. .

host: "republicans have also done the nation no favors in this political rush to turn this oil spill into mr. obama's katrina. in attempts to tie this to mr. obama, they have targeted the mineral management service, suggesting that bureaucracy --

bureaucrats were not tough enough on big oil. never mind that the gop is targeting one of the few federal agencies that happens to believe in more domestic energy production. we suppose that it is too much to expect politics to withhold the game of panic and blame and we learn what really happened and why. the american people watching this spectacle are being given one more reason to doubt the capacity and candor of its political leaders and." we want to hear from you this morning about your thoughts on the politicians in washington and around the country reacting to the gulf oil spill. the front page of "politico" has this, "u.s. governor uses

spotlight to criticize the white house." on the latest attempt to stop the spill in the gulf here is the front page of "the times picayune." "corp. spewing oil well, a 60% chance that it will not work and it could make the situation worse -." actually, 60% chance of success. we will talk about that this morning with admiral thad allen, along with other issues. cooks well, tennessee. the morning. -- good morning. caller: we are not talking about what caused the platform to sink.

was it one of those conservationist groups, a terrorist attack? host: what evidence do you have of that? caller: that is what i am saying. we have not heard anything about what caused the platform to catch fire. host: it is an ongoing investigation. have you been watching the hearings? caller: i have and no one has ever said the reason. at the same time for over 30 to 40 years we have had platforms like this and none have had this problem. i think that conservationists that do not want drilling offshore, i think they started this fire. i believe that. host: william, democratic line. caller: all of these people are trying to bring down president obama.

they are the ones that created all this mess. they will not work with them. republicans will not work with them. these stupid people [unintelligible] and that is all i have to say. host: independent line, good morning. caller: i am calling from oklahoma. host: yes. caller: with this type of operation why did they not have some kind of backup so that they could cut it off? host: all right. north carolina, democratic line. your thoughts on the politicians and the gulf oil spill. good morning. caller: good morning. host: what do you think, sir? caller: the blame for this is placed strictly on the congress for the united states. congress wrote the laws that

govern the oil spill, bp and of the zero oil drillers. then they gave the regulators the right to overlook this and gave them a pass. it left them strictly open to bribery and corruption. the ultimate blame is with congress. host: the president is expected to travel louisiana on friday to look at the latest efforts to stop the oil spill. here is the editorial from "the wall street journal." "changes will allow for new rig safety, additional inspection will be required to verify safety procedures and environmental precautions were in place. regulatory changes are detailed in a 30 day review ordered by the president last month.

ken salazar is expected to reveal many of those recommendations during testimony today." remember, live coverage of that on c-span 3 and seized and radio. "if the oil is still flowing on thursday, mr. obama will also address what more can be done. this step up response comes after political heat is rising as critics said they were too dependent on bp for a solution. others said the government's response has been sluggish and not well coordinated. the office of bill -- bill nelson calls on the president put the military in charge of the clean up." thiensville, north carolina, independent line. caller: you must have an idiot line for that first caller.

sounded like he was way out there in left field with his suggestions. i guess everyone has to have something. well, i got something to say too. with at this petroleum mess, how many people trust this -- we in this petroleum mess, how many people out there -- with this petroleum mess, how much do the people trust these people with nuclear power? host: "bp had takes a swipe at critics over oil spill cleanup. yesterday he insisted that while the reputation of bp has suffered damage, it should not last long if they do the right thing and that the u.s. is an important market for bp. and that they are a big and important company for the u.s.. the position goes both ways."

white haven, pa.. mark? are you there? i think we lost them. tried to call back in. we will move on to freddie on the democratic line in indianapolis. go ahead. caller: i have to agree with the guy that said that this problem falls entirely on the congress. congress makes the rules. they allow this to go on. the last congress with bush allowed to much to go on. i cannot understand, do not get me wrong when i say this, but why is it that white republicans are so crazy about things. they are always so easy to blame others and they are never consistent with anything. that is all i have to say. host: " your post" this morning

has the latest poll on how the -- "the new york post" this morning as the latest poll on approval ratings for the president's handling of the oil spill. 51% approve. dallas, richard, are you there? i think that i pushed the wrong button. sorry about that. we will try to get back to richard in a minute. first let me show you yesterday's hearing before the senate environmental committee. senator grasso's comments on what is happening. >> boyle continues to gush into the gulf after 36 days -- oil continues to gush into the gulf after 36 days. 5,000 barrels per day, now

scientists say that the numbers could be much higher. the cloud of confusion is very concerning. it is also very unclear who is in charge. "administration torn on getting tough with bp." "secretary salazar says that bp has missed the deadline after deadline. secretary salazar says that the key is not doing what it is supposed to be doing." just yesterday the coast guard commandant thad allen says that to push bp out of the way it raises a question to replace them with what. that is why it is hard to tell who is in charge. host: florida, jerry, republican line. we are talking about politicians and the gulf oil spill. good morning.

caller: this oil spill right now, sad to say, mobile, fort walton beach, those areas are open for fishing. no one is covering that. on the other side of the coast of florida there is plenty of fishing still there and no one is talking about it. the people here are suffering. everyone is just suffering and no one is covering the open fishing in florida. come on down and go fishing and have a great time. it would help the businesses here. host: what do you think about the job of politicians? caller: they do not do much for me.

they just wanna get their face in the picture because it is something big. that is all i have to say. host: los angeles, carl, democratic line. caller: the tea party people are always saying that there is too much government, too much government. there was not enough government and we had an oil spill. we had a financial crisis. another thing, the newspapers need to stop calling mr. obama mr. obama and start calling him president obama. host: regulations across the federal government, as quoted in " and your post," thad allen will be our guest later this morning. his blueprint for taking on the

federal deficit, but first we will continue to take your phone calls. showing you from yesterday's hearing a democrat talking about what is happening there. senator debbie stebiabinow. >> in march of 2009 and explosion at abt facility in texas resulted in 170 injuries -- an explosion at a v.p. facility in texas resulted in 170 -- bp facility in texas resulted in 170 injuries. this is part of a track record of safety problems that our fate -- frankly very concerning. they were again find last year

for failing to correct safety hazards after that 2005 explosion. 439 new safety hazards were found, they were fined for a huge oil spill in alaska because of a corroded pipeline. according to a recent study bp refinery is are responsible for 90% of all flagrant violations found by government inspectors. most were found to have egregiously willful behavior. host: talking about politicians and the gulf oil spill, but first we want to talk to jay sherman with "politico." he wrote the story yesterday with the latest report from the minerals management service's.

what has been happening at the mms and what has been happening? caller: as everyone knows the mms has been under increased fire. politicians have been hammering them for bad regulation. but there is this inspector general that details everything from accepting football tickets from the industry and while regulating the industry some of these folks were simultaneously negotiating jobs with the people they work regulating. the obama administration was quick to point out that this did not continue, that they tightened regulations. important to note that this happened previous to 2009.

host: the interior secretary is going to testify today on the house side. do you expect this to be brought up? are you hearing about any announcements that the interior secretary might make on this issue? caller: there are reports that he might announced new regulations when it comes to grilling and he will be at the house natural resources committee. he will get question about this undoubtably. we have heard from chairman grayhall that he plans to bring up not only this but the obama administration's plan that he is not completely on board with it yet. this will prove to be a contentious hearing on both sides of the aisle. as your callers mentioned, democrats are not happy with the obama administration and regulators on this and i think that that will come up. host: what is the likelihood and timeframe for splitting it up

between different agencies? caller: i think we are pretty far from that. the chairman and former chairman of the house natural resources committee have both said that this is not something that they are interested in doing right now. i am not exactly sure how this will play out. mms is in such a state of flux, radical changes do not seem to be welcome by a lot of democrats. host: will the acting ig the testifying? >caller: he will be up there and it will play an incredible part in the hearing today. you will definitely see questions from the republicans and democrats will definitely

point out that this came from before the obama administration. republicans will say that this proves the government regulators cannot be trusted. host: is the ig making a tie between what happened at mms before 2007 and what could have happened in the oil spill? caller: this is an interesting time for this report to come out. that is not lost on anyone. i spoke with george miller yesterday and he pointed out that this administration has inherited a lot of things to fix, that is how democrats are seeing this. they have repeated several times that the bush administration took the referee off the field. that the regulators were a completely secondary fought for

the bush administration. that they were doing these kinds of things that are detailed in the ig report. people regulating, taking tickets and private jets, sending pornography. democrats say that the bush administration regulatory environment was just terrible. everything from banks to offshore oil drilling. host: is there any legislation brewing to increase the amount of regulators or inspectors at the mms? caller: there has been no legislation that has been talked about right now. although the one piece of legislation that seems to come up constantly is the oil liability cap. republicans and democrats have yet to come to agreement on it, but the obama administration has also pushed other

administration. aid for the gulf. that is a little far off. the main thing as a liability tax. host: jake sherman, thank you for joining us this morning. orlando, florida, ronald. independent line. caller: thank you for c-span for providing a forum to talk about this. as much as i would love the place the blame on congress or president obama, and i am not at all pleased with the way that they have been handling these things, i think that we have to accept the blame as a population. it is our culture of consumption. we are all involved because we seem to have no sense a limitation. we think we can continue to grow in population and all of the resources that we consume and

what we are doing is destroying the planet. i hope that this illustrates that people who want to deny we are changing the atmosphere and changing the global temperature, thinking that we could never make a large scale change like that, this is a very large scale change that we are making, that we already have made in the ocean. host: your sentiment is also what al gordano writes on his blog. "without thinking about just how harmful this gusher will be, a lot of people seem to be screaming that people should be yelling louder and screaming harder. every single one of us than ever got in an airplane or drink

from a plastic bottle is to blame. they're made from petroleum as well. the heavier the carbon footprint, the more you are to blame. -- blame." boston, republican line. caller: seems that president obama is hiding. i would like to see him pull together his big government and fix this oil spill. host: you want the military to step in? of the government to take over? caller: he said that the government could take care of everything, that is what he said when he was elected. host: all right. here is "of the baltimore sun" this morning with a piece from tom hamburger. "some people link the gulf spill

to oil tax incentives. taken from the operations in the gulf of mexico, it is smaller than the government share in other countries. the u.s. is 38% to 42%. argentina, australia, china, yemen, they all take much more from these oil companies." robert, democratic line. virginia, good morning. caller: can you hear me ok? like that other gentleman said, this man has inherited a basket of snakes. there is so much quid pro quo. some of these things that are going on, no one man could possibly solve all of these problems. these are things he had nothing to do with. these things happen because you

have oil companies got themselves in to the government and made some deals. we are trying to get things passed, trying to get regulations passed. the republicans are doing everything they can to stop the man from changing the situation. i would not have the job. i would give it back to them and tell them to have a nice day. host: valerie, new york. your next. caller: i want to let people know that obama has been relying too much on bp to clean this up. the other problem is that no one seems to realize that the saudis had a similarly large oil spill. what they did was they sent in

oil tankers to suck it up and it was somewhat -- subsequently claimed by them. i have heard it other places. i guess there are other things to say, but that is all i have. host: thank you for calling in. "the fears of a euro zone banking crisis on the korean peninsula rocked markets in areas of government debt like germany and the united states and." other headlines this morning, an editorial from "the philadelphia inquirer" about joe sestak. "calling on him to fill in the blanks, he went a long way in

his fight with arlen specter by stressing trust and accountability. he needs to be more forthcoming about his allegations that the white house offered him a job to stay out of the res." this morning on immigration news the president went to capitol hill yesterday to meet with senate republicans on immigration and tax legislation, hoping to get some bipartisan support for that. "the washington times" has the headline "obama is to send troops to the mexican border to increase security." in "usa today" this headline, "1 dozen major city police chiefs will meet with eric holder to oppose the controversial immigration lot in arizona that they fear could drive a wedge between the community and local law enforcement."

