miss something. does not miss anything. we have to follow into the footsteps. european solidarity. the foundation of solidarity can be created only by concrete actions, by common basis, upon which we can did visit -- develop ourselves economically. with democracy and human rights. the european union is a great value in itself. in the global world, it supplies reliable partners be a we need cooperation with russia, the united states, and other countries. today, we're here together, and that has great value in itself. itself. we are responsible for the reconciliation of the european

nations. i want to pay tribute to those who are fighting and the defense of freedom. we europeans shall remember. we shall build, we shall build europe which was worth you -- we shall build a europe which was worth your great sacrifice. thank you. [applause] >> will all please rise. what is now here the role of honor. -- let us now here the rolar thf honor. >> we gather here on

westerplatte on the 70th anniversary of the outbreak of the second world war, the most terrible of the cataclysms' of the 20th century, paying tribute to all its victims. maybe it remembered forever. -- mayday be remembered forever. -- may they be remembered forever.

♪

>> now i would like to ask the prime minister of poland, francois fillon, to take the floor. -- the prime minister of poland, donald tusk, to take the floor. >> why?

why here? why now on the first of september in gdansk? and not in some places -- and not in some other place that the leaders of europe have gathered? why in gdansk, and why on the first of september? why do we see here leaders of poland from the previous year s? why here in gdansk on the first of september, veterans are meeting together with young people? it wasn't gdas -- it was in gdansk on the first of september

that the most terrible tragedy of mankind started and the symbols of that global tragedy can be seen everywhere that we can look here, where the first soldiers lost their lives, the first soldiers, but victims of the nazi invasion of poland, exactly here in this place. let us look a little bit further to say -- see the barbwire of the camp, the concentration camp. there were so many concentration camps that were created by that war against humanity, against mankind, and it was in that camp that poles were killed,

russians were killed, jews were killed, and germans were killed. if we look in the other direction, we would be able to see of forrest not far from a small village -- a forest not far from a small village. it was there that in the first weeks of the war thousands of people were gathered. polish teachers, engineers, but also soldiers and people who are absolutely innocent. and they were shot down in many places. in many forests this terrible secret was hidden. this boarwar has its terrible ad

tragic face, because it was here germans with a sign of a swastika or assembling hundreds and thousands of their own countrymen, the disabled, mentally disabled, and they shot them down also here in the forests. hundreds of thousands of poles were moved away from their homes in the first week of the war, but if we look further on, very close to my home, we can see the cemetery of russian soldiers, thousands of young people who lost their lives here in the early spring of 1945. as i have already mentioned, they gave their life for

liberation although they did not bring freedom to us, but we pay tribute to them. and we care for their graves. why am i speaking about those examples of the cruelty of the war? i am doing this because all of us are deeply convinced that the remembrances of the cruelty, the remembrance of about destruction, of people in people's -- of people and peoples, it protects us from the danger of the next war. nobody in the world sustained more. as they remember the events from gdansk and all over the world,

in that period nobody who has the basic responsibility will never do anything to allow this to return. the remembrancer roots are, and responsibility to make sure that a second tragedy never happens again. but gdansk is the home to many polls. blackwell and said i can see here, but hope of many solidarity -- all at: lech -- lech walesa i can see here, the hope of many solidarity. it is possible that base to the things that we remember, says

that war will never happen again. those of the samples values. however here on the first of september, everybody from moscow to row, from london to paris to warsaw, from stockholm to slovenia, the balkans, from the baltic states to the united states, everybody without of section -- without exception, we must say today that we share those values and that they will protect us, that freedoms must be better than slavery, that democracy is always better than dictatorship, that truth is better than lies, that love is better than hatred, but respect is better the content, and trust is better than this trust.

and finally, the solidarity. i do not know a single person who would be speaking here in the audience, dear countrymen, who would not share these values. it is on these values that we found in europe and it is on the values that we have found the order of security which will cover not only be united europe but a whole continent, including ukraine, belarus, and others. we're here to give testimony that in spite of the tragedy of history, in spite of the tragedy, our nation's suffered we believe in interest crust and consequences. otherwise, such a meeting would

never make sense. different interpretations of history are allowed. everyone has their own remembers. but the facts that we interpret differently audubon when nature only. we want to remember the facts in order -- not in order to use history against others but we want history to become the foundation of peace. we want the truth about the event to become the foundation piece. today we remember the holocaust of the jewish nation, of those who lost their lives and who were murdered. 90% was destroyed here. leningrad, dresden -- we poles remember a city particularly. we also remember the words which were the symbolic beginning of this most tragic of course, at

