for the centers for medicare and medicaid will talk about the impact of the health care bill on insurance programs like medicaid. later, we will look at the success and failure of the biggest government initiative. "washington journal" is next. . .

host: killing at least 35 people. russian officials said in the ap reporting this morning that the

number is now at 36, and they also report that the head of russia's main security agency believes the caucasus rebels are the ones to carry out the bombing in moscow this morning. here's the front page of this paper -- obama prices afghan leader about the surprise trip to afghanistan. he visited karzai and troops there. he says his main job is to thank you on behalf of the entire american people. a look at the politics behind this. they writing in this, "obama release troops in afghanistan" -- stirring up successes, and gives the president of hard from health care to domestic and foreign issues. the timing was fortuitous. what else officials believe the

president is on a winning streak and mr. obama would like to make some headway on what may become his biggest foreign policy challenge, the war in afghanistan. our question for you -- are you optimistic on afghanistan? first up, new jersey, tom, on the independent line. caller: good morning. i listened to the president yesterday in afghanistan. i was very disturbed at how he said was so important because the attacks of 9/11 came from their. and that is where they are planning our new attacks.

afghanistan did not become important until we were done in iraq. there is pipeline being built there, now in southern afghanistan. that is why our troops are there. america needs to wake up. host: so, thank you, tom. sunset, louisiana. caller: yes, afghanistan was the front of al qaeda. we dismantled al qaeda in three weeks. we have them running. we have allowed them to reassemble and come back as a mighty force. now president obama has called for [unintelligible] because many of the top leaders. in saudi arabia because the least 100 terrorists. this president will -- we would

not catch osama bin laden alive -- we will kill them. [unintelligible] this norman read this up at about sarah palin comparing her to ronald reagan. he said that she knows little about international affairs. host: where did you see that this morning? caller: it is on morning joe. this is a shame. this woman has joined a terrorist organization, the tea party. not all of them are racists, is like taking a can and throwing it at the ocean -- it will spray for miles and miles. i'm going to come up with a party going against the tea

party -- and called the coffee party. host: someone be used to it already. caller: ok, well i will come up with a different party called the x party. host: well, maybe great minds think alike. philadelphia, good morning. caller: yes, i just wanted to say on the war on afghanistan -- and i did vote for obama because i wanted change and everything. he did say that he would get the troops out of there. i am a jarhead. i just think that the suicide rate of 23 per month, down to 13 -- people do not really see what we see over there. yes, i did serve there, and it

is going very well over there. many people do not realize it is going well over there. right now my heart is racing for these young men and women over there fighting for i do not know what now. it takes me back to the history in my family with the vietnam war. host: thanks for your input. detroit is next up. you are, or you are not caller:, donald i am. president obama says that they are trying to get us out of there. it is a tricky situation. they have to shut down the taliban. it will take a minute. he is trying to get this out of there. we have no business to be over there for a decade or two. we had no business in iraq.

if it were up to obama we would not even have been over there, in iraq at all, period. host: are you optimistic about afghanistan? that is our question this morning. the president will be returning to the washington area this morning after his visit yesterday. this is a report from "the washington times." they write that his visit came against a backdrop of tension with mr. karzai and americans that has not substantially abated. since karzai was declared the winner of an election to by fraud.

-- tainted by fraud. reporting this morning from "the new york times" -- now a caller. caller: good morning, i'm calling from michigan. i do not think that we're going to be able to do as well as we think in terms of afghanistan simply because of the fact that al qaeda and the taliban do not where signs saying that their al qaeda and taliban. in short, we do not know who they are until they choose to act. also, i do not think that mr. karzai is a worthy

representative of his people based upon a number of factors, including questionable activities in terms of his brother. in terms of the poppy fields, what i do not understand is why our military has not taken action just to destroy those every time that they emerge. in any event i know that the troops are doing the best they can, and i think our government is trying to do the best that they can do, but we are in a difficult situation. host: there were some reports last week that in terms of the poppy fields the military is making it less of a priority then and the bush administration. that was not there focus anymore. caller: i understand that.

but i think it should still be a focus if al qaeda and the taliban are making profits and engaging in drug-trafficking, some of the money being diverted to terrorism. another thing that is a concern, i served in the military. one of the things i realized which is also happening in afghanistan, and one of the similarities between afghanistan and vietnam, is that you could go into a village and -- or some area, and you could search for taliban or al qaeda, and not find anyone, and troops have publicly stated its when they have been interviewed by various news media on television. that is one of the biggest

issues. our military will never know whether it is the full force of al qaeda or taliban in any given situation. in fact, similar to the situation where the cia agents were killed, you never know when you have civilian afghani working on a base whether in fact they are taliban. host: we will have a hearing for you this morning on c-span2 looking at wartime contracting particularly in iraq. in other news, to nine marks the first night of passover. palm sunday is the beginning of holy week. here this headline -- church faces sex-abuse crisis. they write that this year, the

most solid week in the catholic church liturgical calendar has been stained by clerical abuse scandal that has spread across europe to the pope's native germany. i will show you an ap story about a poll in israel that says that israelis are increasingly concerned about their country's international standing amid its most serious crisis with the u.s. in decades. it showed that only 14% of israelis define it israel's standing as good. more than 40% called it bad. your thoughts on afghanistan -- optimistic, or less? caller: i'm optimistic.

we have seen that the afghans have been successful, having just elected karzai. i know that he has been kind of corrupt. they can form their own government. the best thing about the surge -- we will be able to get out, by next year. it seems like he might be out of office. i am optimistic. all they have to do is get security and they can form their own office. another host: half hour for your phone calls. baltimore, md., kevin. caller: your first caller had it right.

we propped up this guy named karzai who is nothing but a criminal himself, and oil man. that is the only reason we're there. the poppy fields have been increasing ever since we abated. the taliban had the production under control. the heroine is making it here, to russia, and other places. for someone to say that we will catch osama bin laden alive is delusional in. the guy is not a life. i think it is all a sham. host: plano, texas, the democrats line. caller: i have to tell you, it is very interesting to hear that

you have to ask the republican callers to call in. the one thing you learn in journalism is that when you get to a point where you have so many people who are offering their opinion which is always "i, me, they" they normally do not have anything but their own in sight. but when you look at the president dropping it, dropping in on our troops, wis dirt on his suit -- when he has these huge domestic appointments, he is the cape crusader.

host: where are you going to school now? caller: i am in texas, at the university of texas. host: you said that he swooped in. what you think that the president yesterday at the end of the week, shows yesterday at the end of the healthcare? caller: welcome i think it changes the story line from the attack version from what the republicans are using, based on that the line would still be drifting in on health care. obama is so cavalier, intelligent. i think that you have to look at him as quiet intellect.

he is always thinking. this is planned by the administration. if you think that rahm emanuel and barack obama and his team is not planning every move, this has all been planned after health care was done. they planned the recess. you heard harry reid on the floor saying he would give room for these recess appointments. i'm sure that rahm emanuel had a lot to do with it. what we dead silence the republicans? host: good luck in journalism school. here is a headline -- the article, and the cutline on the photograph "obama caps the most successful week of his presidency with a surprise visit to afghanistan." she writes that looks like obama

is turning a corner in his presidency, and the question is whether he is able to gain on his gains. to huntington, md., and david on the independent line. are you there? we will go to austin, a republican caller. caller: hello. i am very optimistic about afghanistan. we have to go in with force, take up the taliban. back in 2002 -- they drove them towards the pakistan border and we get rid of them. we went into iraq and allowed them to come back and take some strongholds. we have to go in their full force, what amount -- wipe them

out. the need pop be for medical purposes like morphine. it is a cash crop. you cannot take it away from them. -- they need of poppy. looking at the canals built to irrigate, most were built by americans some 30 or 40 years ago. yes, it is a cash crop used for medical purposes which is great, but as long as it is used for hair when and not to support the taliban or al qaeda -- host: things for your input. here is a a tribune newspaper report. the troubled region is now awaiting the u.s. cash. economic aid is being held up by corruption fears as the military of pakistan makes inroads against insurgency and lawless region.

officials said the government must have, must move quickly to launch infrastructure and social service projects to keep extremism from taking root again. that is from "the baltimore sun" this morning. caller: how are you doing this morning? host: fine, thanks. caller: we have no right to go to afghanistan and talk about the corruption there when the correction is right here in the u.s. i think the terrorist we're looking for is right in texas with george bush. i do not believe that barack obama is telling us why we are really in afghanistan. it is not looking for the taliban or osama bin laden. i believe we're there to get these pipelines that will come

through and help the u.s. in the future. host: so, you are not convinced yet? caller: no, i am not convinced that they are the ones involved with 9/11. i'm still there. we had three or 4000 people die in new york. when are we going to win the war on terrorism? host: so, you're not convinced that al qaeda is behind 9/11? caller: yes, i do not believe the u.s. has proved it was them. host: this is a report about the appearance of the florida governor and his opponent in the republican primary. it is august 24. rubio has gained national

attention by erasing the enormous lead of crist. the two were on fox news sunday yesterday. here's a taste. >> the governor likes to call himself of ronald reagan republican. i don't remember ronald reagan being questioned about running as an independent. ronald reagan had a great question he asked, are you better off today than you were four years ago? for floridians there's a powerful answer. we have the highest unemployment history in our history, record foreclosures, and the governor that supported barack obama's stimulus package. it does not sound like ronald reagan record to me. the answer is easy -- the citizens of florida are not better off than four years ago. let me tell you why i'm running

for the u.s. senate. you said this is about trust, and you are absolutely right. who'd you trust to stand up to barack obama and offer a clear alternative? we cannot trust you, governor. host: for the next 20 minutes or so, our question is, are you optimistic gone off? -- are you optimistic on afghanistan? this is michael, in phoenix, arizona. caller: yes, i wanted to comment on the last caller from maryland. i totally agree with him. the u.s. has not proven why we went to iraq. it has not proven by we have

gone to afghanistan. i just wanted to agree with the last caller. we have no business in these islamic states, trying to show them how to run their countries. we need to run our own country properly. host: thanks for your call. this is the lead story from "the new york times" -- the obama team is split on tactics against terror. senior lawmakers in the obama administration are deeply divided over some of the counter-terrorism powers they have inherited from former president george w. bush, according to interviews and a review of legal briefs. huntington, md.. this is david on the

independents line. caller: i'm not optimistic about afghanistan. it has all the elements of the early vietnam war. the corrupt government, the mountains to run and hide in. and the outside government backing the troops. according to the journalist to called in earlier, the democrat, talking about obama being a cape crusader -- when george bush came on like that called him a cowboy and said it was bad for america, and now they're saying it is great with obama acting the same way. i don't see a difference. people complain about going into iraq -- i disagree with president bush going in there. for those asleep during the 1990's, we were at war with

iraq, nearly every week hearing about u.s. military shooting down another iraqi airplane. the war has been going on. before you journalists students go up here spotting your ideas to america, learned a little american history, please. host: on the republican line, okla. caller: good morning. i'm not optimistic at all about the chances to be successful in afghanistan. it is called the graveyard of empires for a reason. the taliban would just sit back. there will wait us out, wait for withdrawal, and then we will have more of the same. to the young journalist the cold in calling obama batman or whatever -- that is just absurd.

