on higher income earners. a reporter on the implementation of the new health care law. "washington journal this is "washington journal."> > . \.

the u.s. recently opened itself to the most intense scrutiny yet by the international monetary fund, and on thursday was offered a bitter pill when the agency criticized some well-defended aspects of american culture. cheap fuel, sub deciding housing and a government retirement check. >> we want to get your reaction to the imf calling for the u.s. to make lifestyle changes. call the numbers on the screen. you can also tweet us at

twitter.com/cspanwj or send an email to journal@c-span.org here are the numbers again to call in. this is back to the "washington post" article on the imf report calling for the u.s. lifestyle changes. the risks are tilted to the downside david robinson of the western hemisphere said as he presented the annual assessment of the u.s. economy in its first-ever review of the financial sector.

host: now we got the imf report that just came out yesterday, and here's what it said -- in part of this report, and this is at imf.org if you want to read it for yourself. the obama administration's intention to freeze

non-security discretionary spending is welcome. however, measures to increase rev knews will also be needed. host: we want to get your reaction. lifestyle changes needed, says the imf. los angeles, you're on the air, republican line. caller: i believe the imf's announcement is a little bit late. there have been many politicians that have described the same issues in the past. i mean, alan greenspan, he went

to countless meetings in the senate banking committee, and he described these same issues. so i think the imf is a little bit late. host: what would you see as needed when it comes to lifestyle changes? what would you support? caller: that's the million-dollar question. we have to be fistically conservative. but the question is when? i mean, doing something right now, it might encourage economic growth or increase standards of living. but then again, if it doesn't work, it can, you know, cause, you know, a misuse of funds. host: you use the term fiscal responsibility or fiscal restraint. what would you cut then? would you cut taxes? would you cut the deficit? how would you work all that? caller: see, that's the hard thing.

if we cut taxes and we continue to spend, our economy will overheat. if we cut spending and cut taxes, you know, that's one way of looking at economic growth. but you know, we've done that for the last few years. so we don't know if that will be as successful as increasing spending in the -- approach. host: do you think that we have lived beyond our means? caller: you know, i think the imf -- i think that -- no. not right now. we're all having a hard time. i mean, our unemployment is as much as the population of canada. things will improve. but i think these people, they fail to announce the current economic situation we went through in 2008. they failed to do that. and they are late. there were people, politicians, you know, alan greenspan and ben bernanke mentioned these

things. they talked about baby boomers and our spending and our promises that we have. now we just have to decide what decisions will be the best and effective? host: what do you do in los angeles? caller: i teach economics. host: at a high school? college? caller: college. host: all right. thank you for calling in. ronald, minneapolis, democrat. caller: good morning. thank you for taking my call. i don't believe cutting social security is necessary, because we live in a place in the century where social security should be privatized and i'm calling on a democratic line but we don't need socialism in the 21st century. host: so you would say no to cutting social security? caller: no. the only thing we need to do is cut down spending. host: where would you cut it, then? caller: between all the departments. defense. host: all right.

thank you for calling in. michael, republican line here from washington, d.c. go ahead, michael. caller: good morning. host: hi. caller: you mean, -- um, yes. the imf has some of it right, nonetheless, it -- got out the recommendations for the big bankers. they have a lot of the big corporations and financial institutions. i think they have a lot of tightening of the belt of their portfolios as well. and lifestyle for the common people, i don't know if the study is just more of the american populous in general, or they are talking about everybody from the high class, middle class or low class. host: well, they are talking about a lot of things, and some of their specific proposals include an energy tax, i.e., tax on a gallon of gasoline,

cutting social security benefits . getting rid of the mortgage interest deduction on your taxes. those are some of the specific changes the imf is advocating for the change in lifestyle. >> well, that's -- caller: well, that's detrimental. there are many people on social security and get checks every month, and these are normally the elderly people, those in bad health, those with disability. what are they going to do cut veterans affairs next? the reform in virginia said ppsd is -- things of that nature is going to make it much more easier for soldiers coming back from iraq and afghanistan to get ptsd benefits. so -- host: pete, new york. democrat. hi. caller: good morning. thank you for c-span. you know, i'm a person who

lives below my means. always have. always will. always managed to stock away a few dollars every week, every month. and i think we can do it on a national scale. certainly, i think that washington -- our elected officials could do it. but as we all know politics is crippling the decisionmaking in washington, d.c. everything is politicized either left or right instead of going forward. the sense i always get from the decisions that seem to dom out of european countries is that they go forward and are not worried about what the right or left is. but over the years, and i'll give you a quick short list of things. taxing imports. not to start a trade war, but if you look at the taxes that countries have to pay to get goods into china and japan for 30, 40 years, they have taxes

on imports. we should have taxes on imports. not starting a trade war. only in this country can you get poor and middle class people to argue in favor of tax cuts for the rich. i know wealthy people in this country that are buying houses. they are taking ski trips for a week that cost $20,000. and you're worried. you got middle class people arguing. middle class congressional leaders arguing to save the rich and keep the taxes low on rich people. it's just so ironic that that's what's comes out. host: we'll be talking about that later, but specific suggest for pete to tax imports thus raiseing the cost on imports. rick, tacoma washington. the imf think it is u.s. needs lifestyle changes. what do you think? caller: i believe that we keep

adding to the retirement roles for government workforces. in all the different sectors. from the counties all the way through the top level of government. and i think that where we could save a lot of money is to -- is to cut those pensions by 2%-5%. host: pensions? caller: yes. cut the pensions. host: now are you a government worker? caller: no. i'm not. host: well, what if somebody said we should raise taxes on your pension? caller: raise taxes on my pension? host: right. caller: um, well, taxes i think are a separate issue. i think we're paying way too much to retired government

employees. we keep adding to the government year after year after year. more and more people retire. and anyway, that's just my thought. host: rick, what do you do in tacoma? caller: i'm a designer. host: what do you mean? caller: i design homes. host: ho how's business? caller: terrible. it's getting better, but. host: well, thanks for calling in. a democrat in athens, georgia. the u.s. needs lifestyle changes. what do you think? caller: good morning. personly, the things that i've seen being proposed on the television, all of them are aggressive taxes. they want to tax the poor. and the middle class. the least of whom can afford these taxes.

we spend 100% of our money each month to live off of where as the rich, the $250,000 and above may use as little as 5% of their income to live. so who benefits? the rich. the imf is for the rich. host: and back to the imf report on the u.s. this is available at imf.org in case you're interested. it's -- it doesn't read quite as easily as the newspaper article in "the washington post." but you can follow along here. since 2007, the debt held by the public in the u.s. has almost doubled to 64% of gross domestic product.

host: another suggested lifestyle change by the imf. oklahoma city, michael, republican. hi.

caller: good morning peter. want to insect squect a little bit of conversation. the first lifestyle change we need to do as a people. is give up socialist government. the decisions that have been made by this government are atroshese. i guess i'm considered -- host: name one. caller: well, not respecting the will of the people. the health care debacle. the stimulus that hasn't worked. bowing to foreign leaders, not enforcing border control. the foreign disaster he is not controlling. host: but given what we're talking about lifestyle changes, i.e. economic. caller: i guess i'm one of the wealthy. i make over $500,000 a year but wealthy people want to create jobs and pay most of the taxes. i don't know one poor person that's ever created a job. host: may i ask what kind of work you do to make that kind

of money? caller: i'm in private aircraft. host: oh. ok. all right. caller: real quickly, no other country in the world is sitting on the oil reserves we have. two moratoriums and the government or economy would have recovered on its own without the stimulus or health care and the commissioner is going to report in december conveniently after the november elections. the bush tax cuts are going to be put out of existence. they have no clue. they have no clue what they are doing. host: and we're going to talk about that a little later. michael, do you think we have lived beyond our means? especially if you look at the spending during the bush administration, during the bush years. do you think the u.s. has lived beyond its means? caller: i, myself, my friends, we piled on bush for a lot of things. amnesty, the supreme court nominee. the terp which was a disaster.

yes. there's bad decisions that were made but it's not going to be helped by making more bad decisions and going against the will of the people time after time. he's got all three houses, but this is going to come back to haunt him. they are committing political suicide in 2010. in 2012 i should say. if we re-elect this guy we deserve exactly what we get. host: marie, good morning. caller: oh, yes. good morning. i'll tell you what should happen. the pentagon budget should be cut by at least one half. they'd never notice. it is a bloated budget. corporate well fare should be ended. 2/3 of corporations pay absolutely no taxes whatsoever. host: now, marie, do you think that may lead to higher prices on goods? caller: no. i don't. i don't believe that it should. and if we have government watch

dogs doing what they should, it would not be allowed except for all the lobbyists. ok. social security should not be cut. it's already cut to the bone. they say that there is no need to increase social security, that there is no inflation. i wonder what planet they shop in. ok. and universal, if this was done, we could afford universal health care. we could join the rest of the civilized world. host: back to the "washington post" article urging lifestyle changes in the u.s. by the imf. allowing home owners to deduct their mortgage interest is a staple of u.s. housing policy, considered a way to make homeownership more affordable. the imf said it was part of a homeownership system that was

costly, inefficient and complex and did not demonstratively -- host: that's in "the washington post," the front page of "the new york times" this morning. biggest defaulters of mortgages are the rich. more than one in seven homeowners with loans in excess of $1 million are seriously delinquent according to data compiled by the "new york times" analytics firm corelogic. host: mary in orange county, california. you're on the air. caller: hello.

yes. i am calling, because it would be a simple matter for this country to solve its financial problems. if we would decide to legalize all illegal drugs. and i want to comment that i've never used an illegal drug in my life. i'm 81 years old, and i never intend to. but when prohibition was passed in 1920, which i lived through. 30% of the federal income came from alcohol taxes. and one of the reasons we have an income tax today is the government had to start an income tax before they could try prohibition. host: that said, mary. u.s. lifestyle changes. do you think more taxes should be added to products such as alcohol? caller: no. i'm focusing on the illegal drugs although yes, i'd be happy to tax --

host: so illegal drugs, you think they should be legalized and taxed? and instead of cutting social security and raising gas taxes? caller: yes. all of them. host: all right. thank you for calling in. from virginia, lloyd on the democrat line. caller: they always seem to try to solve america's problems on the backs of poor and middle class. they need target the rich people. make them pay a fair share of taxes. corporations can get their lawyers and afford to not pay any taxes at all. yet, whenever there's a big problem, the middle class and poor people want to be taxed. as far as raising taxes on products coming into the country, people will only pay so much for products. so if they try to raise the

prices for the products coming into the country to an unreasonable rate, people will stop buying them. host: and three quick emails. my initial reaction was to the headline was to think about all the economies the imf has ruined. argentina, turkey, etc. the specifics that have been read on air sound reasonable but with with such a bad track record, referring to the imf, karl in west virginia the best thing we should do is stop the money contributed to the imf and eliminate the exemption of increased social security taxes for those earning more than $90,000 and means test social security benefits, fairly tax the people with the money! this is his solution. next call, bristol, virginia. howard, independent line, what do you think about the imf's call for u.s. lifestyle changes? caller: well. i've got quite a few ideas. my grievance was mary from

georgia about the drugs, i don't think you should legalize the highly-addictive drugs like hair win or cocaine, but the small step would be to legalize marijuana. host: do you think that would be a way to finance our current lifestyle? caller: yes. a lot of people look to the government for help on things when they could make their own decisions to help the economy. i also agree with the theory that the rich, you know, they -- i mean i think it's not fair to take the money they make, you know, if somebody comes from nothing and they become a millionaire, you know, you shouldn't cap tear salary, however, nobody needs more than $75,000, $100,000 a year. and it's not fair for the working class when, you know, the owner. i work for papa john's, and our owner owned probably 15 papa john's and they paid us less

than minimum wage when we were on the road, and we generated a million a year for anymore one store. and it would not have affected his lifestyle at all if he was willing to pay $12 an hour or $13 an hour. i worked for them for four years, and now i don't have a car. and i generated at least a half a million dollars personally on the pizzas i made and delivered. 40eu7 so you would support higher taxes on the wealthy to support our current lifestyle? caller: well, i think we need to support higher taxes. that g gets the government involved, i don't know it's their job. that just creates more problems. i think the owners of businesses, if they would pay their employees more voluntaryly then the employees would have more money to, you know, go buy stuff, because, like, my girlfriend and i just can't buy anything. host: greg, st. st. missouri, republican.