all peddler on the 22nd of august in a meeting with his generals -- adolf hitler on the 22nd of august said something that was the essence of a nightmare. he said, if you are a winner, no one wall shut down from the lies that you said. he said that only the strong are right. in the order that we wish to build together, there is no room for this. we want to continue building in europe and the world the order where it is not the strong that is right but the one that is right is right. it is not the winner that says

what is in the interests of everybody, asserting it. if we want to build the order of security, we have to resist the temptation of the domination of the strong over the week. -- weak. there are the principles founded of the united europe. i want to say that there would be no point in organizing in this. our common belief. in order to access the history

and the temptations. we are hill heat -- here to build trust and confidence. speak the words that for thousands of years has been said here and westerplatte, never again. never again, war. bank. -- thank you. >> we invite now miss angela merkel, the chancellor of the federal republic of germany. >> mr. president, prime minister, colleagues, excellencies, ladies and gentlemen today, 70 years ago, a

most tragic chapter in the history of europe was ushered in by the german attack against poland. this board broad and as a role -- immeasurable suffering for many people. yet brought years of that provision -- it brought years of deprivation, of humiliation, and of destruction. no other country suffered as long under german occupation in history as poland. particularly about part-time is that we're talking about, the city -- the country was devastated. cities were destroyed. there was hardly any building left that was not in ruins. lawlessness and violence characterized daylight, and hardly any polish town was spare this experience. garrett westerplatte, high as

german chancellor remember the fate of all poles on whom untold suffering was inflicted under the criminal german occupation. this culminated in the hollow cast -- the holocaust, the systematic persecution in murder of jews in europe. i remember the 6 million jews and all those who died a cruel death in german concentration camps and extermination camps. and i remember the many millions who lost their lives and fighting and resisting germany. i remember all those innocent people who died of hunger, cold, and disease through the violence of war and its consequences. i remember the 60 million people who lost their lives in a war unleashed by germany. words cannot adequately describe the suffering inflicted through

this war and the holocaust. i bowed my head before the victims. we all know the horrors of the second world war cannot be made undone. the scars of remain forever visible. but to shape the future in the awareness of our everlasting responsibility is available. it is an experience that europe has changed from a continent of terror and violence into a continent of freedom and peace. that this was possible is nothing short of a miracle. we germans shall never forget and have never forgotten germany's partners in east and west pave the way for reconciliation. you reached out to us germans, stretching us at hand in the

spirit of reconciliation, and we grasped it with gratitude. indeed it is truly a miracle that this year we not only remember the dark chapters, the bis said unit -- of european history that we need to remind ourselves of, but the miracle that we can remember those happy days 20 years ago which brought us the fall of the berlin wall, the reunification of germany, and european unification. for europe's quest for freedom is only truly fulfilled was the iron curtain came down, and the tradition of poland, people everywhere bravely pushed open the gates to freedom. we germans shall never forget this. we shall not forget the role of our friends in poland, hungary, and czechoslovakia, not the role of mikhail gorbachev and our western partners and allies, and we shall not forget the cause of

moral suasion and truth that no one embodied more convincingly incredibly thin pope john paul ii. that is why it was particularly incumbent for germany to stand by poland's side and by the other eastern european countries when they decided to become members of the european union and nato. indeed, it is truly a miracle, a great blessing that we europeans may live in peace and freedom. and there is hardly anything that better symbolizes the difference between 1939 and the close cooperation between germany and poland and in many friendly relations between our countries. it is the underlying strength of european unification and germany's trichet with his patience that we decided to face up to our history. in a recent declaration commemorating today's events, it

was put so appropriately in a quote, "together we need to look into the future toward which we wish to go without forgetting the historical truth in all its aspects nor never belittling @." when we remember the fate of all of those germans who lost their homes as a consequence of the war, we invariably do so in exactly the spirit described by the bishops. we do it in the awareness of the responsibility of germany which was there at the very beginning of war. we do it without ever thinking of reigniting anything that -- releasing the responsibility of germany. this is -- this will never happen. and it is exactly this. that i have come here -- and it

is exactly does that brings me here to this beautifully restored city. i am deeply moved it that you have invited me in my capacity as germany's chancellor to this commemorative ceremony here today. i see this as a sign of our good, neighborly relations based on mutual trust and our true friendships between our countries, between the people of germany and poland, and for this i am truly grateful to you. >> i was like that asked the prime minister of the russian federation, vladimir putin -- i would like to ask the prime minister of the russian federation, vladimir putin, to come forward.