columbia, south carolina. joe, republican line. politicians and the gulf oil spill. caller: i am one of those crazy white republicans that that guy called i about. -- called in about. he is blaming congress and everyone knows that bush is too stupid to understand that congress has been controlled by the democrats since 2006. this thing about people calling the president mr. obama, they are the same people like called bush bush. they did not even call him mr. bush. it is just hypocrisy. i keep listening to you every morning irian a lot of these black people are just totally racist. this is not a political thing.

we need to be together on this and we need to fix it without pointing fingers at people. that is all i have to say. host: melanie, democratic line. new orleans. caller: bp should never have gotten a permit if they did not show that they could solve a problem like this. look at the 29 miners that just got killed. disasters happen. this shows that they should have shown that they could handle someone like this. host: do you think that going forward the government' should have a team that can respond to an oil spill like this? caller: they should. bp does not care.

if the government does not care, who will? i think the united states should do everything in the powerhouse -- in their power to clean this up and did the deed to pay for it. host: in a memo that came out of a congressional investigation cited in "the wall street journal," "something being wrong could have been a fundamental mistake." kalamazoo, michigan. independent line. good morning. caller: can you hear me? host: yes, go ahead. caller: this is an environmental issue, not a political issue. this is something that we as a

species need to take care of. politics and politics, who cares? this is filling our earth. -- this is killing our earth day. -- earth. why are we not using a simple straw? host: we will be talking with admiral thad allen, he will be joining us in about 15 minutes. so, we will talk about the environmental impact dell latest on the oil spill. manassas, virginia. go ahead. caller: this should not be a political issue. a lot of republicans should take blame for this because the bush administration did have a lot to

do with this deregulation. just take care of the problem. republicans, take some blame. host: you do not think that you are being political by saying that republicans are to blame? caller: well, they are because this went on under bush. host: all right. jamie, democratic line. berkeley, california. caller: i do not want to sound political. i believe that this is an environmental problem and we should be working together but we should have been working together from day one, january 20 with, -- 20th, 2009. but they were always criticizing

him, calling him a socialist. now they want him to come in and take over oil companies? why should he not step back? even though this is a collective thing. someone suggested yesterday sending everyone who is out of work done to the gulf coast. before operation does not want you going down there. they do not want you -- the corporation does not want you going down there. they do not want you to having an. they do not even want the media the showy footage of what is going on. these corporations are too big. and they are failing. thank you. host: next caller. caller: this is another bush reagan mess.

no oversight, no oversight, this is what they kept saying. thank you. host: richmond, virginia, republican line. good morning. caller: just listening to what everyone has to say, first of it is political because it happened under obama's watch, so it will be political. did in a black republican. -- i am a black republican. first off, dick cheney and donald rumsfeld were two of the smartest individuals in washington, d.c. they were not racist individuals. a lot of people try to associate racism with of the republican party.

but this is clearly an extension of trying to do too much. i think that they considered it national security to have this much oil. he listened to these people complain but if they went to the gas pump and could not get gas, they would go crazy. dick cheney and donald rumsfeld, some of the smartest individuals in washington. host: we will leave it there. more on that meeting between president obama and senate republicans yesterday. "lunch marked by a spirited conversations. whether he could count on support on any issues was left

open to question, including imposing new sanctions on iran. his less private meeting was in january of 2009 when he was newly inaugurated. partisan tensions have only grown since the aftermath of health care and most recently the overhaul of rules governing banks." louisiana, democratic line. good morning. caller: i do not be -- i do not live very far from the gulf coast. this is a republican state. they cannot have it both ways. it looks like the only time i want the government to step in is when they can benefit. that is all i have to say.

people are very hypocritical. host: tony, independent line. good morning. caller: good morning. people are thoroughly brainwashed, accepting this artificial by the in the two- party system. -- artificial divide in this two party system. going on across the country right now, republicans are being brainwashed to the end of there's a difference between the parties. what is going on? they have created this environmental disaster. they have policies on the shelf. they have allowed this to pass to take the policies of the shell. what really happened in that gulf oil spill?

the oil rig blew up. host: we will leave it there. on the international front, north korea severs all ties with the south. this headline from "the wall street journal," "secretary of state hillary clinton has been in japan along with the treasury secretary, timothy geithner. the summit shows superpower is shifting dynamics as the two secretaries spoke at a news conference here while florence, south carolina. roger, good morning. caller: in a pipe fitter by trade. -- i am a pipe fitter by trade.

i would like to make a comment about this solution, of making the problem go away here. i have e-mail bill o'reilly and my cousin. it will not take but a second. i think that this would work. in the granger supply catalog you will find a test ball nematic. of course it would have to be made to be more heavy-duty and larger in this case. the device would be placed inside of the pipe and then inflated inside of the pipe, which would shut off the flow of the oil. i think they are trying over think this. anyways, you need to inflate some kind of device into the

pipe. i believe that that would work. host: hang on the line for a second, "the times picayune" has an image of the procedure they are trying to day. "heavy mud will carry a pipe down the raid from the surface -- down the rig from the service, hopefully the pressure will choke the oil and gas from flowing." what do you make of that? caller: i think it is a pretty good idea and i hope that it works, but what they've tried so far has not worked. i have spoken to a lot of my pipefitter friends about this. my colleagues. they seem to think that you need to put a inflatable the vice -- device down there. it is called a test ball flow.

host: we will move on to our next phone call. samantha, florida. caller: i do believe that this is a political problem. as well as an environmental problem. this is a very flat state. i think that corporate america, corporations around the world are really dictating what our leaders are doing. it has moved very far out of the reach of the american people. i think that it is a systemic problem worldwide. really, there is very little transparency for the people. for the community around the world. corporate america, global america, what ever you want to call it, corporate interests globally, of what they are doing

to our earth everywhere -- once we have more oversight may be we will have more control. host: remember, ken salazar will be testifying this morning. coming up here on "washington journal" we will be speaking with admiral thad allen, the man responsible with coordinating the government's response in the gulf coast. we'll be right back. ♪ >> this holiday weekend nonfiction books and authors on c-span 2's "book tv."

sebastian younger and his book, "or." as well as -- war." three days of "book tv" on memorial day weekend. again the entire schedule on booktv.org. >> it is hard to be the only woman on the court, something i experienced for about 10 years or so. in a population which these days produces an least 50% of law school graduates being women, it is realistic to think of there being a number of women on the court. not just one. host: learn more from the former justice o'connor and others who have served on the bench in c- span's new book. canton -- candid conversations

with judges of the supreme court. >> "washington journal" continues. host: admiral thad allen is the outgoing commandant of the u.s. coast guard. taking over officially with a new title yesterday as the national incident commander for the deep water rise in oil spill response. thank you so much for being here. we appreciate it. we want to set aside the four gulf coast residents. 202-608-0184. the admiral will answer your questions momentarily. beginning with the front time -- front of "the times picayune." if this does not work it could make the situation worse. what will happen today? when will you know if it will

work? i know that that camera down below for viewers to see what is coming out of there is going to stay on. will people be able to see what is going to happen today? guest: everyone needs to understand that everything that happens down there is to remote operated vehicles. one of the most maddening sports of -- maddening parts of this response. they will see portions of a sequence of events. there are two vessels on the surface. they are pumping this blood--- mud-like substance down to the bottom. putting into a metal frame, there are two lines. slowly they will bring pressure down to the frame and it will be

brought through the hoses in the choke and kill lions. at each point the remotely operated vehicles will be working on the bottom. the public will be able to see whatever they are doing, but without comment. will be very difficult to understand what they're seeing. host: when will they know it works? guest: it will take a few hours. host: when do they start? guest: they are very close to starting. it is one of those things where the sequence of events will go from step latest that be. host: if it fails and makes this worse more could be spewing out according to some reports. what will happen? guest: i do not think they will take it to the point where it will make it worse.

i think that they will take it to the point where it does not work they will come up with another way to attack the oil. the only way that it could be worse is if the pressure was so high that the pipe ruptured. the pressure going down has been carefully calibrated not to exceed the pressure of the pipe. as we mentioned, if this does not work they will be going to a joint shot. -- john -- junk shot. host: what are your impressions so far? we have heard you talking about your relationship with bp. you have flown out in the area. what are your impressions of how bad the oil spill is? guest: is bad. anytime you have oil on the water is an insult to the environment and we should have no illusions that this is a

catastrophic event. i have overflown the impacted areas and been out on the drill rigs and relief wells. i have seen the blowout preventer they are going to use to replace this one. make no mistake, this is a serious issue. bp needs to stop this week. host: -- stop this weeleak. host: what is your response to the people who have criticized the government in their response? guest: the response structure is mandated by law from the oil solution laws of 1990 after the exxon valdez. the notion is that they would be contacted and that they would be identified in plans that there was a spill brought to the scene

to be utilized. most of the work being done down there is being done through oil response contractors through the intent of the original law. the management of the contractors is a matter of command control through the office of the local federal coordinator. is more of trying to get the resources to where the oil is that. one, stopping the oil where it comes out of the pipes. second, dealing with it on the service and how you deal with that of land. each one of those areas requires a different application of resources. host: the man in charge of katrina has been critical, saying that this should be declared a natural disaster. guest: i am not sure what would be gained by that. i think he is talking about national disasters after the

stafford act. as carried out under the national response mandate it is different. there is a structure in place by which to execute the spill. host: some have said that the military should step in. what is your response to that? guest: it depends on what your talking about. if you are talking about controlling a leak at the bottom of the floor of the ocean, the private sector in terms of oil companies as the access, means, and capability to solve a problem. none of that is in a government inventory. the government does not maintain oil drilling equipment. access to the sea floor, to the blowout preventer, it will largely have to be done through the of private-sector.

