illinois has a law that says doctors and providers are able to refuse to give certain care based on their religious and moral beliefs. while we believe in people's ability to exercise their religion, we also wanted to create some kind of balance so that patients' health care needs were being met, so the bill would have created a requirement that a provider would have to put in writing the services that they do and do not provide. they would also have to -- if i came to a provider, and they did not want to give me -- they did not want to tie my tubes after i had a baby, they would need to find someone who would be able to provide that service. and it would have to do it in a pretty quick period of time so the patient does not lose access to a service, but the doctor maintained their ability to not perform the service. the other thing is that we wanted decisions about pregnancy termination to be made by doctors and women using the standard of medical care. what does that mean?

we were getting a lot of older sound bills and a lot of requirements groups that women had to jump through, so we wanted to and that is to say that if you are going to create a rule or regulation, it should be based on medical practices and not based on politics. this was really great and really exciting. a couple of things we realized is people really like having comprehensive and this continuum of care in the legislation. they like the idea of thinking about young people all the way to older folks. thinking about what illinois as a community really needs in order to realize health care. the other thing we experience, which is not so positive, was a huge attack by the catholic church. how many of you are from illinois?

as you may know, we are a pretty catholic state. i'm not from illinois originally. i'm from california. when we introduced this legislation, folks -- catholic folks when a little bit hard core crazy on us. they were at springfield every week. they had this -- visits with their legislators. we had a situation where the cardinal from the archdiocese came down to springfield dressed in his cardinal wrote, and he went to each of the legislators who were in some way demonstrating support for this bill and basically told them that they should not support the bill, that they have to choose their faith, which does not support it. we had a situation where a legislator's kid came home from school with a letter saying that the bill is bad, that is against

the church, and that their parents should not support it. we have scenarios where there was a lot of misinformation about the bill. one of our favorites was back if the bill were passed, then it meant that school nurses would be able to perform abortions in high school gyms. [laughter] i read the bill a lot. it is a really creative reading they did to get to that point, but the crazy thing is when we went to talk to the representatives, they would ask about that provision. even when they knew things were not 100% accurate, they still ask because they had calls, they had e-mails, they had visits from folks who did not want this to go forward. on the positive side, we had a strong progressive coalition. multiple lobby days. folks calling, folks riding, we had the religious coalition group productive choice to the catholic community saying that

it is one idea of what religious people think, and there are some folks who support this religious continuing. the other thing we learned is that while legislation is really important because that is how you actually get it done, the public education is equally as important. folks really want to know why. we had these community meetings, and one parent was like, "i did not realize that my kid does not have sex and in school. i just thought that is what happens." a lot of people really do not know what the status is in terms of their access to reproductive rights and reproductive choice. just because one person can go to walgreen's and pick up the birth control does not mean that everyone else is able to do that, too. the other part about the public education is that it allows us to tell stories. it tells the stories of the people who are directly impacted. this year, we are not going to -- in the last two years, we introduced the reproductive

health and access act. this year, we decided for the coming legislative session that we are not going to introduce a bill, but just did a lot of base building and a lot of story collection so that we will be in an even stronger place to reintroduce it a year after. one of the reasons we're doing that is the aclu is doing a reproductive health road trip. we are going to 13 cities over the course of 10 days and looking for stories of how people's lives are impacted. we are going to videotape, audio record their stories, write it down, and have it on our website, and it will be available for community people to see, for legislators to see, so it is this idea that we are talking about this problem that does really exist. we want to put faces to the problem. the other thing that has been important for us to realize is that this is a multi-year process. in an ideal world, it would have been great to come here and say that after the first time we won and everything is perfect in illinois, but unfortunately, that is how the process works.

we do not have a pro-choice assembly, so it is about pushing them to realize that this is something that is valid, something that needs to happen, and we are encountering years of anti-choice work, and i do think that it is a proactive piece of legislation working in our favor, and i do think that it has a strong chance of passing, but it is work, and is going to take a few years. >> on that note, telling a story, i think, shelby, that is something you had a really powerful when he started working on your hyper local issue. i'm just wondering if you could talk more about that and also the work you have been doing with other young women and men around the country on reproductive health. >> i will start quickly with my story because it is not that interesting anymore, at least to me. when i was 15, i grew up in a place called lubbock, texas. how many of you are from texas? we have one. do not ever got a lubbock, by the way.

it taught me two things. one is that god loves you and you're going to hell, and the other is that sex is the most horrible, a filthy thing on earth and you should shared only with the person you love most in the world. we have abstinence until marriage in my high school. we also had the highest rate of teen pregnancy in the entire country. quite an accomplishment. sex education was taught by a local pastor who would come in. he had this wonderful toothbrush experiment that he did where he would hold up this really nasty dirty toothbrush and he would say, "would you brush your teeth with this?" and everyone would say no, and he would hold a toothbrush in a box and ask if you brush your teeth without on, and he said if you have sex before marriage, you have a dirty toothbrush. i'm seeing we are running out of time, so this is the situation -- i started a campaign to get comprehensive sex education into

schools and partner with the gay/trade alliance to start an alliance in lubbock, texas, and the story was made into a film. it is on netflix and amazon, which is used across the country to talk about comprehensive sex education and convince parents that maybe they should ask if their kids are getting good sex education, but i am a feminist organizer. i did not work for an organization. i'm very lucky. i get to travel across the organization and work with young people working on reproductive rights. what'spisses me off most of the world is when people say our generation is apathetic. we're the post-war generation. we have never been affected by it, and therefore, we do not care. we are the generation that the government spent $1 billion lying to to tell us that condoms do not work and we are going to go to hell if we have sex. we're the generation that pharmacists telling us they did not want to give us birth control so they did not have to come up with young people are