>> distinguished guests, mr. prime minister, distinguished ladies and gentlemen, colleagues, friends, we representing different countries have gathered here today in gdansk were the first salvos of the first bloody and violent and dangerous war in the history of mankind took place. we have gathered to pay -- to pay tribute to the exploits of the winners at it and also to been our heads before the memories of the dozens of memory -- the dozens of millions of those paris soldiers -- of those perished soldiers. those who died at hands of the

torturous at a confession cans. -- at the concentration camps. people who are not spirit -- not spare. the victory in the fight against nazism has been achieved with a humongous price. [unintelligible] over 53,000 soldiers and officers of the red army gave their life. 600,000 of my compatriots are buried in the polish land [unintelligible] and out of 50 million of the people buried during the second world war, over half of them

were citizens of the u.s.s.r.. just think about this humongous figure. our moral duty, the duty of all peoples, to dearly cherished enamoring of the eternal -- too dearly cherished memories of the eternal alliance and dramatic events of our history. recall the first days of the war. what prompted the world to this? what were the ideas of appeasing a potential aggressor, the attempt to secure one security at the expense of one's neighbors? primarily the back door intrigues, plots, the second world war started not at once -- its roots, and i agree with

those who mention this, and the weakness of the treaty of versailles, which not only registered a defeat but also humiliated germany and the wake of world war i, which was used by not he's coming to office in the mid-1930s -- by not seize nazi -- which was used by nazis coming into office in the mid- 1930s. we need to for sake political stereotypes, passed it was, and distortions of history or keep silent. it is important to understand that cawhile talking about world war ii, knots in their

accomplishments -- it will result in tragedy. this is not at all any cooperation, but at plot with a view to addressing problems. one needs to admit that all the attempts made since 1934 until 1939 to appease not senazis, wee from a moral point of view unacceptable. and from a political perspective, senseless, harmful, and dangerous. the combination of all of these acts brought about this tragedy, the beginning of world war ii, and naturally we need to admit such mistakes. our country has done so.

parliament has condemned such pacts, and we are right to expect that in other countries, too, which made a deal with these nazis, they should do the same, and not only the level of the political statement of leaders but in actions to be adopted. naturally we need to think about the victims. without a deep understanding of all that occurred, it will not be possible to build a really secure world, to eradicate the legacy of the cold war and your remove the of -- remove the artificially dividing lines. my country not only in midst to the errors and tragedies of its involvement over the past but makes a practical contribution in building the world on new principles.

my country is making it possible to remove a virtual and real berlin walls and to set up prerequisites to build a new europe without divisive lines. @@@@@@@@@ kb build on the cynical distortion of history. this policy should be based on a common moral and universal legal principle, and in this manner, we can overcome the tragic stage of history of world war ii for the sake of the terrorists. as an example of how we can treat such wounds of the past, there is the relationship between russia and germany. . ver the

years, and they were above the historic scoring and settlement of those scores. .

thank you for your kind attention. >> now i would like to invite the prime minister of friends, francois fillon. >> mr. president, mr. prime minister, ladies and gentlemen, europe's strength, it shared history is forged and ordeals. one of these was on the first of september, 1939.

poland went through great sacrifice, but it bought for the honor -- it fought for the honor of europe as a whole as it did again in 1980 under the banner of solidarity. that is a deep emotion that brings us together today, a complex emotional built of greed, bright, remorse, admiration, and hope. it reflects the changing destiny in of a continent driven by war and divided and then united. divided and then to united -- then it united. the first cries were heard in the terrible conflict that would

become the bloodiest known to mankind. the 200 polish soldiers responded to the shelling of an enemy barrel ship by giving us a magnificent lesson in faith and heroism that the country has upheld in the face of the cruelty of war and the harshness of a authoritarianism for more than two centuries. from the very first hour of the war, the polish resistance rose up and proved more lasting than that concrete a plot houses. few weeks later, the polish army was defeated. nine months later, general de gaulle saw friends in turn overrun by the enemies mechanical force, striking on land and from the air. in this bloodbath, history revived the age-old solidarity between france and poland.

our two countries have always fought side by side for their freedom and for that of europe. on the 20th of september, 1939, the polish government in exile set up its headquarters in france where the general raised a free polish army of more than 80,000 men before the french defeat in june 1940 forced him to move to england. the polish government in exile arrived in london in the english capital on the 18th of june 1940, the same day it when general de gaulle broadcasting on radio london declared no matter what happens, the flame of french resistance was not be extinguished, and it will not be extinguished. for six years, our two

countries, the freedom loving men and women of our countries fought against barbarity. french, polish, and frank a polish soldiers with their lives on the line -- put their lives on the line. polish volunteers risked their lives. the first armored division took part in heroic fighting on the coast of normandy. i would like to pay heartfelt homage to the people -- to the polish people and their fighters, to the men and women who risked everything in the home army and resistance in