i have had conversations with salvage from the navy. if you move from the service we are using dod assets. c-17 cargo planes from as far away as alaska. getting down to the beach clean up there is a role for people that might be able to do the work but i do not think that overall this is the type of response that would call for dod oversight. i think it would be an inappropriate use of their authorities. host: let's turn to the phone lines from people eager to speak to the admiral. dave, your first. caller: good morning. things are starting to get ugly down there. the governor has requested that the corps of engineers has requested dredging of barrier

island. you mentioned a couple of reasons, one of them being that it takes a long time to do. it has been over three weeks and we still have not had a decision. the other reason is the consideration over ecology. if you build barrier islands off of a coast you will have a new eco system. i do not understand why the corps of engineers will not approve this. this could go past august. it would be really nice if the corps of engineers would lead us to some dredging. guest: first of all i have been

in frequent contact with the head of the corps of engineers. the state requested a permit to construct these islands. their responsibility is to review the permits and look at the implications concerning where the materials would come from and how the materials were down. making an estimate on the time and costs, so forth. the corps of engineers is doing that right now and they have not released their report yet. it will be an issue of funding. because of that we have been following this in parallel so that there is no extra process at the end. they are near the point where they will be making a recommendation on the permit. we have been looking at this closely. we have some concerns. six-nine months of getting oil on the beach.

no one understands the barrier island issue better than i do. we know what they mean to the state of louisiana and the gulf. the real question is what the most effective response is right now to deal with the oil on the service and coming ashore. after making that determination hopefully we will know more. host: charlotte, n.c.. republican line. caller: the military is the voting assets to this disaster. exactly what could the military do? what about fighting fire with fire? an explosion caused this

disaster. what would be the navy's response to shooting some sort of torpedo, i guess, something with a bunker busters' capability. is there a way that we could do that? shoot something down, actually? you have to create a force great enough to stop the pressure, as i understand it. what about having to cut off the tap completely and look at it as a last case scenario. host: we want to show the viewers and live video courtesy of bp's web site. go ahead, admiral.

guest: first of all, let me clarify what the well is and what it is not. this will was being drilled as an exploratory well. they were in the process of capping the well to put a production rate on the scene when the accident occurred. he referred to a spider operation, but this was a single real line in this case. regarding the use of explosives, there has been some talk -- it has not been originated in my staff -- about whether that should be done. frankly there are a lot of negatives to that and it is not being realistic reconsider right now. it can be very important to bring that to the service to do forensics with the purpose without the potential use of explosives. host: a live video that we judge

showed our viewers of the oil spill that is happening, we are showing that right now. according to the newspapers you spoke to bp and asked that they keep that camera on during this next procedure. why? guest: there was a lot of discussion about who is really calling the shots and will they listen to the government. i have had a number of conversations with the ceo of british petroleum. he was wondering whether or not running this thing alive might put stress on the operators who are trying very hard to do delicate maneuvers to make sure that these hoses are attached. making sure that they were not under the pressure of being watched as introducing another level of risk. we were having that discussion

was apparently something was leaked out to the public, no pun intended. that was never the case that we were going to take that issues -- we were going to take issues over transparency and what we were doing and not doing, we were hoping that they would go live to the feed even with potential additional risk in the interest of the public understanding that when we make agreements like this this is what happens. host: sarah, democratic line. caller: good morning, admiral. first of all i wanted to say that the coast guard, i realize, is such a small part of our military. it is such a difficult organization, i wanted to talk about that. its size. i also wondered if the admiral could put to rest the stories

that other countries and organizations, such as the dutch, have offered. they have expertise to help control this. i am curious if you have heard this before and whether or not if their health has been offered. host: admiral? guest: let me answer the second one first. we have a team that evaluates and offers to provide equipment. that is according to the state department. if there is a need and an offer that meets in we can do it, we except it -- accept it. bp has the accepted one offer from mexico and we have a vetting team that goes through that. if the capability meet their

requirement, we will except it. . . i sink relates to the fact that there is an institutionalized relationship a cleanup work. there has been visibility at the coast guard. you will see them on the cleanup teams as well to make sure the contractors are performing as they are supposed to. >> can you give us a number?

guest: we probably have about of on-and people. -- about 1000 people. host: how many people across agencies are down there? guest: on any particular day approaching 20,000. host: we have an e-mail asking why fema is not in charge? host: guestguest: the source ofr this is bp. after that it is the oil liability trust fund. the construct of this response and the way it is constructed is different from be met. host: is bp paying into a fund every day to pay for this? some say we should be finding bp

every single day. guest: they are making cost reimbursements as we give them cost every day. they're providing grant money to the states that are affected. this is in terms of economic impact in the equipment. it's a government or anyone that is not bp cents eni resources due to the oil spill liability trust fund the costs are refunded. host: jim on the republican line your next. caller: admiral, i would like to know why no one is using submersible pumps to pick the oil upright at the well. -- pick the oil up right at the well. guest: we are in a way.

the problem is we cannot get a good seal because there are tears in the pipe. we are trying to catch the oil as it is coming out of the pie. that is what they're doing with 2tube.sertion to th if the top kill shot is unsuccessful, there are devices that will pump this to the surface. one of the problems we have with working pump down there is the presence of hydrates. that is a mixture and natural gas and water under pressure at low temperatures that forms ice crystals, which was a problem with the first containment device. in addition to figure in out of pumping device, you have to use ethanol his to make sure they do not freeze in can be pumped to the service. host: louisiana on the independent line. where is river ridge? caller: not too far from new

orleans. my concern is the dispersants being used. in the house infrastructure committee meetings last wednesday, the congressmen have td a list of the dispersants. he said it is the second most toxic compared to this percent, which was 100% effective. i would like to know the relationship between bp, the epa, and you in regards to who has the mandate for which dispersants are being used. i know there has been a plane that has flown over and now they're starting different dispersants. i would like your opinion on why the second most toxic one is being used please. guest: bank you. that is a great question. the epa approves a schedule of dispersants.

-- thank you. prior year to the response, it was on the schedule. one of the things we found is that this is the first massive use of dispersants and an oil spill since the authority to dispersants was granted after the exxon valdez. under that legislation they wanted to look at alternate technologies. in the case of exxon valdez it took a number of days to negotiate how dispersants would be used. wheat lost the opportunity to optimize their use. what has happened in the past 20 years is we have had a number of pre-approved protocols in certain parts of the countries where certain conditions exist. in this case, british petroleum and the contractors are working out there using dispersants letter on the epa approved schedule less. they started using them. what happened is the use of

dispersants has gone way beyond we have done everythin-- what hd is the use of dispersants has gone way beyond what we have ever done in history. it is logical to look at the agricultural impact of those. bp was asked to provide information on alternative dispersants and their effect but the availability and logistics and the issues with shifting to a different dispersant. a number of issues were raised. there will be a decision forthcoming. host: union grove, alabama. jim on the democratic line. i have a short question for you. host: go ahead.

caller: how big was the dispersant tube? why can't we insert other tubes to do collection right alongside those? if there force in there, there should be no ice crystal problems. if more tubes could be placed in there, that kepcould have been done a long time ago. guest: thank you for the question. when we were able to surveil the pipe that has crumbled the line on the bottom we found out there with resources of leakage. when was at the very end where it had disconnected from the mobil drilling unit. there are two other places

where it was torn and oil was coming out. bp was able to successfully ancp the end of the pipe. those are the sources of leaks. the insertion to was put into the other week, and what it is is a smaller piece of pipe, eight to 10 inches in diameter with a rubber sealing to seal the pipe. since the opening of the pipe is a regular and it is spent, it does not perfect reseal it but it does a pretty good job of capturing what is ever coming out of that. we have it as high as 6,000 barrels per day based on the studies. what they have to do is pumped ethanol into it to make sure they do not have the hydrate problem. there's a mixture of gas, oil, and water that comes up a pipe that has to be separated by the

production vessel on top. that is ongoing. the reason we cannot do it at the other week site is the beels because of the bend. if they will have to capture it and treated with methanol and bring to the surface. host: the republican line. go ahead. caller: thank you for your service. they put a tube inside, why don't they put one on the outside over it with a flexible material to go over the pipe and seal it? has there been any discussions on that? at the end of the first iraq war halliburton was hailed as

heroes for stock and all the burdens and oilfields and i know they're part of the problem, but are they participating in any of the situation to try to help stop this? you are a very lucky person that president obama is president because you are not going on vacation on memorial day, are you? guest: when i finished doing press i am flying home to louisiana. i will be on the beach with the cleanup crews, which is where i should be. regarding your first question -- the irregularities nature of the riser pipe that has been spenbe does not make it easy to steal it. almost everything like that has been considered. we're trying to tap into the pipe, basically cut a hole in the pipe and put a ball on it.

that has risk associated with it as well. that may be considered it the top kill is not successful today as well. host: what are you going to be doing today? what is your schedule? guest: i have a meeting at the white house i have a private staff. as soon as we have everything stabilize in the new operating environment, i will be off to the gulf coast. i plan to go to the impacted areas where the oil is on tour and i will work with the oil. i will work with contractors. maybe just talk to people on the street. host: will you be running this response from the new nebraska office or down of the gulf coast? guest: command posts have been set up around the gulf. operations are being conducted out of homa louisiana.

the other command post is in mobile. when i do is deal with the issues above that on resources, issues like dealing with british petroleum on the video feed. dealing with members of the administration. and tried to take as much of the external burden of the commanders down there so they can focus on the task at hand. the chain of command, we are all accountable. host: argue in d.c. or down their? -- are you in d.c. or down there? guest: both. host: how long do you expect to stay at that post as the national commander? guest: i will stay as long as i am needed. i am required to retire by law.

host: the suspect you will be in this role for months? guest: i do not dig it necessarily has to be me. having someone has to speak about the critical issues going on and be in washington and down there when the need arises. host: the you expect this will go on years? guest: months? host: 9 years? g-- not years? guest: it is hard to say. there will be a lot of work going on. it is not unlike at the the initial response in petrina that we shifted to long-term recovery but you're still doing. host: unmanned on the independent line in new orleans. tsk callecaller: with all due ri

am in no way of putting blame on you but as far as the response after katrina and i understand what the doc has to do with oil spill cleanups and there are only so much they are limited with knowledge and capabilities of doing. however, i find it difficult that we're continuing to call this an oil spill. this is an ongoing fawcett. as far as resources go, this is not just an environmental problem, it is going to affect the economy. the way new orleans works, we have a lot of independent fishermen when whenever the economy goes bad, we do farewel well because our guys

were all dead. they do a lot of things. i feel like the way this is going and the lack of response and the fact that no one is accepting any outsiders to put their best foot forward with any ideas they have. if guesguest: you make a good pn the first part of your question and comment. one of the most problematic things about this bspill -- and then not sure that is rthe right word -- but that threat is in directional and indeterminate. what i mean is it is a series of concentrations of oil that came to this service at different times that may have not been treated with this verdict dispe.