caller: how are you doing this morning? host: good. caller: i don't think the imf should have anything to say about what we do in the united states. and i don't think taxes should be increased. they should be decreased. social security should be means-tested and gradually eliminated. i don't think that anybody should be taxed, and the government is spending too much money on wasteful items. host: so you would agree to the imf when it comes to cutting social security? caller: well, it should be means-tested. i don't think benefits for the people that -- if i started collecting today. i'm 61 this year. i would not collect everything that my employer and i have contributed to the poncey scheme over my lifetime until i'm 80 years old. and i wouldn't -- -- so my benefits are puny. and i don't have any big

pensions, and we should cut the pensions for congressmen, senators, for all government employees. host: do you think we live beyond our means, greg? caller: the country does. i don't think the people do as a total. there's been too much easy credit. there's people buying houses that aren't qualified and 100% loans. i had to put -- when i got my first house loan, i had to put 10% down. it was minimum, and i put 20% down. people are getting loans, 110% of the property value and falsely inflateed the community investment act. those are the things that should be cut out and stopped. to that degree. but i think that if you start taxing -- when the bush tax cuts come in, it's going to crash the economy. host: when they end? caller: yes. host: again, we'll talk about that a little later in the program.

we'll talk about that specific issue raising taxes on wealthy americans with curtis dubay of the heritage foundation. memo from "the new york times," obama on the tightrope. president obama on thursday confronted a challenge. how to reconcile the challenge of unemployment. host: lodi, new jersey. gloria. democrats line, the u.s. needs

lifestyle changes. do you agree with that? caller: i don't agree with half the things these politicians do. i don't know much about politics, but i will tell you what's happening to the senior citizens is a crying shame. they don't care about us. they don't talk about us when they are doing their speeches on tv. they just don't care. and as far as the wealthy is concerned. they don't want to be taxed because they want to keep all the money for themselves. they don't care about people either. host: good morning. caller: good morning. what a topic. i had just come back from myrtle beach, and i was at a marina down there, and i saw all these multi-million dollar yachts or pleasure crafts, and i thought they were fishing boats until the manager of the marina told me they were just pleasure crafts.

now i'm looking forward to a lifestyle change, and that's called retirement. i played by the rules. my wife and i have worked all our lives with the exception of the time when i was in the army. i paid my taxes. i paid my mortgage, and i expect to relationship my reward, and that is to live a fairly reasonable retirement. now, it amazes me that the imf, these very wealthy, upper class bankers who caused this housing bubble with their greed, and we had to bail them out. they would say i need to change my life and get rid of my social security. get rid of the interest i paid on my mortgage. all these things are targeted towards the middle class. and if you want to get rid of the middle class, go ahead. do that. but to me, if people can afford these very large multi-million dollar pleasure crafts, and

homes, second and third homes that they buy as an investment and with the loophole of having a gally and so on, then obviously they can afford to pay a little more taxes too. and i think that the middle class in this country is being pummeled. and i'm not against paying my fair share, but you know something? the wealthy. and i'm not against the wealthy. more power to them. they'll find a loophole any which way they can, because they can afford to. and i don't think i should be penalized, because i played by the rules. thank you. host: from "the new york times," election to replace bird gets officials apatrol. west virginia's attorney general has determined goverpbl joe mansion iii can call a special election to fill the vacancy created by senator bird clearing a way to fill the

remaining two years of mr. byrd's term. he said he would speak with the state's legislative leadership immediately to determine how we will further proceed in order to reach a conclusion to this matter. host: govern mansion will be a guest on this show on sunday. next call comes from fairfax, virginia, republican, ben, hi. caller: yes. hello. rich topic for pension. the country we live in. most people try to live within their means and do a much better job than the government does. but the -- a lot -- today have

emanated from the -- government, the clinton era, the defense cuts he did are egregious. anytime in world history when a country is making military cuts is up as he did, -- president bush started the efforts to save our country, and had to play catchup in defense and went and had to fight a global war because of the cuts in defense. clinton also assigned people that -- host: so ben, if you would, wrap this back up to u.s. needs lifestyle changes according to the imf. what do you think? >> it all -- caller: it all comes from the federal government. we need to stop congress to have the power to initiate things that caused the housing bubble. we need to stop the president assigning people that are

relative unphones that are -- appointees that do the biddings and identify in assigning czars. host: tell you what, ben, we're going to leave you there and move on to california, apple valley. democrat, ralph. what do you think? caller: hi. how are you doing? host: good. caller: first of all, i think we have one of the best presidents we've had in a long time. that's number one. and he is trying to do everything he can do to try to save our country. host: so going to the question at hand, though, ben or ral ralph. the u.s. needs lifestyle changes such as losing mortgage detuxes, raising taxes. raising taxes on the wealthy. cutting social security. caller: well, i don't think any of those things are going to make too much of a dips. think i we're basically whole as people. but one of the problems is

military problem. friend of mine told me one time that there was a friend of his that told him that was in the military that when they come back with these ships and everything that they dump all their ammunition before they come back here and they reload, and that's got to be billions of dollars wasted right there. that's just one concept of waste. taxpayers' money. host: so you would say military cuts need to be made before we start cutting social security or something like that? caller: what i think is i think that before somebody throws something in the ocean, i think they ought to save it. fit hasn't gone bad, if the war is going to keep going on, that they ought to save the ammunition. host: all right. ralph, tell you what, we're going to leave it there and go

on to roger in dallas. what do you think? caller: yes. hello. i think government lives beyond its means. if what the imf is saying is we have to raise taxes in order to support bigger got to the -- bigger government. so we stop the growth of government. reduce government, and you don't need the extra taxes. host: so where would you cut things? caller: cut everything across the board. since we have interest groups on both sides of the fence. whatever, cut it all across the board equally. cut defense, social security. host: why do you think that's never been effective? why do you think that's never just been supported across the board? caller: because it's easier for the politicians to compromise up than compromise down. when america had a huge industrial base and a robust economy, they could get away with spending more money,

because the world would finance our debt, and we could get away with it. but that has come to an end. host: terry in spear fish, sdsd, republican line. hi. caller: good morning. i've just tuned in here about 12-or 15 minutes ago. and i haven't heard one person say that they are going to have to grab the bull by the horns and actually be interested in saving this country from the debt that we have now. the lifestyles have to change for esche. we have been riding a pretty horse here for a long time on this credit thing, and we are going to have to think about ourselves here as far as the country goes. not about yourselves so much, or that it's somebody else's fault. let's get into being a very good citizen of this country. go to work.

some people are going to have to take lesser jobs. some people are going to have to change their lifestyle just about completely because of the kind of job they were doing. host: all right from the "wall street journal" a push for funds to finance campaigns, jody writes advocates for campaign funding argue their plan would reduce the doneers from wealthy corporations.

host: new jersey, independent line, sean, you are on. u.s. needs some lifestyle changes. agree? disagree? if so, how? caller: i disagree with cutting back on social security due to the fact that i've been paying into it since i was 16, and in my lifetime, my benefits have been cut back from social security for me, 65 to 73. there's already a cutback there. but as far as taxing, yes. we do need to tariff products coming on to our shores and making us non-competitive. host: and you're willing to pay more for imported goods? caller: no. i would hope that that would force people into buying

domestic goods which is really the spearhead of getting out of this bad economy. host: greece aproves austerity plan. they approve sweeping pension cuts. the vote in the greek parliament was held during a peaceful strike called by unions in protest. host: ken, dayton, ohio, republican, good morning. caller: good morning. host: go ahead. caller: yes. i do believe that the government does spend too much money on affirmative louse things.

and yes. they should cut on a lot of stuff. taking handouts from back door dealings and wheelings and stuff like that. politicians should be for the people not for their own pockets. i served in the military every september, whatever, military had this money to spend in the sense of we got to spend $1 million by a certain time yet the stuff is still good. that's one area -- host: so you would say defense cutting could happen and not affect our lifestyle? caller: well, i'm just saying that's one area where they could save some money. host: $500,000 donated to defend migrant law. to arizona paid to defend its immigration law now totaling nearly $500,000 with most of the donations made after the law was challengeed in court.

host: tennessee, arnold, democrat, hi. caller: hi. good morning. how are you? host: good. the u.s. needs to make lifestyle changes. what do you think? caller: yes. absolutely. and i think the major lifestyle change that we are going to have to make is one of our attitude. until we get an attitude adjustment, we're going to continue down this same path that we're on. and the type of attitude adjustment is the type -- i'm

sure you've seen the story called "a christmas carol" with scrooge. the love of money is the root of all evil. and it is leading us down this path that we're going on. we need to return to a belief in love thy neighbor as thyself. i'd like to read you a very quick sentence. host: tell you what, we're running a little low on time, so we're going to leave your comments stand where they were. here again from "the washington post" from al cayman's fed page in the loop. host: the british, the russians who ventureed in afghanistan, the new book by rand cornings

seth jones is not entirely discouraging. host: that's according to al cayman in "the washington post." and by the way, we interviewed seth jones on book tv. if you go to book tv.org webpage up there in the left-hand corner is a search function. you can go there, and you can type in seth jones, and you'll be able to watch the interview and call-in program that we did with seth jones. pardon me. by the way, "wall street journal" praising obama and obama home run, if all barack obama had to do as generals, his approval rating would probably be flying high. yesterday robert gates announced marine general james maddux would proceed, not with

standing the rolling stone, it led mccrystal to leave the night afghanistan was the right one as was his decision to replace general petraeus. the u.s. needs lifestyle changes according to the imf. what do you think? caller: good morning, peter. well, i think congress can easily avoid debt simply by ordering the u.s. treasury to pay for goods and other things that congress needs nover permit incurring debt on which interest acostume lates. an important point is that any delay by the u.s. treasury to issue money to pay down our federal debt results in the accumulation of more interest on the debt and the need to eventually issue even more money to pay down the debt. host: that all said, how does

that affect our lifestyle? caller: well, when the interest on the debt, we aren't getting anything from that. debt can be easily avoided. host: ok. thank you for calling in. want to show you some of the local papers that have some national stories with national implications playing out. this is the boston globe, as you know, that the a judge up there rejected the gay marriage ban. that was in a u.s. district judge in boston. that's the lead story in the boston globe. in the boston tribune, the blagojevich trial, an aid said the govern hid from his duties and also a story about lebron james, i'm not sure what that's about. they had a lead story about a court case that ensurers can

continue to tie rates to credit scores. that was a michigan state court. and finally in the times pick kuehne out in new orleans. another court decision, court rejects fwoid restore drill ban. that's their lead story. and finally in the politico this morning is this story. darryl icea, congress darryl icea, republican from california, steel is not my leader is what he says. and he will be on our news makeers program for a half-hour this coming sunday at 10:30 a.m., or 10:00 a.m., sorry about that. a little error. 10:00 a.m., and here's just a little bit of congressman icea. >> michael steele, the -- issaa. michael steele the head of your party. >> the head of the republican national committee, not head of my party. >> you're a republican. is this somebody who should remain as the top executive of

the rnc? >> michael steele is supposed to reflect a consensus of republican platform and policies. if he does that, he certainly could remain. if he's not willing to do that and wants to be a political lead owner his own, there's plenty of seats open in november, i suggest he run for one of them. and i feel strongly he is not my leader. he does not make policy for me. the fact is the national republican committee is made up of elected republican leaders. 178 or so of us, and we elect our own leaders and figure out what our policies will be going into november, and we're figuring out how to get jobs going in america and getting the government out of owning combingts and distorting markets. and that's what we're focused on. jobs and the business of the people from a congressional stand point. so i'm sorry that michael

steele has become the news, because he's a bubbling up of state national committee men, and he's supposed to execute on behalf of their decisions and platforms. he doesn't represent me. i don't side with the statements he's made, but at the same time i hope he realizes he should be a consensus explainer for the erepublican party across america, which i think would be helpful. i think haley barber did a superb job when he was the chairman, because he was the chairman realizing he spoke on behalf of consensus not that he make policy. >> so it's your -- i think he has to make a decision and everyone at the rnc has to make a decision. are they going to speak on behalf of the republicans what we've already established as point man? if so, great. if he cannot do that, he should resign.