their churches and schools, in clandestine universities, in order to accomplish what honor dictated. i am thinking of those who overcame indescribable despair and took part in the warsaw ghetto uprising and the warsaw uprising. i am thinking of leading polish figures, the heroes of the jewish community and the righteous among the nation's, the man who founded the jewish come back organization with his comrade 66 years ago and saved more than 2000 jewish children', and a 17-year-old catholic student who became the main interpreter of the country's moral and intellectual imperatives. we shall not forget the light

that their actions shed in a time of darkness, and we would like to talk of the future under their auspices today. ladies and gentlemen, the european idea of peace has been nourished by the most prominent minds of the past centuries, and is now embodied in our european institutions. after the war, a renewed germany played a major role in creating these institutions, and russia, which has now been transformed, is in dialogue with them. the foundation of this european union is a shared political determination. its ramparts are unchanging values, the foremost of which are respect for national sovereignty, human dignity,

individual rights, an absolute rejection of any discrimination based on race, gender, origin, or belief. for centuries, gdansk symbolize everything that could be achieved through cooperation and conduct between peoples, with the enthusiasm generatedy solid guarantee -- solidarity and the spiritual strength of lech walesa, it became a bastion for civil liberties. this is where several of the innermost convictions that enable us to live and work together airborne. today, -- were born. today we find ourselves not only a outskirts of europe, but at its heart, in a major european country.

the election of the president of the european parliament has crowned poland's exemplary integration into europe. we now face a number of shared challenges together, such as the economic crisis, global warming, promoting the technologies of the future, security, energy security, the fight against terrorism, and control of migratory flows. the european union can meet these challenges, provided that its members have the political will to implement the solutions. i know how ambition -- the contributions poland cannot make. poland should become without support and friendship, a place where the future is invented.

in the very heart of gdansk, across from the old box, -- across from the old docks, there is a vacant piece of land were: can create and build. this means that the tragedy that started on this very spot 70 years ago show not only find its end, it will also find its answer. [applause] >> we now invite the prime minister to speak.

>> dear mr. president, dear prime minister, your president of the european parliament, your excellencies, ladies and gentleman, we meet today at a place of battle, but also a place of liberty. 70 years ago, polish men and women defended here their nation and their country. from here, darkness fell across europe. free nations found themselves in slavery. ukrainians, jews, poles, russians, the french, and many other nations cried out from the concentration camps. holocaust was gaining strength. million sprayed for liberation from despair -- millions prayed

for liberation from despair. over 7 million ukrainians joined the war. every second of those who survived remained wounded and disabled. all in all, at the front and concentration camps and mask. actions, almost 10 million of my people died. together with the other nations, we have paid an extremely high price, but we have been able to overcome, and not only to overcome, we have one -- we have won. you can close your eyes to reality, but you cannot closure eyes to memories. so it is right and proper that we meet here, where europe's enslavement began, and where do

rejigger two decades ago, its liberation, complete liberation took place. few of those who survived the battles for poland are with us today, but the memory of their courage lives on in all of us. as well as the memory of all those who perished at those fronts, but today, many of their sons and daughters of poland, the men and women of solidarity who completed their struggle, they are with us today, and their courage is also our inspiration. today, in their memory, we are marking not so much the beginning of war, but rather the triumph of liberty. we reaffirm the unity of the people who fought a war of liberation, who came to join hands in an unbreakable bond of peace with those who were once

at the other side of the front. it is only this unity that can make us in vincible. today, this unity continues to keep us free. our history, since those dark days, has shown that countries define themselves by the choices they make. those who endured the bitterness of invasion, occupation and defeat, could be filled with resentment, hatred, and desire for revenge. in the years after 1945, all of europe could have moved in that direction of recrimination and rage and escalation of tension, but europe started looking for a new solidarity. a handful of nations, in forging the european union at of the ruins of four.

a favorite poet of mine which road to -- once rode, even in our sleep cannot forget which drops by -- drop by drop upon our heart, the degrees of god. 70 years of painful memories have brought us to drop by drop to the wisdom to know that what we need is not a vision, what we need is not hatred or violence or lawlessness, but rather generosity and wisdom and compassion toward one another and a feeling of justice toward those who suffer.