there are concentrations of oil and miles of open water that are not impacted. because of that we have to have resources ready from basically central louisiana coastline to pensacola, florida. that really raises the degree of complexity and the resources required to do that. what we need to have is more agility and flexibility and bring the resources were there is no impact and put them where we need them, similar to southern parisienne right now. in response to your second point, everyone that has anything to do with this problem is being asked about it. people are being comment -- augmented by people of the national labs. i have been down there on a couple of occasions to talk to them. the u.s. geological survey is leading a team to establish what the actual flow rate is.

i would tell you that the best minds we confined are being brought to problem -- brought to the problem. host: tony on the independent line. caller: good morning. why can't they just put a bomb and bomb that things tha shut? guest: you could do something kinetic down there. i am not sure we understand what the implications would be. we now have a board that is bringing hydrocarbons up under pressure to the surface of the ocean. even if we were able to close told and pick the mess and, that oil has the possibility of going out into the strata, closer to the surface. there are under water practices that are poll of water and that could come to the surface

through a crack and it would be out of control. i think that is a risk that is too great to take a chance on myself. host: don on the democratic line. caller: pie have a solution to the problem. using another linyou sink anothp into the pipe so the oil will go to the top. what you do is to slowly reduce the pressure with that type. you control the oil flow. guest: that is exactly what the

solution to the problem is. the issue is at intercepting the pipe has to be done much lower down to make sure they can relieve the pressure and do what they need to do. right now there are two relief wells that are being dug to intercept the pipe. that will allow the current welter thl to be capped. it makes an imperative we control the league of the top of the well head right now. you are correct. the solution is to intercept the pipe. host: the independent line pearman caller. caller: are you familiar with the blow and the gulf of mexico in 1979? guest: yes, sir.

caller: 10,000 barrels per day for 10 months or so. all this business about how the world is coming to an end and so on and so forth i am hearing, will you discuss the impact of that and why we're all still alive and those kinds of consequences. guest: i am happy to do that, but let me make something very clear. the current situation is unacceptable. any delay than what it takes to stop the well should not be accepted by anybody. the fact that we had a catastrophic events in the 1970's that puts that much oil out and the notion that we have recovered today, i guess that is ok but saying this is anything less than catastrophic is not indicated here. i would say that that blood was not in the vicinity of the very

sensitive marsh lands in barrier islands we have in louisiana. i understand your point but i do not agree to minimize the importance of this event. host: cornelia on the republican line. caller: my son has a very good idea. he came up with an idea of somehow -- i do not know because i am not mechanical -- but did you have a number or a way we can reach you and get ideaive i, and also i would like to ask our nation to pray. guest: i will give you a website. it is called deepwaterhorizon response.com. everything can be accessed through the site.

host: how many people are working on ideas to solve this? guest: we are getting thousands of calls. it is almost more than we can manage. everyone has an idea. i get messages left on my phone. a lot of ideas coming out. host: you are getting messages on your home phone? people have found to? guest: i will not get into that. i work for them all to the central clearing house of ideas. -- i refer them all to the central clearing house of ideas. host: go ahead. caller: thank you for c-span. i served in the air force for nine years, and also i am a mechanical contractor for pipe fittings. i think everyone needs to settle down. this situation is something that impacts the entire climate. we are all using trains, planes, and cars. we will have this type of thing

happen. serving overseas in italy i saw some things happen. we can get this under control. pointing to each other has nothing to do with it. this is an economic thing we need to do. if we can come together, it will happen and happen right. host: what are the chances that the top kill or any of other procedures that you are trying or any other procedures -- do you think any of them will work or will we have to wait until august until this is finally resolved? guest: waiting until aug. is unacceptable to me. i think doug settles estimate 60% success chance. that is what their position is.

there are a couple of other things. in the can actually use a rally operated vehicle to cut the riser pipe of of the blowout preventer and dredge but of all the in. they have not wanted to do that because they do not know how many hydrocarbons will be released. the second is in probably a more substantial fix would to be putting a new glow prevent dirt on top of the other one. it is actually two different devices. that can be separated by a hydrostatics felc valve. host: that is in the sequence of when? went with that have been? guest: it would be at the top kill shot is unsuccessful and the use the drugs shot and were not able to reduce the pressure

and go back to the top job. then they would have two choices. one would to be cut the riser pipe and then put a new blow up for a venture in. the pressure inside the blow up reminder that we have some indication. i was out on the relief role wells last week. -- i was out on the relief drills last week. if this fails, they will be in a position to bet anew blowout preventer aput on a new blowoutr on. you need to understand that while the diagrams were extremely accurate, the entire package weighs 1 million pounds. it is four or five stories high.

while it looks simple, and this very large enough to be suspended down. progressions are being made if they have to use that. host: the independent line from new jersey. caller: the tank looks pretty good, but have you thought of putting several pressure relief valves on the tank so the pressure would blow off until you can pipe them one at a time to the surface? >> they call that a top hat solution. afollowing the sequence i just talked about, if these things fail, they would also take the top has at devices as well.

they have those devices available if they are needed. host: an e-mail asking, perhaps this is speculation, but what is the worst case scenario? what could happen? guest: if the leak goes up and checked or there is a catastrophic loss, oil would come out of the well until the pressure was equal to the pressure in the reservoir 18,000 feet below. right now the pressure in the reservoir is around 9000. that is the pressure that is forcing the hydrocarbons up. the pressure below the blow up printer is somewhere around 3000. what would happen is that there was open contacts of the oil into the water, it would continue to rise until the pressure of the water column was equal to the pressure of the oil pushing up. that would be probably counted in hundreds of days.

that would be catastrophic. we need to avoid that at all means. caller: i have a suggestion. why couldn't you take a share in a piece of pipe together temporarily to slow the flow down. could that be done? guest: theoretically it could but the problem is it would have to go around the riser pipe where it couldn't move the oil. right now there is only 3,000 feet above the riser pipe. then it turns sharply over. that is where one of the leaks are at. the layout of the pipe does not allow you to do that. and what you will ultimately need to do is put another blowout preventer over the existing one.

host: some have called for a government fleet capable of responding to a blown well in the future. what are your thoughts about in the future should it be the private sector or the government with some sort of sleefleet that response to a similar condition in the future? guest: i think a lot of things will be looked at. there was a basic decision and foreign some of the oil pollution act. we have been working under the paradigm for 20 years that there is a combination of rules for the private sector and the u.s. government. that has confused a lot of people in this response. another than that the assumption was made up most of the oil response and oil production lies in the hands of the private sector. this is a classic economic case of should this be public goods or private goods? i think there will be a lot of

discussion on this moving forward. host: one more quick phone call. susan on the independent line. caller: what happened to the black box that nobody seems to be addressing? #2, here in florida they are starting a pre-clean up by gathering of haiup hair puttingo panty hose and putting it into a mesh bag -- will that work? guest: we have done a comparison and we have found that the traditional boom is superior. it does not appear that is an optimal use of that material. when you say black box -- i am

assuming you are referring to the control box. and one of the banks that had to be done was to put an new electronic brain to be able to operate the choke and kill lions. for that reason the control panel that was there and failed was brought to the service and repair. it was put back down so it could provide the signals to the choking kill line. host: admiral thad allen, thank you for talking to the public. we will turn our attention to medical next. first, an update from c-span radio. >> in the headlines, space shuttle atlantis and its six crew members are set to land soon in florida. in this will end the third to last shuttle flight. there were concerns the rain could interfere, but mr. control says it is looking favorable for

a touchdown at 8:48 a.m.. north korea threatened to block crossed border traffic and blow up any south korean speakers blasting propaganda. as tensions continue to increase over the attention of the south korean warship. meanwhile, in seoul, after meeting with south korean leaders, secretary of state hillary clinton says the world has a duty to respond to the sinking of the south korean ship. president obama has ordered 12 hudgens national guard troops to be security -- prison obama has ordered 1200 national guard troops to boost security along the border. according to lawmakers. finally, a new census figures say the growth of interracial marriages is blowing across hispanics and asians while african americans are substantially more likely than before to marry a white. the number of interracial

marriages have risen 20% since 2000, to about 4.5 million. those are some of the latest headlines and his band radio. >> years from now when you return here, when the shadows have grown longer, i have no doubt that you will have added your name to the book of history. >> memorial day weekend on c- span. what commitments from leaders in the arts, sports, and sciences. right now watch past years speeches online at the c-span video library. it is commencement speeches your way with every program since 1987 available free online. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] host: dr. james earl hackey is here to talk about legislation that is moving through congress right now.

for the physicians for medicare reimbursement -- if this does not pass we will see a 21% cut in their reimbursements forcing medicare patients. here is the newspaper this morning. "doc fix cut that could yield an extra 20 billion. some are concerned because of the total price tag is about 65,000. the doc fix not allowing a reduction in medicare reimbursement to go through is nearly a third of the tax bill costs. some senators are very concerned about that. with the deficit 1.4 trillion and medicare costing and medication costing 774 trillion , why should the government be making this cut for overall

fiscal help? guest: this is a great example that congress created. they created a formula that said the more care is provided to medimedicare patients, the grear the cut next year. it gives the impression there will be a cut because of services that will be provided in the future. that is not really true. this is care that physicians have already provided to patients. the problem with the formula is that when a physician cares for someone with heart failure, sees them more often, adjust their medicine, test their laboratory, keep them out of hospital, this formula kicks and that results of in a 21% reduction in the payments to physicians. the issue is it is not a fix, the reality is that if they do

not fix this, there will be an access problem for medicare patients as well as military families because they're covered under the same formula that is broken. host: what would be the result? guest: right now the p program pays physicians 20% less than what it costs to keep office open. doctors still want to take care of patients, so we continue to try to see these patients. but as the costs to keep office open goes up in the payment from medicare goes down, at some point you have to say i cannot accept any new medicare patients. that is what we're seeing. we are seeing one in four new medicare patients are finding it hard to find a primary-care physician. host: how many other patients would you have if you did not

see medicare patients? guest: i am cardiologists but not all specialties have that sort of population. when you have is a very difficult situation for physicians. they're saying i want to see these patients that i have cared for four years and years but when they go on the medicare program when they hit 65 and all of a sudden i cannot cover the cost to keep my office open, i am left with a couple of options. i can drop out of the medicare program completely or what i can do is say i will not accept anybody knew, but i will keep taking care of the patients that i once or i will disclose practice. i have 60% of my practice is medicare patients. i am trying to invest in information technology, but i am looking at a 21% cut june 1 and what congress is talking about is temporarily making a change,