not responsible enough to take ec like everyone else. if you have ever gone to a clinic and been afraid that you used your parents held assurance -- insurance that they might find that you were having sex and you cannot go to the health clinic, if you have ever gone to a clinic and had protestor scream at you and been scared, reproductive rights have impacted your life, and you know that. everyone in this room knows that, and you are not the apathetic people because i really have not found many of them. one of the things is change in message. reproductive justice works better for us because of all of these things that are not specifically abortion related that have really affected our lives and what we do. reproductive justice -- just a quick explanation, reproductive justice is most of all about bodily and economy, whether it is -- whether you want to get an abortion or you want the right to take hormones and you want them to be covered in health care. be corrected justice is about fighting and having the resources to -- if you want to have a family, and being able to

do so having community support to take care of that family. it is also about the right to reproductive health care and health care in general without them being separate. reproductive health care is health care. that is simply what it is. within this reproductive justice framework, people of our generation are doing some very cool organizing on the ground. as i said, we are the generation that has been was impacted by abstinence only until marriage. highest rates of sti's, abortions, unintended pregnancies -- we really got screwed on that one. this is our generation. on college campuses, young people are finding that because they did not have sex education on high school, they need more resources from their college health centers. they need more basic information. the need the kind of demonstration. they need that sort of thing. lots of people are organizing on their campuses to beef up sexual health centers at their schools. another campaign that is fun and cool to do on the family -- and

the feminist majority campus is doing a cool one on crisis pregnancy centers. crisis pregnancy centers are those places where you see the ads -- "pregnant, scared, call this number he can you go in there, and they tell lots of lies about abortion. like you can get breast cancer from having an abortion. some of them even said that a woman is later along in her pregnancy so she thinks she cannot access an abortion, so by the time she figured out she is not, she is already too late. lots of deceptive tactics. students on college campuses are doing a couple of things. they are finding out where those places are and sending people in to see exactly what their tactics are, and then, you get to write an op-ed in your school newspaper and sort of expo's what this is. the power of stories is very important. also, a lot of college health centers, either knowingly or unknowingly, are referring to these crisis pregnancy centers, which is very dangerous, so people are organizing campaigns

to make sure that their health center is not referring to a crisis pregnancy center. the last thing i will say more generally touches on this story, which i think our generation is uniquely poised to really take hold up because we are so good at social media, and this is what we use it for, so we treat -- tweet about our experiences. we use the cash tag, we post on facebook. therefore, now, all of your friends know. during the stupak campaign, one organization gathered 35,000 signatures in one day, mostly through twitter and facebook and online organizing, which we know is supervised mostly by our organization, so i will shut up now. >> i do want to touch base on a little of that. what have you seen to be most

effective when you are working -- just briefly -- we only have five minutes left before we open up to audience q&a, but what kinds of things have invective in terms of either fighting against anti-choice legislation or, in your case, working to advocate for proactive? >> i think language is a big thing. it is interesting because shelby was talking about the use of the word "reproductive justice." our campaign was originally called the campaign for reproductive health and justice. the focus group and talking about the bill, and it turned out that a lot of the folks who live in illinois who are not part of communities of color and who are not part of organizing communities, so that is a big chunk of illinois -- the idea of reproductive just this just does not appeal to them. they are more connected to reproductive health and reproductive access, and access is a term were mostly latino

communities held more resident, were as an organizer background, if i -- to me, if you see justice, and ready to get out of my chair and do something. for folks who may not be as connected to the world, the language does make a big deal. i cannot emphasize enough the stories, and also getting to people where they are. going and doing community forums with partners from that community and talking with them as opposed to talking at them, really listening to what they need and what they have to say. it becomes my job and the job of the partners we work with to make sure that what they need is reflected in the work that we are doing. >> i think all of that is exactly right. i would just add, when you are in the anti-choice legislation world, when you are fighting back at that, i think there's two important things to keep in mind. the first one is -- and this is going back to what elizabeth talk a little bit about -- getting involved in your state.

is that individuals and states have a lot more power than they realize that they have. i think that is super important to realize that you are a constituent. wherever you are, whoever you are, you are a constituent of somebody, multiple legislators in your state. while your congressman represents 535,000 people, your state senator represents 35,000 people, and your state assemblyman probably represents 17,000 people. you and your 10 friends give your state assemblyperson a call, that probably flooded that person's office for that morning, and that can make a big difference. just making sure people know what is going on in the state legislature, paying attention, so it is incumbent on us as advocates to make sure that the message is getting out. this is what is happening, and these are the people that need to know. i think the second thing i want to add about language -- i think the really important thing to keep in mind when you're talking about reproductive rights or justice or, specifically, about

abortion is that abortion and contraception and sex and are all part of the section of reproductive health care. people, women, families, men, everybody does their access to. it is important to talk about health and longer productive lives where and women will have one to two children in a lifetime and spent 30 years not trying to have children in their lifetime, and that reality is something a lot of legislators can forget when they are faced with a bill that seems, "ok, fine, so a woman has to jump through more hoops, but i'm getting calls from people saying that they want me to sign this." is letting them know that this is impacting individual lives and making the phone call. >> i think generational organizing is really great. the most successful bit visit we had was parents going with their kids. i know that it is a luxury to have -- for parents to have the time to take off work to do that.