so as we remember those who sacrificed their life or liberty, i pray for the compassion and understanding of which i just spoke. in victories over terrorism, do not mark the end of hate, and did not bring in into lawlessness, gdansk, poland is now part of a free and united europe. this is what you polls have chosen. this is what you just to make of them. and as i close, let me ask you to ask all of us to look beyond the worries of today to the hopes of tomorrow, be on the freedoms that you now enjoying to the advance of freedom everywhere, beyond memories to the day when all of europe and all of the world will be united in peace and justice. all of europe and all of the

world will be united in peace and justice. our challenge today is a matter of healing the will. so as we recall the soros and scars of the past, as we celebrate the triumph of freedom, let us rededicate ourselves to what the ancient greeks wrote at the dawn of europe, to tame the savagery of man and a gentle the life of this world. now about to all of those who gave their life away -- i've out to all of those who gave their lives away to make peace for us all. this is a great honor to be with you on this sacred day. [applause]

>> now i invite the prime minister of the kingdom of sweden who currently holds the presidency of the european union. ♪ >> president, prime minister, excellencies, distinguished guests, ladies and gentlemen, 70 years ago today, we saw the outbreak of a storm, a storm that ravaged our continent and spread throughout the world. world. ii had begun. -- world war ii had begun.

a battleship suddenly opened fire on the polish garrison. in the years that followed, we saw nations ball, democracy stumble, and people enslaved. we saw the destruction of in valuable cultural heritage. we saw cities engulfed by fire. we saw killing that we still find hard to understand. over 60 million people lost their lives, the majority of them civilians. this makes the second world war the deadliest, bloodiest conflict in human history. we like to celebrate the bright moments in the history of mankind, our scientific and cultural achievements, are creation of wealth and welfare, our good deeds, yet we know that

man is not simply the genuinely good being we wish we were. human beings are capable amazing achievements and good, heartfelt deeds, but humans are also frail in the sense of being capable of actions that can hurt ourselves or others. at their worst, these actions can cause enormous destruction. such actions have given us words like genocide and holocaust. though these deeds cannot of course be described in words. gathered here today, we call for the remembrance of one of the darkest hours in the history of mankind, and remembrances necessary. it is necessary because if not

remember, history may repeat itself. world war ii change not only europe, but the entire world. in europe, we learned a lesson that we must build a common future, not on conflict, but on cooperation. it was a painful lesson, and that makes it even more important to remember. never again. these were the words that rose to the skies from the survivors in the ruins left by the war. never again war. that was the founding pillar of the european project that we know today as the european union. the european cooperation that followed the end of world war ii was not only created as an escape from the extreme forms of nationalism which had

devastated our continent. it was also founded in order to give the people in europe a chance to build a common future, based on values such as tolerance, democracy, economy, and rule of law. from this point of view, this year is also a year of celebration and remembrance of european cooperation, integration, democracy, and freedom. 60 years ago, the council of europe was founded, and just two years later, the european coal and steel community was established. 30 years ago, the first direct elections of the european parliament were held, and 20 years ago, we saw the fall of the berlin wall and the birth of a new and free europe. certainly we have reason to celebrate, yet the celebrations

are worth nothing if we do not remember the war that 70 years ago ravished our continent. if we do not remember the victims, the survivors and the people who gave their lives to save the others, if we do not remember and honor those who sacrificed their lives to respect for human dignity, our collective memory becomes weaker and weaker, and the older generation, those who survived, disappear and can no longer bear witness. but here today, we must say we will never let this memory escape. we must remember. we must show that we have learned a lesson. today, tomorrow, and in the days to come. we must do so to ensure that two words will have genuine

meeting as we build our common future, the words "never again." thank you. [applause] >> amar celebrations have come to an end. -- our celebrations have come to an end. i hope that the message of this assembly will stay in your memories for a long time. will the delegations turned to the exit on the right, and the public will >> coming next, a discussion on the british health-care system. after that, t. boone pickens

outlines his energy plan and a senate hearing on health care legislation. >> the supreme court has s -- as a rare special session on wednesday, hearing oral arguments on a campaign finance case. it also marks the first time on the bench for justice sonia sotomayor. before that, her formal investiture ceremony takes place. ruth bader ginsberg on what it is like to work with the other justices. >> i think that you'd be surprised by a high level of collegiality here. we had divided opinions and one- third of the cases. we might get -- one might get a false impression of that -- from that. justice scalia once commented that in his early years on this

court, there was no justice within he does agree more often than just as brin and -- that he disagreed with more often than justice brennan, but he was his best friend on the court at that time. any but the feeling was reciprocated. you probably would not know that from reading an opinion by brennan or by a rigid or dissent by scalia, or the other way around. but these two men genuinely liked each other and enjoy each other's company. >> hear from other justices during supreme court week as c- span looks at the home to america as high as court, starting october 4. >> this case is on whether the court to overrule a 1990 decision on corporate campaign finance. that oral argument will be on

the same day it takes place, starting at 11:30 a.m. eastern on c-span3, c-span.org, and c- span radio. a discussion now on the british health-care system with the british ambassador for health and life sciences. from today's "washington journal," this is about 45 minutes. host: dr. ara darzi is the british ambassador for health and life sciences and is here to help us understand a little more about the british health-care system. welcome. guest: thank you. well, the british health-care system is a national health system. it was created back in 1948 by a very charismatic politician. we celebrated its 60th anniversary last year.