but then coming back in 2014 with a 35% cut. and what we're trying to do is a look at congress, if you need to permanently fix this. nine times in the last seven years they have put temporary band-aids on this that have grown the problem. we think it is time that they will have to permanently fix it. host: you wonder permanent fix to the formula that they came up with, which is now under current law going to mean a 21% reduction in reimbursement starting june 1, unless the senate and house were to go forward with this so-called "doc fix" and put a temporary solution in place. put this in dollar amounts. this means what for a dr.? guest: for the average physician, it depends on how many patients who are seeing. myself, it did% is medicare patients, so we would see a

reduction over $20,000. you say that is a lot of money. you're absolutely right, it is a lot of money. that money is needed to pay my rent, utilities, staff. also invest in the health information technology. medicare and the federal government has consented us to said let's get electronic medical records. let's move towards a better way to connect with each other. that, unfortunately, cost dollars. when you have a program that does not cover your costs and says we will cut you 21% more, and every time you see a patient and you provide the preventive care and you keep them out of the hospital we will penalize you by cutting you more -- it is a broken system. that is what we have been arguing with congress to say this form of the was created in 1997. a lot of medical care was done in the hospital. and now the majority is done as an outpatient. this formula penalizes

outpatient care that positions are providing to keep medicare beneficiaries healthy. this is care that has already been provided. that is why we are telling congress you are playing with books that are wrong. this is an accounting gain. we think that we need to reconcile it appropriately. this would keep medicare patients healthy and out of a hospital. we should not have to be faced with these cuts. host: for your practice, how much does it cost to run your office? the paperwork, the administration costs. guest: about 50% of the cost is overhead. that is all those things you talked about. salaries for staff, the rent, utilities, that liability insurance premiums. all of the things that are required to really keep your office going. in addition, what we find for

many positions, they are basically not taking salaries so that they can keep their offices open while they are trying to figure out what is congress going to do because of congress allows this set to go through, and again they have temporarily patched it three times. host: in this year? guest: in this year alone. when you look at the money they are allocating under budget to migimmicks, three years ago and they could have fixed this whole problem for less than 50 billion dahliait dollars. it is 210 billion right now to fix it. if they temporarily patch it for three or four more years, it may be half a trillion dollars. host: if the reduction where to

go into effect june 1 -- were to go into effect june 1 would that lead to quality care versus quantity care? guest: the ultimate default is always gone to the emergency room. our colleagues in emergency medicine do great stuff, but on the other hand if the patient needs to have their diabetes managed, they do not necessarily have to go to the emergency room to have it managed. that is widely believed that the reality in the united states is the medicare program he has some buckets. one packet covers a hospital. part b is what we're talking about. we are covering the part of medicare that covers physicians' reimbursement. we have changed how we provide

better care by keeping people healthy, but this formula penalizes doctors for doing what is right. host: carol on the democratic line in maryland. caller: my daughter is a position in texas, every have opposition. -- a rehab position. all of her patients are medicare and medicaid. and her social security is withholding what they owe her, and they say they will pay her in june and take a 21% off what they owe her, and i was wondering if she earned it before june, how can they take another 21% off? guest: thank you for the

question because to highlight one of the challenges that the medicare program sometimes has. they will say to file a claim for a service that you provide in, and then medicare can say we're not going to pay you for 14 days or 30 days or 60 days, but that is the service you have already provided. as a business person, 50% of physicians in the united states are small businessmen and women that are trying to keep their offices moving in the cash flow slowing. and when you have a pay here where the predominant player is the federal government and they are saying we will not pay you for a while that becomes very difficult to keep office open. -- when you have a payor where the predominant payor is the

federal government and they are saying we will not pay you for awhile, that becomes very difficult to keep office open. host: a tweet who asked deplease give me an example of investing in information technology. what and where would you have to spend money on? guest: right now in the federal government they are trying to come up with standards. where we are in the united states is kind of like the old roads. i have a computer and the department of defense have a computer but none of them talk to each other when we talk about an electronic medical records. that will require $50,000 for the hardware and software and upkeep to be able to interact

back and forth. we have to recognize that the medicare program, when they pay what ever they pay, a physician cannot builill the difference. if you have to generate more revenue and able to invest, you have to do it somehow, and when you have a 21% cut you are looking at, that is not economically viable. host: washington, d.c., call on the republican line. caller: imf position in the d.c. area. -- i am a doctor in the d.c. area. my practice takes medicare, but that is not a high percentage of the volume we see. unfortunately i feel if the payments for medicare and so forth are followed closely by the insurance companies, and while a good percentage of the income is from insurance

companies, which it paid about 30 cents on the dollar. my question is, with that sort of normal insurance company tied payments and so forth, how do you find that these cuts that the insurance companies will respond to that? guest: thank you for the question. you have highlighted one of the challenges we have in the united states where medicare, the see that the medicare rates pegg, many private, commercial insurance companies tied their payment to a percentage of that. back in 2000 to the medicare program -- bakc in 2002 there was a 5% cut. men need wound up suing their payment rates from the commercial carriers also decrease. -- many wound of seeing their

payment rates from the commercial carriers also decrease. it becomes very difficult for physician who is trying to deal with the medicare program, and medicaid program, and a commercial payor where you do not have the ability to negotiate to keep your practice viable. we have tried to be working with the federal trade commission so that we can deal with some of this insurance market dominance that does not allow physicians to have choice, and certainly does not allow patients to have choice in providing a product that can allow you access to the positions that you want to see. host: cleveland, ohio, on the independent line. caller: i have to man the health insurance. -- humana health insurance.

they gave me a prescription plan but i refuse because i paid $4 for each of my prescriptions that i get, and they automatically capture from my health insurance. what do i do about this? guest: for a situation like that, usually in the state you have office of insurance council or a state department of insurance that you can usually complain to. it is the medicare program, certainly you complain to the medicare program regarding your situation so that they can look at it and investigate it. host: patrick on the democratic line. caller: i just want to say that i think you mentioned the system earlier, and i think the real problem is that the system would be between making a choice between people's lives and money to begin with.

i just wanted to ask a question about what you think of the single payer system. we run at 70% gdp. i think the question is how we use our tax money to support our health benefits versus what we're doing now. guest: when we take a look at the last year and half of the discussion of health reform it was very clear that the solution we would start to deal with was going to be an american solution, and one of the values america has always had its choice. that choice, but we have, is a pluralistic system. in other words we have our private sector system and a public safety net, but when we take a look of the medicare program, that actually is a program that has been around

since 1965. many of the beneficiaries right now under medicare have worked all of their lives to pay the taxes and to the medicare program, and they expect as a result of that that congress will provide them what they have been promised, which is access to medicare. that is why we believe this formula needs to be permanently fixed. host: russell on the independent line. caller: good morning. doesn't many hospitals negotiate with the doctors on different prices for procedures? guest: usually the hospitals and physicians are not negotiating with each other. they are both interacting with peers, and those can be the private insurance plans or when

we talk about the medicare program, there really is not a negotiation. the medicare program set up of fees schedule, and that is what you have to live with. the problem is that when they do not cover your costs, and go to the private sector to subsidize that that is something that has been going on since 1965 with the private side has been subsidizing the public side because of the chronic underpayment for what it really costs to provide good, quality care. host: one issue that has come up since the passage of the health care legislation is droctors dealing with insurers. guest: there is something called the claim. when i provide a service i have to file a claim, that service. it cost dollars. it cost personal calls on my

side and the interchange with the pay year. if they take the claim in and says you did not kill everything out and send it back to me, then have to pull it back out. -- then i have to fill it back out. that has created administrative waste. if i have contracts with 10 different insurers, they have 10 different processes and 10 different forms. i have duplicated the effort tremendously. one of the advantages in the legislation were rules that need to be developed of the next few years to streamline the process. they have a unified way that all papers will be able to follow and all positions and folphysicd hospitals will be able to follow.

host: what is the timeline for streamlining the regulation? guest: they are supposed to be implemented by around 2013. time for the health insurance exchanges online in 2014. host: ed on the independent line from kansas. caller: i am a formweer medical school professor. i would like you to address what medicare spends for attorney doctors and physicians. when you graduate medical school york people pull -- when you graduate medical school, you are capable of doing nothing. it is years of training. you are cardiologists. that would require some more in the neighborhood of five years of training. in 2008, medicare spent $9

billion training about 64,000 positions -- physicians. i would like to hear you speak about that and liability or at least a moral responsibility that positiondoctors have to car the elderly. and guest: the doctor brings up the issue of the medicare program. in 1965 it paid for graduate medical education. four years of medical training graduate degree, but you sometimes need additional training at the bedside with clinical professor said are able to oversee what you are doing so you can come out and become what we call a board certified in a particular area. many times that takes three to seven years.

what the medicare program did in 1997 is it throws the number of positions they would pay and only paid for the first board certification. as the doctor mentioned, i am a cardiologists. my sprfirst three years was becoming an internal medical specialists. they did pay for that. this is something that we have said that needs to be recognized, that as we need more doctors to be able to provide care for the baby boomers -- remember it next year they start entering the medicare programs -- as we need more doctors, the cap on what medicare is paying for for3 becomes very problematic for us to get enough people trained in needed specialty like primary- care come in general surgery.

we know that the medicare program, the federal government has been helpful, but there is still more that we recognize to deal with the workforce issues for the future population. host: the democratic line is next. caller: i have medicare and supplemental insurance. does the supplemental insurance pick up the reduction by medicare to the doctor? says the supplemental pick up the difference in the amount? -- does the supplemental pick up the difference in the amount? guest: it will pay for 80% for what the sea is and the beneficiary is responsible for

the 20% difference. when you buy the supplement program, usually the supplement will pick up the 20% that normally is required for the individual to pay for. however, that does not go more than what medicare is going to pay. it really cost me $70 when you take a look at the personal costs and administrative costs to see you in office but medicare only pays $30, you would be responsible for the 20% of the 30 and your supplement takes care of that, but the difference between $30 and $70, right now positiodoctors provid, but we know the cuts of 21% on top of what we are currently not getting reimbursed for is making it difficult, and we're seeing doctors have that difficult choice to close the practice

completely to a new medicare patients. the ama does not want that to happen. they want congress to live up to the obligations they made many years ago when they created the medicare program so that people like yourself have access to the doctors they want to see. >> on the issue of medicare reimbursement. senator kent conrad who opposes what is currently written in the legislation has come up with a compromise. he wants to reduce the bill prizefights freezing a scheduled cut in medicare payments for two years instead of the 3.5 planned in the initial bill. this would take a final solution on medicamedicare payments. what are you picking up about what this commission might do or say on the issue of medicare reimbursement? guest: i think it highlights that people are elected in to congress to make difficult

decisions, and our belief is that the commission congress created many years ago is that they have been advising for congress many years they need to fix the formula and increase the rates. and whether or not this new commission will suddenly have a different product cost than the start commissions that have been advising congress, we will have to wait and see. . .