the offense is not just to republicans or independentss, but to democrats and to all americans because you are belittling the president of the u.s. down to some comic super hero. why is the u.s. military being kept in stonewalls and places like kabul? they're not doing much in the countryside. they are being held in the stronger areas where they can keep themselves protected. host: corbin, kentucky, on the democrats online. caller: i was watching news reports before the war began with the taliban executing helpless women for practically no reasons at all in the soccer stadium. since our troops have gone over there that nonsense has been

stopped. i fully supported george bush and a matter of afghanistan, and also support obama in the matter of afghanistan. as an ex-marine, service- connected, disable, i think we need to support our president. there is very good reason for being in afghanistan. host: n.c., a republican caller. caller: i would like to make a respectful criticism here about c-span. the last two guys i know where white guys, but you have black folks calling in on the republican lines, independents, and you have so many of them i cannot believe this is just an accident. if you keep on with the way you have been programming you should change your name from c-span to blackspan. i know they have an opinion, but

wished it would be honest and call in on the right line. every one of them thinks that obama is jesus christ, and they do not like when anybody criticizes him. well, i did not hear all this anger when george bush was in. all they did was criticized george bush. every day you would hear "he lied, he lied." i do not know how some many of these folks if they are 12% of the population, seems to be 80% of your callers. i do not know what you can do about it, but myself and a lot of other republicans or conservatives are about ready to go somewhere else. host: in tristan your frustration. we open up our phone lines with

categories based on party. we hope that folks call in on the line that best reflects their political view. it is tough sometimes to discern that. silver spring, md., an independent. caller: hi. i am optimistic on the war because i trust our government. even more so, i would really like to hear your opinion because -- obviously, you're privy to the opinions of different people. host: i appreciate your asking that, but this program is all for your opinion. a couple of opinions shared by e-mail. what is the plan, what is the strategy?

we are left in the dark. this is from new hampshire. another e-mail from paul, i am optimistic about the changes in tactics, believe it and end of military occupation. that is where those who attack the u.s. on 9/11 reside. i learned there will be a larger offensive this spring. to kansas city, a democratic caller. caller: thank you. i do not see any reason why we should be over there in afghanistan. i know that obama ran on that in the campaign that we need more troops there. i remember when we first sent more and they said we had to guard the border. will we be there forever to guard that border? can we build a wall or fence? we need to get troops home. we're just wasting billions of our dollars that we could use here at home.

host: here is from "usa today" -- the tea party takes the message on the road. it opens near arizona and nevada cities, and heads to 39 more. here's a look at what sarah palin had to say in the rally. >> harry will come home and explain what he has been up to in the washington, and harr y will hold campaign rallies and can halls and try to explain away the big government takeover of health care and student loans, and try to explain the bailouts, and try to sell you on the leftist plans for national energy tax and for more spending, and more steps toward

insolvency. so, searchlight, i hope that when he does come back,, i hope he will open up the floor to questions so that you can start asking him. ask him a thing or two about when the early voting begins and who else is running for his seat. host: that was sarah palin at the saturday tea party in searchlight, nevada. about a little spat between rbio and crist on sunday -- this message but twitter says thatrubio should give florida voters a scare. back to the article here, they write that the rally in phoenix was the lowest attended of the first three stops with an estimated 1200 in attendance on sunday.

but indianapolis, good morning, andre. are you on the republican line? caller: no, i'm on the independent. i want to respond to the republican caller who said that black people are calling on the wrong line. i'm a black man, definitely an independent. i'm not optimistic about the war in afghanistan. the reason being is that, this year we will only be spending about $700 billion in "defense spending." if we got out of afghanistan and cut that expenditure in half, our issues would be resolved in our favor. the longer that we stay, the more money we spend, the worse off the dollar and the country

will become. host: del ray beach, fla., sue. caller: good morning, c-span, except for sarah palin screaming in my ear. i'm a little torn concerning afghanistan. it takes me back to "charlie wilson's war" if we had finished what we started i believe that we could have been out by now. but you understand that there is reason to be there, but every time a soldier come some i cry. i grew up during the vietnam war and i will never forget the images on the tv and in the newspaper. i have great respect for the president and nbelieve he knows more about this than i do. my husband and i are both from texas originally. my husband is a dead red

republican. he is still backing the president. host: thank you. the republican line. caller: good morning. thank you so much, c-span. with all due respect, i do not understand why you divide the callers by party. either they are all american, or not. the situation of afghanistan is very complicated. unfortunately, the u.s. has been taken for a sucker. they are paying the life, the money, everything -- and what they're getting? nothing. karzai goes to london and europe. they have meetings. pakistan is out of the picture, then comes into the picture.

we are pouring money into pakistan, afghanistan -- everywhere. for what? but then we finish this the first year they did that 9/11? right away the jumped to iraq and the same congress approved of that. this is unbelievable that this poor, a beautiful country is being treated like that. and on the line of republicans, whether i am republican, or democrat -- if we have our best is sarah palin -- we really have to be a, really -- host: well, you are on the republican line, so if it is not sarah palin leading the party, then caller: who i think mitt romney is the best candidate to lead the party. sarah palin -- just a pretty

figure, that is it. she does not have the depth, the knowledge, she does not know how to deal with these kind of problems. you think that if she were president or vice-president when this crisis came up -- she would have had a heart attack. host: emil, we appreciate your input. an e-mail here that says optimism premised on a false flag operation that murdered 3000 people in the cold blood. it is most disgusting. it is for control of oil and gas pipelines. to los angeles, tom lange, on the republican line. caller: good morning.

-- to tommy, on the republican line. caller: i want to express my opinion -- people voted for the end of the war, and relied on obama. he just did not deliver that. now he sends more trips to afghanistan. the only thing really changed with obama is he fits the bill more for a modern and new politically correct version of the same supremacy of democracy. i see lots of parallels with "1984." this all strikes me as very scary. obama and his administration and democrats have not come up with anything new.

they are trying to imitate the regime's of western democratic socialism seeing in canada and other such countries. i'm not optimistic about the war in iraq, or the war in afghanistan. i think he is only unifying his own agenda and try to fit the bill with the western europe and canada and many of the regimes that seem very similar. host: thanks for your call. about health care, we will talk more about it later in the program. an article here in "the washington post" -- harry reid is losing ground. the approval rating of other democrats is holding steady.

shifts among constituentcies suggest the president obama and house speaker nancy pelosi may have reaped some benefit from the legislation's passage. trawls, a independent line, florida. -- charles. caller: this is the deal. when we go into a country we need to ask them for one thing. in your bill of democracy put in freedom of religion. number two, when we go into countries it is for gas and oil. everyone knows that's true.

here's the thing. we need to stop this stuff in our country. we need the senators and congressmen to have term limits. we need it now. the democrats and republicans are just putting nails in their coffins. the independents will come up to take the country back. host: the president returns this morning from his visit to afghanistan and will meet with the french president mike nicholas sarkozy. sarkozy and carla bruni, his wife, will have at dinner and

the white house quarters. we will show you a picture of the french president and his wife in central park yesterday. to stockton, california caller: no, i'm not particularly optimistic concerning the afghanistan conflict. that has been the place where nations have gone historically to die. i do support the obama presidency. i wish that he would have been given some better decisions to be able to make regarding afghanistan, but that was part of the bush failure. i do briefly want to address -- if you do not hang up on me, one gentleman read like a 400-word manifesto. i like to touch on the racism shown this morning on c-span, especially by the gentleman calling and labeling the african-american scholars unable

to be a republican, independent, as if they are all democrats. i would like to invite that gentleman to listen to fox news. america is a melting pot, sir. it is a place where you can be whoever or whatever you want to be. i happen to be caucasian and a democrat. i know a few african-american citizens who are indeed republicans. you can be what you want to be. i am ashamed of you, c-span, because you let the man go on and on. from the very beginning it was obvious which direction that was going. it seems many times you are more likely to push the button on a radical talking leftist ideas, and not so quick to push that disconnect button on an older gentleman, or older woman who is espousing racist beliefs. do you see what i'm talking about? host: yes, and i appreciate your

input. part of what i think he was saying, his frustration of people calling on the wrong line that did not reflect their party. but you have made a good case for your statement as well. i appreciate all the calls. we have more coming up. we will look at the political season after the passage of health care. " candidates are doing in this recess. when they head back to their home districts. we will speak to reid wilson, the editor with hot line on call. he would join us momentarily -- he will join us momentarily.

>> the commission on wartime contracting holds a hearing this morning, looking at the drawdown of nearly 100,000 employees in iraq. on c-span this morning right after "washington journal" as the president prepares to sign a new treaty with russia, a discussion on the future of nuclear weapons arms control. it is at the brookings institution, live at 10:00 a.m. also, tim geithner takes part in a symposium on women and finance on c-span 3. >> when i hear president obama say he is president of all-

america, i say absolutely. black people helped make you president. >> tonight, the black agenda forum. at age 30 p.m. eastern on2 on. throughout april see the winners of c-span studentcam video documentary competition. they submitted videos on one of the country's greatest strengths or challenge the country is facing. during the program, meet the students who made them, and for preview of all the winners visit studentcam.org. host: joining us is reid wilson, editor with hot line on call to

look at this recess. and what candidates on both sides will do to either sell or defend their vote on health care. you write about it on friday. you wrote that john boehner had pushed members to make the case that the white house has lost touch. "americans have never felt more disconnected from the government than today." this seems like a broader, more different argument than just opposition to health care? guest: that is right. health care has not been clearly defined in the minds of most voters. last week some polls show the bill is gaining support. another shows the bill still relatively unpopular. that tells me that nationally people do not really know what to think about this bill. people have not solidified an opinion. that means both parties have to

spend this week really selling their vision of the bill. republicans realize that 89 months from now and election day rolls around, health care will not be on the top of voters' minds. unemployment, the recovery of the economy, and the stimulus package from last year have not shown the kind of results that democrats had hoped for. it is part of a larger argument republicans are trying to make the democrats are out of touch. the healthcare bill is the latest in a series their turn to bill to the crescendo to convince people that democrats do not have the american people's best interests in mind. host: this is the longest stretch democrats will have been away from congress. when the recess is over, what signs are you looking for that health care or opposition to it still has attraction among

republicans, independents? guest: the kind of signs to show, headlines and news stores that drive the day. if the white house successful, they can move beyond health care and talk about regulatory reform, jobs, the economy. even now that the president has gone to afghanistan start talking about some of the successes they have had there. democrats need to turn the page, get to the next step. make the unpopular topic of health care go away. in this news cycle era with news on twitter and blogs, the real goal is to win the next news cycle. when the next one comes along and it is not about health care, then democrats will have been slightly successful. we will seek, when they come back from recess. host: reid wilson will take your

calls. we will speak particularly about this recess period. we began the morning talking about the afghanistan trip by the president. we said it was a white house political effort to change the scenery. guest: on the political side i'm sure the trip itself is just to go meet with the generals at hand, karzai and talking about moving beyond corruption. from the political aspect, the liberal base system not happy with the war. obama ran as president as someone who wanted to get out of iraq. and as someone who wanted to correct the prosecute the correct or, the war in afghanistan.

