they can't afford the medicaid roles. >> taxes are another area. what's under consideration in that regard. the most likely major source of revenue on the senate side is a tax on very valuable health insurance plans. most people have no idea what the value of their plan is. many high income and union workers get generous benefit that's kind of flow through the system without being taxed.

>> because it is part of their package? >> right. a lot of conservatives would like to start taxing those benefits. it's the largest loophole in the tax system. but that's not going to happen. because so many union workers benefit from that. sort of like a mortgage

deduction. doctors and hospitals practice this in order to avoid lawsuits. this has created a lot of doctor shortages across the country. could this receive the

negotiations? >> we'll hear from the government in this 20 minute debate or so over med i call liability. >> this amendment is to improve access and medical care. improving access to improve rural communities and essentially among primary care physicians? it takes on the issue directly. let's be honest about it.

if they changed that law to where it become a doctrine of employed concept. the liability especially to

gynecologist and especially in rural areas. every case goes to the jury, even if there was no negligence. you could have run away jury verdicts. a lot of gynecologist and ob stit rishians, we've had a lot quit their practice.

this amendment is aimed at eliminating needless elimination costs. we had a doctor who would testify against any debtor, no matter what. he would make a case that would

go before the jury we told doctors, if you do get sued, you can then say, look, i went way beyond the standard of care in the community. i did everything i possibly could against every procedure and device. every drug, bingo, bingo, bingo. at least you would have a very good argument in court that you did everything that a great

doctor would do doctors do the necessary procedures and approaches at minimum >> the cat scans, mris. we don't do anything about them.

one of which is medical liability. >> they can make a lot more money and a lot of things. >> unnecessariry meet up. imagine what it would really be. it was many times that. they do know it. i know it. today, it is far more than that.

it would enroll those in other areas. this amendment. in suits against these doctors that are particular vulnerability. i'm the first to say that there is negatively against. we mentioned the wrong leg, wrong eye, wrong kidney.

these were they were mistakes made by some top physicians. some are between $250,000 on average. if we could do it, at least it would move in that direction.

>> there might be some other reports without having to enjoy run away verdicts. this puts limits on non-economic damages. it would have unlimited economic damages. >> now i prefer maybe even for all of us to work on something better than this. if they want to get healthcare

under control. wherever they've done this type of succession. >> the problems are otherwise. personally, i think it is something we are open to in better ideas. we need to set an example here. i contend that the medicine is

eating our country alive. i don't blame the doctors for trying to buildup their medical histories so that they can try to protect themselves if they get to court. that's really what's happening. in states where they have unlimited, non-economic damages i know it is an unpleasant

subject. i'm devoted to them. it is time we start getting this uncontrol. >> senator white house. >> thank you, madam chair. let me first express my appreciation to this distinguished body. he was first a nationally recognized lawyer.

the cost of liability insurance is compromised of administrative expense. investment income, experience and the cost of the individual claims. in dealing with all of this, the one place the insurance company chooses to turn its guns is on high claims. this is experienced by the people who suffer the most devastating injuries. the couple who have to come home with a damaged infant, which has completely changed their lives.

they will carry the burden of care. their whole lives are turned upside down by it. it's from them that this place is a burden. the person that comes home so severely disable pd and disfigured by a medical error, that is the person that has to bear the burden under this insurance reform.

that tip of the iceberg is part of the larger medical error that isn't lethal. actually doing a great deal to reduce the bill not to take away

the rights of people most injured just yesterday, i believe it was yesterday. it's been kind of a blur now for a while. where the saveings would be in tort reform. it's been very small. you really can't pick out defense medicine. there's so many reasons.

there is a lot of defensive medicine practice. some keeps americans healthy. some of this can't be documented for that. the last point i'd like to make. we all know the jury system can be disruptive and uncomfortable. it is supposed to be. it is often the last refuge when moneyed interests control the

legislature. our founding fathers were keenly aware of the krumgs and passing passion. that constitution found applies to the 14th amendment. a portion of the debate of medical liability the washington poft as we go tlut debate trying

a number of times as it stands now, the senate house side. you are not getting any votes if you give it away. you are going to deal on this issue, it will deal on the support. it's too much of an issue. >> the final bill when it comes

out. >> it's been focussed on the provisions. it could go in a lot of directions. democrats could try with the 60 vote majority. if that does not lead them across the finish line, they will have to find a way to go

back to republicans and bring a few of them to the table at least. that could be the only way to a successful conclusion at this rate. we'll have to see the frame of mind. >> the next piece we'll show has to deal with giving states grants with help to set up singer payer systems. how would this work? >> it's an interesting issue.

there's concern about the cost flowing down to states. >> for the medicare insuring adults without children. the government would have to subsidize it. at the left, this bill should ultimately move towards the single payer system. >> this seems to be working against this at this point.

just skktly the way it operates where there's a national healthcare system. on a cost basis around the healthcare service. hear 10 minutes of debate on a

debate to sing will payer. >> what i am introducing today is an opportunity to allow those states. it would provide a maximum of planning grants for five states a year up to 4.5 minutes. that's the maximum. if a state chooses to go forward. 24e then carry out the plan.

a grant of the subcities in the gateway not implementing the project. whatever they would have received. federal laws basing out the plan and the federal health insurance program. i used to be a mayor of a city.

i am a stlong, strong believer of using the communities as a democracy. >> mr. chairman, that is the amendment. i ask for the support of my colleagues. >> thank you for that. any comments.