he should decide what he is going to be. the national committee has never 15eud anything about afghanistan being obama's war at all. and i suspect you could find lots of those. he is not supposed to be, nor am i supposed to be a single spokesperson for the party. >> and you can watch that full interview with representative darryl issa at 10:00 a.m. and 6:00 p.m. on sunday on c-span's news makeers program. dr. john howard is the director director of the national institute for occupational safety & health, which is the division of the institute of health? >> it's a part of the centers for disease control and prevention. host: well, tell us about your organization and its role in the gulf cleanup. guest: well, c.c. as well as the other components for the department of health around human services are responding

to the gulf oil crisis from the health perspective. we are the department of health and human services, so we're concerned about the health of the responders and the community and talents health of consumers that are buying and eating sea food from the gulf. we have the food and drug administration which is a part of the department of health and human services also, and they together with the ocean yanek, noah, are monitoring the seafood from the gulf. host: now, doctor, are you also working with the clean yum workers? guest: yes. together with the occupational safety and health administration is to make sure that we're protecting the response workers from the kinds of exposures that they are experiencing in their response work. host: what are you finding from the cleanup workers down there as far as health concerns?

guest: well, one of the big issues that a lot of people focus on is exposures to crude oil. whether crude oil dispersements, but our biggest problem is heat exhaustion and heat issues. in the gulf area there's a lot of heat and humidity and the heat index gets quite hot during the day. and we have workers who have to be protected from oil so they have to wear gloves and foot wear and suits, and that creates an additional workload. plus, some of them have to have respiratory protection, which is a heat load. so that's the primary issue the heat stress. host: if we could talk about the crude oil exposure and what being around that chemical does to people. what happens to people? guest: well, it depends on whether the crude oil is fresh

or whether it's weathered. these are interesting terms. but as the crude oil bubbles up from the source, you know, through the water column, usually the shorter carbon chains, they tend to be more volatile and they go into the air easier, and then people can breathe them easier. they account for the oweders and those types of things, and they can be very harmful. but as the oil bubblets up through the water column, a lot of those bubble up in the air and distributed into the general atmosphere. the oil as it comes ashore through those 50 miles and wave action etc, gets weathered. a lot of those voltills dissipate and disappear. but there are still harmful chemicals within weathered crude. 10 one of the big issues is we don't want workers or reporters to be handling weathered tar

balls or tar crude with their hands, because it can be irritating to the skin. host: just irritating to the skin? is it more than irritating? or is it dangerous? >> it is dangerous. guest: because those are toxic chemicals and certainly if you're at the beach, wear sandals, don't let your kids pick up the tar balls and roll them around their hands and squish them with their fingers or anything. we don't want any contact with oil even though they are weathered, it stills contains chemicals that can be harmful. host: we're talking about public health and the gulf of mexico oil spill. let's put the numbers on the screen. we've set aside and dedicated our fourth line for oil spill cleanup workers. we want to hear from you and

hear your stories. 628-0184 is the number for you to call. so please go ahead and start dialing in. dr. john howard, director of the national institute for occupational safety & health. he is our guest. how is the health -- the public health aspect of the gulf cleanup coordinated? there seems to be a lot of overlapping agencies there. guest: well, there are a lot of federal agencies responding. and each one has a specific mission. but we're coordinated by working through the unified command. admiral alan is the incident commander in the department of homeland security. so they are the primary instant commander. for the department of health and human services, for instance, we have a physician, admiral james galloway who is admiral alan's health advisor. so wef6 a presence in the unified command. e.p.a. and f.d.a. has a

presence in the unified command and other agencies. so we're integrated at the unified command headquarters, which really helps, because that's operationly where things happen. but outside of that, there are folks in every federal agency that are responding to this. scientists, etc, who are working on issues back at their laboratories or looking at seafood. for knowa, they have individuals flying over the area in planes, doing samples. host: air samples? guest: yes. host: so what are you finding when it comes to what's happening for the air and how that's affecting people? guest: for the air, as opposed workingers sampeled by osha in terms of their response work. for the general population, though, we're seeing either very, very low levels or undetectable. although there was a report i

heard this morning where the epa was rorget some air in venice and grand isle that they were seeing some issues there. i don't have any details about that, but i did hear it on the radio this morning. host: i want to tell you again, we have a dedicated line for gulf oil cleanup workers. we want to hear from you, 628- 0184. area code is 202. how many folks do you have down there? guest: well, for the federal response, there are several thousand folks that are working. both in the gulf as well as working back in their home areas where their departments are. you have to remember there are probably close to 30,000-40,000 response workers that we have workers at the source. we have workers who are engaged in burning oil in vessels. we have others that are engaged in booming and skiming the oil.

we have thousands of shore line and marsh cleanup workers. we have workers doing decontamination of equipment and w50eu8d life. we have workers that are responsible for manageing the waste stream. taking the oil from the beaches and disposing of it properly. so there are workers in every area. host: dr. howard, you were head of this agency during hurricane katrina, correct? guest: yes. host: how does this compare, the public as pecks of this spill in guest: well, it's a different kind of crisis. hurricane katrina was water inundation, severe trauma on the population. that's a point i think is important to remember. this is a population. folks in the gulf. new orleans and the gulf states were severely affected by hurricane katrina. and now this is another trauma. so it adds to i think the stress that everyone in the

gulf is feeling right now. host: first call comes from mobile, alabama. an oil spill worker. milton, go ahead. you're on with dr. john howard from the national national. from the national national. from the national national. >> i just like to say i think the doctor is fudgeing the evidence. because the money. the coastal states don't want to lose the tourism money but this disbersment in the oil is deadly and a hazard and they are playing it down, because they want to money. host: can you tell us what you're doing? caller: we're out on the water. the oil is every where. they pretend like it about. our local news media, everybody is trying to cover it up, because they all want the money. guest: well, i certainly thill

the oil dispursement which are other types of high drove carbons -- high drove carbons are not knock use chemicals. milton, i agree with you. what we're trying to do is monitor the health of folks like you and others. . .

chris: who is paying for our cleanup, for the federal cleanup workers and public safety and public health workers down there? guest: what the unified command

has established is an invoice system. for instance, federal agencies that are bringing employees to the area to respond or to do work say in their laboratories back in their locations, then will invoice the unified command. the unified command then seeks reimbursement from b.p. chris: has b.p. been paying? guest: to my understanding, yes. chris: webster, texas. john: good morning, gentlemen. i have a little 15-pound jack russell and greyhound mix and i talked to the vet because he loves to go down to the beaches. we are about three miles away r from galveston. but i asked the vet if i should allow him to splash in the water and she said not to do it.

i would like to know because i was planning to go down today but i'm not certain if it is safe enough to take him down will. guest: well, i'm going to quote lisa jackson the e.p.a. administrator when she was in the gulf over the weekend. her quote was you can look at the water, you can use common sepns sense. no laboratory will tell you whether the water safe. you can tell. if you see tar balls floating in the water, if you see tar balls on the beach i wouldn't have the dog running all over the place nor a kid or any human being. i would sa-- i would use sandal. but check with the local health department to see their recommendations. maybe it is time for the dog to run the grassy areas. chris: blacksburg, virginia. independent line. you are on with dr. john howard with the national institute for

occupational safety and health. we are talking about public health and the gulf of mexico oil spill. john: one of my biggest concerns about the whole situation, not exactly on topic but really important to address for the futu future, i have read that there is an acoustic switch that could have been used that would have cut the leak off below the source or below the ground, and the companies involved decided that it was too expensive to put it and from what i understand they cost about a half million dollars. chris: tyler, again, we are talking about public health with the the gulf oil spill. i don't think dr. howard -- guest: that is a little outside my field of expertise. chris: craig, lake charles, louisiana. democrat. you are on, please go ahead. john: good morning. just had a question about the

dispersant how it was banned in other countries and they brought it here to use on our gulf coast which we depend on our seafood and oil and gas for servicing the rest of the country. second of all, why did they need to use the dispersant? why couldn't they let the oil come to the surface which is easier to get to and won't mess up the environment as far as health hazard and get super tankers in here and take it off the top of the water? guest: that is a little outside my field of expertise again in terms of the logic of using oil dispersants. from a public health perspective, we obviously would like to see the least amount of hydrocarbons in in the human health space. so, i can't really comment on the logic of why oil dispersants were used. chris: are you --

chris: are you supplying your clean-up workers with masks guest: respiratory protection is an important issue especially for workers working at the source because this is the area where the crude oil is coming up from the water column and the volatiles are very -- are higher at the source. so we are monitoring those individuals and those individuals have to have been enrolled in the protection program. workers engaged in burning the oil on the surface, the boats tend to work so that they are p upwind from the burn. but occasionally winds can shift and we are asking that the b.p. company hire those folks and enroll them in a respiratory protection program. for shoreline workers not so much because we are not seeing as much in the way of inhalational hazard. there is a lot of wind blowing on the shore, et cetera, so we are not the requiring it there

unless folks are developing symptoms. that is a different thing that. means we have to evaluate what is going on more closely, monitor that area more closely and we may need rest per lators for this bush respirators for guest: fish can't come from certain areas. the oil itself moves around this 600,000 square mile gulf. so, fish -- and this is a commercial fisherman impact can't fish in certain areas but in other areas the seafood is examined by f.d.a. as it is coming to the market, before it gets into the market. so, i think american consumers

can be confident that the seafood they are buying in the store has been looked at very carefully. host: is it being tested? because if the oil is shifting the fish shift, too. guest: exactly. i have learned something in this oil spill crisis myself. fin fish, those fish that have fins, i'm told, swim away from any contamination in the water. seafood that is the creepy crawlers, you know, like lobsters and oysters that are trapped in water they don't move, those types of seafood is where you have to watch contamination because at the can't escape the oil. host: next call is jacksonville, florida. matt. independent line.

caller: what is worst oil or dispersants? guest: we have to look at that issue. when the exxon valdiz spill happened in 1989 we really didn't follow up with longer-term health studies. we are attempting that now and preparing for that and will do that in this bill. but also in terms of the toxicity of crude oil and dispersants together that is an excellent question because we do not know what synergistic effects there may be. in other words, effect from the crude and dispersant that combine may be greater than the effect of either one by itself. we don't know that. that is what we are studying in the laboratory now. so, thank you for this question. host: what have we learned from past oil spills, exxon valdiz or

1969 california oil spill that can apply to public health concerns for this one? guest: this is another great question. if you look at the world literature, not just exxon valdiz chiefly from tank there's run aground and that happens fairly frequently, you look at the world medical literature there and you are only going to seven or eight studies. so, this area really has not been studied well. then when you look at the studies you will see that most of them are of the clean-up worke workers, and they are mostly short term. meaning while the response was taking place people looked at the health of the response workers. did they have irritation? skin air station? eye, nose and throat irritation? but there is scant medical information of chronic or longer-term health effects. that is where we have the major gap and that is the tkpwp we will fill with studies of these

folks. host: are any studies indicating there are long-term effects? guest: the few studies done -- and it is done primarily from t the prestige oil tanker that ran aground in off of spain -- those studies show there is some concern about pulmonary function issues. in other words, breathing issues. then some long-term sort of g o genotoxic issues why d.n.a. issues have taken place. but no one is sure what the changes mean because it is a small population. so, we need more of those studies. so there is some concern about longer-term health effects. host: that is part of what you are studying now, are you going to put a test group into place? guest: a cohort that we will foil through time. host: if you are a gulf oil worker we would like to hear your story.