the principles and values are the unique -- very much in our country as part of our social fabric. health care is provided at the point of need, in respect of of your ability to pay and everyone in the u.k. and england has the right of free health care. it is universal coverage to every citizen in this country. host: so the people in great britain have a choice between private and public if they cannot afford private? then they go to the public? or is everyone under this public health care system? guest: firstly, the majority of health care provision in the u.k. is public. there is however a 10% market in private insurance.

that has been a constant feature over the years. and has reduced of the last four or five years. i will explain in a minute. as far as choice is concerned you certainly do have the choice act you wish to speak private insurance, but more importantly in our public system there is a legal right -- and this was part of the reform i took your parliament -- there is a legal right for every person seeking health care to have free choice of any provider in england. that is a very powerful lever for the patients. the whole reform agenda of the last decade is how do we empowered the patients and the public? the right to choice in the public sector is one of the most powerful levers we have in

england. host: we have a little more from tonight's show with the author of the "killing of america, a global quest for better, cheaper, and fairer health care." we will look at that and then have more conversation with our guest. >> we moved to london in 1998 and our kids and you're risking my life. my wife and i said we would make the transition as easy as possible. my 13-year-old goes over to a neighborhood, pretty dodgy one, and finds some stores selling for 10 pounds brass earrings. you have to have pierced ears. the guy goes ahead and pierce's her ears. two days later she wakes up with a swollen here. it is very painful. we have been in the country for four days and did not know where

the doctor was or anything. we got into a taxicab. the driver says no problem, took this to st. mary's hospital next to paddington station. this is solana. as you walk in the hospital and there's a gold plaque that says on october 28, 1928 sir alexander fleming discovered penicillin in this hospital. it looked like it had not been painted since 1920. british hospitals are gross and a bucket sketching leaking rain, not reassuring. but a woman comes -- she is the head of award. she takes my daughter into the room. 10 minutes later a doctor comes along. after a while she comes out and they have fixed the air, given her stern lecture on hygiene. she was cured and fine. you can imagine how i felt.

i felt great. i walked over and pulled out my checkbook. the matrons is with great pride, no, you put away your checks. we do it differently here. free, go home, no bill, paperwork. no co-pay or deductible. but turned to my wife -- and i said there are different ways to deliver health care. they haven't figured out. host: dr. ara darzi, british ambassador. is this a typical experience with the british health-care system? guest: before i begin to answer i have to declare an interest. some of your viewers may not do this, but and the surgeon, a surgical oncologist. in a fully active clinician. -- but i am a surgeon. i actually work at st. mary's hospital for your guests visited back in 1998.

may i also suggest that, or at least clarify that yes, alexander fleming did discover penicillin at st. mary's hospital. the answer to your question is, absolutely. that is what our health-care system is all about. you obviously had a very friendly driver. may i just make a plug for our taxi drivers who took the child and family to the right place. matrons are very powerful figures in our hospital and i'm glad to hear the doctor did the right thing. this is back in 1998. if the treatment was satisfactory then, a lot has changed since 1990. i was appointed in the hospital back in 1994.

-- much has changed since 1998. the whole health service has been completely transformed. host: we appreciate your candor, sir. we want to let listeners and viewers know how they can get involved. we have a special line for residents of the united kingdom. we will be simulcasting live on the bbc parliament channel. for those across the pond would like to get involved in the conversation, please do. you can also send us an e-mails or a message by twitter.

let's take all look at some comparisons of united states and u.k. health-care systems. the source for this is a "the guardian newspapers." everything seems to be relatively equal in these comparisons. your thoughts? guest: i agree.

the comparisons you are now making are after 10 years of major reform. that is why we are very proud of the healthcare system. the only difference as you have highlighted are the costs. there's a huge difference in the cost between $6,800 and $2,600 per person. if you took those very high indicators, they are equal, but there's a big difference in cost. host: how is the healthcare system paid for in the uk? guest: it is paid through taxpayers. it is through the taxes collected at the national level

and the government makes the assignments are budget expenditure as in most other public services. our current expenditure in healthcare is about 8.3% of gdp. the me give an example. back in 1998 for your previous speaker visited st. mary's hospital, our expenditure then was about $43 billion -- 43 billion pounds, which is about $90 billion. now spend 110 billion pounds which is nearly $200 billion. we have seen significant growth in the past decade. it has come with major reforms, improving access, improving the quality of health care.