>> let me first commend the senator for his passion and focus on this issue. i agree with him. let me give two reasons. this decide and all we have been going through all these days and weeks. the current healthcare system to fix the problems in the insurance market provided maybe

it would make sense to adopt this amendment. i would have particular problems with the implementation grant starting on page 6. the second shall grant the following waivers.

when you start looking at those waivers they would be required, they would include an in all the funds. providing to be used for this. all funds provided by medicaid for the chip funds. to be taken by the state to pump that would otherwise be

available for healthcare to be made availability. other federal funds to be identified and used. various of the other federal programs. there are many people in my state that very much appreciate those programs. they would be upset with the thought of their ability to put those at risk. by a state

>> what you are worried about is somebody on medicare or the benefits they have. >> those would be at least as generous. >> the concern would be that this would insert into our

current uncertainty. i'm aware of that provision you sited. i think there are people in my state receiving their healthcare who would not want to trust to the good offices of the secretary, that's all of this would be taken care of.

>> if the system is broken and the sdes prit need of repair. the public financing campaigns many have supported for years. it is dangerous to my view. as we started out. the people in our country like the plans that they have.

moving in that direction. i would take this to some degree. that's the danger i would see. open owing the amendment. everything i see about it and the legitmacy in the things i have made. thank you. applauding the senator from vermont for utilizing this laboratory as a way to expirement with a single payer

plan. the senator has laid out here what will cultivate an intense debate. it would give an example of all that we could learn from. certainlily ben fish mys taking place of the lechl allowing a far more flexible latitude. it certainlily supports the amendment >> we are watching a portion of

the debate there. giving state grants to studies setting up single payer system. it failed.

>> creating a lot of these healthcare costs, this debate among many other things is an opportunity for people to express. in this case, it has been their life passion trying to change their healthcare to adapt. a lot of what we saw was the passions stoeked by those very strong positions.

>> in a program focussed on single payer, public option and discussion of cooperatives. is any one of those ideas gaini gaining traction or the more gainful idea. what people seem to be galvanizing now. this is very early but people on both sides agrees there needs to a sort of reconstitution of the national insurance industry. a lot of the extremely popular provisions would stop insurers from denying coverage based on

preexisting provisions. the lifetime caps and barriers to coverage that people confront on a regular basis. there seems to be consensus forming around the idea of creating some alternative, possibly, only on a cat strof yik level that the government would set forth the policy that everybody would have access to or is that the individual

mandate. contracting it to like a kaiser or something. that it would be administered by a brand name insurer everybody feels comfortable with. >> is that done in any other country? >> no. there isn't the well fertilized private insurer that we have. the good new forz deal makers is that they come back.

there probably won't be any language in the bill. all these issues are still there and left pretty much where they were a month ago. it is up to these deal makers and theous to navigate. we'll take a look at about 10 more minutes of debate. >> this is real straight forward. we'll create a government-run plan, let's put us in it. we like what we got. let's demonstrate leadership by requiring that every member of

congress has to get their coverage from the plan. >> will you yield? >> i will. >> ok. i ask that the amendment be agreed to. >> let me object. . . >> we are in leadership positions. it is not good enough for us, it

is not good enough for the rest of america. >> if there rest of america does not want to participate, we are protecting their right not to participate. we should protect the right of every american not to participate, including ourselves. >> i would fundamentally disagree with that. we are already 60% of health care under the control of the government in this country. we're going to move to 80%. all this amendment says is we should take the lead and say, we will sacrifice. we will give up our right to choose. we will put ourselves as a demonstration of state and how could this will be. we will put us into that plan. >> why should we be giving up the right to choose, which we are explicitly providing for every american? >> to demonstrate our confidence in how wonderful this will work. >> i accept the endorsement of

the public option. >> if the idea -- >> i seem to mind that have caught my tinge of scarred -- karr system -- sarcasm. >> the idea is that the government plan will be available for members of staff and other federal workers to participate in if they choose to, i would agree with that. i will support that amendment, but i think the right to choose whether you buy a private plan or the community health insurance option or by your coverage through that, this bill goes to great lengths to ensure that that choice is there for everyone. it should be there for ourselves, our staff, every american. tito every american is subsidizing our insurance to the tune of $12,000 per year. -- >> every american is

subsidizing our insurance to the tune of $12,000 per year. everyone at this table. >> we're not asking anyone to give up the right to choose. just the opposite. we're giving people an additional choice that they can make or can reject. >> ultimately he will have everyone in this plan. in -- ultimately you will have everyone in this plan. you are the only one who believes that. cbo has been wrong on every mandatory plan on the cost and outcomes. we can rely on cbo just like to the much of the difference given yesterday. they said employees' wages will generally declined by the amounts of feed that was ever quite -- otherwise pay.