62 628-0184. area code 202. stephanie in hot springs, arkansas, on the air, republican. stephanie? caller: i'm stephanie columbus and i'm a public health educate or from the university of tennessee originally but i work with the university of north carolina in charlotte. each public health educato educt do an internship. i would encourage you to think about one of your individuals getting in touch with every school of public health in the country, have a group of students from every school and one professor working together on this project. when you get that type of mindset, those educators that have been involved or the professors have been involved for years in public health efforts, plus the students that

must do internships to graduate, you are going to kind of kill two birds with one stone. guest: that is an excellent suggestion. a lot of gulf academic units are involved in our response effort. and in terms of public health education. one of the components of our departme department, the substance abuse mental health services administration is on their website a lot of tip sheets for population behavioral health issues and stress issues of the population. a lot of that work outreach and intervention will be done through the gulf coast institutions and by working with local health departments and state health departments. and a lot of those folks will be the type of folks you are describing. host: bill it key largo.

hi. caller: i run a snorkeling company that snorkels from key largo down to key west. and generally when you are new yorkling you -- when you are snorkeling you just wear a bathing suit. i was wondering if the water quality has been checked for dispersants and oil down in that area. host: bill, have you seen any evidence yet down in the keys? caller: i have not seen any things except small, real mall pieces of -- real small pieces of oil floating in the water. host: let's get an answer from the doctor. guest: what i would do first of

all, bill, is go on the e.p.a. website which is epa.gov, and they have oil spill updates that they post all the time. the things that e.p.a. are monitoring are the things you are interested in, water settle, sediment quality, air quality, et cetera. i think that i would look there. i would also look on the noaa site which is another sampler of water quality in the gulf area as well as the end of the loop current as it goes by the keys into the atlantic. also, your local health department, i think, is extremely important in key largo there and throughout the keys. i think that you have some resources there to rely on as well as your own common sense when you are in the water. obviously, you are your own observer there. that is what i would do to monitor that for your business. host: fred is an oil spill worker calling from new orleans.

please go ahead. caller: yes. i have got evidence that i have been able to sneak in and take of nighttime spraying, of chemicals along the beach and planes with their lights out to bleach the beach to make it look like the oil is cleaned up. i also want to bring this up. all of the workers that worked on the valdiz oil spill are now dead. they are dead because the material that is banned in other countries they are allowed to use down here. when the water heats up sufficiently down here all of that oil that has been suppressed will rise. we will then see massive amounts of hijaydrogen successful fight benzene and chlorine dispersed

into the area to a deadly level. host: what are you doing as far as cleaning up in the gulf? caller: i'm volunteering right now. you have to go through the course to get down there to do the actual clean up so i'm on the island and i'll able to go ahead and i snuck in cameras to take pictures. guest: well, fred, i would hope that you would share your pictures because we all need to be educated about some of the things you may be seeing. and certainly some of the issues you are raising with respect to the chemicals that are both chemical constituents of crude oil and the dispersants are extremely important questions and the toxicity of those things are extremely important. so, i hope also that when you do the training that you are able to share some of that information with folks so that they know what you are seeing also. we all need to share all of the information that we have so that

we are all educated about conditions. host: as far as you know, what is the coordination with b.p.? guest: b.p. is the funder if you will through the unified command. the unified command approves things. host: so everything is funneled through the unified command. do you have any contact with b.p.? guest: i have spoken to, for instance, the medical affairs vice president for b.p. on health issues who has been very supportive of some of the work we want to do. and i think that the unified command has more of a direct relationship with b.p. than we do in health and human services. host: from burlington, vermont, ron on the democrat line on with dr. howard. caller: good morning. there is a lot to be learned from the 9/11 attacks where had the e.p.a. telling the workers that the air quality was fine

and now we find out that there are thousands of workers that worked on that pile that have respiratory problems. you had tens of thousands of mercury lamp fluorescent bulbs vain supportized -- vaporized, things that really hurt the people. host: can we learn something from 9/11? guest: definitely. this is really a great comment. the lessons that we have learned from the world trade center we are applying now in the gulf response for public health. and one of the issues that the call brought up is certainly one of the most serious ones in the world trade center where we didn't have, for instance, a list of all of the workers that were there. so, we are rostering all of the workers now in the gulf. we have rostered about 35,000 workers so far. we are also doing real-time exposure assessment.

so we are not saying anything is safe as in the world trade center. we are doing assessments so we can determine whether it is safe or not. and even as some of the other callers have brought up there is nothing inherently safe about cried oil. -- crude oil. people can be exposed to all of the toxins within crude oil. so the declaration of safety is not something we are doing. we are trying to protect people from these harmful chemicals. host: in fact you are currently or were the world trade center trade center health program? guest: yes, the recent caller comment really resonates with me because i have lived through the mistakes that happened at the world trade center and we are determined not to make the same mistakes again. host: dr. howard is not only a medical doctor, graduate of loyola university and harvard university school of health but a lawyer or at least you have a

law degree. guest: yes, i do. host: new york city, scott, independent line. caller: yes, hi. i have a follow-up from the last clean-up worker there. on the benzene level. lindsey williams reported on several radio shows the safe level of benzene is four parts per billion and the e.p.a. test is three parts. hoeupbl is five to 10 parts a billion and the texas level is 1200. method lean chloride is 61 per biological and tested level is 3,000 to 3,400 parts per million. host: so, wrap it up, scott. caller: so, these are three gases that are coming out of the oil plume at the bottom and there seems to be kind of a cover-up going on as to why we

are not being told about this and there seems to be a plan in place to evacuate up to 20 million people from the gull area -- gulf area. guest: one of the issues you bring up is the transparency issue of data that is being collected. for instance, if you look at the e.p.a. website, they post reams of data of air monitoring on all the chemicals you mentioned in great detail. one of their p.d.f. files has 300 pages of data. so, i would encourage everyone to look at that. noaa also does that. the osha website has the data on response workers. so, what we are trying to do in this response is to be as transparent as we can possibly be from the government perspective. so i encourage everybody to look at the results on the websites and be educated about the levels and to ask the questions that

you raised. host: brenda, oklahoma city, democrat. caller: caller: i have two comments much first as to the testing for the workers. because government testing takes forever these people could be dead from the toxins before you ever know if they are affected by them. secondly, object the safety of the seafood, you can't possibly be testing every piece of shrimp that comes out of the gulf. guest: certainly on the last issue that is true. i don't think that that is possible. but batching is one way.

f.d.a. is increasing its ability to sample and get at that 100% sample rate that you are raising. so, that is being done now. with regard to the testing of response workers, the type of monitoring, air monitoring of their breathing zone samples are being done quite rapidly. you are right though in terms of longer-term health effects. those sometimes take quite a bit of time to figure out. sometimes months or years. but the acute exposures, those results are coming back to us very quickly and again i would go on the osha website to see their air monitoring levels for workers. host: dr. howard, do you have any idea if the spill were capped today, how long the toxic effect of the oil would remain in the water? guest: well, that is a very difficult question and i don't think i have an answer to it.

what we have been thinking is if the well was capped today we would not be putting more hydrocarbons into the gulf environment because the oil would be capped. then it is a matter of pure clean-up. how long does it take for that o oil, those weathered oil elements, et cetera, to come to shore? what happens to the oil, the oil that drops to the bottom of the gulf? how long is this process of clean-up going to take place and i don't think any of us knows at any time at the present time. host: next is baltimore, nat, independent line. caller: thank you for taking my call. i'm a former director of science and technology development for the navy. one gas i didn't hear about is the one i'm concerned more about and that is sulfur dioxide

because when it merges with the water will be sulfuric acid. that is liable to drop the rate below 6.8 and have a deleterious effect on anybody swimming and certainly the life of -- the sea life. i was wondering if that is being monitored also. guest: you are certainly a far more astute observer of these things than i am. the only comment i would have is that -- and we are testing the toxicity of this particular type of crude. my understand something that this particular type of crude is the lighter or sweeter crude and has much less sulfur in it than other types of crude. so that hydrogen sulfide and some of the successful tur oxides are -- sulfur oxides are

not as prominent. host: sandy hook, connecticut. caller: this is such a fabulous show that you are having. my big concern is the relationship that government has with b.p. that b.p. really has control so that when you have investigations and people wanting to take pictures or give information it is like b.p. has their own police department i don't understand why the united states government hasn't taken complete control. guest: that may be an issue beyond my public health expertise. and probably is better addressed by somebody in the -- host: from your perspective have you said no cameras allowed to see the public health workers? guest: oh, no. we are very transparent. our work is always transparent.