sometimes legislators are like, "you are under 18. can you really tell me anything? because you cannot vote." but it does make a difference when we are dealing with a bill like ours that involves parental notification. it involves contraception, and it involves an abortion. it is a situation where legislators are like, "you know what, we are doing it to protect your kids." but if you had a situation where parents are saying they want to protect their kids and they are doing something to protect them, i think it does send a powerful statement. >> i would like to add one other thing, when you go talk to your state legislator or your local county or board member, make sure you have your facts straight. i come from a research organization, so it is really helpful to make sure that your on point and you have the facts straight because sometimes, the legislator, if they know something about the issue, and they may know more than me or you, they may call you on it if you do not have your facts straight. that is it. >> can i say something really

fast? make non-traditional partnerships with a movement that might not necessarily be considered reproductive rights because the key to all of this is that we are each invested in it in different ways. the environmental justice community heavily invested in women being able to control and plan their families. the immigration movement is invested in people having privacy and having autonomy over themselves, so making those partnerships can give you a lot more votes when it comes to go in and talking to your senator. >> and we care about their issues, too. >> it is time to move to audience q&a. there are two microphones on either side, so if you could line up and go ahead and ask questions. >> i'm an intern with the feminist majority foundation, so you guys should definitely all stop by our table. basically, my question is the

following -- the subtitle of the panel is "the new battleground for reproductive justice state legislators." i'm a history major, and and 20, so i do not really know what that means. basically, i know that before roe v wade, there was a bunch of state legislators who did legalize abortion, and i know people have been working on local and state reproductive justice movements for a really long time, so basically, my question is -- what are the lessons from the past that we can apply to the present when it comes to the reproductive justice movement and organizing on the state level? >> we can both do it. you can start. >> i will start with some of the history stuff. the first anti-choice law was adopted in about 1850 in massachusetts, and then, basically, every state ban abortion, and then there was this movement that grew out of social justice movements starting in the 1950's, and about four states legalized

their abortion laws before, but there was this whole movement. thousands of people and in millions of people. they were marching and talking to their legislators and working to expand better access to abortion, and what people were realizing was that this was a needed service, that women should not be in back alleys. it was not like -- my point of this was it was not like the supreme court just made a decision. they made a decision based on this upswing of interest, of people trying to make sure that reproductive rights were really real. it was not just -- because a lot of people say that the supreme court did this thing, and the states are trying to make it better by restricting abortion. no, there was a whole movement behind it. there is a really good book that just came out, and if i can remember the title of it and the author, i will tell you. i will get it to you. yes. i just heard -- linda greenhouse.

linda greenhouse just wrote this new book. she is a pulitzer prize-winning author. she wrote it with an attorney. look it up because i just heard her speak about it, and it is fantastic. so, please, go get this book. basically, what is telling us is that the supreme court did not just make this decision. it was because there was a lot of hope and love for reproductive rights, so there is the kind of -- and then, also, the states start adopting restrictions because we got the right, and then we felt our job was done, and that is not true. people have been trying to restrict abortion rights since 1873. a lot of them have that struck down, but they may come back, and we are unfortunately in the boat we are in. what do you want to say? [laughter] >> interesting. so i wanted to ask that just to say that prior to 1850, which is

when the contract law was passed, right? women have been figuring out how to plan their families since women existed, right? and there has always been methods of preventing pregnancy and terminating a pregnancy early on, and there were no laws prohibiting the up until the 1850's, and there's a lot of reasons for that, but basically, after the supreme court said women have the right to choose to terminate a pregnancy with their doctor and that any law that impedes on that is going to be looked at really carefully, there was a backlash. there was a huge upswing of people who previously had not something to organize around and now they did, so there was a lot of energy to push back on that, and they have been relatively successful. there has been a number of court cases. the courts have changed, and there has been a swing back the other way, so the point that elizabeth made is absolutely right, which is that prior to

1973, there was a lot of energy in women and families and in the progressive movement to make a change here. when we got roe v wade, a lot of people just said that we were done, and that is clearly not the case, so i think what we can take from what happened prior is that when people make this a priority, when they understand how important it is to their own lives, their family lives, their children's lives, they will do something about it. that is where we are again now. >> i then i could answer your question a little bit. adopting inside/outside approach, making sure that our organizing is still passing on the state level, and then running for the position. either -- like your board of education that will help you in terms of thinking about comprehensive sex at nine schools, running for representative -- a lot of the decisions that are made that affect our lives are at that level. that means depending what your case is, those are two with the

constant options you could explore. >> one lesson that we can learn is one little roll back is never just one little ball back. we can never, ever accept the sort of things. especially as it is a small price to pay if you keep access for a larger group. one, because the group retaining access is the group that had access anyway, and the ones that are losing access id for women, women of color, native women, military women. that is what happened with the most recent legislation, so we cannot let that happen. also because it just energizes then every single time they win. then a quick question from the woman in the striped dress over there. >> can you hear me? my name is nicole. i'm an intern with planned parenthood this summer. looking around this room, we are all here to talk about reproductive justice, but when they did a poll of attendees, everybody said that the big issue in upcoming elections is going to be the economy and