guest: well, again, when we take a look at the differences and the payment of medicare bills, we have to understand that what the physician bills is not necessarily what medicare or certainly medicaid pays. there are many services that a physician provides. for example, people that have long disease sometimes get breathing tests called astrometry as part of the office visit. you get your oxidant -- your oxygen checked. host: next phone call, houston, texas, kathleen on independent line. caller: the question i have for the doctor is what is the ama's

position to the political trend that the patient is not entitled to their own facts? guest: not entitled to their own -- host: kathleen, are you still there? caller: yes. guest: not entitled to your own facts? caller: joe biden would often use that phrase, saying that the patient is not entitled to their own facts. i got into an interaction with a doctor where one i communicated what happened, she came from the perspective that i hallucinated it. guest: well, thank you for the question. what we recognize at the american medical association is that the patient must interaction with the position is a very important documentation, called a medical record, and that the physicians document in the medical record what they have heard from the patient, what the perceptions are. the patient should come under

current law, have the right to see what is in the medical record and make recommendations if they don't believe that is correct. that can be added to it. however, there is no obligation under law that a physician has to change the record, because again, the record is the physician's impression of what the patient has said, with the physical examination has shown. again, i think we are very forceful, from the ama's perspective, of saying we want group communication between the patient and physician, because once you start with that, the chance of a better health outcome is much higher. host: scott, democratic line. caller: doctor, you had previously mentioned the use of electronics. i'm curious -- where does the ama stand on the use of

biometric devices? it would appear that that kind of device would eliminate certain types of a fraud perpetrated against. as, as well as preserving the integrity of medical records, but also be a red flag, which is obviously a recent issue with respect to the lawsuit. i would love to hear your take on that. guest: thank you for the question. we have a house of delegates at the ama that twice a year come together, representing states and specialty societies, medical students, to create policy. we do not have a specific ama policy on biometrics. we do, however, encourage that interact with a patient with electronics, there is, before the interaction occurs, the patient and physician having an agreement of what the electronic interchange is going to be. there is security so that the patient, if they are going to interact with the opposition and

the position is going to interact with the patient, -- with the physician and the physician is going to interact with the patient, they agree on proper encryption for security and privacy reasons, as well as to make sure that if i am going to communicate with you, you sign in on your electronic computer with your thumb print, that i know is exactly you want all of a sudden that e-mail direction comes across. host: the ama is against a 21% reduction in medicare reimbursements. is there percentage of cuts that is reasonable, that you could still covered all of your costs and provide access to patients? guest: what the ama wants to do is fix a formula that is broken. this formula continues to create an issue that when doctors in 2010 are providing health care, there is going to be a cut in

2011, because we provide better care now, more things we can do to keep people healthy and keep them out of all hospital. when they go to the hospital, part a program pays for that. this is part of the problems. if we save money by keeping the patient out of the hospital with heart failure, it saves part a but it penalizes the doctor for doing what is right. we believe that we need to fix the formula, that this concept of taking it down the road, a little bit of a band-aid -- host: are you saying no reductions whatsoever in medicare reimbursements? guest: we believe that right now the physicians are taking a 20% reduction and what they would be paid, they would be paid under the same medicare economic index that hospitals and nursing homes had been paid for since 1997. what we feel is that we are already seeing medicare patients under what it really costs to keep your office open,

and that is one of the reasons we are seeing more physicians that are saying, "i am taking care of you, you are 64, but when you turn 65 and go on the medicare program, i will not be able to care for you, here are some of physicians you might need to transfer to practice over, i cannot keep my office opened with over a certain percentage of medicare patients, because the payment system is not allowing me to do that, and i cannot build you as a patient the difference in what is really costs may, unless i dropped out of the medicare program for two years, and i don't want to do that." host: david on the republican line. caller: this is a doctor. thank you for speaking up for physicians. the problem is not 1997 and the formula for expert at the problem is 1965, when congress made -- 1997 and the formula

fix. the problem is 1965, when congress made the promise and they cannot keep the promise, and they change the law so that when the doctor drops out of medicare, you cannot get the benefit that medicare promises to pay. with medicare promising to pay $60 for the doctor's bill, medicare will not pay the doctor the $60 you pay out of your paycheck for your attire working like. i would like you, -- for your entire working life. i would like to, if that is fair, for medicare to keep a promise even if the doctor leaves medicare and the patient can pay the balance. guest: certainly, the doctor brings up the challenge th, that this does not allow the

patient and physician to enter what is called a private contract. if the patient and physician wants to negotiate what the fee should be, and medicare pays $50 when it really costs you $100 to provide the service, the patient and physician could decide whether or not the patient can afford that additional $50. that was prohibited in 1997. as a result, the only way the private interaction between the patient and physician occurs is it the position dropped out of the medicare program for two years. what this has created is more of a stress on the federal government, trying to come up with all the dollars. it has moved away from the interaction between the patient and physician. as the ama, we believe that the medicare program has done a tremendous benefit for medicare beneficiaries. it has provided security and stability for those who reach age 65. but over this last year, with

all the patches that have been going on, the medicare program is not as secure and stable as it used to be. as the ama, we believe very strongly that as physicians, we want to care for our patients. we are trying to convince congress to quit putting band- aids on a problem that you are only growing every time you put a band-aid on. there is an old texas saying, if you are going to have to swallow a frog, the lottery look at it, the bigger it becomes. -- the logger you look at it, the bigger it becomes good years ago it was -- the bigger it becomes. years ago it was a tadpole, now it is a bullfrog, and it will become jabba the hutt. host: floyd from west virginia on the independents' line. caller: i have a couple comments. one way to deal with the cost of

medical care would be to -- you go to the hospital, they take an x-ray, they read it, someone else reads it, you go in and the doctor that is in their read it, and they give it to someone else to read. it is directed to protect the doctors, and that is fine, but if that is the case, let the doctors paid for it. guest: you bring up the question of if i interpret and ekg, the pair, be it the federal government or the private payer, is only going to pay for 1 ekg interpretation. but you bring up a valid question. because hospitals and doctors tend not to interact with each other, because we don't have an

electronic system that links, there are times where, for patients seen in one part of the country and having tests done and going vacationing summer isles -- vacationing somewhere else, all the tests seem to be duplicated because no one has access to it. one of the things that we as the ama has encouraged is developing the interoperable standards in ways that physicians can interact with each other so that we do not have to do the duplication tests. at the time you are being seen by your physician, that physician has access to all the medical records they need to serve you at the time they are be -- at the time you are being seen. host: last fall, at north carolina on the democratic line. -- last call, north carolina on the democratic line. caller: how do doctors decide how much they charge? guest: the question is how

doctors decide how much they charge. it is like a business person. you look at what your overhead costs are, and then you calculate based on the rent and utilities and how much staff i have, what is my student loan repayment that i am going to have to come up with every month, since i am now coming out of medical school with to audit thousand dollars worth of debt. i put all that in -- with a $200,000 worth of debt. i put all that in, and i sit at to see a patient, it will cost $75. what will i get paid for that? if the medicare program only pays you $35, but it costs you $70, and at $35 they are telling you we will cut a 21% starting june 1, you don't have to go to business school to say, "i may not want to see medicare as the payer." we believe that we want to keep

a physician's office is a viable. physicians are trying to do what date went to medical school to do, to take care of patients, but to do that, you have to wrap up his practice that will allow you to do that -- to have an office practice that will allow you to do that. host: dr. james rohack, thank you for being here. guest: thank you for allowing us to do this. host: next up is steven pearlstein. at usdebtclock.org, you can see a running tally of the deficit. we will talk about all that would steven pearlstein. first, headlines from c-span radio. >> touchdown for the space shuttle atlantis in florida, bringing down the astronauts to boosted the international space station size and power, and ending the atlantis' 25-year

playing career. bp is still running tests as it decides whether to go ahead with another effort to seal the well in the gulf mexico. the chief executive says that if he gives the green light, they expect the so-called top kill procedure to happen today. it involves pumping heavy mud into the gutter. cabinet officials, including interior secretary ken salazar, will be back on capitol hill the day to take questions about the spill. live coverage of the house national resources committee hearing starts at 10:00 a.m. eastern on c-span radio and c- span3 tv grid the gulf spill raising doubts about expand offshore drilling, president obama will be talking today about alternative energy sources. he is said to to to or a solar panel manufacturing plant in northern california -- set to tour a solar panel manufacturing plant in northern california. finally, a republican who lost

one of the closest governor's races in u.s. history in washington state, is expected to announce his candidacy as senator against patty murray. >> this weekend, nonfiction books and authors on booktv. on "after words," "perfect storm" authors sebastian j junger, and john hofmeister on "why we hate the oil company's stock was that the full schedule at -- why we hate the oil companies." get a full schedule at booktv.org. host: steven pearlstein of "the washington post close what to talk about a column you wrote this month -- steven pearlstein

of "the washington post close " to talk about a column you wrote this month. it is this is what republicans have called for an democrats of call for over the years. i want to take our viewers to the debt clock web site, which showed that the intro of this segment, and it shows $13 trillion for the federal debt, $1.40 trillion in real time for the federal deficit. what is your 50/50 solution to this? guest: well, it is a blueprint. it does not have all the details in it, but it is more details than most people in journalism come up with. my thought was that we are basically looking at a old = 6% of gdp -- a whole that equals 6% of gdp. we will be on eight fundamental bases 6% of gdp more than what we are paying for.

we need to close that gap. my thought was to do 3% of it through spending cuts and 3% for tax increases, 3% of gdp. in time, the proposal that i put forward action would be more spending cuts and less taxes as the restraint on entitlement spending starts to really bite in, they start to save more and more money. we will probably get to about 2/3, 1/3, or a 60/40 split. but initially, 50-50. host: you write that part of the blueprint is to hold federal help spending, medicare and medicaid, increases to gdp growth plus 1%. and rather than the ttp-+ 2.5% that has been the norm. -- the gdp + 2.5% that has been

the norm. can you explain that? guest: why do i pick gdp? it is essentially our income. our spending on health has been growing 2.5 percentage points every year, which compounds, remember, faster than our income. guess what? you cannot do that forever, obviously. pretty soon it will consume all of our income. just making that one little change -- it is not so little in terms of dollars, it is a lot of dollars -- but 1.5 percentage points of growth every year, and again, that compounds, and it becomes a much bigger factor -- is really a key to the reduction in spending. i have other reductions in spending as well. but that one is really the key. host: we're talking to the ama about the so-called undock fix

and the medicare reimbursement rate. they're supposed to get a reduction starting june 21, but it looks like congress will do what they have to do it for the last seven years and step in and not have that reduction. -- what they have been doing for the last seven years and step in and not have that protection. how much is that to our overall spending? the medicare reimbursement wi. guest: i think the doctor was disingenuous when he answered the questions put by the words and you. -- by viewers and you. he talks about the cost of the office, he talks about the eve -- rent, and the staff, and all of those are real costs. but the biggest cost in the doctor's office is the doctors pay. he did not talk about that. doctors in the united states in general are paid twice as much as doctors in every other country.

