who is -- what japanese government is in power. i think obviously there are a great number of regional issues that we've discussed many times in here, particularly the actions of the north koreans that might lead the japanese to seek better regional ties from their allies. we certainly wouldn't begrudge that and believe the relationship will continue in a strong way. >> the new leader says he wants to move japan away from u.s. dependency. >> well, i don't -- i don't know what dependency he's referring. >> do you expect a change we might see as early as the g-20 in pittsburgh? >> none that i'm aware of, no.

>> the a.p. is reporting governor blagojevich's new book says rahm emanuel asked him to see if they have a placeholder when his house seat is back two years as house chief of staff he can go back and win the seat again and pursue his ambition to become speaker. can you tell us if that's the case? >> i have not -- i barely covered with rahm what will happen the rest of the week. i've not talked to him about that nor have i -- i've not seen the book by the indicted former governor of illinois. >> that never came up in the transition you're aware of? >> no, not that i -- i do not remember any discussion about that. >> on afghanistan, the previous president often said he had a policy of deferring on issues of troop levels to his

commanders regardless whether he fulfilled that but is that a policy of this president he supposedly has or does not have? >> as i said to chuck, i think the president wants the report reviewed by those in the commain of -- chain of command and will want to review with that chain of command what they see and hear from this report. i think one of the hallmarks of what this president has always believed in -- believed in when it comes to making these decisions is all of those involved should have a seat at the table and the president should and will listen to their opinion. >> it was basically said if a commander asks for it there's nothing he wouldn't get, is that it? >> but what was sitting on the general's desk or yen mckeernen had written a request for troops for more than a year before we got here. i'm not sure that's a standard

by which to measure that. >> is that the policy of this president? >> i think the president is anxious to continue discussions about afghanistan to see what general mccrystal, again, the commander that he was supportive of putting in place in a very dangerous and challenging part of the world, see what he has to say about going forward and decisions about troop levels and further resources will be made when that comes. >> as a natural disaster, the fires north of los angeles are proportions, is there any need for the president to get involved, or does he have any kind of updates onçó that? >> i can check. i assume he gets a regular update, we all get regular updates on these types of news events. and these types of disasters. i assume as part of his daily briefing this morning, he was briefed on the situation in

local, state, and federal response. yes, sir. >> robert, former senator bradley said over the weekend he suggested -- >> busy former senators. >> including torte reform might help to win republican support for the health care reform. is that something the administration sees? >> i would inform you to what the president talked about in front of the a.m.a. >> it's a little hard to say exactly -- how far he was willing to go in his a.m.a. speech. [inaudible] >> voila. that seems to be good business these days. again, i think there's at least a healthy amount of evidence that in many states that have seen caps like this you haven't necessarily seen decreases in insurance costs. bless you. i think, again, president is willing to consider any number of approaches but there have to be people on the other side of the table to respond to -- to

respond to those gestures. i'm concerned i think a lot of us are, that the people in those chairs seem to be leaving more rapidly than the american people want them to. yes, ma'am. >> if you put health care aside for a minute, are there bright spots on the legislative calendar that the white house is looking forward? how is the climate change bill going from the white house's perspective right now and anything else that you've flagged? >> in all honesty i haven't heard an update on where energy legislation is in the senate. you know, obviously we've, i think, a very important date coming up in mid september marking in many ways, i think the date that most americans in their mind begin to see the real impacts and affects of the deteriorating financial crisis with the collapse of lehman brothers.

i think a major push from this administration and i think from members on both sides of the aisle on capitol hill with the efforts to reform the regulatory mechanisms by which our financial institutions have to operate and i think that will be a very important part of the legislative agenda moving forward in the fall in strong hopes that by the end of the year we have new rules of the road going forward so that something like this doesn't happen under the same circumstances again. >> has president obama talked about anyone about the anniversary of katrina. >> i don't know if the president made specific calls last week to new orleans. >> also, during the campaign for oval office, there were

reports u.s. troops were tired then, what have you, what are the reports that this white house is getting on troop strength, their attitudes and things of that nature right now as we're possibly talking about putting more troops over in afghanistan? >> look, i think there's no doubt we have a military that is -- has been called to do a lot of things in a short period of time, that it has trained our military, that it has strained relationships with soldiers and their families. we've seen -- i think the president talked in many ways about this in phoenix when he spoke there about ensuring that we protect those who protect us, and that secretary gates has outlined a speeding up of the expansion of our armed forces in order to meet the commitments that we have around

the world. i think obviously one of the things that this president talked about a lot before the campaign, during the campaign and certainly implemented afterwards is withdrawal of our troops from iraq as a way of lessening the burden that we see going on in our military. >> and also, last question, senator kennedy's letter to the pope where he says, i'm committed to doing everything i can to achieve access to health care for everyone in my country, what has the president said about that, what is anyone around the white house saying about this especially at a time the words "choice" and "competition" are at the forefront instead of what it used to be, access for all? >> choice and competition is one aspect of what one has to have in the insurance market to ensure that those who don't have access to affordable insurance have that ability to get it. you can't have access without

that choice in competition in a market that's dominated by one insurance company. i can assure you the president shares the late senator's -- the late senator's goal of ensuring that every american in this country has access to affordable health care coverage, that's strongly in our interest. david? >> two quick questions, is the white house preparing to push for the creation of a financial product safety commission this fall? is that what you were referring to in part? >> i was referring to the larger financial regulatory reform. i know, obviously, part of that is a consumer -- something that will take up the tasks of -- and be the advocate of consumers. that's obviously will be a strong push of the administration. >> secondly, going back to afghanistan, how would you define winnable? as it relates to afghanistan.

>> i think the president and his advisors have talked about disrupting, dismantling and destroying al qaeda and the extremist allies. we have to ensure that there are -- while there are those currently plotting to do our country harm, that we will provide them a safe haven to do that, that we have a government in afghanistan that is self-sufficient, that we have a security force in that country that's able to deal with the challenges that are presented to it, and i think, obviously, going back to april's question, our commitment can't be forever. >> it's not military -- if it's not a win, it's not militarily? >> no, no. if you don't have a country that has the governmental institutions to provide for its citizens, that is what ultimately creates lawless or

ungoverned areas that can spawn the type of extremist activity that we've seen in afghanistan. >> how can you say the commitment is not forever if you set up those goals? maybe it will take close to forever to reach those points. >> i don't think it will take close to forever. but i don't -- you know, i don't know what year that would be. >> on wednesday the administration is going to host a clean energy economy forum in saginaw and i was wondering why did you choose saginaw and what does the administration hope to accomplish with the forum and how are the stakeholders being chosen? it was interesting that it's invitation only, if you're trying to get people awarir of the president's -- >> let me find some information about the forum and get back to you. thanks, guys.