jobs. even this crowd knows that that is not the priority. given that in the november elections, the big talking debates will be about the economy and jobs and not really reproductive rights, how can we keep these issues in the forefront and make sure that we are still mobilizing for these issues even when they are not necessarily key, especially in states besides colorado and mississippi? >> but it is still connected. part of the issue with the economy is people losing their jobs or getting cutbacks in hours. that affect their ability to access health care. within that framework, there is reproductive health care. your statistics and i do not want to say what they are because i want to be accurate, where situations where people are losing their jobs, and they have an unintended pregnancy. they are more likely to think about abortion as a potential option. you have more people who will be on medicaid or some kind of

state medical assistance, and that is a health and reproductive issue. anything about reproductive justice broadly, it is also about having someone to take care of your kids while you go to work, and having it done in a safe place. it is a pretty broad area. i think our -- is our responsibility to learn about his connections. when people say that the economy is different, just connect into how it is similar. >> [inaudible] about the rise in poor women having abortions. >> yes, access to reproductive health during his times, and the four planned parenthood that are getting a lot more clients -- the poor planned parenthoods that a getting a lot more plans. >> our generation is generally more progressive, but in contrast to what you were

saying, polls suggest the support for abortion rights is actually lower among our age group than people 20, 30 years older than us, and i was wondering if you think that that is not really accurate, and if it is, what the reasons for that might be. >> that actually depends on how to ask the question. >> for call attendees, the set when the a considering going to pull this fall, which the issues will you be considering most. >> she is talking about, like, a gallup poll or something. and yes, shelby is exactly right. it depends on how you ask the question, so if you ask if they're pro-choice or anti- choice or pro-abortion or what words you use, people feel

differently, and they respond to different words, so that could be part of it. also, part of it -- and i'm kind of in this in between generation. i'm in between the feminists from the 1970's and this third- generation feminist, so i'm, like, in this weird place, but it also seems to me that there are lots more opportunities to become active around different kinds of issues. the environment and immigration and all that kind of stuff, so maybe, we need to raise the profile of reproductive rights in a sense, so that people know how they think about it, maybe. what do you think? >> i sweated to add something. i am used to raising my hand. we detest. i also wanted to say that i think that' with reproductive rights and reproductive health care issues, they are very personal, and i think that what someone says to a gallup pollster who asked them a funny word question on the phone and

what they might choose to do for themselves are very different. the way that the statistics over the years have shown is as we increase access to contraception, the numbers of abortions go down, but there has never been an enormous bit -- dip as people claim their positions have changed. you are not going to see what polling numbers show, that people are less pro-choice and therefore there are less abortions. this is a reproductive need women have and you have and when they make personal decisions, what a poll says is not going to be relevant to them, and that is what i think we need to think about and talk about more. >> with that said, i have to give my favorite new poll for our generation. when young women are asked if they support the issues and the goals of the women's liberation movement, which sounds like old language, 90% say that they do, when women over the age of 50 are asked the question, only 74% say that they did. >> interesting.

i want to see that. >> i think we have time for one more question. >> i'm stephanie, and i'm working with the rcrc. i just wanted to know, how important do you guys think that the upcoming midterm election is that is happening in november? >> well -- you go. .

i would say that -- please. find out where it -- who you are voting for. anyone from alaska? nobody is from alaska. but you guys are voting in august. find out what is going on in your world. hold those people to the fire. >> i think the congressional midterms are important, absolutely.

on a day-to-day basis, a woman's access to reproductive health care depends on who is in her state legislator. -- legislature. those elections are super important, too. >> i think that is all the time that we have. >> they have been waiting so long. >> we can take one more question. >> i really appreciate it. i am julia. i am with the national gay and lesbian task force. it is really important to recognize how these movements are interconnected. recently, i was at baltimore pride to spend -- and was very

disheartening to to see a group that was against choice. do you have an example where you successfully partnered with another group and you were able to message at this issue to other groups, either religious groups or racial groups? >> that is sad. what the coalition we are a part of -- we have the most progressive coalition. we got this a group from -- of nuns from across the country to talk about why this is needed, why this bill is needed. it is about building relationships. it is about going to talk to them and saying, here is what we are doing. here are the opportunities for

partnership. what can you help us with? what can we help you with? did you start a those relationships, the sooner the better. -- if you start those relationships, the sooner the better. make sure that it is continual. >> thank you so much to our panelists. [applause] >> we are going to break up into groups now. facilitators, if you could find a table and take the questions. come up with your own. >> thank you so much. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010]

>> saturday, on "washington journal," the governor of utah. then a look at use participation in politics with the communications and outreach associates for campus progress. later, neil or when. he explains what he believes is driving the current economic recovery. "washington journal" takes your

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analyst on the unconstitutional behavior of both the bush and the obama administration. he is interviewed by consumer advocate and a 4 time a presidential candidate ross nader. >> can you tell me a little bit about the state of the fishing industry in louisiana right now? >> right now, it is challenged because of the closures that are taking place. that is our biggest challenge. branting -- branding, we need to

have more areas opened, and we need to have more vessels of opportunities for back and forth fishing. >> how many fishermen are out in the waters right now? >> in may of 2009, we have 4500 fishermen fishing. in may of 2010, we had 28 fishermen fishing. -- 2800 fishermen fishing. the vessel of opportunity program is the program where you can go to work for bp. that difference is almost the same. we need to try to get those fishermen back to work. >> what is the incentive to fishing -- for a fisherman to -- >> i am trying to give bp -- but it bp to give a bonus based on

last year's average price of each of fishery. they would go to the dock and get their normal dock price and get a 30% kick. that would give them incentive to go back to work. it is the 70% there are mitigating damage is on. -- they are mitigating damage is on. as far as the consumer understanding how safe are seafood is, they need to understand that the restaurants they have beaten at across the country are those same restaurants they have been eating at before. -- they had eaten at across the country. our industry is sort of self policing. that is part of the process. the distributors are going to make doubly sure that the quality of the product is there. you should be less afraid today