i had the privilege over the last two years of working with many clinicians and colleagues to design the next decade. host: our first call for dr. ara darzi comes from california on the line for independents. caller: thank you, doctor, for taking time to address these issues. i personally am on social security in the u.s. and the simon covered basically on what is public health. -- and i am basically covered on public health. i have been on the other side where i have been denied services and have had to suffer many of the problems my fellow

countrymen have over the years. there is an obvious disconnect in this country with the idea that we can have the best of services. i would like to address this. maybe tell my country how this can work. guest: yes, well, thank you, sir for that. i support that. one of the challenges we have when we look at the debates in the u.s. is in the u.k. every person has a bright to access to health care. -- has a right to access.

it is part of our social fabric. when we look at the u.s., and i speak as a condition -- depending on the figure, up to 45 or 50 million people having no access, that is quite disturbing considering that we all look up to the u.s. in all aspects of life. on the other hand, it is quite important to make this point that in the u.s. you also have some of the best health care providers in the world globally. you should all be very proud of that. i have had the privilege of working with many organizations in the u.s., spend time in kettering in new york, no people in the cleveland clinic, at the

mayo clinic, and these organizations have got it right. they have worked very hard to improve access locally. the differences unique in the u.s. from the u.k. are different parts of the u.s. which have different local access and quality issues. that is why for me as a condition we're looking with great interest on what you're trying to do here in the u.s. it is the opportunity of a lifetime to sort out your health care system. you have the best on one hand, on the other you have issues of how to really provide universal access. could i also make a point about the universal access? i am not suggesting that our system could be transplanted. you need a u.s. solution to your problem of universal access.

how you find that is a completely different debate which must be debated and the solution found within the u.s. system itself. host: were the u.s. to try to go to universal system, how would the differences compare between a u.s. system and a u.k. system? what needs to be established here? guest: a universal health-care system as we have it is a single-payer been funded by taxation. universal health care system in the u.s. will certainly not be single-payer, or universal taxation because you have other vehicles and which you have provided coverage to many of your citizens. ultimately, if you look at the expenditure, who pays for it?

either the individual as in the u.s., or the employer in the u.s., or the government in the u.s. there is no other source of funding. if you look at those three, then you try to identify it away to provide universal health care by these three different mechanisms. that debate and the solution for it has to be the leadership of congress and senate to find the right solution. i do not believe, and neither do i think that the model we have which is 60 years old is the model for us, the model you employ in the u.s. the principle of having universal cover, whether by the individual or by the government, i believe strongly is the correct model.

if you look at most industrial countries they have universal coverage of some sort. but host: we are talking to the british ambassador for health and life sciences. our next call comes from austin in manhattan, kan. on our line for republicans. caller: yes, it is always great to be able to speak on c-span. i watched the show on a daily basis. first of all, a lot like that the doctor for his fine compliments as far as our -- i would like to thank the doctor for his fine compliments to our health care providers. i am sure the doctors in this country provide the same courtesies to their patients. a couple of questions. on the universal, we had an example of an individual that it

brought his daughter in for an ear infection. my first question is, what about as far as a more extreme case such as cancer or somebody with more long-term medical condition? is that also all paid for through the taxation process, because it is all paid for by the government? question then is, what are the taxes per individuals in come? how does that compare to the u.s.? one of our major concerns is right now we're looking at robbing peter to pay paul. people in the u.s. are more concerned about their taxes being raised to provide for this

care. eventually, i know we will have to raise taxes. host: thank you for your call, austin. guest: as far as cancer -- my specialty is cancer surgery. i'm a surgeon working at st. mary's hospital. the answer is yes, it irrespective of your condition, cancer is very much -- every healthcare is universal and free at the point of need. many things have happened in cancer. if you look at two decades ago our cancer mortality rates were not as good. a significant amount of reform and funding has gone into cancer treatment.

one area i should qualify is that every u.k. citizen is registered with the primary care physician. if you have any symptoms you good to see that primary-care physician who then makes the referral to a hospital. say a patient has a high -- the general practitioner feels there is a suspicion the individual might have cancer, that patient is referred to my clinic. i have to see the patient within two weeks. once a i see the referral letter, the patient who might have the suspected cancer is through the whole cancer pathway to see me, it get the diagnostic tests done, the diagnosis established, the treatment which is surgical it

that cancer needs it, and then referral to the oncologist if the patient needs further chemotherapy. the first part including the surgery is done within 18 weeks. if the patient is receiving chemotherapy, then that one goes through treatment course for up to six months. all that is covered. as far as long-term conditions, and you're absolutely right to ask about that question -- one of the impact of technology and innovation of the last 50 years -- we have in away transformed something that is a legal into a long-term condition. in england we know that we have 17 million people with long-term conditions. the biggest or diabetes, heart failure, as my, depression, and others.