-- as someone who wanted to correctly prosecute the right war. at the end of the day can only depressed the democratic base. if afghanistan is working well, it is a great way to woo independent voters and make democrats a little happier with the process. host: we are seven months away from the general election. in your view will the healthcare bill still have some political attraction? guest: it will be part of a larger narrative that republicans are trying to push. one thing democrats are concerned about is the idea they are not governing affectively. republicans have tried to show that three things like the cornhuskers kickback, the louisiana purchase. they have won a couple of key swing votes successfully.

they say the process is broken. the idea that republicans are filibustering everything has not been effective for the majority party. at the end of the day, democrats are fighting against the republican-built narrative that health care fits into, that the incumbents are spending too much, and trying to do too much, over-reaching. republicans are making that argument. we will see if it is effective. host: louisville, ky. caller: yes, first of all, i would like to make a statement. the lady who called, she pretty much made me tell her exactly what i would say until she allowed me to get on.

i told her i wanted to comment on the last thing. as an african-american i was offended by giving the gentleman a platform to speak as african- americans as if they are known by their speech and liars. just because he thinks there cannot be that many black people calling on the republican party. it is quite offensive. to this other situation here, in regards to health care, it is amazing to me that there is such a hatred for that -- the president is simply trying to help people, make sure the people do not go into bankruptcy, are not disallowed from having insurance due to being sick. if this does not regret exactly

right, we have done social security and welfare and the like -- but to give it a chance, people should be happy that someone is trying to help -- if this does not work out exactly right. it is no free ride. everyone has to pay for what you get. it is just americans helping americans. i do not understand the rhetoric. host: thanks for the call. guest: we have seen the level of anger over the past couple of weeks that is interesting. it has come largely from the right, from folks who opposed the health care legislation. now after it is passed it has manifested into [unintelligible] the extreme fringe. republicans have now distanced

themselves from those violent movements. republican leaders want nothing to do with that. on the other hand, the left is now getting more energized. a poll this weekend showed democrats are little more enthusiastic about coming out to vote for their candidates. this has been a big problem throughout the year for democrats. republican voters have been very excited to come out. democratic voters have not. now that the health care legislation has passed, we have seen the gap clothes a little. it will be important to keep that gap as close as possible. host: "the wall street journal" has a front-page article about tea party candidates.

by the time the election comes around, what do you see their role as? guest: is a largely undefined movement, and entirely without a leader. they are intentionally keep in the distance from the republican party because they want it to remain a grass-roots initiatives. tea party candidates have struggled in the first couple months to get any electoral candidates. many claim victory with scott brown. i think that is debatable. scott brown ran an excellent campaign while his opponent ran a very poor one. it was the perfect storm. i think he is now a u.s. senator more on his own merits than of the tea party. the only race where they can

claim credit is a special election in new york last november. doug was a conservative party candidate who forced the republican nominee to the sidelines. at the end of the day hoffman lost. that was in the midst of the worst part of the healthcare debate. the simple fact was that nancy pelosi picked up another vote. host: what is the next big test race? guest: a series of primaries in which a tea-party endorsed candidate is running against a more established candidate. host: tom? guest: yes, and an establishment candidate running against other tea party favorites. there is another race in alabama.

martha is a big time favorite of the national republicans, but on the other hand has new challengers who are more involved with the tea party. they could give the tea party more credence and threaten the republicans by taking back thatseat. host: north carolina. caller: first, a comment on health care. everyone knows that something needed to be done. what is being done now is not the right thing. already, or my wife works she has been told as a manager that she can no longer have people part time. [inaudible] maybe, what is being done now is not the right thing.

some of the things they're recovering through her entrance there will no longer cover. something has to be done, but maybe what is being done will help. ." . .

and we're not being told about. one good example is the nerve gas and tests that was being used on the people there. host: lots there, ben. thank for that. you mentioned earlier a little bit, some of the pressure for the administration feeling from the more liberal wing of the party about the u.s. president in afghanistan and in iraq and how that may play out ahead of the election. guest: one thing the caller did mention i wanted to talk about a little bit was the protests. there is still an anger on both the left and the right about -- there's an anger about several issues. last weekend, when the healthcare debate was in full force and the house was about to pass it late on a sunday night, there were actually several protests that day. it wasn't just healthcare. the cameras focused on the folks on the south side of the capitol who were chanting anti-healthcare reform slogans. on the other hand, though, there was a large immigration rally. anybody who's on capitol hill at all saw people streaming in for a pro-immigration reform

rally. that same day, i happened to go into the office and i walked by the white house, and there was a huge anti-iraq war protest as well, not as many people as were protesting the healthcare reform bill, but there were folks all around the white house protesting involvement. so there is still a frustration on the left, even though president obama is in office, that we are both still in iraq and afghanistan. another point the caller made was the economy and some of these companies who have already started making moves on healthcare. the people, companies to watch include companies like caterpillar, john deere, these are sort of midwestern, you know, manufacturing companies. host: what kind of moves are they making? guest: they have both suggested that healthcare is going to cost them a significant amount of money. this debate will not be good for democrats if companies like that, companies that are actually employing the people they need to vote for them, are saying that we're going to have to lay off people, we're going to have to make some new

changes because of these healthcare laws. i don't think the companies or the policy makers truly appreciate just what is going to be required yet, but that means it's going to be a bmpy ride over the next six or eight moss as people sort of figure that out. host: in a "wall street journal" opinion piece last weerks karl rove said he thinks the repeal of healthcare will still be a big issue in the november election. senator charles schumer yesterday on "meet the press" talked about -- and he has, not surprisingly, the opposite view about where healthcare will play in the election. here's what he had to safe. >> if you're up to 26 years old, you can stay on your parents' health coverage. my daughter is graduating from law school. we tolder had the day after she graduates, she's on her own. she has a job in september, but she was fretting, what does she do for the four months? does she buy health insurance for $1,200 a month? she called me up at midnight and said, dad, i'm covered. i feel great. there are going to be millions of calls like that. so i predict that by november,

those who voted for healthcare will find it an asset. twhodse voted against it will find it a liability. host: think of his argument there. guest: the repeal argument is pretty interesting, and i think it's going to be a losing argument in the long run largely for the reason chuck schumer just laid out. the idea that republicans want to take something away, something that has been given, is going to be disturbing. what we've seen is going to be disturbing to voters. what we've seen from republican leaders is that they're saying, but we're now going to repeal and replace. they've added that "and replace" so they can talk about what they would do for voters on their own. this is forcing republicans to come out with an idea. one of the fascinating things about the 1994 election in which republicans swept back the power for the first time in the house in 40 years is that everybody talked about the contract with america and what role that played. well, the contract with america didn't come out until late september of 1994.

there were only five or six weeks for democrats to say, this is what the republicans are preposing and that's why it's wrong. without an idea, without a proposal of their own, republicans can attack a democratic idea that remains either unpopular or, you know, is a 50-50 issue here. at the end of the day, though, if republicans are forced to come out with their own proposal, their own legislation, it will be something for democrats to attack. that's going to be a problem for republicans in the long run. host: let's hear from long island. david on our democrats line, go ahead. caller: yeah, hi. of a couple of questions. one is, does the government have the money to pay for the healthcare plan? and if it does, how come the people of our country have to pay four years upfront? i also -- i'm kind of upset at what's going on because i feel president obama has made quite a bit of promises and some of

them have not been completed yet, and he spent a lot of time working on his healthcare plan, and it's not really finished. and he's saying even though it's broken, we should pass it, and i really kind of looked at it like buying a house or a car. i wouldn't invest any money in time to buy something broke whn i can search a little longer and maybe consult a few people and get it right in buying something that's actually more affordable than buying something that i really don't know what's in it. so i feel that the character of the president is kind of in question, and he's holding this healthcare like a carrot on a string, and nobody really knows how good it is, when it's going to start, why we're paying for it, and it just seems that the country doesn't have a lot of money right now, why would we waste our time and effort on a healthcare plan where everybody that doesn't have money or a job has to pay something for something and not even get the

benefits of using it. host: one of the moments of the healthcare debate that was most beneficial for democrats is when the congressional budget office came out with their estimates of how much the reconciliation bill and the fixes it would make to the healthcare bill at large would have impacted the budget. it was -- the score was much better than democrats could have hoped for, i think. i think they got very lucky on that. not only wood bill reduce the deficit by, i think it was $120 billion, i could be wrong on that figure, but over the first 10 years, over the second 10 years of the bill's life, it would reduce the deficit by $1.3 trillion so. that trillion with a t really gave a lot of independent voters the idea that it was an ok bill to actually pass, and it also gave cover to democratic members of congress who were wavering who can now go back to their district and make the argument that this

bill will reduce the deficit. republicans are not going to make them make that argument unchallenged, but that is an argument that democrats will be making about this bill over the next month, over the next eight months. host: have you talked to any members who changed their vote from a no the first time around to a yes on the most recent? guest: well, we've heard from a number of them who cited that c.b.o. score, saying that, you know, they were worried about the cost of the bill, they were worried about various other provisions, but when that c.b.o. score came out, that was really the moment that they decided, ok, they can vote in favor of this bill. host: let's hear from brockton, massachusetts. bill, good morning on our republican line. caller: good morning. you know, ever since this bill passed, they've been talking about the pros and cons of the healthcare bill, but i've heard no comment on the talking heads from any network or any of your visitors -- and thank you for c-span -- but i haven't heard anyone talk about the $2.55

billion, that's with a b, $2.55 billion to be handed out and given to the negro colleges. that's $2.55 billion, essential given to the united states negro college fund. nothing has been mentioned. is that a back door reparations thing? why aren't people talking about that? or even just notifying the public? people talk about the pell grants and things like, that the other things that were attached to this bill, but no mention has been made of the $2.55 billion being given to the negro colleges and these other people are calling to c-span saying we are still a racist society. really, if up to the see how racist we are, you can watch tonight on c-span2. the tavis smiley show, that should scare the daylights out of everybody.

host: reid wilson, do you know anything about this? guest: i haven't heard anything about that. one of the interesting things about the reconciliation bill, though, is that it didn't just fix health care. it did deal a lot with student loan bills that is going to dramatically change the way student loans are handled in this country. one of the things that -- host: and is that a winning argument for democrats? guest: i think it s. i think at the he happened of the day, they will be able to say, look, we voted in favor of reducing everybody's student loan payments and republicans voted against it. one of the things that democrats are trying to set republicans up for is not only being the party of no idea, that's what democrats keep saying about republicans, but that they are against these very popular things. and let me tell you, when they come back from recess, one of the things that's going to be top of the docket is regulatory reform, financial regulatory reform. senator chris dodd is the chairman of the senate banking committee. he has come out with his proposed set of reforms after

negotiating with several republican senators, most notably bob corker of ten tefpble he's the republican to watch most closely on this effort. when that regulatory reform bill came out, though, it was because the negotiations had really broken down. so if at the end of the day, when this bill made it through committee, all the republicans voted against it. now democrats are going to be able to make the argument that republicans are against fixing wall street. republicans are for wall street, democrats are for main street, that's the main argument that democrats have going forward. host: what argument will republicans use in opposing a financial regulations bill? guest: i don't think republicans are going to end up opposing the final product on regulatory reform. i think there is going to be some compromise. i think both sides want to see a bipartisan bill. at the end of the day, democrats have a pretty powerful schedule here, and republicans are going to have to find a way to make their small changes to the bill and not be labeled as the wall street party. host: say good morning to

charlotte, north carolina. go ahead. caller: hello. thanks for letting me be on c-span. my comment is i don't have insurance, and if they pass -- they already passed the ball, this is just bank for me, and i appreciate them doing this for me. but one thing i don't understand is the bill that says that in 2014 we all have to be mandatory to buy insurance. i appreciate them helping us out like that, but i think that's a little overboard. i kind of agree with the republicans with that. but die appreciate them passing this bill. thanks for letting me call. host: go ahead. guest: i was just going to say, the individual mandate, and, of course, the most controversial part of this whole bill, the interesting thing that some

democrats have been putting out lately is that back in 1994, -- i'm sorry, 1993, when the clintons were trying to move healthcare through congress, it was several republicans who favored an individual mandate, most notably senator john chafee, the late republican senator from rhode island, and a number of other republicans, including some incumbents actually signed on to that bill. so that was a couple of decades ago, but way back when, even republicans supported an individual mandate. host: an article you wrote last week, we talked about the preview of the republicans in this district work period, this recess. you write about the memo that came from the speaker's office for democratic members with the passage of health insurance reform. this is a critical time to go on offense, the packet sent to members yesterday said dems should focus on the immediate benefits the bill provides, while also talking up job creation legislation and taxes, which de ms say have been cut by $800 billion this session. in terms of job creation,

because we've heard a lot about jobs, jobs, jobs, what can they say, what can democrats say they've done so far in this area? guest: democrats, of course, have passed the stimulus measure back in february of last year, joined by just three republicans, one of whom is now a democrat, by the way, senator arlen specter. they have passed a number of smaller jobs bills on a bipartisan basis over the first couple of months. but you're right, jobs have got to be the focus for democrats over the next eight months before election day. they are going to have to convince people that they are focused on jobs, that they are trying to create new jobs. they're able to create new jobs and able to govern fishtly in a manner that actually does so. so at the end of the day, the american public still, even after this long, drawn-out healthcare debate, the american public still says the economy is a major issue, is their priority issue by a huge margin. 60% are saying the economy is the number one issue, something that, you know, levels that