now, the ama thinks that is right, thinks it should be written in stone, thinks that is the way the world must be, because that is the way it is today. there is no reason why doctors have to get paid so much, frankly. now, there are a lot of doctors, maybe even have doctors, who probably are not overpaid -- even half doctors, who are probably not overpaid. primary physicians, emergency rooms, and they get and stay -- get nice pay. you and i live in a major metropolitan area on the east coast, specialists here, surgeons, a urologist, cardiologists, people who, you might say, higher level work and might get paid it little more -- five ordered thousand

dollars, $600,000, $800,000 a year. some of it from medicare, some of it from private insurance, but they think of it as their divine right, and any reduction is terrible. costs,ey don't meet my they really mean a don't meet my target for what i make next year. for doctors in the ama to talk about the costs of running the doctor's office and that we're losing money every time someone comes through the door, that is a spurious argument. if you capped the spending increases to 1% of gdp growth, where would patients and other people see reductions in health care? guest: lots of different ways. we could be here all day t. just limiting the growth in dr.'s income would be sufficient. not producing, just limiting the growth -- not reducing, just

limiting the growth. more of the money should go to primary care physicians, and less money to the specialists. medicare is the process of trying to make that, but as you can imagine, that is very controversial. the only way he could do that is to basically say to the overpaid doctors, we will not give you as much of an increase this year as the primary physician. but that is really not the major area. the major way you save money in help it is to reduce utilization, reduce the number of procedures, the number of tests done, and how do you do that? we waste a lot of money. a lot of times when people call in to shows like this, they refer to their own experience -- last week i got an mri or last week i did this or that. what health reformers tell you

is that you should not think about those things, because those generally are not with the big money is, not with the big savings is. remember this thing we all talked about, and you have heard many times -- a small number of cases every year, 10%, 20% of the cases, account for 70% of the spending. that is when people get really sick. sometimes it happens at the end of life, sometimes not. sometimes that care is unnecessary, most of the time is necessary. but not all of it is necessary. and we do not have good systems for doing what we know, what science knows works, and sticking to that and not doing the other stuff. host: we are talking to steven pearlstein for tackling the deficit but he came up with -- on tackling the deficit. he came up with a blueprint for tackling the deficit.

guest: every -- lately, in the last generation, we have probably -- last two generations we have added almost seven or eight years to life expectancy, the average life expectancy in the united states. and yet the retirement, the official retirement age, has sort of remained the same. actually, it creep up a little bit in social security. if this keeps going on -- when social security started, most people did not live up to 65. now most people live to the mid- 80s. what started out as a program for the people who happened to live a long life is now program for the average person, lasting 20 years. it creeps up that much again, and people leap to at 95, and they only work 40 years, and the

retirement is 30 years, the mathematics don't work out. you have to put more money aside during those 40 years of working to pay for what is a much longer retirement. what i am only suggesting is that it does not have to be month-to-month, because our population is growing and that helps us. our incomes grow when we work. but we cannot continue to hold the retirement age at the same and yet let the longevity and like of retirement keep getting longer. the system does not work. something has to give an something is giving. host: if you read a little bit more from a column, it says "at the same time, slowly reduce the cost-of-living increases for social security benefits for wealthy seniors while slowly increasing their medicare premiums. everyone else's benefits would remain untouched." how much would that say? guest: well, it is a lot.

all of these things is a lot. each one of these little things i've suggested -- the big one is the going from 2% to 115%. this is a medium-sized way to cut spending. -- to 1.5%. this is a medium-sized way to cut spending. even liberals are concerned about the means test in social security and medicare repo. everybody pays roughly the same percentage to maintain road public support. if these are seen as a welfare programs, mostly for the poor, they are concern that the public will stop funding them because political support will go away. frankly, that is a luxury we cannot afford any more. there are a lot of a very comfortable elderly people now.

they can afford to spend a little more every year, all in the case of social security benefits, afford to have their increases be a little less in order to make this system solvent again. that is probably what we're going to have to do. in addition, as we go to the other side of the ledger with my plan, it also suggests raising more money for social security and medicare taxes. we need to put more money in on the front end but slow the money going out on the back end. host: we will talk about more in the column, but first, your phone calls. albuquerque, new mexico, go ahead. thanks for waiting. you are on the air. caller: ok, thank you. host: the ahead, please. caller: first off, i want to say that i'm 76 years old. i worked until i was 73.

i paid into medicare and social security, which of course i still. my husband is a federal retiree. we pay over $8,000 a year on insurance. i tried to get in when the doctor was on. i never hear anybody mention -- they act like we get all of this for free. social security and medicare. we do not. we pay out of every paycheck. and they raise it every year. nobody ever mentions -- they act like we are freeloading. guest: no one ever suggested that people on medicare and social some pretty are freeloading. we pay into the system all the years that -- that people on medicare and social security are freeloading. we pay into the systems all the years that you work. in the united states, we had a

pay-as-you-go system. the money you pay in is not the money you are taking out. the money is the money that your children that, if you have them, your children and grandchildren are metaphorically earning now. the population mix more and more money over the years -- makes more and more money over the years and we're able to afford these increasing benefits. but you are right, people on medicare to pay -- do pay for part b, which is mostly doctors' services. if there are other services that a lot of medicare recipients pay for could but medicare covers the basic hospital costs, which is a major medical costs. when you get really sick, that is when medicare part a kicks in. people don't talk about it, but the money that medicare and

social security recipients pay while they are receiving benefits -- but i don't think people consider you freeloaders. host: more from steven pearlstein's column, solutions to the budget deficit and how to tackle that. another proposal is to limit discretionary spending on defense and domestic to the rate of inflation, except to paper wars and natural disasters -- and safety net disasters -- to pay for wars and natural disasters, and to impose a new, broad based value added tax of 6% but that is something that a lot of viewers have brought on this show. would that do? guest: -- what would that do? guest: it raises money. host: a lot? millions? guest: 6% -- what does that raise? $2 billion a year.

it sounds like -- theoretically it is the same as the 6% national sales tax, although you do not see it on the bill when you buy something. it is different from the sales tax in that way. but it effectively works that way . the reason it does not raise as much as people say is that, number one, it has an impact on other taxes paid if you collect that tax, income taxes, personal income taxes, and corporate profit taxes go down. you have to take the net effect of that. the second thing is that when most people talk about the value added tax, it is one of two things. either they want to take out things like food and clothing and shelter, so that the things that people pay, the basic things of life, are not taxed, or, the better way to do that is not to do that but to give a

rebate at the end of the year to people who are low income. that is the cleaner way and more tax efficient way to do it. if you net out the cost of giving those rebates, which most plans do, you get down to $200 billion. if i did not do the rebate part, it would be $300 billion. but that gives you the order of magnitude idea of what it does not raise as much as everyone says it does with 6%. in europe, they have a higher value added tax. my thought was, from the political standpoint, 6% was probably all we could get away with. host: we are talking about tackling the deficit with steven pearlstein. the website i give before is usdebtclock.org. it is real time figures of how much debt we are racking up, as well as the deficit, and how much as some of these government programs are costing.

houston, texas, republican line. caller: i want to talk to mr. pearlstein and "the washington time post." if you are looking at it get caught right now, go to the bottom, and it's as small -- the debt clock right now, go to the bottom, and it's as small corporate debt assets. each of them have been taking 1 million, and it out. look at -- 1 million on minute out. why? guest: sir, i wish i could answer your question, but -- i cannot see the clock here -- host: it is a little difficult. guest: my eyes are not so good that i probably cannot see those lines. i don't know why it would say that at any point in time, the stock market goes up and down.

that has an effect on the balance sheets of banks in particular, which are corporations. they can go up and down. but as a general rule, business assets and business balance sheets are improving these days, as businesses continued to rack up a pretty good profits last year. that would increase their balance sheet. i don't know why the assets number would be going down. also, remember, when you look at a balance sheet, you look at assets and liabilities. sometimes assets go up and liabilities go up more. while assets look like they are going up, and that is a good thing, its liabilities are going up more than assets, on balance that is not a good thing. host: on the corporate tax rate, steven pearlstein suggest a reduction in that rate from 35% to 25%, apply only to profits earned in the united states.

pennsylvania, democratic line. caller: wow, i finally talked to c-span. i listen to you guys every morning. the question i have is on the new bill just introduced by alan brace on -- alan grayson, where he would take the money that mr. obama wants for the war, $157 billion, and incorporate it into the military budget and eliminate that, and make everybody on their tax forms, their first $35,000 would be nontaxable. that would be a portion of this come from the $157 billion that is going into the wars, the military would be forced to use that -- take that money right out of the budget of almost $600

billion and give the taxpayers back the first $35,000 of their earnings, tax free, and use the remainder of it off the deficit. i will take my answer off the phone. host: any thoughts? guest: first of all, as you see on that thing there, i'd like the idea of making a clean statement but we do this today, but it is not as clean. what did i say, the first $35,000 or $50,000 of the income -- host: on the individual income tax? guest: family of four. host: personal exemptions that no taxes paid by a family but for within income of under $50,000 -- family of four with an income of under $50,000 -- 17% of income for $50,000 to

$150,000, up 27% for between $150,000.20 water to be thousand dollars, and that the 7% above that. guest: between republicans and democrats, everyone agrees that what we move the tax form, there should be some number of around that area. we tend to talk in washington in terms of the household family of four, an easier and more consistent ever to talk about. -- and easier and more consistent number to talk about. if you earn less than $50,000, and you might even get a check so that the negative engine tax would make the system more progressive. -- negative income tax would make the system more progressive. somewhat like the line to be