-- are testing protocols are much heavier today than they have ever been. we have everybody -- we are under a microscope right now. any product that goes to market place is safe, more so than anything you have seen before. what you need to do is support us. understand everything we have down here is wonderful and great courage to do not listen to the hype. -- wonderful. do not listen to the height. our fish are great. the areas that are open are fine. the areas that are close are a precaution. exxon valdez was heavy crude. this is a very different product. this is not a new occurrence for us. we are being very cautious about

what we are doing. what i told kenneth feinberg is that to $20 billion -- if we lose our heritage and culture, it is not enough. one-third of the domestic seafood comes from louisiana. in may of 2009, we had 37 billion pounds of products. mywe're standing in processing facility. these are fresh softshell crabs that we get in daily. it is a delicacy in louisiana. they start in early spring and in -- and end in early fall. you are looking at 50 dozen at soft crabs right there.

everything is refrigerated. we are under an act of planned. -- at the planned. this is the main room right now. normally, we have about 30,000 pounds of fish. right now, we have about 10,000 or 12,000 pounds of fish right now. this is processing over here.

this is the black drum that we are processing over here. these will go to the restaurants. some of these will be eaten for lunch today. over here, we have to know, black drama, -- a black drablac, tuna, fresh snapper, grouper. i buy from a lot of local fishermen.

i have a doctor that buys them for me. -- adopt that buys them for me. -- adock. here is some rainbow trout, oysters. process to meet. -- a processed meat. that is pretty much a quick run. we can hold 100,000 pounds of fish. we are holding conference calls, helping each other. we are doing a lot of things

that are positive. we will be very aggressive with our brand purchases. that is going to be that we need help so that people understand what is going on. anybody who is in this country needs to know that the way to help louisiana is to eat louisiana seafood. it is very safe. >> next, protecting the gulf of mexico oil spill workers. our guest is dr. john howard, director of the national institute for occupational safety and health. this is 40 minutes. or 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

theulf clean. 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 andalents health of consumers that are buying and eating sea food from the gulf. have the food and drug administration which is a part of the departmentf 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 expiencing in their response work. host: what are yo 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 i exposures to crude oil. whether crude oil dispersements, but our biggest problem is heat exhaustion and heat issues. in the gulf area there's lot of heat and humidity and the he 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 e 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 t 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 integted 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 o 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 wkers. 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 playi it down, because they want to money. host: can y 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 new media, everybody is trying to cover it up, because they all want the money. guest: well, certainly thill the oil dispursemen 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. . .

>> we are talking about the gulf of mexico oil spill. do you have any comment that you would like to make about that? >> social security is not strictly entitlement. it was barred by the government and it has never been paid back. -- it was borrowed by the government and it has never been paid back. host: her husband is a clean-up worker. please go ahead. caller: you talk about how many cleanup workers are being brought into the gulf to clean up, but you do not talk about

the type of people that they are bringing into our communities. they are bringing in anyone that they can get their hands on, regardless of criminal history, current criminal problems, drug dealers, drug addicts. our communities -- our communities are being inundated. host: what does your husband do? caller: he is a former commercial fishermen. host: s.c. participating in the cleanup effort? caller: that is another problem. you'll have a hard time finding any of these people who are former fishermen who are now participating in the cleanup effort to talk. they are scared to death to talk to anyone in the media. they are terrified because they're being told that they could lose their contracts.

they are scared to complain about the working conditions. they are scared to complain about their safety concerns. we have had some people who have complained and they have lost their jobs. guest: there are whistle-blower protections for workers. they can make anonymous complaints to osha. there is an avenue for workers that may be intimidated or frightened by working conditions, their employer in not warning them to speak. i would encourage you to tell your husband that there is an avenue is there. an anonymous call to osha is very helpful. guest: who is paying for our cleanup for the federal cleanup

workers and the public safety and public health workers down there? guest: what the unified command has established is an invoice system. federal agencies that are bringing employees to the area to respond or to do work in their laboratories back in their locations, they will invoice the unified command. the unified command then seeks reimbursement from bp. host: has bp been a pain? guest: to mike understanding, yes. caller: good morning. i have three concerns. i have a jack russell and he loves to go to the beaches down there.

i am so concerned. i asked the event if it was ok to allow him to splash in the water and she said not to do it. i would like to know. i was planning on going down today, but i do not know if it is safe. guest: i am going to " lisa jackson. she is the epa administrator. you can look at the water. you can use common sense. no laboratory is going to tell you whether the water is safe or not. you can tell. if you see tar balls floating on the water, i would not have the dog running all over the place nor any human being. certainly, if the beach is contaminated, you should check with your local help department, see what their recommendations are. be careful.