haven't been reached since the 1970 anticipates according to these polls. so at the end of the day, democrats must tell people, must convince voters that they care most about jobs and the economy, because that's what voters care about. it's not going to be about this healthcare bill if democrats are going to succeed. it has to be about how much they are doing to create new jobs in america. host: maryland, we say good morning to ken on our independents line. hi there. caller: hi. how you doing? host: fine, thanks. caller: two quick things. one is about the lobbying that was going on even before the healthcare bill was enacted, passed, it i guess it's a law now. i'm association i'm a little nervous. host: it's all right. go ahead, ken. caller: i understand that there was, from the insurance companies that the democrats were lobbied about 40 some million dollars, $47 million was given to democrats,

especially to a large portion to -- i think his name is baucus, a committee guy, use in charge of that. you understand what i'm saying? host: i think we've got your drift in terms of lobbying. you mentioned a term of $47 million. what do you know about that? guest: well, that's right. millions have been spent on lobbying these members of congress during this healthcare debate. over the last week or so of the debate, the healthcare reform opponents were spending about a million dollars a day on television ads around the country talking about the drawbacks of this bill. not to be outdone, the proponents of reform came out with somewhere between $1.5 million and $2.5 million per day of their own advertising, talking about how great healthcare reform is going to be. this debate has no shortage of  money in it. it's going to be a series -- it has been a huge boon for cable

networks, for the local tv news, when ads are down in the journalism industry, well, hey, healthcare is a great stimulus bill for the television networks. so lobbyists have spent a lot of time on both sides, both the d's and the r's are spending huge amounts to convince those sort of swing democrats of their best arguments. millions of dollars have been spent, millions more will continue to be spent until election day. host: we've been talk ago lot about democratic members. here's the national section today of the "new york times." a number of members heading back home after the vote on healthcare overhaul. lawmakers head home for an accounting. and i wanted to focus on one in particular. one republican who voted yes the first time around back in november on the healthcare bill, and then no. he won william jever season's seat back in 2008 and is up for

re-election, obviously again in 2010 in a very heavily democratic race. what can you tell us about his race? guest: he's the first vietnamese immigrant to be elected to congress. he was elected in a district primarily because the up couple bent, william jefferson, had $90,000 of cash stuffed in his freezer. that's not a great way to run for re-election if you're keeping cash in the freezer. so cao has been he corrected to a district that president obama won by something like a 75% to 25% far yin. it is the city of new orleans. it is overwhelmingly minority in population. it's a group that is very likely to vote for the eventual democratic candidate in the fall. you know, joseph cao voted in favor of the bill the first time in november, the house version of the bill. he said in the runup to the second version that he could not vote for the senate version of the bill because it did not have strong enough anti-abortion provisions. when he voted against that,

though, he put his own re-election in serious danger. we're talking about all these democrats who are in danger because they voted in favor of this, well, here's one republican who's in real danger because he voted against it. this is a heavily democratic district. there's a state senator down there who's likely to come out of the democratic primary. he looks to be the favorite over the incumbent, joseph cao, in november. host: let's hear from norwich, connecticut, irene on our republican line. go ahead. caller: good morning. i received a notice from the medicare, and i'll read it. it's just a short paragraph. i don't know whether people have had these notices. it says that both cuts to existing government progress includes a significant cost reduction and the medicare program resulting in an increase in premiums and fees that you must pay and a

decrease? n some benefits. this new cutback in the federal medicare program means that you will become responsible for an even greater portion of your healthcare expenses, expenses that were previously paid by medicare. also, for the seniors who carry supplementalal and who have medicine in their supplemental may be taken away from us because the government no longer will be paying a certain amount for us to stay with these groups and be like a double whammy. host: a couple of good questions there. we have dr. scott got leeb coming in to talk about the healthcare bill and medicare and medicaid, but reid wilson, if up to the weigh in on that, that's fine. guest: i was going say, that's the one great argument that republicans have on this healthcare bill, is that it changes the way medicare is

going to be wrifpblet that is why it's dangerous for republicans talking about repeal. at the end of the day, it is very difficult to convince people you're going to take away an entitlement. republicans will paint democrats and have been over the last couple of weeks as having taken away entitlement, and part of it sbeelingsment, part of medicare with these consults that are in this bill. we've seen polls that say that seniors oppose this bill more than just about any other age demographic. that's going to be a problem for democrats in november, primarily because seniors are the ones who vote most. host: kansas city, good morning to carl on our democrats line, hi. carl, go ahead. let's hear from scottsdale, arizona. scottsdale, go ahead. caller: yes, hi, good morning. i am calling about the healthcare. you know, the healthcare bill that just passed, i have it now, and i have preexisting conditions, and i know i'm able

to get insurance. everything is not going to come until 2004. my question, is this is a very good program. do you think the democrats are particularly to make it through the benefits. i tried to highlight what the benefits of this program is, which is what this should be doing, and i don't think they did that whether they were talking about what was the noise that was made about this. so do you think the democrats are doing enough? because a lot of people have been misinformed about this program. host: we'll get a response. thank you, helen, in scottsdale. go ahead. guest: that's right. the problem for democrats is that they have not sold the bill. they have to go out and spend this week selingt bill. she was from skates bail. one of the members who's going

to have to do the best job, harry mitchell, a two-term democrat, former mayor of tempe. tempe is sort of half a district. and he is going to have to go to a largely republican area in scottsdale, sort of a wealthy, older area. host: and he voted in favor of the stpwhill guest: voted in favor of it both times. he's going to have to really sell people on why this bill is good for them. there are a lot of seniors in scottsdale. there are a lot of people who are wealthier who will not see the immediate benefits of this bill, but he's got to convince them that, at the end of the day, their insurance rates will go down and their cost will go down, and everything good from this bill he's got to convince them. arizona is a fascinating state, because it's got three incumbent democrats who have only been there for a couple -- well, two have been there for two terms, one is a freshman democrat, all of whom are going to have to sell this bill, and they're all in very different situations, but we're going to see -- i think we're going see some textbook examples from those three members, congress

woman ann kirkpatrick, and congressman harry mitchell on how this bill -- how democrats should be approaching this bill. host: take a look at that race between senator mccain and his republican opponent, j.d. haywoode. we covered one of the rallies over the weekend in mesa. what's that look like for senator mccain? guest: i think this is fascinating. without sarah palin, the rise of sarah palin and the accompanying rise of the tea parties, i don't think somebody like j.d. heyward, former congressman from harry mitchell's district -- mitchell beat him in 2006 -- i don't think j.d. heyworth would be a serious candidate. but because arizona is so decided within its republican electorate and because the tea party is going to play a role in that primary, john mccain has something to seriously worry about. j.d. heyworth is a conservative, you know, tried and true, radio host for a long time, big on the social issues. one fascinating thing is that immigration is going to be a

huge part of this race. john mccain favored a comprehensive approach. that divide between the two plays out within the state party. it plays out within primaries around the state t. plays out within the state legislature, and now it's going play out in a u.s. senate race. so john mccain has some serious work to do in his home state just two years after he was the party's presidential nominee. host: and it was the story over the weekend, it might have been on fox, about joe the plumber taking his support away from senator mccain because of the immigration issue. guest: yeah, that's right. and j.d. heyworth's biggest settlementer is a guy that's the sheriff of maricopa county. he famously made all his inmates wear pink underwear and things like this. he is a very controversial figure both in the state and around the country in immigration sir kells. he's very anti-illegal immigration, and he is someone who has been a thorn in john mccain's side for a long time.

this is something that sections of the republican electorate feel very strongly about, and they feel very strongly about it in juxtaposition to sort of the business republican side, the business republican side that needs workers, needs immigrants to come and fill the jobs that won't otherwise be filled by those who actually live in the u.s. so this tension between the left, between the right, the right activists of the republican party, and the business activists has played out sort of subtly in very crucial races across the anyway. now it's going play out in the u.s. senate race and spill all over the front page. host: a couple more calls for reid wilson. to kansas city, carl on our democrats line. caller: hello, kansas city, i wrote a letter to clare mccaskill, my senator, with this idea, and i'd like the gentleman's opinion on it in the form of a question and a comment. first of all, if the information is correct, there's $1,000 approximately assessed to every american, middle class, because of emergency rooms and hospitals that aren't

reimbursed. and also, there's pop you're lism in the country, so why don't they take this mandate? first of all, they haven't explained adequately to the americans that the mandate is necessary to get preexisting conditions covered, ok? everybody knows that, but it isn't said enough. people are up in arms about the mandate and they're wasting the taxpayer money going to court because they're going to turn it into a tax and put two lines on the i.r.s. form, one that says you pay a fixed amount, and then second line deducts it if you have insurance. the money that they collect should go to the emergency rooms and hospitals to cover the people that are freeloading. so this whole thing about the mandate is a red herring, because if they waste the money going to court, they're going turn the mandate into a tax, and it's going to be legal. host: carl, we'll get a response, thanks. guest: one interesting point that carl brings up, wrote a letter to senator mccass till. in this weekend's "washington post" poll, an incredible number of respondents, i think

it was 26%, said they had called or emailed their member of congress. that is -- that's huge. that'sen believable. i think it's no wonder that none of us have been able to get through to the congressional switchboard over the last couple of weeks because they've been lit up and they've crashed a number of times. so, you know, the number of people who have gotten involved are really key to how members are seeing this. they heard from their constituents and the bill ended up passing. he also mentioned going to court. i think it's 14 states at the moment whose attorneys general have joined a lawsuit spearheaded by the florida attorney general to challenge the individual mandate in court. a lot of people who i'm talking to, the legal experts say that the case is unlikely to be successful. but it's fascinating from a political perspective, because of these attorneys general who are going to court, a very large number of them are running for governor next year, and a number of others are planning on future runs for governor. it's going to be -- this is

going to be a role in more state races than it should be because these candidates have really made it into a signature issue for them. host: this story broke over the weekend about the tension flare after recess maneuver. the president making recess appointments, some 15 appointments. did he give republicans a gift for the recess? guest: well, i think one reason that people are angry with washington, one reason that people were the most upset about this healthcare bill is because the process has become the lead story in this. there's the old joke the two things nobody wants to see being made are laws and soffits. the recess appointments are a tiny, tiny little argument. there were 15 people who were appointed over the weekend, some controversial ones who republicans had blocked, including craig becker, sort of the most prominent, a nominee

for the national labor relations board. but again, here we are talking about process. democrats do poor when the argument is about process. this is why they are concerned that the argument that they are doing a poor job legislating, poor job governing, could be effective in the fall. the more we talk about process, the more we talk about recess appointments and filibusters and reconciliation and these inside d.c. thirnings the more voters get upset with washington. that only hurts the majority party. host: one more quick call. gainesville, georgia, and this is george on our republican line. hi there. guest: -- caller: obama thought everybody has to pay for it and everything. i've never heard him cutting his pay or senators or anything like that, and that long-term healthcare, the cost of that is for everybody -- is automatic, going to be took out unless they waiver off of it and all.

i bet that cost right there, too many if's, in so much money comes in for this and all, healthcare is going to work and all. i'd like somebody to explain why social security would take care of old people when they got old. host: george, i'd let did you there and let reid wilson wrap it up. guest: the one thing is the way members of congress have treated themselves on this. last week there were a couple of stories that came out about top staffers in congress who may have exempted themselves in writing this bill from actually being covered. president obama and the white house came out and said president obama would be covered under the exchange assuming he's still president in 2014, gets elected to a second term. host: that's when the exchanges kick in? guest: that he would be a part of the exchange. members of congress would be part of the exchanges, and now it looks like the senior staffers will be part of the

exchanges as well. so that's sort of -- again, the inside baseball stuff where it looks like people are gaming the system. democrats have to avoid that if they're going to appeal to those voters who are most angry with washington. host: reid wilson, thanks for being with us this morning. guest: thanks for having me. host: we will look at long-term healthcare momentarily, particularly medicaid with the healthcare law. we'll talk to dr. scott got leeb, with former and senior adviser for the centers for medicare and medicaid can. he'll join us next. we'll take your causms first, a news update from c-span radio. >> it's 8:33 a.m. eastern time. president obama is condemning the rush hour bombings in moscow in the metro. in a statement issued by the white house earlier, the president says the american people stand united with the people of russia in opposition to violent extremism and heinous terrorist attacks. the blast came about 30 minutes apart during the morning rush hour, killing at least 37

people and wounding over 100. meanwhile, kevin ortiz, a spokesman for new york metropolitan transit authority, says the agency has a heightened security presence as a result of the bombing in moscow. the m.t.a. is in charge of new york city buses and subways, as well as suburban trains, bridges, and tunnels. some of the suspects from the f.b.i.'s weekend raids in indiana, michigan, and ohio are expected in court today. federal warrants are sealed, but a law enforcement official, speaking on condition of anonymity, says some of those arrested face gun charges. open officials are pursuing other suspects. a militia leader in michigan says the target of at least one raid was a cris yn militia group. and south korea's defense chief says north korea may have intentionally floated a mine to damage a naval ship. the remarks come as rescue divers got no response today when they hammered on the wreckage of the south korean navy ship that exploded and sank nearly three days ago.