that is why i encourage, when i have visited the gulf and spoken to workers, is to make them aware that their concerns can be brought forward even anonymously through osha's telephone lines, et cetera. so, i'm hoping that folks will heed that if they have concerns and issues and make them known. host: our last call for dr. howard is from denver, norman, republican, please go ahead. caller: hi. i grew up in southern california in the 1950's and 1960's and every time i ever went to the beach when we got back from the beach we had a gallon of kerosene we used to get all the tar off our bodies and out of our hair. there's been a natural oil se seepage off california for millions of years as far as i know. i don't know of any negative effects it caused on any one in my family over those many years

we went to the beach on a daily basis. so i'm wondering how bad tar balls are. we used to pile them up and burn fires with them. guest: again, that is certainly, you know, tar, asphalt, is something we all come in contact with. i hope we don't have as direct a contact as you had. but clearly the long-term issue you are raising is what is it on the population and that is what we hope to find out from the studies. host: dr. john howard, we have been talking about public health in the gulf of mexico. coming up we will talk about taxes and increasing taxes on wealthy americans and cutting the deficit and how the best way to do that is and that is with curtis dubay of the heritage foundation but first this

campaign 2010 update. >> today we are looking at two competitive senate races and joining us from the politico is a reporter to talk about indiana where brad ellsworth is out with a new ad the democratic candidate running against the republican candidate dan coates. why is ellsworth spending in july, some of his money, on a new ad for this general election? >> he is from the southwestern part of indiana, and if you remember how this went down he was a late entry in the race because of the retirement of edmond bye. coates was a long-time nor, been there -- senator and has much higher name identification in the entire state. ellsworth is really only known in the one district, that one pocket of southwest indiana, the eighth congressional district so he is not in the media markets of fort wayne and indianapolis, the bigger portion. so he needs to get on the air to

basically introduce himself to voters. that is what he is doing in this first ad, really running against washington even though's two-term congressman. >> let's look at the new ad and talk about it. >> one thing 25 years as a sheriff teaches you is zero tolerance for voting. it is like they live an breathe the stuff. they waste money, take care of special interests and don't care if lobbyists write the laws. i approve this message because the special interests and lobbyists already have enough senators on their side. >> david, you wrote about this new ad. how much is he spending and why has the dan coates campaign taken a look at that spending? >> we know he isn't spending that much. they put out a release saying it is covering about 66% of the

state. but if you go into the details of the ad buys like most campaigns do, there is not a lot of ads that people are going to see on the air, at least in this initial buy. it is not a big ad buy for indianapolis which is the most populous part of the state. so the coates campaign immediately pointed out to us this is his first tv ad but how many will see it. really a lot of times campaigns release ads and put them out to members of the press and media because they want to be able fund raise to show how much that will be on later. that is what we saw on this case. >> one of the other ones is arizona where also a lesser known candidate is running in the primary against john mccain known across the country when he ran for president. let's look at the new ad. >> i'm mary hayworth and john

mccain is hiding his record behind false attacks on my husband. john mccain has sold out the people of arizona on immigration, bailouts and tax increases. 0 now he has embraced character assassination to keep his job. he should be ashamed. j.d. is not perfect. >> i'm j.d. aworth and i approve this. >> this primary is august 24. what has been the tenor and what is the latest as far as money raised and polls? >> the first thing that hayworth has to go on with his first ad with his wife defending his own record. that shows you the barrage of attacks that j.d. hayworth has had to sustain from the mccain campaign and the mccain campaign has been very aggressive. some almost feel like they never got out of presidential campaign mode going after him realizing

the environment is tough and they were going to get hit for mccain's questionable conservative record on things. j.d. hayworth trails in finances. he has not put out the second quarter fund-raising numbers that were due at the end of june. mccain is expected to have a huge cash lead. but this is another example of an ad on the air but the mccain campaign did the ad tracking and said it is only a few thousand dollars being spent in one market in the state. the hayworth campaign said that is not true and, you know, we are going to put this ad up in a wider area and put it out for a much longer time but right now there is no evidence of that. >> what are the polls saying? >> right now mccain has been holding a double-digit lead. some are close to single digits but he has held a consistent 10 to 12-point league. he is protecting in because he

has been one of the most aggressive campaigns in the country this cycle. >> thank you for your time david. for more information about campaign 2010 go to c-span.org. host:

guest: we can't raise taxes. we are no longer in a recession but a bad economic way right now. this is the time to raise taxes on anybody. with those constraints with spending having to come down but taxes not -- not the time to raise taxes. i'm not sure what we are going to see. host: why can't we raise taxes maybe as the i.m.f. called for a national gas tax or consumption tax or some type of taxation? raising taxes on the wealthy guest: they all have negative economic consequences. you get slower economic growth. raise them on the rich that will slow investment which will reduce the number of jobs and reduce wage increases and slow the recovery. so it is not the time to raise taxes on the rich, any type of tax. host: we have a gentleman called in earlier from oklahoma city, works for a private aircraft and said that he makes over $500,000 a year.

raising his taxes by $10,000 to $20,000 how would that affect growth and why couldn't that be a solution to a current debt? guest: i'm glad you phrased it that way so and so makes $500,000, he can afford to pay $50,000 more. that is not the standard. anyone can afford to pay more taxes. i have five dollars i can pay five more dollars in taxes. the guys on the street can 10 dollars can pay 10 more. that not the question. the question is what is the economic impact of raising taxes. the gentleman in oklahoma city i'm sure he can afford it but if you take that $50,000 and transfer it to the government that is is money he is not using to invest in his business. that means he doesn't add a new worker or piece of equipment to ra raise wages. host: if we take your five dollars? guest: it is a difference in scale but you can see raising it

on rich is harmful. that is not just that one gentleman that is paying that extra money. it is economy-wide all of the people and adds up and a lot of jobs gone. host: we want to put the numbers up on the screen so you can dial in and talk with mr. dubay. host: please allow 0 days between calls. we are talking about the current basically whether or not taxes should be raised on the wealthy americans and talking about other related issues around that. what is the current status of the tax extenders bill talked about on capitol hill? guest: they are a group of about 45 tax reducing provisions that congress has to pass each year so they don't expire. they are like research and development credit and a host of

other things we commonly think about when we think of the tax code. but it passed the house of representatives and stalled in the senate because they loaded it spending and there is no out for that. they added unemployment benefits, the doc fix that prevents them from having reduced payments. cobra health insurance. all sorts of spending loaded on that and the senate couldn't pass it. they tried to strip some of it out but it didn't get through. there is too much loaded spending in thrpbd a right now it is stalled. i don't expect to see it back in the senate until september. host: does that tax extender's bill include bush tax cuts? guest: no, those are separate. the tax extenders are a yearly thing congress does. it ends up being an excuse to raise taxes because of the pay-go rules that says if you

are going to cut taxes or increase spending it has to be paid for by other reductions or tax increases. so, by calling them a tax cut year after year they extend the tax extender but raise other taxes. this year they are using the tax on carried interest and hedge fund managers that are paid through capital gains. basically it is a year after year excuse to raise taxes. but the 2001 and 2002 tax cuts are separate. host: a recent blog from robert reisch tax being the super rich is not about chass envy. it is about the nation having enough money to pay for national defense and homeland security, good schools and crumbling infrastructure the upcoming costs of boomers' social security and hopefully

affordable national health insurance. he goes on to write what is fair? i would say a 50% marginal tax rate on the very rich, those earning over $500,000. plus an annual wealth tax of one half of 1% on net worth of people holding more than $5 million in total assets. can't be done you say? the highest marginal tax rate under president eisenhower was 91%. it dropped to 70% under j.f.k. you say the rich will left the country rather than face a marginal tax of 50%? let them and take away their citizenship. guest: that sound awfully harsh. for somebody as smart as he is and knows so much about economics i'm surprised he would say that. they are not going to leave the country. they are going to do the same people did in the time when the rate was 91%. they will take their wages and less taxable forms. instead of taking income they

will take it as capital gains or dividend or other ways. they will ask for more lavish office, a company car. they will ask that the company pick up season tickets to the local baseball team. they will ask that they get a larger expense account. these are forms of exception that will tphnot be taxed. they will exploit every nook and cranny. they will pay their lawyer more to get every deduction they can get and most importantly and the most detrimental they will cut back object working and say it is not worth that 16th or 17th hour. i will spend time with my family. i won't go in on the weekend or saturday and sunday. i will do what i enjoy rather than work half time for the government. that is going to have a negative impact on the economy. we are talking about destroying jobs, wages permanently because people will cut back and growth

will slow. it is cutting your nose to spite your face system. host: a tax guy with smart money writes about how the expiring bush tax cuts affect you. he concludes that the bush tax cuts don't just offer tax relief to the wealthiest americans but to just about anyone who pays federal income taxes. their scheduled demise next your will raise the tax bill nearly every taxpayer unless congress makes changes and the president jumps on board. guest: that is true. because been this concept that the tax cuts were for the wealthy. it is not true. wait to see. if congress does nothing, wait to see the difference between the last paycheck in december and first one in january. you will see a much bigger bite out of the paycheck. those families with children wait until the taxes the following april the child tax

credit will go from $100 to $500. we here all the time that the tax cuts were for the rich and they made the tax code more regressive. that is not true. you look at data from the congressional budget office it showed the share of tax from the top 20% hgone up. the bottom 80% have seen their tax share decrease. so, the rich are paying more, the rest are paying less. so it is not true there are tax cuts for the wealthy. host: you are a senior policy analyst. prior to that a senior columnist at the tax foundation and senior associate at pricewaterhousecoopers. lands down, pennsylvania. will, a democrat. caller: how are you doing. host: please go ahead. caller: i'm just wondering, we are talking about taxes.

every time i hear about taxes it seems like we pay and pay all of this tax money and then wherever the taxes are supposed to go to we never have enough money for that situation. guest: i agree with you 100%. you hit on something that i talk about a lot. governments will spend every dime they get and then some. they will spending they can get. all the tax money and every dime they can borrow. that is when a tax increase doesn't close a deficit. the way to close a deficit is cut spending. that is the only way. another important thing we need to hear is that we hear that we cannot get the deficit under control because spend something on autopilot and it will increase. we can't cut it. over the last 60 years we have spent about 20% of g.d.p. at the federal government level. during that time we have raised

about 18% of g.d.p. in tax revenue arranging about a 2% gross domestic product deficit. it is not great but it is sustainable. at the end of the decade we will be spending over 24% of g.d.p. but the tax revenue will be over 18%, almost 19%. we will be above the historical average. we do not have a tax problem. we have a spending problem. the only way to get that under control is cut spending. host: the congressional budget office released a grim report last week from daily finance noting that the federal debt had risen from 40% of g.d.p. in 2008 to 62% of g.d.p. this your. that is expected to rise to 80% in 2035 if the bush tax cuts are extended. they say the debt would rise to

185% of g.d.p. by 2035. spending on healthcare is expected to double as a percentage of g.d.p. guest: i do not think that those numbers are the result of extending the tax cut. the data i'm talking about are not from heritage. this is out of the tax policy center. if we extend all the tax cuts for were, people above $250,000 and below, tax revenue at the end of the decade will be over the historical average. it is not the tax cuts that are driving the deficits. it is spending. mostly entitlement. we are likely going to hit the wave of uncontrollable or out of control spending in the near future. however, the policy that has been passed in the last 18 months have bridged the gap and brought the future today. host: morgan, republican from chicago. caller: good morning, gentlemen. how are you? i want to talk about this concept of tax competition and specifically with regard to

marketplaces for tax rates. i looked just yesterday and saw lebron james' decision to play in florida. you can't help but wonder if part of his decision making has to do with knowing the state income tax is zero percent. i think that does play a role. what extent do you think the united states need to maintain a competitive tax climate to attract investment and make people motivated to work here? guest: i think that is very important and something we need to be very mindful of. right now the top income tax rate is scheduled to go from 35% to 40% beginning next year. you add in the new taxes that have been passed, healthcare legislation, taxes at the state and local level we are talking rates that are the top marginal rate that is pretty close to 50%. that is not competitive when you look around the world. there are some that have higher rates but we are going to be in the top group in six months.

one area that doesn't get a lot of attention is corporate income tax rate. corporate tax rate in the u.s. is about 40%, second highest in the world of economic developed countries. only japan is higher. that is one factor that driving jobs out of the country every day. until we get that down they will continue to be driven overseas. there is bipartisan consensus in washington that that rate needs to come down. the average rate of the organization of economic corporation development is about 25%. we are almost -- i'm sorry, our top rate is 35%. we are 10 points above that. we need to get down to that range or below it to remain competitive. otherwise companies will keep expanding and opening up new operations overseas. host: ike from charleston, south carolina. you are on the line. caller: yes, good morning.