host: va., and dependent line. you are on with dr. john howard. we're talking about public health and the gulf of mexico oil spill. caller: one of my biggest concerns is that i have read that there is an acoustic switch that could have been installed that would have cut a week off below the source. the companies involved decided that it was too expensive to put it in. it cost about half a million dollars. caller: we are talking about public health. i do not think that dr. howard --

caller: good morning. i have a question about dispersion. why did they need to use the dispersant? i could never let it come to the surface? it was easier to get to and it really would not mess up the environment as far as health hazards. guest: that is a little outside my field of expertise in terms of the logic of using oil dispersants. from a public health perspective, we would like to see the least amount of hydrocarbons in the human health space. i cannot really comment on the

logic of why. host: are you supplying your cleanup workers with masks, with oxygen tanks? 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 closel 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 aas 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 t 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 thione? 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 tha 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 estige 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 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 u 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 uversity of tennesse 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 gul 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 issuesnd 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. ththings that e.p.a. are monitoring are the things y 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 sitehich is anoer sampler of water quality in the gulf area as well as the end of the loop current as it goes by the keys into theatlantic. 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 inuck in cameras to take pictures. guest: well, fred, i would hope th 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 mmand. 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 -- vaporid, 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 alth. 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 wld 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 ttappened 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 tee 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 plann place to evacuate up to 20 million people from the gull area -- gulf area. gut: 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 a that. noaa also ds 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 itsbility 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 longhe 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 theoi 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 y for taking my call. m a forme 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 pticular type of crude. my understand something that this particular type of crude is e 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 informion 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 iss what is it n >> saturday, the governor of utah. he discusses this weekend's

meeting of the national governors meeting in boston. then a look at u.s. participation in politics with the communications and outreach associate for campus progress. later, the economics reporter for the washington post. "washington journal" to insure e-mails and calls life every morning starting at 7:00. >> today, we are acting insure air, outside the new orleans airport. we are transporting brown pelicans from the rehabilitation center here in louisiana to the tampa bay, fla., area. >> we have 32 birds that will be released today. so far, it is over the 400 mark.

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♪ >> ladies and gentlemen, please welcome senator harry reid. [applause] [cheers and applause]

>> thank you very much. thank you. unlv. every time i come here, i have to tell everybody, my wife was a cheerleader here. [applause] it is an understatement to say thank you for being here today. this is a thrill for me, to be present at the university of nevada, las vegas. it is an understatement to say

that nevada is being tested economically like never before, but we have to put nevadans to work in our economy back on track. we have a lot to fight ahead of us, but more importantly, we have a lot of fight left in us. [applause] and really, how we react to this crisis is about renewing our future and not repeating the past. there is one way to get out of this mess, being honest about what does it -- what got us into it. we have all watched very closely, or at least when we read the sports page we first get up in the morning, the lebron james situation. [laughter] i do not know much about those basketball teams, but i know about that he might have served

on now for the last 18 months. it has been a good team. we have been able to accomplish a lot. in fact, one eminent pundit, a scholar in congress says it is the most productive congress in the history of the country. [applause] he said that because -- i will run through a few of the things this team has been able to accomplish. we did the most significant internal piece of legislation, more than 200,000 acres, and many other things. we were able to pass the ledbetter legislation. [applause] ted kennedy bought for 40 years to have a program of national

service. we now have one where young men and women can be involved in the environment, health care, working with people that are poor, they can get a few bucks for doing that, and then when they finish the program, they go to college and we help them. that is national service. [applause] every one of my family smokes. they all were addicted to smoking whenever teenagers. but we have changed the law. no longer will the tobacco companies be able to easily adapt our children, because now the fda controls the back of. -- controls tobacco. credit cards were unfair to the american consumer, especially the middle class. no longer do they control us. we control credit card companies, in the right way.

[applause] we have done a lot of other things, mortgage fraud, we have done some things that relate to what we do in times of crisis. but the most important thing we worked on, and it was really hard, but it was so necessary, health care reform. [cheers and applause] and for those who say that this team cannot afford to do it, tell everyone that raises a question, during the first 20 years of this legislation, we reduce the debt by 1.3 trillion dollars. no longer will insurance companies be able to willy-nilly deny insurance because of pre- existing dilks -- disabilities because the child has diabetes.

that is no longer the lot in america. we have changed it. how have we done this? we have done it by working together as a team. we know who is responsible, for what took place in nevada. the place where people all over america looked, the place to get a job for 20 years, a place to start a business for 20 years, a place where if you wanted to invest in real estate, it was here. but greedy wall street took that away from us. that is unfortunate. reckless wall street's banks gamble with our money. they gambled with our jobs, and they lost, and it hurt nevada more than any other place. the ruthless insurance companies deny health care. we took them on. irresponsible oil companies polluted art economy. we will leave in renewable

energy at this great university. -- lead in renewable energy at this great university. [cheers and applause] have we done enough? of course not. but we promised there would be some jobs in renewable energy, and there are thousands of people working in nevada right now because we fulfill that promise. [applause] never again will americans be required to bail out the banks that created their own problems. one thing, we are holding bp accountable, and we are not apologizing for doing it. [applause] we have a lot more to do. we are not going to wait until a

long time from now. right now we are working on improving our economy. we want to make sure everyone in the batter who wants to work has a job. we are roaring to make nevada a world leader we -- we are going to make nevada world leader in renewable energy. this university, within the foreseeable future, will be the leader in renewable energy, especially solar energy. i think that is pretty clear. [applause] i am not here to be rate republicans, because throughout the country, and throughout the state of nevada, there are republicans who are relyinreliad doing a great job. the republicans in congress do not represent republicans in nevada.