46 crew members are missing and believed trapped. another 58 were rescued. those are some of the latest headlines on c-span radio. >> which president was buried wrapped in an american flag and a copy of the tugs under his head? andrew johnson. find these and other presidential facts in c-span's newly yurp dated book "who's buried in grant's tomb"? >> a guidebook, a travel log, if you will, but it's also kind of a mini history work of buy greg of each of these presidents, and let's face, it you can tale lot about people at the end of their lives. >> a resource guide to of presidential grave, the story of their final moments, and insights about their lives, who's buried in grant's tomb, now available at your favorite book seller or get a 25% discount at the publishers website, publicaffairsbooks.com. type in grant's tomb at checkout.

"washington journal" continues. host: dr. scott got leeb is from the enterprise institute and also former senior advisor at the center for medicare and medicaid services. we thank you for joining us this morning in our last significant, a woman, i believe her name was irene, called about the healthcare bill and talked about seniors having to pick up more of the cost of the health care under the law. what can you tell us about that? guest: well, that's lot of cuts, and that's going to translate to cuts to beneficiaries. there's no question about that. the cuts in the reconciliation bill, the side car bill that passed the senate, were about $200 billion, and it was actually up what was originally in the bill. so plans that offer medicaid advantage options to better than airs now are going to have to cut beneficiaries. you're already starting to see that. you're starting to see some urban markets where private plans used to offer plans, now

pulling out. the other thing that's going happen under this bill is there's a lot of new authority given to medicare and medicaid services to actually restrict access to certain providers and technologies in the future. one of the ways to do this is through a new medicare commission that's going to basically have independent authority to make decisions about what should and shouldn't be paid for under medicare. it's mandated to tamp down on excessive growth. type will this be broadly they'll say these practices don't -- guest: yeah, interesting question. the thing about this medicare commission, it basically leverages congress' inability to act. so the commission, by law, needs to find certain amount of savings in a group of people to keep pace with gpped, so medicare growth has to keep pace with growth. and if the senate and congress doesn't like the list of cuts that this commission has come up, with they have 30 days to come up with a separate list of cuts that achieve the same amount of savings. we know congress has a hard time acting in the course of a

year, let alone 30 days, so it's basically leveraging the inability of congress to act. these decisions won't be subject to official review. they've actually exempted the courts from being able to review the decision. there's no appeals process for beneficiaries. getting to your question of whether or not they're going to target individual technologies or target broad groups of people, i think that it's going to be easier for them to go after broad categories of services, so they'll do things like take down reimbursement for injectable drugs by 2% across the board rather than target individual drugs, rather than try to target individual providers, they'll just bring down reimbursement across the board. there's a lot of schedules for setting grades in medicare already, and so it's easier to bring those down by small percentage points rather than target individual technologies. they'll do some of both, and medicare has targeted this in the past, but that's a much harder thing to do politically. host: could it be argued that, absent this bill, that would have been done anyway to rein in medicare costs? guest: well, there's really

only two ways to control costs. either the consumer is cost-conscious and makes decisions based on some consideration of the cost of that decision or the government controls the decision that consumers get to make to try to bring down costs. and clearly we're moving in a direction of trying to put more of those decisions in the hands of government agencies, new bodies are being created by this bill. if you look at the debate that's gone under the bush administration, leading into this administration, the question is whether or not you're going to put more hands into the hands of consumers, which is what the bush administration tried to do, the decisions when they came to the decisions, or you're going to to let those decisions being made by government agencies. the democrats are clearly moving in the latter direction. you know, their feeling is, when i talked to my colleagues on the democratic side, their feeling is that, you know, when people are facing an illness, they shouldn't have to corps costs.

it's an anathema that anyone should consider costs at the time they're making clinical healthcare decisions, but the reality is if the consumer is not conscious of the costs, then government is going to be. host: what about medicaid? how is it affected under the law? guest: of the 32 million that are going to be newly insured, about 15 million get medicaid. medicaid eligibility has increased to 133% of the federal poverty level. what's interesting under law is that the people who are getting that new medicaid benefit, that benefit might very well be a different benefit than the medicaid benefit that medicaid recipients are currently getting. so there's actually mandates -- host: better or worse? guest: well, you can argue better. there's mandates on what provides need to be paid and the scope of the benefit package that needs to be available to people who are newly eligible for medicaid. so i think it's a fair statement and probably one that has bipartisan consensus that medicaid really has become a third rate insurance system in the country. it's really a national shame we don't do more to fix it. there are medical study that is show that just having medicaid

is an independent predictor of outcomes because of the lack of access that people on medicaid get. so they've taken steps to try to improve the benefit package under medicaid that's only going to be available to people newly eligible for it. host: we'll take your calls. 202-737-0002 for democrats. 202-737-0001 for republicans. independents and others, 202-628-0205. we'll get to your tweets and emails if you want to send us those, all about medicare, in particular medicaid, with dr. got leeb with the american enterprise institute. the 16 million that are going begun added under the law under medicaid, where's the money coming from that? is that from the savings they're finding in medicare or what? guest: well, it's cross the board. they're cutting medicare to the tune of almost $500 billion overall, and there's a lot of new taxes in the bill, new taxes on capital gains, new

payroll tax, so it's coming from everything. it's one new slush fund. some of it's being foisted upon the states, and the states are going to feel a lot of burden. the thing that the democrats have been trying to do in this administration is to federalize medicaid and also expand the program itself. but the expansion is happening at a faster rate than the federalization so. even though they're picking up more of the cost of medicaid on the federal docket, the expansion is sort of superseding that, so the states are going to be hit with new costs. host: bradford township in michigan, we say hi to sylvia. caller: hi, good morning. bill, this is really mainly for you. and also possibly -- it's regarding the last segment. you handled a call from a woman, a senior citizen, i did not catch the state. i was busy. i think it was out west somewhere. host: right. caller: she said she received a letter from medicare, and she read this letter, you know, you remember that one, i'm sure, as

did everybody that was listening. i'm on medicare. i've not received a letter from medicare this year, period. the healthcare bill was passed just, what, i don't know, wednesday night -- or signed wednesday or something. host: yeah, signed wednesday or tuesday last week. caller: those that love the government or hate the government all know they don't move that fast. i mean, how could they do that? so i'm wondering if perhaps that woman got the letter maybe even last week or the week before last and that if she didn't look closely enough at the fine print at the bottom, these are scare tactics that i'm afraid is what happened there, and i know you have to be really careful what do you as a host, but i would have appreciated if you could have dug into that a tiny part and thrown it over to the hotline guy, because he didn't comment either, and this guy that you

have on now on on the opposite side completely, so no matter what he says or doesn't say, it's coming from a different angle, you know what people who listen to that, please don't just take the word for something, and i'm not calling her a liar. i'm not. host: sylvia, anything in particular up to the ask scott got leeb? caller: there isn't at all. host: thank you for your call. let's hear from tennessee on our republican line. everett, go ahead. caller: good morning. how are you folks? host: doing fine. caller: great. i'm a little nervous, so burglary with me. i have a comment, and i have a question. the comment, i just really don't believe that there's going to be anything for free. these people that think they're just going to get back and draw benefits from the government without paying -- and everyone's going pay in, i don't care whether they work or not, if they get some kind of assistance from the government, they're going to have to pay in on the healthcare.

the question i'd like to ask, when this healthcare thing kicks in, and i'm getting ready to retire in a couple of years, and i was just wondering, are l the amount you pay be on the retirement income you have, or will it just be a setback for all seniors, or will each person pay a different price according to like if you have a savings account, quite a bit of money in the bank, and you're getting ready to retire, are you going to have to pay a higher premium than a person that has less income for the retirement? thank you. i'll take the answer off the air. guest: well, there's no net worth test as far as i can tell in the bill. the tests are on income. so the bill creates these exchanges in which certain citizens -- everyone's going to be able to buy private

insurance, and certain people will be subsidized by private insurance. they will offer one health plan. they talk about a bronze, silver, and gold health plan, but it's basically the same benefit pickage. it only varies according to co-pay. so, for example, the silver plan is going to cost $14,700 a year for a family of four in 2016. those are c.b.o. numbers so. a family of four earning $42,000 a year will be eligible for $12,100 subsidy to apply that plan. so their out of pocket cost will be greatly reduced. as you move up the income heard, the amount of subsidy will go down. so, for example, in that family of four is now making $54,000 a year, their subsidy goes down to $9,000. so it's actually one of the things about this bill that's going to create some complexity, let's say, in the job market, is that as you move

up it the earnings ladder, your subsidy is going to go down, so your effective tax rate is going to go up much more. so, for example, just the example i gave, you're earning $12,000 more a year, but your subsidy goes down by more than $2,000, so your effective tax rate is well over 30%, so it's going to have the effect of keeping people stuck at certain income levels, and people would be willing to trade more income for more benefits at work that won't get factored into the calculations around the subsidy. host: kaylee from denver, colorado, democratic caller, go ahead. caller: i really appreciate scott being here so i can ask him some questions. i like the point you just made, that that could complicate things, but it's nice to see tax subsidies going to regular people instead of the oil companies. i work in the home healthcare field, and one of my clients just went from medicaid to medicare because he turned 65.

and this has been a complete nightmare. people that are somewhat disabled have the hardest time understanding medicare part d, because you have to sign up for it in advance. they take -- you get a letter like that one lady said, and they literally take your social security money, $100 of it, to pay for medicare part d so. medicare part d is actually sort of a subsidized program for the insurance companies. and you get this book list, and it's got pages and pages and pages of different companies that you can subscribe to for your doctor, you know? and you call and you try to find out what's going on, well, nobody wants to say anything because nobody understands it and they don't want to be liable. and the answer is always, well,

punch in the med tation that you're taking on your computer and you will be able to find out which medicare part d plan is the best for you. well, most of these people don't have computers. so what ended up happening to me -- this is just a personal story -- i worked for a man that went from medicaid, which covers everything, to medicare part d. they took $100 out of his social security check. didn't understand it because the political environment right now, he thought the government was trying to kill him because they kept talking about death panels. and he end ended up being taking his prescriptions for 30 days because he didn't sign up in time. so with the medicare part d is actually private insurance companies getting subsidized, private pharmaceutical companies getting subsidized by the government. host: we're going to let did you there and get a response from dr. got leeb.

guest: yeah, it's an unfortunate story, and i suspect a story you hear a lot of. there's a lot of complexities navigating these systems, these programs, whether they're being administered by, you know, private contractors on behalf of the government or by the government directly. most of these healthcare programs, in fact, are delivered by private companies that are contracted for by the government. there are a lot of web-based tools that make the complexity of signing up for part d much easier if you don't have access to a computer, that could be very difficult. there's no question about that. as for the issue of subsidizing private companies that deliver the benefits, if you don't like the fact that the part d plans are getting subsidized to deliver the drug benefits, you're not going to like the new obama health plan, where the private companies are effectively becoming tools for the company and they'll deliver the new benefits. host: she talked about the gentleman going to medicare part d. sent it usually the other way, that a person would go from medicare to medicaid? guest: it depends on the state.