this has been going on for quite a long time and i seem to recall a figure of 125% of g.d.p. when we came out of world war ii being spent. so we have been in higher debt load. my question is, you continue to hear from the tea republicans and there is a big group that continue to push for something called the fair tax which to me is nothing more than a dressed up consumption tax. looking around the world there are other places that have trade this. what is your view on the fair tax system and do you think it is viable to bring us out of this or are we going to continue to give special interest groups on either side of the equation their tax breaks and everybody trying to get out of paying taxes rather than getting the revenue we need? guest: the first thing you said we have had a higher deabt load but that was at the end of the

spending to fund world war ii. we are at the beginning and we already have a debt load unsustainable. we are entering period of danger. that is a major difference. the fair tax. you said it is a dress-up consumption tax. it is consumption tax. it is a national sales tax. we do need minimum tax in the country. the best thing is to transition into a system that does tax consumption rather than the hybrid system which taxes income and consumption. we want to be encouraging people to produce income. it is good to switch to a consumption tax. but there are different ways to do that. we don't have to do it with a national sales tax. this are tricky aspects of trying to a i my that. the major one is that is the domain of the state. most states rely heavily on sales taxes to fund their governments. it would be an intrusion of the federal government if they went and passed a national sales tax.

but you can tax consumption through the income tax and it would avoid another problem that being the 16th amendment of the income tax. if we pass a separate consumption tax we are liable to have both. for something like a flat consumed income flat tax, it addresses the same issues and accomplishes the same goals but without intruding on the states and having the problem of both. host: this tweet from left of center 44. guest: i'm sorry, say the first part again. host: it is in tweet form but what good is it to cut spending, close deficits and have surplus when there is no money in the economy causing another

depression? hooverism? guest: i disagree that there is no money in the economy. there is money in the economy. companies and individuals are not investing because they are uncertain about the economic future. they think the economy will remain soft for the foreseeable future. they are uncertain about all the legislation out of washington, d.c., what that will mean. so they are waiting and keeping their money in very safe investments, money markets or treasury bills. there is not a lack of money. it is a lack of people willing to rick it to put -- risk it to put it things to create jobs because this is so much uncertainty. host: we have it tweet. guest: that is not true. you look at a study recently that locked at what he is talking about is the effective marginal tax rate. the top marginal rate in the u.s. is 35%. you factor in the deductions

corporations get they pay a lower marginal effective rate. and what he is saying is we are more competitive with other countries. but recent studies show that that is not true. when you take into account our high rate and deductions our companies are still paying much higher effective rates than most other countries. there is a consensus in the u.s. we need to get the rate down. no doubt about that. host: gerald, 3467, democrat. we are talking about taxing wealthy americans. caller: i'm on here because of i know for a fact if you take a new product to wal-mart and try to sell it to them they will -- first thing they will do is hang your phone number and tell you to call one of the companies in china or somewhere else. the reason the rich got richer is because of a profit margin that was made off these moves to

china and all the other places. i worked in the gift shop. i watched this unbelievable amount of mark-up and profit that are made off stuff because there was less profit when it was made in the united states but we had jobs. guest: i think what you are getting at is we should -- again trade protectionism. the point is that or the result is we end up less well off. we engage in that protectionism and say we keep the jobs here by maybe levies higher tariffs but we force all of to us pay higher prices for the good we purchase. we hurt ourselves. we end up with less jobs. there is little we can do to keep jobs here when it is cheaper to produce in other countries. but what we can do is keep taxes low. we do not do a good job of that. we have high taxes on businesses

that force them to look to other countries. they will always search out the lowest possibly cost because they are driven by profit margin and shareholders to earn the highest possible return they can. so they will severarch out chinr brazil to produce their goods at the lowest possible cost. we can compete better though if we get our taxes low and we will keep the jobs here that we specialize in and we are better at, higher jobs, service industry jobs, higher skilled jobs will stay here if we keep a hospitalable khaoeuplt. host: george a republican from ocala, florida. caller: good morning, gentlemen. i have a nonpartisan idea that may bring trillions back in the united states. i think we should start an international lottery sponsored and headquartered in d. krfpc. what would happen is we could

have the people, the allies of the countries of ours in the game and anyone else would be not allowed in the game. but an international lottery would bring in so much money that probably in the beginning there would be hundreds of millions of dollars to a win are and could roll over into billions and it should bring in trillions of dollars back to the united states from countries that we have given aid to. so, that is about it. i would like to have your opinion on that. thank you, sir. guest: i'm very wary of gimmicks like the lottery to pay for government spending.

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guest: there are lots of steps we need to take it the first is to stop spending. congress got knocked it off. no morepending. host: we had a caller earlier suggest a 1% cut but that has always been a regular suggestion. why not? guest: i don't think that is enough. 1% -- trying to get congress to do that might be difficult, but they need to do it. 1% is not enough. take all the unspent stimulus money, use that to pay down the deficit, reduce the national debt. that will give us breathing room with the credit markets that will show that we're serious. there are other programs. unspent tarp money, stimulus

money, we could repeal the health care initiative, which cost trillions of dollars. this would give us breathing room. the problems are entitlements. medicare, medicaid, social security. we need to make some sustainable in the long run. we need to make them what they were designed to become a social safety nets, not entitlements to help fund retirements for 20 years and paid for all their health care for 20 or 30 years. we can do that and turn them into safety nets rather than open intolerance and get the -- open entitlements and get the debt stabilized. host: view, as a young man -- you, as a young man, want to cut benefits, and john boehner wants to raise the retirement age, etc. -- guest: i understand the

reaction, but keep in mind that this would not happen overnight. this would be phased in over years. it would be phased in over time. the retirement age would be increased, benefits would be changed over time, so that we would not have that effect. you talk to people my age, and our expectation is that we need to get to zero because we know it is not affordable in the long run. if we can fix it, we will get something, we will be better off. my generation, we understand a problem. host: michigan, thank you for holding. independent line. you are on with curtis dubay of the heritage foundation. caller: good morning. i would like to be the first congratulate you and the fortune

cookies like frank luntz and grover norquist for finally winning the class war. ronald reagan that started it, lowering taxes for the wealthy, and they will be incentivized to create these jobs. how many jobs has rush limbaugh or glenn beck created, other than maybe the drug industry? guest: i don't have much to say to that. the point being, i think, that pro-growth tax policies have been vindicated over 25 years, and after we cut taxes during the reagan administration, which had the longest, most successful period of growth in our history. host: florida, republican line. caller: good morning. i don't really have a problem with taxes going up. what i do have a problem with this tax is being spent on things that i have no control over. one side impact of that is that

i tried to give as much to charity as i can, but if i am looking at a tax that is going to go to thousand dollars at the end of the tax year, that is money i cannot give to those charities. i would like to hear comments on how they're spending money. guest: i agree with you, that taxes go up and you up less money to spend in the ways that you want to spend it. taxes go up, you will have less to donate to charity and less to spend on other things, too. there are those who want to give to charity, or they want to invest in safe retirement or their children's future, future college expenses, and they will not be able to do that because taxes will go up. tax cuts were not tax cuts just for the wealthy. they were tax cuts for everybody. everybody will see a significant portion of their check, come january, be diverted to taxes.

another thing that we overlooked is the impact on small businesses, the businesses that create the most jobs should the tax rate go up. president obama's plan calls for .ncreasing the top two grearates we hear that it is not a big problem for small businesses. it is not true. here is the statistics from the treasury department. only 8% of small businesses pay that rate, but 75% of small business and job and pay 85% of small business taxes -- they earned 75% of small business income and pay 85% of the small business taxes. they are the ones who are hit the hardest, the ones who will cut back the most, should the taxes go up. host: next call is from wilma in illinois, democrat. caller: you were saying the

companies go overseas because of higher taxes. the biggest problem that companies go overseas for is because of wages that they have to pay, and also, they don't have to worry about any pollution laws, and they don't have to worry so much about what goes into a product. we see that when products come back from china and they have led in -- have lead in them. i also worry about food products that come back. that is the biggest problem with the company's going overseas. i don't think it is the taxes at all. guest: i would not underestimate the impact of taxes. it is certainly true that corporations are always going to go overseas where they can produce products for the least amount of money. there are countries that have less stringent regulations that we value here. we are not going to lessen our

regulations, and they are not going to improve the there's for the time being. but don't underestimate the impact of the corporate income tax rate. it is a major factor. i used to do this at price waterhouse coopers. all day long we were structuring how to move money from this country to other countries because it would pass at a lesser rate. a lot of income generated by corporations now is generated by things that, you know, are products of the mind and thought. we tax those things heavily here. it is cheaper to move to a place like switzerland, where they pay no taxes, and keep the intellectual property here. host: the imf recommended in a report issued yesterday that the u.s. get rid of its mortgage deduction tax break. what are your thoughts? guest: our tax code certainly does encourage home purchases.

but i don't think that reduction is the answer. we hear that the mortgage interest deduction is not justifiable. it depends on how you look at it. if you have an income tax, anything that goes into the production of income should be deductible. if we look at the purchase of a house as a capital asset, purchasing a home and renting it out and running income from that, in trust is rightly deducted. what the tax expenditure is in that scenario is if you occupy the home yourself, you do not incorporate the income that you would have gotten from renting out your home. it really comes down to what we're talking about here. there is something else out there that should be included in our income to make up for that.

if you are talking about a consumption tax, it is a whole different story. the story is a lot murkier, a lot more difficult it is why we need fundamental tax reform to clarify these issues. host: wayne, new hampshire, go ahead with your question or comment. caller: i am just wondering, like the guy before, it seems like the old wendy's commercial, "where's the beef?" listening to your other callers, also, there is an old saying -- i am just a dumb carpenter, you know, so i am trying to make sense of this political stuff, being thrust upon bureaucracy over the past several years of my life, to no avail. it seems to me that it is very difficult for everybody, with its complicated and component issues -- the old saying, the

nail is used to build a house of failure. that is what i am seeing, a bunch of excuses -- host: what would you like to see done when it comes to taxation and federal spending? caller: i let thi -- would like to see more bang for the buck. host: what does that mean? caller: motivating people to do their job. host: right, but when it comes to spending and taxation, are you willing to pay more in taxes? caller: i am willing to pay more in taxes if -- host: you think your taxation rates are fair? caller: i think it's fair if we can see some progression in these institutions that say they are there for our welfare -- host: should there be cuts in government spending? caller: absolutely.