the senate republicans have been the party of no. we have a couple of women at work with us, but that is about it, the two senators from maine. it has been a struggle. they are betting on our failure. we are betting on our success, and it is of bet we are going to win. [applause] finally, i want to say a word about our honored guest today. i have had the good fortune of working with him very closely. he is a man of great patience. he is a man as calm and cool indeliberate in every situation he comes up against. i want everyone to know here, barack obama is my friend, but he is your friend. it is a great pleasure to know him. [applause]

the president knows that we are a state full of fighters. we will continue to fight for everything we have got. we need to do that. we are the battle born state. we are going to continue to fight, because we are on the right side of this fight. i am so honored, here at the university of nevada at las vegas to introduce to you my friend and your friend, the president of the united states, barack obama. [applause] >> thank you, everybody. thank you. good to see you. thank you, everybody. please, have a seat.

well, thank you, harry. thank you for giving me a chance to get out of washington. it is very hot there. [laughter] it is hot here, too, but there is a little bit more humidity there. i just love coming to vegas, and i love being here. i mentioned last night, i am not the only one who loves it, because i noticed that for some reason, air force one is more crowded when we are coming to vegas. [laughter] somehow i need more staff and logistical support and a couple of extra secret service guys. we have got some wonderful leaders here, and i just want to acknowledge them very quickly. u.s. rep dena titus is here. [applause]

the nevada secretary of state is here. [applause] and all of you are here. i am thrilled to see it. but i am especially thrilled to be here with my friend and your senator, harry reid. [applause] one of the first stories i heard about him was that he was a boxer back in the day here in nevada. i was -- she is laughing, saying i cannot believe it. he was. it would not know that because he is so soft-spoken, but when he first told me he was a boxer,

he said i was not the fastest, i was not the hardest hitting, but i knew how to take a punch. he knew how to take a punch. and harry reid became a pretty good boxer because he would simply outclassed his opponents -- outlast his opponents. he had a stronger wheel. i think that tells you something about the kind of person he is, the kind of a senator and senate majority leader he is. he is a fighter. you should never bet against him. that is what we need right now. that is what nevada needs right now. we need someone who is going to fight for nevada and for the american people. he was not born with a silver spoon in his mouth.

when you are going through tough times, harry reid has been there. he knows what it feels like to be scraping and screaming and struggling -- scraping and scrimping and struggling to make ends meet. when his home state and the country are having a tough time, he knows he has to be fighting on behalf of not those who are powerful, but on behalf of those who need help the most. let me tell you, when we first took office, amidst the worst economy since the great depression, when needed harry's fighting spirit, because we had lost nearly 3 million jobs during the last six months of 2008. the month was sworn in, january

2009, we lost 750,000 jobs in that month alone. the following month we lost 600,000 jobs. these were all the consequence of a decade of misguided economic policies, a decade of stagnant wages, a decade of declining incomes, a decade of spiralling deficits. so our first mission was to break the momentum of the deepest and most vicious recession since the great depression. we had to stop the freefall and get the economy and jobs growing again. and being out this mess required us taking some tough decisions, and sometimes those decisions were not popular. harry knew they were not popular and i knew they were not popular, but they were the right thing to do. harry was willing to lead those fights because he knew that we had to change course. that to do nothing, to simply continue with the policies that had gotten us into this mess in

the first place would mean further disaster. and to fail to act on some of the great challenges facing the country that we had been putting off for decades would mean a lesser future for our children and grandchildren. as a result of those tough steps that we took, we are in a different place today than we were a year ago. an economy that was shrinking is now growing. we have gained private sector jobs for each of the past six months, instead of losing them, almost 600,000 new jobs. as terry pointed out, that is not enough. i do not have to tell you that. the unemployment rate is still unacceptably high, particularly in some states like nevada. a lot of you have felt that pain personally, or you have somebody in your family who has felt that pain. maybe you found yourself under water on your mortgage and faced the terrible prospect of losing your home.

maybe you are out of work, worried about how you are going to provide for your family, or maybe you are a student at unlv and you are wondering if you will be able to find a job when you graduate, or pay off your student loans, or bable to start your career off on the right foot. the simple truth is, it took years to dig this whole. it is going to take more time than any of us would like to climb out of it. the question is, number one, are we on the right track? the answer is yes. no. 2, how do we accelerate the process? how do we get the recovery to pick up more steam? how we feel this hole faster? there is a big debate in washington right now about the role the government should play in all this. as i said in the campaign, and i have repeated many times as president, the greatest

generator of jobs in america is our private sector. it is not government. it is our entrepreneurs and innovators who are willing to take a chance on a good idea. it is our businesses, large and small, who are making payrolls, working with suppliers, distributing goods and services across the country and now across the world. the private sector, not government, is, was, and always will be the source of america's economic success. that is our strength, the dynamism of our economy. that is why one of the first things harry reid did, one of the first things we did, was cut dozens of taxes. not raise them, cut them, for middle-class and small business people. and we extended loan programs to put capital in the hands of startups, and worked to reduce the cost of health care for small businesses.

right now, harry is fighting to pass additional tax credits and loan authorities to help small businesses grow and higher. all across the country, but he has also tried to look out specifically for nevada. he understands, for example, that tourism is so enormous and aspect of our economy, and to bring folks here to enjoy the incredible hospitality. the point is, our role in government, especially in difficult times like these, is to break down barriers that are standing in the way of innovation, to unleash the ingenuity that springs from our people, to give an impetus to businesses to grow and expand.