some states have pretty easy formulas. now, they're pretty rigid. certain things are covered, certain things around. but so long as the drug that you're on is covered by the medicare formula, it might be an easy system to navigate within certain states, and some states have richer med cared benefits than others. generally speaking, i think people find medicare to be even on a drug side, certainly on the provision of healthcare side, but even on the drug side, to be more of a robust benefit. but when it comes to the provision of healthcare, just in terms of getting access to specialists, very difficult under medicaid. 70% of physicians are taking medicare patients, 40% of the government study recently done, 40% of physicians report taking new medicaid patients, and i suspect eighth lot lower than that just in my own clinical practice. host: do states determine individual income levels for that or is that a federal determination? guest: they determine eligibility, although there are certain federal mandates on eligibility, but they can

exceed those mandates. but they do set the benefit package, so some states will have all of their medicaid-eligible citizens going into h.m.o.'s, drug plans vary. the states have a lot of flexibility now in determining the scope of the benefits. that's going to change actually in the future, because medicaid itself is becoming more federalized. host: here's greg on our republican line, go ahead. caller: good morning. all right, sir, of a couple of quick questions. i got disabled back in august of last year, and i'm drawing through my employer a long-term disability. i had to sign up for social security this past february, or last month. now, the question that i've got with my insurance that i have, which is aetna, is the cap going off of that?

and also -- host: why did you go on disability? tell us again. caller: i got very ill in august last year of 2009. and now i'm not able to work. i'm not able to work at all right now. host: ok. sexoip i'm getting my temporary long-term disability through my employer. and i'm on cobra insurance. and with their program, cobra's 15 months. now, the question with the new healthcare plan, is the cap gone off the insurance like a million dollar lifetime cap, is that gone? and also, with the insurance, is the cobra period, is that gone with the new healthcare plan? host: we'll get a response. thanks for the call. guest: sorry to hear about all that, greg.

the cap on spending, a lot of plans have caps on how much lifetime benefits you can receive under the plan, a million dollars under a lot of plans, sometimes more, that is phased out in 2014. so right now, that cap still exists. as far as the cobra, as far as i know, there's been no additional cobra extension in this bill. there was a cobra extension in the stimulus package and the jobs bill, but there hasn't been one as far as i know. host: what's the maximum length for cobra insurance? guest: i think the caller is right, 15 months. host: and in terms of funding for cobra, is there any extra money in the bill for that? guest: not as far as i know. it didn't address cobra. i could be missing that in this bill, it's only 2,000 pages. host: kalamazoo, michigan, here's sue on the democrats line, hi. caller: hi, good morning. thanks for taking my call. i guess i just wanted to make a comment in light of all the

bickering going on in our government. we've seen that business is running our country instead of a democracy has gotten us nowhere. and it's sad that we have to mandate kindness and fairness when it comes to healthcare. at least this administration is trying something it's kind of a shame we haven't had this previously anyway, instead of being so negative about it, can't the republicans and the democrats you have no work together now that the bill has passed to fine tune it and to work all of your negativity out instead of just saying, oh, we're going to repeal it and redo it? take what we have right now and work on it. we need to give it time. you know, we need to wait for

the money to balance itself in the system and to say, it ok, you know, medicare is going to be ripped apart. we can't sustain what we have right now financially. that's one of the reasons that this is happening now. host: you mean sustain in terms of how healthcare impacts the economy, is that what you're talking about? caller: exactly. i mean, the systems were going broke anyway. so it's time now to try and fix it and, you know, if the government had to step in, they had to step in, just with, you know, trying to take over the banks and the car companies. you know, the car companies and the banks wouldn't be here, and no one wanted to take it over. they had to be bailed out. host: thanks, sue, we'll keep it in healthcare. guest: well, i think the caller makes a lot of good points. i think that there is a national consensus on both the part of the republicans and democrats that we need -- we

need to do something to give people the opportunity to buy health insurance, so the idea of universal access, universal coverage, i think you had seen a political consensus. now, it's unfortunate that, you know, when the republicans were in control of all three branches, them didn't do more to address that. they focused a lot of energy on the drug benefits, getting some other things done, education reform, you know, perhaps this should have come up earlier and it could have gotten something done, and i think the parties should have worked on that. there's no question that this bill will need fixing. the idea of repealing this bill is going to be exceedingly difficult politically. the bill itself is going to be fixed. i think democrats and republicans both agree on that, and this bill was not drafted well. that's becoming apparent, even days after the bill is out. the regulations are going to be very difficult to implement legislation a. lot of is left to the department of health and human services. they will not implement it on time. there's no question about that. what i think you're going to see is costs are going to go up between now and 2014, perhaps

quite dramatically, on premiums, and the number of of uninsured might go up because there's nothing to address the near-term impact, but there's a lot of new mandates put on insurance companies, lot of new costs foisted on the system that are going to get passed on to the scaumples you'll see the democrats want to do something in the interim as well. host: and i want to follow up on that, because you wrote a piece at the american enterprise institute about the numbers of folks that you thought would be joining the uninsured with premiums higher and more americans joining the uninsured. how is that going to happen? i mean, i thought that's what this bill was supposed to prevent. guest: wrbling the core of the bill, which is a state-based exchange of people buying health insurance and people get sub sid ise, don't get started between 2014. what does it do? it imposes new mandates on existing insurance companies, imposes new taxes on companies, and those insurance companies, loft them -- the products that they are currently marketing won't exist after 2014.

and so what you're going to see companies do, i think, is hike premiums aggressive until certain parts of the market, the small group market. they'll hike premiums fairly aggressively, and the individual market, they'll hike it aggressively, so the extent they can politically and won't incur political backlash. i think you'll also see a lot of employers so it their hands and wait to see what happens after 2014, fillinging it will be easier to put their employees into exchanges. so employer who might have considered offering health insurance are expanding their policies, just will take a wait and see attitude. both those forces combined are going to have the effect of increasing premiums and probably increasing the number of insurers. we could have a situation in 2012, you know, 2012 election, 2013, where the bill's been passed, and actually the dynamics have got an lot worse. now, i suspect politically proponents are going to use that as an argument for saying, well, we should have had the public option all along. that's not going to be why this happened. it's going to be because of the

mandates and taxes that were front-loaded in this bill actually made the system more expensive before any sort of subsidies or benefits could be apportioned to consumers. host: scott got leeb our guest for the next 15 minutes till the:15 eastern. in particular, focusing on medicare and medicaid in the healthcare legislation. you spent some time at the centers for medicare and medicaid in 2004. the news this morning is the president is going to choose his health scholar, he's an scholar of health policy to run the medicare and medicaid services program, serving nearly 1/3 of all americans, administration officials said on saturday. .

guest: the amount of regulations in this bill force anything i've seen before ever. i suspect it will not get it done on time, just judging how they have operated in the past. host: next call, richmond, va., philip on the republican line. caller: i'm wondering how much of my medicare that i pay every week goes to prescription goals, in particular. -- to prescription pills, in particular. i think the u.s. government seems to be the biggest drug dealer in the world now.

i have friends that are addicted to all of these painkillers goals that are being pushed out throughout the country. whatever happened to natural healing and herbs in? i understand you cannot -- host: let's let scott got lead into the first part of your question. -- scott gottlieb's -- scott got leavtlinb can answr the first part of your question. guest: there is a portion of medicare that pays for injectable medicines, but that is not what the caller is talking about. host: certain income of folks that are using medicare and

medicaid services are using those services a great deal. is that going to affect whether they are cut from standard procedure in terms of medicare and medicaid? guest: the providers that get hurt particularly badly under this bill are the cardiologists and radiologists, people use diagnostic tools in their practices. the radiologists will be particularly badly hurt and you will see utilization rates come down at probably. there are consolidating in a lot of states and in other states they are closing. the thing in the bill but hid them particularly hard it is that there are assumptions about how much time a ct scan or mri machine needs to be in operation. medicare apportions -- it says well, it needs to be in use 50% of the time. they have increased the number

and they have indicated that it needs to be used 70% of the day. they are not used that much because there are patients in between and there is downtime. host: it needs to be used that much for them to be reimbursed? >> guest: it brings down the rivers across the board. host: the next caller from new york, a democrat, go ahead. caller: i myself am on medicare and i do not think we should worry very much about the people on medicare because they are a smaller percentage of the population. the big one in this bill is like the cable company and the television providers, they were given all of these airwaves. and given, not auctioned off. that was billions of dollars. and not worry about caterpillar

and others. do not worry about them. they're going to china. there are some big winners in this. the insurance companies picked up 32 million new customers. we have to worry about the pharmaceutical companies, the major manufacturers. that is what we have to worry about. the people on medicare are tough. we can deal with it. the we have to worry about the crybabies. host: any thoughts? guest: there are winners and losers under this bill. obviously, my opinion is that there are more losers than winners. people who will do better are people who are more insured currently. i do not think the people or uninsured are going to do well necessarily. but we are still giving them a benefit toward what we should strive for.

if a family of four is turning up to $66,000 per year, there's no question they will do better under this bill. the will of subsidies to go into the marketplace and buy a pretty robust package. a lot of those costs will be offset. there are people who will be helped under this bill. but we are paying a lot to do that. host: he said the insurance companies are winners under this bill. do you agree? guest: they will no longer be bearing risk and rising insurance plans according to an assessment and risk. they will basically be transaction processors on behalf of the government. the most endangered species right now in the u.s. is the actuary who does risk assessments for the insurance companies. many of them will be joining the unemployment lines because most of the companies will not be

writing those contracts anymore. host: going to michigan, this is alan on the republican line. caller: i want to go way back to the woman who was calling about fear mongering and the other lady that mention that she received a letter. my mother passed away february 19 and prior to air passing -- to her passing she was sent a bill to our four -- and in the past she had not. beyond that, the insurance companies are winners. the reason why everybody raised their prices is because they knew that all of these people are going to have no choice. i fall in the category of those who will be mandated to receive medicaid. medicaid is going to mandate every move, everything that i

do. the thing that worries me besides the mandate that everybody needs to have some kind of insurance is the mandate that they are going to make you get your vaccines, make you do these things in order to continue your coverage. i am opposed to vaccines and of these other things they will make you do. i disagree with it completely. host: are those in there, the mandates for vaccine coverage? guest: it is not written into the legislation that you have to take certain steps, but there are a lot of things that people need to be part of certain well as programs. you could see those being course of in the future. over -- those being coercive in the future. over time, those could become prescriptive. it is hard to assess whether the insurance companies made out well or not. they are trading one line of business for another, affectively. they're getting out of a

declining business and now they are becoming a fixed rate. i think the pharmacies probably did make out well in terms of what they negotiated. long term, i think they made out very badly because another entire books are in the hands of the government. people made their insurance companies. dade haggling with their insurance companies. date denials. -- they hate haggling with their insurance companies. they hate denials. i can call up an insurance company, i can appeal. i can have felt -- i can elevated. i win most of the appeals. i try appealing to medicare. the one gao study that looked at medicare appeals shows that medicare has more reviles than private insurance companies. if people did not like -- has more denials than private insurance companies. host: what is your practice?