host: where? caller: you know, i am not an expert on military or anything like that, but everybody is talking about this $33 billion that is needed for this war. it seems odd to me that there is new leader is being instituted, with the coast guard, for example, on the oil spill, and now general petraeus, and got lost them all -- and god bless them all, but i just think that this was the golden solution, appointing new leaders, i think we should start seeing some results, don't you? host: what did you hear from wayne? guest: of frustration that is completely understandable, that we're spending trillions of dollars and washington every year and is not being used efficiently. the best way to make the government be efficient is to give it less revenue and make it perform functions is to perform, like providing national

defense and homeland security and courts and a legal system, providing transportation, building roads and bridges. the things the government does well and should be doing. if we force the government to do those things only, we would see a much improved efficiency, and people would not resent paying taxes so much. at this point, government is in so many areas of our lives that cannot be efficient. bureaucracy grows on its own and has its own inherent inefficiencies. the inefficiencies become built in. the point is to constrain the therebyhat exists and we limit the number of inefficiencies. it is a frustration in a lot of americans feel, that washington wastes all the money we spend here. host: florida, republican line, please go ahead. caller: mr. dubay, i agree with

it what you are saying 100%, but i have to scold you on something. it is a simple tool to use to see the impact of the bush tax cuts expiring -- go to the irs website and go to the year 2000, when clinton was president, and look at the taxes for families making $75,000 a year, and pulled down the 2006 irs tax tables, 1 bu. lower tax rates for everybody, not. -- when bush lowered tax rates for everybody, not the rich, and i am not rich. if the bush tax cuts expire in december, as planned, a family of four's income tax will go up by over $3,000. guest: i agree wholeheartedly. i did a paper showing what a family of four that earned about $50,000 would pay this year

under the current tax system and under the previous tax system. it came out to over $2,000 more that they would pay if the rates go up. it is not a trivial amount, and that is the point i'm trying to make. we have heard for years and years and years, tax cuts for the rich. it just isn't true. it is important to recognize that we are less than six months away from this happening and congress has done nothing. they have had all year to get around to extending this, if they take president obama's plan -- they have not done either wind. they have done nothing. there is no plan for them to do something at this moment. it is very dangerous. i think there is a plan effort to push this as long as possible and maybe deal with it after the midterm elections in november or not deal with it at all and get to the end of this year and have all of these tax cuts expire, which would be a disaster for the economy and disaster for

families and small businesses. we cannot -- it is a situation we cannot have. pressure must be put on congress now to get these tax cuts and extend them, permanently for all taxpayers. failing that, extend them temporarily for all taxpayers, or permanently for certain people -- whatever is, but get to it by the end of the year. host: scott on the democrats' line. caller: good morning. there is a few things i would like to say. mimi, i think the income tax right now is a fair and i believe that the bush tax cuts should be expired on the rich. the only way that the poor are going to be paying more taxes is if the party of no continues to say no. i am retired and i paid a higher percentage of my income in

income tax last year than general electric did. you mentioned that the share of the engine tax that the rich is paying is increased. but that is because they are the only class that has seen income increase. guest: a couple things. one, that is not true, only rich had their income increase. i don't have the numbers and a foot of me, but other groups that seem to enjoy -- i don't have the numbers in front of me, but other groups have seen their income increase as well as he compared his tax rate to general electric. we came out a steep recession and general electric probably did not earn a whole lot of money last year. if you look at the corporation tax rate, you cannot just look at a snapshot of one year. you have to look at it over a longer horizon and look at the amount of taxes they are paying.

if you look at that time i am sure that general electric is paying much more taxes than the tournament is paying. -- than the gentleman is paying. if we raise those taxes at the beginning of the year, we will face steep economic costs and economic damage. we cannot afford it now. there is never a good time to raise taxes, but doing so right now would be downright irresponsible. host: curtis dubay, thank you for being on "washington journal." coming up, we will talk to ceci connolly of "the washington post." it has been 100-plus days since president obama signed the health care legislation. we will get an update.

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span.org/store. >> "washington journal" continues. host: on your screen is ceci connolly of "the washington post." it has been about 100 days since the president signed the health care legislation. what has happened? peter, thank you for having me. it is always a treat being here. 100 days -- time flies. they are trying to staff up. they need a lot more people in that department and the various agencies to figure out regulations and implementing this complicated new law, as well as the irs. we have seen some immediate changes in the health insurance marketplace. the one that a lot of people are familiar with, and frankly, i hear excitement about, is the

idea that you can keep a child up to age 26 on a parent's health insurance policy -- host: that has happened? guest: that has happened, and what we heard from the insurance companies, after some initial blocking over materials, -- initial balking over the materials, they realized it was an opportunity to do something popular so everybody got over that quickly. another one that is pretty darn popular, and the administration and president obama likes to talk about when they get that chance, are those rebate checks that went out to many senior citizens who fall into the doughnut hole, the coverage gap that we hear a lot about. host: said the initial $1,500 medical and drug expense and then they go into the doughnut hole -- they got their rebates already? guest: many of them have

received this checks and many more are in the mail as we speak. that is another popular item that we have seen. the states, as well as the federal government, are moving forward in setting up this big reinsurance pool. that is a tricky one. about $5 billion is set aside for the next several years, and it is essentially for people who, because of a pre-existing medical condition, have difficulty getting insurance on the open marketplace. as you know, that has been a big problem for our great deal of time. you might think of this as something of a stop-gap measure, peter, for those and it is officially hope that in 2014 that they will be able to go to the insurance exchanges and shop for what they want. this reinsurance is a way for them to get coverage in the intervening years with some money from the federal government to help pay for them,

because everybody recognizes that because of their existing conditions, they tend to be more expensive and need more care. host: is that state-by-state? guest: yes, that is correct. we saw a couple dozen states that quickly said, yes, we would like to participate in this and design our own state program with the federal money. other states have not been so it is asked about doing that, so there will be the federal. -- there will be the federal reinsurance program or state governments are not doing that. host: how much of that has been implemented? guest: implemented is a little bit tricky. i don't think there are many people getting their health insurance yet because of that, but i would say that probably by the fall, you will see a good number of people that are eligible. some of the estimates i have seen are that by january you

will have gotten about 1 million additional people covered through a number of these things that we're talking about right now. host: ceci connolly is our guest, a longtime health care reporter for "the washington post," and co-author of the book "landmark." one of your to what this will be featured on booktv this week, alec mcginnis -- one of your co- authors will be featured on booktv this week, alec mcinnis. guest: yes. host: any question you have, ceci connolly can probably answer it. please allow 30 days between your calls. what else has been implemented at this point, or what else is scheduled to be implemented in 2011? guest: in 2011, through the fall

we will see more of this activity continuing -- the high insurance risk pool, as we mentioned. there also be about $51 million in grants that states will be eligible for so that they can do reviews of insurance premiums in their states. this is another thing that is not contingent in a couple of stage, such as teleport -- another thing that has gotten attention in a couple of states, such as california. we want a 30% premium increase next year, and this money will hold the state's review with the those increases make sense, are legitimate, it justified, etc. that will be another big help. the other thing i should mention is that small business tax credits are becoming available. these are for companies that are, i believe, less than 25

employees, workers up to about $50,000 a year. they are now eligible for some tax credits to help cover their employees. it is interesting, peter -- i don't have anything to scientific, but certainly anecdotally, we are hearing from insurance companies around the country, especially some of those that cater to that small business market, that they are getting a lot of increased business and a lot of interest in this because of those tax credits. that is something that does seem to be sparking some interest and some movement. i will say that a lot of this is balanced by the ongoing terrible economy. even as we sit here and speak, there are other people who continue to lose their jobs and health insurance. it will be very tough to make forward progress in this economy. host: do you have any estimates of how much federal dollars have been spent so far since the bill was signed towards this

healthcare bill? is there any figures out there? guest: no, not that i have seen, i don't think there is a lot of money going out the door at this moment, per se. it is more about opening at some of these programs and changing some of the insurance regulations that we've been talking about. another one that has gone into effect is the idea that children with a pre-existing condition cannot be denied health coverage or cannot have their coverage turned away. that was a very important one. it is those sorts of things more than a lot of money going out the door. host: as you can see by the phone lines, they are all lit up. montana, republican line. caller: hello. i would like to ask you, the cbo said that this is going to cost the american public $1 trillion. i know that there was a better way to pass this bill that would make insurance that would go

across state lines, millions of other ideas, but congress just pushed this down the american people's throat. people like myself think it is always of money -- think it is a waste of money any time you have a bureaucracy and more people in the health care system -- you the wages are -- for naught. guest: he brought up the price tag, and all the estimates are that this law over the next decade will cost about $1 trillion. what the administration and the congressional budget office will say in addition is that it is paid for, and what they mean by that is that it is not expected to increase the deficit.

in fact, there are projections that it could reduce it a very small amount. the way it is paid for is a combination of things -- some are tax increases on the wealthy, certain industries, insurers. we had take effect on july 1 at tanning tax. there are some areas where he will seek money squeezed out of the system -- where you will see money squeeze out of the system -- the medicare advantage program, as well as hospitals, which agreed to receiving lower growth over the next decade. it is a whole combination of things to get to that $1 trillion. host: what are you finding in public attitudes right now? guest: it is interesting. there have been all sorts of polls out there, but one by the kaiser family foundation, a well-respected, a nonprofit

organization, another by gallup, that are suggesting a slight rise in acceptance or -- i am hesitant to use the word popularity on stopping like this, but acceptance might be the better word. the country is still pretty evenly divided, but they are seeing some indications that other people are growing a little bit more comfortable with this law, or certain provisions of this law, or, frankly, they have other things they are more worried about. host: have you found that most people have been affected or not affected by this so far? guest: so far not affected. but by 2014, absolutely everyone will, because of the individual mandate. host: independent line, chicago, good morning. caller: i had a quick question about accountability. do you really think that individuals will stop smoking, stopped eating 4000 or 5000

calories a day? i think it is wrong for me to work hard every day and then the government tells me i have to take the fruits of your labor to pay for individuals who smoked for 20 years and now have long cancer. guest: great question, great question, and something that i wonder if lot about. we have seen smoking rates in this country come down dramatically over a few decades. we have seen people wear seatbelts, something we did not do even when i was growing up i can remember writing in my parents station wagon and standing on that hump in the back seat. changes can take place through a combination of educational campaigns, awareness, taxes or penalties, you name it. now the focus is on healthy eating. it is a difficult one, because congress thought about something like a soda tax and

decided not to go that route. but in this legislation, employers right away are going to get much more latitude in the way that date price insurance for their employees -- the way that they price insurance for their employees. i did you get a discount or you pay extra if you do not get your provided screenings. if you do not take this help survey on-line so you can figure out if you might have diabetes and we can get you into our program. in some ways, the employer will have a powerful tool over workers to either incentivize or penalize them if they do not start living in a little bit healthier. host: susan, omaha, nebraska, a democrat. caller: the one thing i it would like to say is that i tried to work, but people would fire me because i had epilepsy.

i felt like if i am getting kicked out of the work force, what am i going to do? my mother kept hammering in my head, "oh, apply for disability." i did not want to give them disability. i did not want the taxpayers money. i wanted my own money. the only thing i could do was go to the street, and they took care of me until i was 32 years old. but i got tired of going to jail. i just did not think it was fair. now that i am on disability, because the laws here not so strict, living off of what i live and comparing it -- laws here got so strict, living off of what i live and comparing it to what i was making, it is better to live on at the st.. guest: first of all, i am sorry,

it sounds like you have had incredible hardships, and i'm glad to know you are doing better now. as you know, it is illegal to discriminate in the workplace against people with medical conditions. i do not say that that does not happen, but it is illegal and it is distressing to hear a story like that. i wish i had a magic solution to a situation like that, peter. it is disconcerting to hear. host: next call for ceci connolly, talking about the health care bill signed about 100 days ago by president obama -- houston, david, republican, and you are on. caller: good morning. thank you for taking my call. i spoke to you two months ago regarding competitive bidding as a small medical provider in houston, and he basically said you expected -- you basically

said he expected that to continue throughout the health- care industry. i'm curious if you have any feedback as to how the house bill might be coming across -- host: what is that, caller? caller: it is an amendment that basically says they needed to eliminate competitive bidding because of different issues that kendrick meek brought up in the bill, that is excluding providers in being able to provide service in the medicare program through up bidding process -- host: we got the point, i think ceci connolly probably has an answer for you, but as you know, during the debate there was a lot of discussion regarding medical and equipment providers, and i recall that houston was one of the areas targeted for fraud, as well as florida, kendrick meek's home district is

that fair? caller: there are certainly fraudulent issues that have gone on in the houston area, but what bothers me is that congress has used this competitive bidding idea as an anti-fraud measure. i do not see how it is it cms had done due diligence and a properly in rowling providers to begin with and checking them out to begin with to make sure that this never took place. guest: i am a tiny bit confused. are you opposed to competitive bidding? host: it sounded like he was great he is not with us anymore. -- it sounded like he was. he is not with us anymore. guest: i confess i have not heard that bill moving in this session, and i suspect that it will not make it through in this legislative progress. it means that it would have to start all over again in 2011. at least in the near term, it is unlikely to become law.