you will lose jobs, that is what they said today. you're going to move more. one program that creates work disincentives for the employees is medicaid. >> what does this have to do with your amendment? >> and has to do with the fact that i know where we're going. you assume we're not going there, but it never seen a government program not grow in health care. if in fact the government plan is competitive for people all said of the plan, they will move to the plan, except it will never be financially viable because the secretary will set the rates. the only way we'll have a plan by a bald head and have enough people in is to have a lower rate. just like the main public plan, the main has of public plan

right now. -- maine has a public plan right now and it is a failure. >> this may turn out to be a failure, too. i understand you did not like the idea of a public plan but the idea that we would provide that for an option, except members of congress and their staffs, who would be required to be and it, i think it is an ecological way to proceed. i propose -- i oppose it. >> i ask for call of role. >> senator dodd, aye? >> aye. >> senator murray?

>> no. >> senator reid? >> no by proxy. >> sirte casey? >> no. >> senator merkley? >> no. >> senator byrd? deegan no. >> no. >> voted 12 allies, 11 nays.

-- 12 ayes, 11 nays. and >> we're a team. >> for a while it was you and bernie samberg and now is you and me. >> you see senator coburn docking -- joking about this being called on requiring members of congress to be on the public plan, failed in the house. this is one of the few non-party votes in the committee. does this have any chance when it goes to market? >> it is certainly one of those positions that makes people very uncomfortable it, and i think that is the way it was intended.

also, like many of tom coburn's of minutes, she is making a powerful point, which is to not pass anything you would not want to participate in yourself. so many of the problems of health care because they're done in the third person, without really thinking about the practical implications. >> we will presumably steeped this session in the coming weeks or weeks as congress returns from the august recess. " you give us a snapshot of what you think will take place and how quickly they will get it done? >> first the finance committee will have to bring forward a bill. this is very unclear whether this will produce a bipartisan bill. it will certainly produce a bill. the finance committee, democratic -- dominated by democrats, will certainly be

able to pass it. it will probably be a smaller bill in scope. i think members coming back will build a little bit more conservative base on this overall cost pressure that they just do not want to take a huge risk. they want to pass something they can pay for through medicare savings and reduce tax incentives. after the finance committee acts the health will try to lift -- the house will try to lift the bill out of these three committees and on to the floor. there will be pretty extensive revisions, including the wealth of surtax that has gone over like a ton of bricks. >> this will be a markup session of the three committees in the

house? >> it will be every right of the bill before it goes to the floor. -- it will be a re-write of the bill before it goes to the floor. some of the tax options will probably be adopted by the house. the big question going forward and, ultimately is how partisan as this debate going to become and the more partisan it becomes, the more of a challenge it is going to be, especially in the senate. >> what can you tell us about the cost of the bill, especially on the senate side. >> this was scored by the cbo at about 16 billion over 10 years. that does not include the medicaid expansion. does not include the medicare changes. and and other issues that the finance committee has -- so that

is not a full committee. i>> during the course of our conversation we have seen you consult your notes. what is it like for you -- how difficult is it for you to keep track of the debate and changes? >> it is very satisfying in a couple of levels because it is very interesting material. >> i was squeezing down at my notes and one of the insurance regulations that would change policy so that children under the age of 26 could be covered by the parents plan. that is an enormous change that would affect many people those

gaps years when most people coming at a college do not have parents' insurance cannoand cant afford insurance at your own is when your mother st. -- screaming at the phone that you to get something, those slipped through the cracks in this warfare process, force raise coverage -- course race coverage -- horse race coverage that has taken over this debate. hopefully we can study that a little bit more in the months ahead because the biggest enemy to this bill or of the bill passing is people not understanding what it is. the less people understand, the greater opportunities to demonize it. we bear a large responsibility for conveying to people a clear

and concise way what this is all about. >> we really appreciate you coming by to help explain it to us. think you for being with us. did you can read -- you can read her work on line. you can watch this as well as other c-span programming by visiting our web site. we have set up a special health care have where you can you town halls, interviews, in tv ads all related to the debate. >> the debate over health care continues on wednesday when president obama lays out his proposal before agent -- joint session of congress. and watch live coverage beginning at 8:00 eastern time on c-span.

>> on c-span today, washington journal is next. conservatives discuss the obama administration's budget policy at the institute in colorado. later a discussion on the future of children's television. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> in a moment, a look at afghanistan with arnaud de borchgrave. we will talk about the fda in regulating food safety with erik olson. a look at higher education with kevin ker