guest: hospital medicine. i do critical care. host: how often are you in the hospital? guest: 2 weekends a month. host: i have a tweet. guest: of insurance companies' profits are actually fixed under this bill. how much they need to spend on medical of the net -- benefits relative to the margin is fixed in the bill. only 15% of the money they bring in can go towards overhead and things that are non-medical. an insurance company will try to push everything into the medical cost ledger and the government i'm sure will write a lot of liberals on what can be and cannot be. -- write a lot of rules on what can be and cannot be. host: what is the biggest thing that you would like to see fixed that is not fixed currently to

your satisfaction? guest: the cost escalation in this health bill. it is very costly. if you listen to the people in the white house to cost -- to talk about the cost saving elements, all of them are designed to give medicare more authority to make decisions on behalf of patients to restrict access to things. there's nothing to make the marketplace more competitive, if you will. i think that is a -- an extreme failing of the bill on a structural standpoint. on a moral standpoint, we have dramatically expanded medicaid without addressing the short, -- the shortcomings of the program. i see a lot of medicaid patients because of the nation -- the nature of my practice. i do not even bill medicaid because of what it would cost to do the program. it is charity care. but what is really difficult is when i get -- i need to do some

specialist outpatient procedure. it is very hard to find providers who will take medicare patients. they effectively lose money on them. you have to find providers who were willing to take on a lot of charity work. host: columbus, mississippi, bombing good morning -- bonnie, good morning. caller: the gem and was just talking about what medicaid, and i will put in their medicare, pays. -- the gentleman was just talking about what medicaid, and i will put in their medicare, pays. this administration has just flipped. it is going to wind up being a one pair plan. there is no way that the government and our tax dollars -- and they will not have the revenue coming in to pay for all of these programs. already, we have doctors who are not taking medicare simply

because they are not reimbursed enough, and medicaid is the same thing. what are we going to do when doctors start getting out of practice and stop taking -- either stop taking medicare and medicaid altogether? where is that going to leave the other people who are depending on the government? the government is not working any way. guest: the caller touches -- the caller touches on the medical practices that will be changing under this bill. i think you will be seen the private practice doctor and the group of doctors practicing probably go away. you will see them earning a salary and sort of regulated by the hospital. the bill drives in that direction by changes in reimbursement. the reason why the bill wants to do that, or the administration wants to do that, is because

doctors are easier to regulate because they're working for an entity. right now, 50% of all medicare beneficiaries get their primary care for me there a doctor a few doctors from -- from a doctor or a few doctors in a local practice. if they consolidate that into a unit it becomes much easier to regulate. the other callers that said it is going to be a one national plan. my understanding is that this is a basic benefit package and everything is going to have to conform to that. eventually, all of the employer- provided coverage needs to conform to the exchanges. how they write the regulations will determine how prescriptive that needs to be. there is a dispute between the white house and the department about giving more or less

flexibility to insurance companies to offer a multitude of products. but the people who write the regulations in the department are the ones who believe you need to standardize the benefit. the president has a noble goal in mind. he wants a robust set of benefits, but the reality may be that it will -- may be that what people want can be different from what they can afford. host: it sounds like some of the changes that they were not aware of my prts it then. guest: --- that they were not af might be out to the then. one more call on the republican line. caller: when they're talking about the cost of the health care system, you never hear them talk about the cost of our tax system in the medical system, let alone the private sector

manufacturing. we have no idea how many new pages of the tax code this bill is going to be -- bring in. nobody discusses it. if you talk to the congressmen and senators and the president, they all say, and have for 30 years, our tax code is too complicated. there is a bill in congress, h.r. 25. is there. there will not allow a public, fair hearing so that we can see the cost of this. it is called the fair tax. until we change our tax system, we are going to be here year after year going billions of dollars more trying to implicate -- trying to implement a health care system. guest: i saw a story of a day that they're going to hire

16,000 new people at the irs because of this bill. host: is that true? guest: it is incredible. it was in one of the major newspapers. one of the larger takeaways from this is that there are a lot of taxes in this bill, capital gains and others. none of them went to shore up medicare, which is going bankrupt. those taxes are not going to be there when we need them to go back and pay down the deficit. there's only so much you can hike of the capital gains tax before it becomes exorbitant trade host: -- before it becomes exorbitant. host: dr. gottlieb, thanks for being with us this morning. john o'leary talks next about big government projects and about why they succeed or fail. he has a new book out.

but first, a news update from c- span radio. >> it is 9:15 a.m. here in washington d.c. economic numbers just in from a commerce department say consumers boosted spending by 0.3% in february. it is a bit slower than january's slight increase. still, it is considered an -- a respectable showing, especially considering the snowstorms. an update on the bombing in moscow today. russian prime minister vladimir putin is promising that the attackers responsible for setting off explosions at two moscow subway stations "will be destroyed." two female suicide bombers blew them up on trains, killing at least 37 people and injuring dozens. the attacks are being blamed on rebels in the region that included the chechnya. and in iraq, nouri al maliki,

says he is not happy that the united nations is not backing his calls to recount alex -- recount boss. the u.n. insists the elections were fair -- to recount balance. the u.n. insists the elections were fair. a group of independent experts will assess the global body response to the swine flu outbreak. specifically, how agencies and government -- how government agencies reacted to to the opera glass year. -- to the virus last year. >> tonight, a discussion on the just released national brockman plant. -- national broadband plan. >> a hearing this morning looking at the drawdown of nearly 100,000 contractor

employees in iraq. that is live at 9:30 p.m. -- 9:30 a.m. on c-span2. and a discussion on the future of nuclear weapons arms control at the brookings institution live at 10:00 a.m. eastern. also at 10:00 a.m., timothy geithner takes part in a symposium on women in finance. that will be on c-span3. >> "washington journal" continues. host: john o'leary is the ashe institute research fellow at harvard university and co-author of this relatively new book. you have a piece in the "washington post" a couple of weeks ago, while our greatest ambition succeed or fail. you write about a lot of things in there, the big dig, hurricane

katrina recovery, etc.. there -- are there more big government failures in the last decade and historically? >> yes, the recent drop record of government when it is a -- the recent track record of government when it is attacking big challenges has not been as good as before. starting with world war ii and you just think about the 25 year time frame starting in 1944 you have the manhattan project, winning world war ii, the marshall plan, the berlin airlift, restoring democracy in japan, a highway system. you have this incredible string of victories culminating with putting in man on the moon. and if you look at the past 10 or 15 years, the frustration that you see at government today, the anger, a lot of it has to do with iraq, katrina, the big dig, dealing with

immigration, health care. the process to get things done has not been producing the results that we would all like. host: why did the things like the berlin airlift and other things in that time friend, why did those things succeed? guest: it is not the case that in the past we got everything right and out everything fails. the bay of pigs was a failure in the early 1960's. we have had some successes of government more recently. but what we found is that all of these big achievements follow a pattern, a process if you will, that begins with an idea, goes to a legislative design, get a moment of democratic commitment. it would just signed a health care bill into law last week that was a moment of democratic commitment. but it is just a matter of the

process not being as effective today for a variety of reasons that we explore in the book. there are a number of traps along the journey and it seems like the political system is falling into more and more of those traps. host: i was going to ask you, is it because of politics? guest: i think that partisanship is a contributor. we talk in the book about a number of successful projects that take ideas from both sides. for example, astin rain -- acid rain, it was a major environmental problem in the 1980's, but we do not hear about it anymore. we were putting pollution in the air that was poisoning the lakes, but we could not find a way to deal with it. it was bringing together the market's perspective and a -- and an environmental perspective. it has been one of the most effective environmental programs in the history. it was a democratic and

republican senator -- a democratic senator and a republican center that worked across by -- a democratic senator and a republican senator that worked across ideologies. host: is that worked with acid rain, by kent that argument be made successfully again on climate -- why can't that argument be made successfully again on climate change? guest: for every example there is a counterexample. the idea of smashing together different ideologies and testing the ideas with people who see things differently than you do, it is a very important step. it is really a specific to the details of the specific legislation. for example, deregulation very much worked in trucking and airline deregulation in the 1970's.

it has lowered costs, improve service, etc. but in the late 1990's, calif. wanted something called electricity deregulation. it was not expect the the same as trucking or airlines. what happened was a major meltdown in california. billions were lost, but rolling blackouts throughout the state. just because it is called the regulation does not mean it is going to work. host: we will start taking calls here momentarily. the numbers are on the screen. while we do this, we will show some video of some of these events in the past, and the signing of the welfare bill under president clinton, the no child but left behind bill under president bush -- the no child left behind bill under president bush. we're talking about major

programs. you mentioned the big dig. that was a horrible mess. what happened there? guest: there were a lot of things that happened to their, but what we talk about -- what that happened there,, but what we talk about in the book was when the tunnel collapsed and killed a woman driving in to logan airport. when you read the ntsb report on what happened is that engineers had been seeing these bolts that held up the ceiling pulling out time and time again. rather than looking at the systemic underlying cause of this problem, they kept contributing it to, oh, a worker must have put in wrong. there must have been some dust on the bolt. there was one bold that they found that had a lot of superficial flaws on it. they attributed it to poor

workmanship. the reality is when you see a recurring pattern of failure, it helps to look at underlying systemic causes as opposed to individual failures. when we look at the big dig, we said, there are lots of problems with respect to local folks spending "federal dollars." it was supposed to be a $3 billion project 90% paid for by the federal government. what that essentially did in massachusetts is that you are spending free money. as it turned out, we ended up close to $22 billion. the vast majority was local dollars because the fed eventually put a cap on it. >> whahost: what about welfare m in the 1990's and the bill that president clinton signed. why did that work? guest: 415 or 20 years, people

up and realizing that the traditional approach to welfare was creating unintended consequences in terms of rewarding the beaters you want to prevent. just as franklin roosevelt said -- and rewarding the behavior's you want to prevent. just as franklin roosevelt said when he signed the original bill, it can undermine people's well-being if they become dependent on it. there was wide cat -- widespread consensus on it on both sides. most importantly, there had been test cases of the reform but at the state level. and in the laboratories of democracy. when that bill was signed into law, there was a high level of confidence that it was going to work because there work real instances in wisconsin and other states where you could -- where there were real instances in wisconsin and other states where you could see that it worked.

a lot of the diary predictions about welfare reform did not come to pass. -- a lot of the dire predictions about welfare reform did not come to pass. host: good morning to you, deborah, on the independent line. caller: i think this is a fascinating subject. i am of the generation of the peace corps. my husband was the -- was in the peace corps. i'm wondering if there was a shift in the mentality of the government employee, the people will put these projects together. i'm thinking back to the time when big bonuses were put in place for management in the government'-- in the governmentd wondering if that did not have an effect. guest: i think a shift that has

taken place and that we have seen is that there has been an increase in the extent to which political appointees are overseeing kind of career established bureaucrats. and i do not used the term bureaucrat pejoratively. senior executive officials whose talents and capabilities are sometimes unneeded. -- unheeded. we talk in the book about a longtime federal government employee and what happened was that he got such a good reputation for being able to implement on big projects that his partisanship became irrelevant. he was on the atomic commission for eisenhower, but when kennedy came in, he continued to be a voice for the nuclear trade

limitation talks. there was an earthquake in alaska and lyndon johnson sent him out to fix it. and nixon had him in the white house in the daily meetings. that positive symbiosis between elected officials and senior level public bureaucrats has been diminished. we have gone into a more partisan and political environments where sort of the best and brightest within public service, sometimes their voices go unheard. host: no up, roger on the caller: i have a point to make when you for started to speak. dyqthere's a difference betweee manhattan project and winning world war ii and putting a man on the moon and all of the legislation that has been coming along in the last 40 years that tends to want to micromanage every aspect of our personal

laws. we have the government telling us what is good for us, what we should do and what we should not do to lead better lives. i think many of us are very frustrated and feel that our freedoms are being systematically taken away from us. you know, for the greater good, i believe the term is. this creates a rash of frustration and anger and i believe it is responsible for a great deal of the bitter partisanship. you have a a a great deal of people who are very accomplished and learned who do believe they are qualified to determine what is best for everybody. and then you have the majority of the public. i think that is probably the key to what you would initially said as to why there is so much

frustration and anger in the country. big projects like putting a man on the moon, this is something that we can all get behind. but deciding whether or not we should eat salt or sugar or fat in our diets or how often we should go for a walk is something quite different. guest: it sounds like roger likes to make up his own mind on things in his life, which is fine. in the book, we do not try to make too many philosophical judgment. but one thing we did find is that when government does try to do something that involves altering human behavior, whether it is some of the great society programs of the 1960's or some of the education programs, teen drug awareness or teen anti- pregnancy programs, we often in the public sector underestimate the difficulties and the complexities of trying to set up