host: but there was a lot of discussion about equipment suppliers. guest: that's right. as you point out, there have been incredible fraud cases that been discovered and prosecuted it is frequently the republicans who say that there is much more waste and fraud and abuse in the system we should be bringing out to get more savings, and there are a couple of measures in the new law that have some more money to investigate those cases. host: ceci connolly, what is going to happen to medicare advantage? guest: medicare advantage is a program within medicare for seniors that would like to sign up for a managed care, private managed-care insurance option, as opposed to the traditional fee-for-service medicare that most seniors still get. these managed care plans these have been attractive to many

seniors because they can often offer extra benefits -- eyeglasses, sometimes a gym membership, prescriptions even before there was a prescription drug benefit. but there have been a number of studies suggesting that those plans have been essentially over paid by the government. the whole reason that they started was that they argued that managed care it should seize money, a more efficient way of delivering care, and no one be all, these programs were getting about 8% -- and lo and behold, these programs are getting 8% more than traditional medicare. congress said they would bring it more in line with money that we spend on a traditional medicare, and what that means is that seniors may see some of those experts, like the gym membership, disappear. host: next call, north massapequa, new york, democrat. caller: hi, peter, hi, ceci.

i manage the web site democratz.org. the democratic party, of which i am a liberal member, as disappointed me and millions of seniors and disabled people by gradual change that you cannot believe in. the $250 is really small in comparison when people go into the doughnut hole and they will have thousands of dollars to pay. and then for the prescription drugs to have a 50% discount, we will get wiped out when the drug companies it doubled prices next year. i have a question -- why do elderly and disabled people have to pay two sets of monthly premiums and two yearly deductibles, which are expensive, to get one prescription drug benefit that would have gone into medicare part b, which covers some

medications and now, and they should have covered every medication? for this reason, the democrats, which have disappointed me -- i refuse to vote for a senator or representative in 2010, and in to doesn't 12, if there is no prescription drug benefit -- and in 2012, if there is no prescription drug benefit, i refuse to vote for the president, either -- guest: lots of good, important points there. $250 compared to thousands more that some of these seniors paying -- that is a relatively small amount, no doubt about it. i think what we heard in the frustration in this call is reflected in the polling, peter. we have seen consistently from the beginning of this debate right up until today that the group's most unhappy about this law it tends to be senior citizens, for many of these very reasons.

now, i think in full fairness here, we have to point out that the medicare prescription drug benefit was enacted by a republican congress under republican president. again, all of these things are much more complicated than they initially seem. but i certainly understand that there is still a great deal of frustration with that. host: if i remember correctly, you cover, just out of high school, the clinton health care debate. how does this compare? guest: in terms of substance or politics? host: substance. guest: substantively, the obama administration took a very different approach, to say that quite clearly we will maintain the existing private, employer- based health-care system. we will not mess with that too much, because they recognize that in the clinton debate, when there was a proposal for upending the entire system,

people got very nervous and alarmed. if you are one of the 180 million people today in this country who get their health insurance through their job, chances are you are not going to see many changes. host: next call, chirico, pennsylvania, republican. -- erie, pennsylvania, republican. caller: 94 c-span. the president said clearly, as i understand, that none of the tax dollars will be going to fund abortions. yet i see that the abortion pill coverage will remain, which is an abortion. it is a chemical abortion, basically. i understand that tom coburn are heard an amendment to remove it, but democrats defeated the amendment -- host: what is your second point? caller: the second is that the under 26 can stay on their parents' health care coverage.

i heard discussion on the radio in detroit that this will discourage marriage, an unforeseen consequence, because many young people. under the age of 26 -- guest: discouraged? host: marriage. guest: i had not thought about that, to be honest with you. that is an interesting thing to look into. with respect to ru486, there are real differences of opinion on that, and i don't think that i am the person to arbitrate that. host: are those each individually sponsored health- care plans that may or may not fund -- guest: yes, and it is very much depending on which helped plan. it is worth noting that today, again, in the private insurance market, where most of us are still getting our coverage, i

think about half of the health insurance policies already cover abortion. a lot of people may not realize that, but that has been something of the industry standard for awhile. host: is there any talk about maybe segmenting insurance where you can pick and choose, a la carte, like the type to do with cable a few years ago? i may not want to pay for an ob/gyn, but i may want to pay for x. guest: we will see in 2014 when the health-insurance exchanges are up and running. there will be several levels or tiers of coverage. they are going with a bronze, silver, gold kind of thing, but you could envision it as you would ask for a very basic, some might say here bound, kind of coverage for catastrophic plan.

other people would like to spend their own money and get a wider coverage plan. host: george r., independent line. go ahead with your question for ceci connolly. caller: good morning. very quick, this bill needs to be repealed as soon as possible. we were told the three outstanding allies and the beginning to one is the cost, that it would be under $1 trillion . the cbo was told to withhold the figures -- guess what, it is over $1 trillion. host: what is your second point? caller: the health-care fund -- they will take money out of medicare, up $500 billion coming out of medicare. rationing of health care, which the new czar -- i think it was

dr. bernstein, a recess appointment recently, has come out and said that not only will we ration, with our eyes open, make a decision on who lives and dies -- host: we will have ceci connolly respond to those three things. have you been affected by the new bill yet? caller: -- not -- not yet -- guest: lots of good points. i do not mean to sound flip about large sums of money, but as far back as 2007, we knew that this would cost over $1 trillion over a decade. the savings coming out of medicare over the next decade -- a big chunk of the money is the savings from medicare advantage, that we talked about here this morning. not any court medicare benefits, but some of the things like

eyeglasses and gym memberships could be lost in the process. another chunk of this medicare savings, and they are not cuts, they are slowing the rate of growth, but those savings will come from an agreement that hospitals made saying, listen, we will take less in federal medicare payments in return for many of these millions of people getting health insurance coverage, because hospitals know that right now they are taking care of them in the emergency room for free anyway. that was a little bit of the trade-off there. that is what makes up most of the $500 billion. host: speaking of dr. donald berwick, two of your colleagues in "the post" have opinions. david ignatius writes, "

washington is not irrational world. it's a never never land where politicians from both parties and be well our debt and deficits and resist efforts to do anything about them." another one of your colleagues, ruth marcus -- these are both columnists. ceci connolly is a reporter. "as a matter of politics, the president's choice was, well, the polite word would be bold. the less polite word -- b oneheaded. he offered opponents a loaded gun with his talk about rationing." who is donald berwick?

guest: he is a pediatrician from harvard, has run a quality institute in massachusetts, and much of it has been doing work to get hospitals to reduce required infections. he has said that you can improve quality and lower costs in today's health care system. a lot of people think that we have got the best health care system and they don't want to hear that actually, our quality is not that great, and a lot of people don't want to that we could spend less money on health care. -- and a lot of people the one here that we could spend less money on health care. but that happens to be true. this administration put his name out there but did nothing to promote him or defend him in any way. that is a tough situation for any nominee in today's environment to be thrust into.

host: and he did use the word "rationing." guest: absolutely. he has said quite often, and people have the videos to prove it, "we have rationing in our system today and i am a proponent of rationing." that is absolutely his position. host: you live in mexico for several years. what did you find about their health care system? guest: what you see in mexico and many latin american countries where we had a chance to travel is more of a two- tiered system. that is a concern in the united states as well -- are we moving in that direction? you have a basic level of coverage of people there. but to get more of the cutting edge kinds of technologies, to really be at a top-notch facility, costs a good bit more money out of your own pocket.

one interesting battle twist, i recall -- if you had a friend or family member going in for surgery, that person had to ensure that a certain number of people came and gave blood before you got your surgery. it is sort of an interesting approach to things. host: did your health care through "the washington post" cover you down there? guest: yes, absolutely, because you are out on assignment. host: los angeles, republican. thanks for holding on. caller: i had more of our commented that a question. i recently went to a medical center, and had an x-ray and saw an orthopedic. it was just one visit repor -- it was just one visit. they had held roughly firefighter $69 -- had billed roughly $569. it is an encouragement for old

people like me not to go to doctors, because we are not high on their priority list in terms of patients. you are always ask if you have secondary. for them to get $62 for an x- ray, in disappointment with an orthopedic, i was stunned -- in this supplement with an orthopedic, i was stunned -- host: did medicare pay for this? caller: $62. host: did you pay out of pocket? caller: i am not sure, but i can see the resistance of them to accept old people. i am literally going to buy a give and send it to the doctor bird i feel horrible that he is being -- shafted i am -- litter i am -- i am literally going to buy again and send it to the doctor. i feel horrible that he is being shafted by this. guest: i am not familiar enough

with that procedure and the exact dollar amount of speed on that specifically, -- and the exact dollar amount to speak on that specifically, but this is the concern for physicians. frequently, when you get these statements, that it whopping number is an number that almost nobody pays. you are probably looking at the two extremes of the inflated estimate and a very low payment from medicare. i think that most the time, reality is somewhere in the middle. host: i am sure a lot of people hurt $569 and thought, for an x- ray? guest: even the folks who have private insurance are negotiating a discount off of that number as well. host: louisiana, democrats' line, please go ahead. caller: how are you doing this

morning? guest: good. caller: the american people are not happy with the law they are passing it is affecting people already paid . all the people that are paying for health care are already getting increases, already, on the bills from this. why couldn't they just pass when the insurance companies for health insurance could c ross state lines and anyone could buy insurance from anywhere in the country? guest: we are continuing to see health insurance premiums rise, and that was a concern throughout the debate. it is likely to continue for a variety of reasons, but especially in this economy, people really feel that pinch. it will take awhile to start to squeeze down the growth rate, if

it can be done at all. with respect to the idea of purchasing insurance across state lines, it is a very popular, attractive idea. it is a little bit more complicated in reality, because today, our health insurance is still largely regulated by each state, and so they're a different regulations about -- there are different recollections about what you get covered and how the insurance operates and each state. some medical care in new york, for instance, is a lot more expensive than in new hampshire, where i used to live. if everybody in new york wanted policyan insurance from new hampshire, the pricing may not work out. host: it reinforces the state's role in some ways, through reinsurance and things like that. guest: and these grants going

out for states to start looking more aggressively at premiums paid on the other hand, i really noticed that secretary sebelius, a former state health insurance commissioner, seems to have that hat back on lately. she is out there hitting hard at the market changes. it is an interest of hers and she is focusing hard on it. host: next call, you are on with ceci connolly "the washington post." caller: i hear a lot about cigarettes and cancer is it causes. but what about alcohol? that causes cancer and accidents that cripples innocent people for life. what are they not doing anything about alcohol? why is it just about cigarettes? guest: a very good point, absolutely, and when i hear in the discussions.

many of these things are societal, cultural attitudes that do not necessarily change easily. there are many, many americans out there that feel very much that they ought to be entitled to either a cigarette if they feel it relieves their stress, where a drink after a hard day at work -- or a drink after a hard day at work. there is not necessarily anything wrong with that. but experts tell you is that it is the people with addictions and people who go too far with these habits. it's a tricky situation in this society. host: are they addressed in this healthcare bill? guest: we do not see a lot of the specifics on the very spirit there is money for prevention and wellness, -- we do not see a lot of specifics in this area. there is money for prevention and wellness, the medicare and wellness, the medicare programs, some of the