the management of those are mostly done in primary care by your general practitioners who are well-equipped to manage them. as the burden of long-term conditions is increasing we are investing more in primary-care. we are improving care to prevent readmission to hospital, the costly bit of long-term conditions. because if you look at some figures, not necessarily in the u.s. but in other parts of the world, long term conditions is one of the big challenges facing us in the next decade or two because it could be extremely costly if you treat long term conditions in hospital environments. it is best treated by prevention. how you prevent someone getting

a relapse of asthma? someone getting a relapse from the chronic obstructive airwave disease? such as with emphysema? the best, most effective and cost-effective way is through your primary care physicians. that is what we call the general practitioners. that is the rock of our health- care system. host: your next call comes from london. caller: good morning, we are in anglo-american family. my husband is 72 and a u.s. resident and u.k. residents. we would like to use his example and that of my 86-year-old mother to give the lie to the fear mongering spreading in the u.s. regard to -- were guarding the palace. my husband has had non-malignant carcinomas removed recently

superbly. two cataract operations, success super. he contributes as a u.s. citizen to american medicaid and is happy to do so because we believe is right for all citizens to pay towards the health care of all. regardless of whether he personally will ever benefit from that. my 86-year-old mother had a heart attack last year. her post-heart attack care has evolved ct scans, specialist, hematologist, cardiology, diabetes care, specialist nursing, and this for a 86-year- old lady. please, please, pass the message to all our friends in the u.s. -- do not believe in that panels. they do not exist here. thank you.

host: dr. ara darzi? guest: i'm delighted to hear this, someone who works in this and has the experience. it is the pride of what we do. that is what we hear from our patients. that is a fantastic example of someone with good experience. we may not do this with every patient. no health care system is able to do this with every patient. this is why over the last two years some reforms we have introduced -- and i have taken the bill through parliament. from now on every provider in england will publish on an annual basis something called a quality account. besides the financial accounts of the company, a hospital, they will provide the quality accounts. the patient experience -- we all love to hear the experience of

patience as with one of your previous speakers -- will be published openly, a transparent, and patience will make choices based on these. the concept of death panels -- yes, it has alarmed many of us when we heard some of these statements made. as one of your -- the person who just spoke to us, people are very proud of our health-care system. however, people always want to improve it. there is no health care system that should stay. we're always trying to improve it. how do put the investor sure to actually improve your health care system? host: we have a message from twitter.

on top of that i will ask you, how are doctors in the u.k. actually paid? guest: it depends on the specialties of the different doctors. that is no different than the u.s. the pay is very different in the u.s., but in the u.k. hospital doctors have a salary. it is a nationally-agreed salaried negotiated by the professional bodies and that has been seriously reformed over the last five years. . . their businesses are small independent businesses but their pay is, i think, much higher than a general practitioner is

paid in the u.s., and i think that is the challenge you had in recruiting more people into general practice. but that was reported back in 2004. -- reformed back in 2004. some are paid significantly greater than us, but the overall average, we are paid -- the differential is not that great between the us and the u.s., what the one difference in net your system has fee-for-service while ours is salary. that has a different impact on the actual condition, whether you are a doctor providing help. host: these doctors that are salaried, are they considered government employees? guest: they are actually employed by the provider of the

health care. guest: they are not government employees but provided by the health care. there is a misconception in the u.s., most of our providers are called foundation trust, they are independent of government. but they provide care for patients who are obviously through the single-paired system are funded by the government. so they are governed by the organization employing them. but we have a national agreement of what the salaries of such doctors should be. and there are local bonuses and incentives and others provided at every organization and at the local level above the level. host: ara darzi is a member of the doctor of sciences and he's

a practicing health surgeon and at the imperial college at london, and provides information in the use of surgeon robots and he was knighted in 2002 and considered lord darzi, a former member of the house of lords. back to the phones, elria, ohio, wally on the line for democrats. caller: that's ok, thanks to c-span and the hosts and the great guests you have on both sides of the story. my comment in question to dr. darzi is this, most of us agree that last year's economic collapse was predicated caused by greed on the parts of many

people, the people mainly making money hand over fist. you know, for many years. and would dr. darzi agree if there isn't any fiscally-responsible health care reform passed through the government, that would be caused because of greed, does dr. darzi believe that wall street and greed would cause no reform to come to our government? host: dr. darzi. guest: i will try to give my own views about this. i think -- well, firstly the economic collapse is straining all countries globally. and that point is well made. however, i agree with the question, one of