just the right incentives to get people to believe in the way that we want or expect them to. there was a housing unit that was constructed in the mid- 1950's and the actual -- people are doing thidoing this were noo do anything bad, but the reality of what took place in that housing unit was so bad in st. louis that they actually had to dynamite it. and i was in 20 years. to roger's point, when you are trying to alter human behavior you are going to run against even harder challenges. we talked to the folks in your lens who are trying to rebuild the school system after katrina and we said, what do you think it's harder, to fix the schools or put a man on the moon or the

schools? and they said, no question about it, the schools. and we had an official there from nasa, so he knew what he was talking about. host: next up, david, democratic collar. caller: i have discipline in the government. i really do not believe the government has the answers collectively for the entire country. i think is going to be very costly to ensure -- insure republicans and democrats, the entire country, young, old. i think it has to be fair. i think insurance is just insurance. i know it sounds a vulgar, but we are all going to pass. we're all going to get to an age where we are going to pass and insurance is to help protect us. there was a competitiveness

where i was going to work and i would choose which job have the best benefits, which job is going to pay me for my skills. and i would go to look for jobs that i needed, that would pay me for my skills and give me the benefits. we would negotiate and discuss. this is all going to be taken away. the competitive market for small, medium, or large businesses or education to get those jobs are diminishing, i feel, because the government is going to control most of these things. i look at the president and he is just trying to grab votes. he just wants us to look at what a better world we are going to have. host: thanks for the call and we will hear from john o'leary. guest: that is a good call. one of the traps that we talked about in the book is the

overconfidence trap. you need to be a confident, bold personality to be a leader. we talk about the fact that the first president bush was the sort of known for "wouldn't be prudent." he was a more prudent fellow, and it did not necessarily win him a claim with the voters. he was a one-term president. there is definitely the case that the biggest challenge that we have right now facing government is the idea of the gap, and the growing gap between the promises we have made for expenditures and the expected revenue. everyone who looks at this a and analyzes it from the white house to the congressional budget office sees this huge mismatch between what government is promising to do and what it will actually be able to deliver. there is such a gap between the republican side and democratic side that we cannot even have a conversation around that very

central topic. this notion of confidence and overconfidence, and this idea that -- and maybe some of it is rooted in our great past successes. we have been a nation of such great achievements. if you are my age in your mid 40's, you know that you can do anything that you set your mind to, but we have failed at some things we have set out to accomplish of late. host: there is a column in the "wall street journal" and/owitha gallup poll about how much you can trust the government and these diverging lines of black of faith in these u.s. institutions. guest: yes, i think the lack of faith is are rising because of the 10 ability of failing -- the tangibility of the feeling

results. you can keep things looking good in the short term, but reality is relentless. the fact of some of our struggles and challenges, whether it is in immigration or public education -- this is an enduring, four-decade struggle to try to get schools to work. and of course, faith in institutions is going to be less. it is going to be harder to get things done with the lack of confidence. president bush declared we're going to go to the moon. that was in 2004. nowlin 2012, that moon trip is canceled -- now in 2012, that moon trip is canceled, and we are not surprised. we have come to a place where we say, we said we are going to

do that, but now we are not. host: president bush argues in his book that no child left beyond what was a success. do you write about that -- no child left behind was a success. you write about that in your book? guest: yes, 90% of the congress voted for it and you had a lot of glowing pronouncements. it was a great achievement. we are finally going to tackle the urban education problem. in reality, -- and the results can sometimes take time. but nine years later, i do not think there are many folks out there who will say anything other than, you know, at best, it has not had a negative impact and at worst, it has been a bit of a burden placed on schools in terms of testing and reporting that has created gaming in the

states. it has been a disappointment. host: here's a photo of the president find -- citing health care legislation. -- citing health care legislation. guest: there are philosophical issues. either because it does not provide free options for all or because it violates states' rights. but in terms of just the ability to execute on it, i think the fact that it was passed on such a slim majority -- if you think about what the health care bill was doing, in order to have an impact at the end of the day, it has to be designed so as to pass through congress and get signed by the president. it also has to be designed to

work in the real world. when those two things are in conflict, clearly, on a bill like this, these changes were geared to get through congress. it is going to be interesting to see played out and it is not a process them lends itself to a lot of confidence. this is it, this bill is great and it is going to do all the wonderful things that the folks who are signing it are hopeful that it will do -- we will wait for the results. it does not inspire confidence. host: just under 20 minutes or so with john o'leary on the successes or failures of big government. this is tom on the republican line. caller: why is it that the democrats seem to encourage more and more of a percentage of our population to be in the mind of

dependence? from the callers i hear call-in, they say, i do not understand why people do not want to help the american people. well, this health care bill, for example, might as well because a welfare bill because it is just transferring from those who have money to those who cannot afford it. instead of spending time on the details of who does not have insurance and why, the thing we should do is reeducate people to the structure of america so that you, too, can prosper. that does not mean you will have things right away. america is not a high degree of dependent people depending on a few have money. it is u.f. to produce something and it -- it is you who have to

produce something that is going to be gradual. guest: i think he points out something that is very prevalent today, which is that when folks on the right look at what folks on the left want to do, they cannot comprehend why they would want to do that because they believe it would be destructive. like tom says, why do they want to move more people to dependence? and when you turn it around, the folks on the left looked at the folks on the right and they cannot believe that they would not want to help those in need, their neighbors, what have you. the idea that there is such a disconnect between the left and the right is what makes it so difficult to have a conversation. that is why -- that is one of the reasons we focus on the process. when you look at intend to results, you begin to understand why there are unintended consequences with many of the things that we have done in the past in terms of

helping, or some of the assistance programs. and you can see some of the things that have worked and tried to move to a place where both sides can apply a in an appropriate way -- apply aid in an appropriate way. the bottom line, every once a government they can be proud of. one of the things -- everyone wants a government they can be proud of. one of the things we do not like to do is itself a reflection. host: john o'leary is the author of the book "if we can put a man on the moon." he is also executive editor -- executive editor of the website better, faster, cheaper. guest: steven goldsmith is really the owner of it at the-

center. we look at -- at the ash center. we look at news, published stories about innovative practices, best practices at state and local rubber bands. one challenge is that -- at state and local government. one challenge is that governments tend to move more slowly. we try to collect good ideas, collect things that do work and promote them and spread them. host: what is the website? guest: betterfastercheaper.com. host: we will have it on the screen. frank, democratic collar. -- caller.

caller: i would like to ask if you could give an assessment of what the financial investment economy influence is on these major projects and programs. in 1958, the amount of money invested in financial products like these derivatives and such surpassed the amount of money invested in companies that actually made things. i think right now, no one can dispute the fact that corporations have tremendous effect on our agreement works and the laws that are passed. i wonder if these influences, these powers, can actually grow a branch in the works -- a monkey wrench in the works. guest: one thing that is

actually clear is the political influence of special interest, normally, special interests coalesced around producers because they are already organized. the financial industry is organized. they trade groups and can sponsor lobbyists. public-sector unions are already organized. they can pay for lobbyists. this is, without a doubt, altering and affecting the way washington operates, not necessarily for the better. the remarks process -- earmarks process in which congress men are putting in specific things for their districts, how like to call that the broken window process because it shows that they are more intent on electioneering and electoral activities that get them elected as opposed to the public good. that is a disturbing trend that

we see too much of. we have a lot of the great successes that we talked about earlier, the marshall plan, world war ii, putting a man on the moon, there was always an external threat. one of the reasons j.f.k. said, let's go to the moon, was to show that our system of government and our system of democracy could achieve great things. we could have a great economy and we could get to the moon before the soviet union. in an era where we have been unrivaled for some time, we seem to be more interested in our districts for some reason. host: in this article, it shows that were the government is that it -- is at its peak year is in 2001. mrs. 9/11 and the faith in institutions rises there -- this is 9/11 and the faith in

institutions rises there. guest: it is the attitude that as americans we can pull together and accomplish anything. and when we do face something external, but we do that -- we do that. i will say this, if we do not recognize the fact that our financial trajectory is a threat as real and as powerful as an external threat, we are in trouble. because we need to pull together to deal with ... between revenues and expenditures. -- to deal with that gap between revenues and expenditures. it is going to make everything harder for our children and our grandchildren. host: next up is a william, independent. caller: 90 you have been looking at this for a while. -- i know you have been looking at this for a while. there are a few things that have

stood out to me. as far as the health care bill, they have made it like a tv show. as far as majority rule in congress, specific politicians are never brought up in american conversation. i do not mean any disrespect, buand i know your a harvard graduate -- you are a harvard graduate, but if you pay attention [unintelligible] you have no new people in their

from any outside sector. host: we will get an answer to your call. guest: i think there is something to be said for their -- for the fact that there are a lot of very smart people that have gone to prestigious institutions who have known nothing but success. when they put their mind to some of these public challenges, the thinking is that they will be able to figure out what those before them have been unable to figure out. i think the complexity of the bills before congress, whether it is a farm bill, or in military expenditure bill, you know, a health-care bill, or an immigration bill, the details and complexity that we ask our senior elected officials to be familiar with are just daunting. i do not care how intelligent you are.

i think this idea of humility and the ability to establish protocols in situations that leverage the intelligence and the wealth of knowledge that is distributed among the people is very important. host: going back to putting a man on the moon, based on what you have written and reported about, if we were pressed to do something of that scope again, to you think that the u.s. is up to it? guest: we just cancel the moon landing program after eight years in the budget. i am ultimately optimistic because we can set the direction. the problems that we have created for ourselves, we can fix for ourselves. but i also believe that we can fail. one thing that is in washington is that there is not an appreciation of the fact that there is the possibility of big failure. you your politicians say all the

time that failure is just not an option. -- you hear politicians say all the time that figure is just not an option. the reality is that it is always an option. we ought to be realistic about the way things have been going, we have to say that we need to address our problems with the process of how we things -- how we get big things done in government. host: ken on the line from seattle, republican. caller: i just wanted to say, with the budget that we have to work with four big government money -- to work with four big government money -- host: use the term in the book sometimes called brainstorming. what is that?

-- blame storming. what is that? guest: there is often times the systemic underlying process failures. you can take intelligent, well meaning people and have them trying to do the right thing and still have things fail. there are handicaps or systemic factors that make getting big things done in government even harder than getting things done in the private sector. we think that the blame game is ultimately destructive that it lends the notion that it is a human failing. it is because george bush did not care. or it is because barack obama wants to get reelected. the aftermath to hurricane katrina, for example, there were a lot of things that went wrong. a lot of people made mistakes.

but also, the systems were not well aligned to deal with the problems. the local government and the state debt -- state government and the federal government were not sync up in a way to deal with the problem. it did not matter who was in the mayor's seat or the governments -- the governor's seat or the presence seat. host: john in massachusetts, democratic collar. caller: what about people who make deals with certain corporations and they make certain rules or laws and find ways to give breaks to corporations through taxes? and all of these things where they come in and say, non-profit and everything else. it always seems like there is a redistribution of wealth and it always comes down to people who have money being able to find lawyers to find loopholes, a

democrat or republican. and when they talk about their children and grandchildren, they are already set. these are millionaires that have passed down the wealth through generations. i think that certain populations would like to see more representatives of their color and their kind. but it seems like there is a disparity with a certain race that does not want to let go of the power. in america, everyone should serve and represent the country. host: john, thanks for your input. guest: there is no question that the influence, or what i call the electoral demand of being in the house -- in the senate or congress, every two years or so you will go up for election.

for almost every politician in this town, it means being able to raise incredible sums of money or being able to write yourself at a check for an incredible sum of money. i think that the potential is there to refocus. i think there is a culture shift that almost needs to hit washington. yes, there are electronic demands -- collect world demand, but at the same time there are higher priorities. -- electoral demands, but at the same time there are hired parties. -- higher priorities. host: next caller on the line from wyoming.

caller: my question is, how can we make our senators and everybody back in washington accountable for the loss of our manufacturing, our textiles, our wood? everything that we working people have to pay taxes. you know, families and people before us have died in wars to pay into social security since its inception. we have guys doing backroom deals selling our country, you know, our banks. there is just no end to what these special interest groups will do as lobbyists.