$150,000 because -- somewhat like the light to be 100 to $2,000 because they don't like the taxes. -- some would like to the line to be 150 dozen laws because they don't like the taxes but your idea on using the war to pay for this budget. the normal budget is higher than it needs to be, and it is not just i or you who thinks that the secretary of defense thinks that. he has been trying to whittle it down but it is very hard. there are systems that he does not want and the military does not want, but their business and regional interests that think that those things represent current jobs. we do need to cut that. whether that should come out of the existing budget, i think that is really not fair. we have decided to our elected officials -- you obviously don't

like that decision -- but we have decided to fight these wars, iraq and afghanistan, and that is fine. we should pay for it somehow. but the notion that it is somehow the responsibility of people in uniform to pay it or people who are trying to provide a basic level of the fence so that the country around the world, all of those ships that are -- a basic level of defense said that the countries about the world, those ships at sea that need to be mad at a case somebody attacks us -- the notion that day to come out the money because -- that they should come up with the money because they want to fight the war -- we wanted to fight it and we should pay for it. host: next call. caller: something he said earlier -- i cannot remember now, because there have been so many people talking, but i guess

what i'm trying to say it is that back in the summer -- i am on medicare, and i disabled. i was a registered nurse, and i have been on disability for years and i'm raising grandchildren after my daughter's death. before the entrance was even voted on, i had to get a hold -- before the entrance was even voted on, i had to get a hold -- before the insurance was voted on, i had to get ahold of my nurse. i was put on something called the eastern bloc. that was before the insurance change was even voted on. i get a very small amount and i have these children that i am responsible for. before medicaid took part of what medicare did, i had no copay, and now i am having to pay 10, 20, and 50, depending on which dr. ice, a specialist or whatever, which is not very much -- which a doctor icy, a

specialist or whatever, which is not for much for most people, but for it -- guest: of like to ask the caller, if i can still talk to were -- host: i'm sorry. guest: if your earns less than $100,000 a year. -- if she earns less than $100,000 a year. my guess is that she does. that is not where we need to cut, people like her. there are people who are elderly, that the majority, but still a lot, who have a very comfortable incomes. they have made a lot of money, they are quite wealthy. there is no reason why we cannot ask them to th basically sacrife a little to solve what is a big problem, which is that we have a fiscal situation that cannot be sustained and we are running up

too much deficit. too much debt. my answer is that no one should -- and frankly, no one is proposing -- not me, not anyone else -- that a call like the one you just that has got to sacrifice. that is not the kind of person that any of us want to throw money into the pot. host: you talked earlier about when it comes to payroll tax for social security and medicare, reducing its slightly to 12% -- guest: some fraction of a percent. host: over time, opposing it on wages and salary up to $150,000 -- imposing it on wages and salary up to $150,000 -- guest: as opposed to $100,000 right now. medicare is almost three, not

quite. i suggested simplifying that and making it and even three. but slightly changing the -- most importantly, raising the amount of engine that is taxed -- the amount of income that is taxed. under the health care reform law, there never was a cap on medicare income, the medicare payroll tax. it now applies not only to ordinary income, wages and salaries, but all income. it is continuing to do that. host: st. charles, a little light, republican line. caller: nice to have you on the program. we know something has to be done. there is no argument about the question that something has to be done. i have a number of points and i know you will not let me respond -- guest: give us the most

important wanone. caller: the lawyer's fee paid charging only 1% for the costs of medical. that is not true. i filled out so many forms. you find that it is not 1%. the lack of tort reform in this country second, social security. if it belongs to the people, at the representatives would not have been spending it for the last 40 years -- guest: let's start there. it is owned by the people. first of all, it is owned by the people. it is on by the government, and the government is owned by the people. you get to control it with your representatives every two years, in the case of the federal years, six years with the senate, four years with the president. so the notion that the government is some for body that

is out of our control, that is not -- some foreign body that is out of our control, that is not true. it is not 14th century france. social security was set up so that could take effect right away. it roosevelt led followed your advice and said that we want to make it possible now so that workers can start saving ifor their accounts, so that they owned their social security accounts like an old-fashioned retirement accounts, when they retire, it would have economic security, then the first checks would have started to come out around 1955, saw the light that -- something like that. he wanted to start the program right away. the only way to start such a program right away is a pay-as- you-go program, which is that today's retirees will get their money from today's workers, and

there will always be a forward tilt to the program. today's retirees, as is still the case, get their money from today's workers. your solution in theory would be better. it would have been better to do it that way. in 1935, when people were really struggling, no one really thought it was a good idea to wait 20 years. most retirees at that point, or people close to retirement, would be dead by the time they could collect anything. host: john on the democratic line. caller: hi, mr. pearlstine to i want to thank you and to thank -- pearlstein. i want to thank you and thank c- span for everything you do. as we become more technologically advanced, these should keep up as we move forward as a society.

i want to know what you thought about the private ownership of resources such as oil and the land, now that we see this oil disaster in louisiana, which is horrible and we will be seeing the repercussions of that for years and generations to come. it is a privately owned company. i don't think we can allow people to be profiting off the destruction of our nation to begin with and we need to address that. and the second thing, you talk a little bit about the free- spending -- about military spending. there is a new book out by sebastian junger and he talks about how the missile the cost $80,000 to manufacture and put in place is fired by a person who makes $35,000 to kill a person who makes less than $100 a year. our spending is out of control. realistically, what do you want to see us do? i am all for all the changes you've talked about so far, but what is the key component to get

out of this spending spree? guest: well, we've been talking since i got on largely about, you know, how to reduce spending. there is not a silver bullet, as i said. military spending -- i don't know whether it is out of control, but it is probably higher than it needs to be, given our world situation. at the missile think, with each missile costs $80,000 and comparing it to the cellar of the person -- the salary of the person who fires it, that is if little unfair. the reason we spend so much on missiles is because they are precise things. they are precise in getting to where they are going in the old days, we had to fire 15 missiles to get one of them to go to the right place. if you get one missile, we have less collateral damage.

we don't killed two innocent people along with the one bad guy we want to kill. having precision missiles is a good thing, not a bad thing, and it is not only efficient, it is a lot more humane. the other question -- host: i am blanking myself. i apologize. guest: we should not ask two questions but when you had a test that is over 50 years old, he will not -- when you have a guest that is over 50 years old, he will not remember both of them at the same time. i am very fond of new hampshire. i work for "the concord daily monitor." i also used to work for your senator, i was his administrative assistant. i've been around for awhile and i have fond memories of new hampshire.

host: 1 other proposal, requiring states to pay any differed -- deferred or unpaid taxes on all assets. why is the inheritance tax problem? guest: it is not a problem, but it has been made a problem by certain republicans -- republicans who somehow created this iterrible thing, the inheritance tax, double taxation. people earn money, they pay taxes on it, and then they are forced to pay the interest its tax. my answer to that -- it is not a huge amount of money for the government, but it is some. democrats have made a huge thing about it because they don't like the fact that the rich are getting richer, and this is the way to make them pay their fair share. i think we should forget about

all that on both sides, forget about the political argument, and just remember something -- if you start a company -- by the way, this is where most of this money comes from -- you start a company and it grows to be a big company, you or bill gates and you start microsoft and it becomes a huge company and you are the world's richest person, and now all of a sudden your estate when you die is worth, i don't know, $100 billion, all that is capital gains. bill gates does not sell this microsoft stock, or much of it, and when he dies -- he should not -- you should not use bill gates, because he is put into a charitable trust -- bill yates, and he dies, and he is worth $100 billion. it is all in the stock of the

company he started. he is not paid any taxes on that. when you say to pay the capital gains tax, it can go on to the yates children. that seems to be the fair way to do it. let's get out of this notion that we are some of punishing the rich, or getting money back from them -- somehow punishing the rich, or getting money back from them, or that this is somehow a death tax. there is a lot of wealth that is passed on for which no tax has ever been paid. let's not double tax it, but let's surely tax it once. host: donna on the independent line. caller: my question or statement is that no one really addresses the real reason social security has a problem.

originally, the government promised that would go into -- it would go into a fund and stay separately from all other funds and spending, and it grew into so much money that the government cannot stand it -- stop you'am, can i right there? that is just factually not true. there never was a fund, a separate pot of money and there. that is never the way social security works. as i explained to the previous caller, the reason it never worked that way is because if you are franklin roosevelt in 1935 and hes in wanted to provide money right away to people, there is no fund.

if you wanted to start the program right away, which said they did, you had to go with a pay-as-you-go program. fund.e just never was a after 1982 with the greenspan commission looking ahead and seeing that the baby boomers are coming, and that will cause a problem, because this long string of thing, this generational snake -- there is a pig in there and that will cause problems in the years when the baby boomers are heading towards retirement. so let's increase the social security tax so that we are building up a fund. they sort of the top -- they sort of built up a fund, but it was the government, at the same time and they were borrowing money. the social security fund lent the money to the government so that the government would not

have to go out and borrow it from someone else. the government borrows it from the left pocket to put it in the right pocket. but it never went away. the iou is still there. in the next year or two, we have been throwing it down and we will get to the point were able be -- where we will be -- where it will be drawn down. but it was never intended as a pension -- as a private pension program and they took it away. that was never the case and is not the case today. dan, on the republican line in california. caller: in the costs of medical delivery systems, we ought to increase at physicians and medical schools. i spoke to the dean of a medical school, and if we increased the

number of medical schools, we would still have a problem, placing these in residencies. we have created a system where a significant number of physicians are coming from india and the art world companies and establishing hmoo-- and third world countries and establishing hmo's. there must be a shortage of physicians in our country if we have a flood of physicians coming in at practicing -- guest: let's stop there and talk about the physician shortage program. -- shortage problem. there is a shortage in certain specialties. but he wanted to be careful about reading too many more doctors -- you want to be careful about creating too many more doctors. for some reason, the more doctors there are, the more supply. it seems to have an effect on the amount of demand.

the more services people seem to want. why is this the case? why would supply have any effect on demand? the reason is because how much medical services, how much health care you or i consume is largely depend on what our doctors tell us we need. there is the human tendency on the part of doctors to want to fill up their time. if a doctor does not have anyone coming in, he says to you, "why don't you come back every three weeks and we will take a look at it?" as opposed to coming back every five weeks, which is what is really recommended by protocol. doctors have a tendency to create demand. if you create more doctors, he will create more demand for healthcare services, and raise the cost of health care to the federal government.

you want to be careful about overdoing the supply. obviously, we have the baby boom generation that is getting into this year's when they require more health care services. it may be true in some regional areas and some specialties that we need more doctors. but you want to be careful about that, because right now we need to do, rather than increase the supply of doctors, is do a better job at reducing the demand for services of doctors that are unnecessary. there is a lot of unnecessary medical care out there. that is what we need to keep our eye on, not the doctor supply problem. we have a good, robust marketplace. the signal goes out and it is called higher pay, and more people go into medicine, either here in the united states, or doctors from overseas come over here, and frankly, there is nothing wrong with that. if the indian government must to train d