that is the not some abstract theory. we have seen the results. we have seen what we can do to catalyze job growth in the private sector. one of the places we have seen in most is in the clean energy sector. an industry that will not only produce jobs of the future, but help free america from our dependence on foreign oil in the process, clean up our environment in the process, improve our national security in the process. so let me give you an example. just yesterday, i took a tour of smith electric vehicles in kansas city, missouri, on the way here. this is a company that just hired its 50th worker and is on to hiring 15 more. it is aiming to produce 500 electric vehicles at that plant alone. [applause] these are spiffy looking trucks.

they are used by fortune 500 companies for distribution and also used by the united states military. electric trucks that are very strong, with a lot of horsepower. the reason for their success is their entrepreneurialis drive. it is also because they are part of a grant. because of these grants, we are going from only having two% of the global capacity to make advanced batteries they go in trucks and cars that run on electricity to 40% just in the next five years. [applause]

that will create thousands of jobs across the country, not just this year or next year, but for decades to come. so it is a powerful example of how we can generate jobs and promote robust economic growth here in nevada and all across the country by incentivizing private sector investments. that is what we are working to do with the clean energy manufacturing tax credits that we enacted last year, thanks to harry's leadership. [applause] some people know these tax credits by the name 48-c. here is how the tax credits work. we say to clean energy companies, if you are willing to put up 70% of the capitol for a

worthy project, a clean energy project, we will put up the remaining 30%. to put it another way, for every dollar we invest, we leverage to more private sector dollars. we are betting on the ingenuity and talents of american businesses. [applause] these manufacturing tax credits are already having an extraordinary effect. a solar panel company -- solar power co. received roughly $6 million tax credit for a new facility their building in the las vegas area, a tax credit they were able to match with roughly $12 million in private capital. that is happening right now. that is just one of over 180

projects that received manufacturing tax credits in over 40 states. the only problem we have is, these credits were working so well, there are not in of tax credits to go around. there are more worthy projects and there are tax credits. when we announce the program last year, it was such a success, we received 500 applications requesting over $8 billion in tax credits, but we only had $2.3 billion to invest. we had almost four times as many were the request as we had tax credits. my attitude and harry's attitude is that if an american company wants to create jobs and growth, we should be there to help them do it. that is why i am urging congress to invest $5 billion more in these kinds of clean energy manufacturing tax credits, more than doubling the amount we made

available last year. [applause] this investment would generate nearly 40,000 jobs and $12 billion or more in private sector investment, which could trigger an additional 90,000 jobs. i am gratified that this initiative is strong support from members of congress from both sides of the aisle, including republican senators richard lugar and orrin hatch. unfortunately, that kind of bipartisanship has been absent on a lot of efforts that harry and i have taken up over the past year and a half. we fought to keep nevada teachers and firefighters and police officers on the job and to extend unemployment insurance and cobra it so that folks have health insurance while they are looking for work. we fought to stop health insurance companies from dropping your coverage on the basis of pre-existing conditions or write when you get sick, or

placing like time limits on the amount of care you can receive. we fought to eliminate wasteful subsidies that go to banks that were acting as an unnecessary middleman for guaranteed student loans from the federal government, and as a consequence, freed up tens of billions of dollars that are now going directly to students, which means more than 1 million students have access to financial aid that they did not have before. [applause] and we are now on the cusp of enacting wall street reforms that will empower consumers with clear and concise information that they need to make financial decisions that are best for them, and to help prevent another crisis like this from ever happening again, putting an end to some of the predatory lending and subprime loans that had all kinds of fine print and hidden fees that have been such a burden for the economy of a state like nevada and have not been fair to individual consumers in the process.

that is what harry and i have fought for. frankly, at every turn, we have met opposition and obstruction from a lot of leaders across iowa. that is why -- across t aisle. that is why i am glad we have a boxer in the senate, who is not afraid to fight for what he believes in. we will fight until americans are headed back to work again and we are recovered from this recession and we are building this economy stronger than before. that is what we are committed to doing. [applause] so nevada, i know we have been through tough times. not all the difficult days are behind us. there will be some tough times to come, but i can promise you this. we are headed in the right direction. we are moving forward. we are not going to move backwards.

i am absolutely confident that if we keep on moving forward, if we refuse to turn backwards, if we are willing to show the same kind of fighting spirit that harry reid has shown throughout his career, then out of this storm, brighter days are going to come. thank you very much, everybody. god bless you. [cheers and applause] ♪ ♪ [captioning performed by national captioning institute]

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♪ ♪ >> coming up, the national governors' association annual summer meeting, with a look at how states are coping during the

recession, and how to reduce health care expenses. following that, discussion on conservative women in politics and feminism, which national review's catherine lopez. then, the latest on the gulf of mexico oil spill. >> tomorrow, on c-span, a kansas senate republican primary debate. some of the topics, tax policy, a arizonas immigration law, and prosecuting suspected terrorist in military tribunals. that is that a 30 p.m. eastern, here on c-span. also tomorrow, president obama speaks at a campaign fund- raiser for the missouri state democratic candidate. also republican candidate congressman roy blount talks about the economy and jobs. that is that 9:30 p.m. eastern, here on c-span. >> c-span is now available in

more than 100 million homes, bringing you a direct link to public affairs, politics, history, all as a public service, created by america's cable companies vicariate >> now, remarks from the national governors' association chairman, jim douglas of vermont on how states have coped during the recession. this is about half an hour. >> good morning, everyone. thank you all for coming. he gives me great pleasure to welcome you to this kick off press conference of the national governors' association summer meeting and to welcome my colleagues and their staff and families and our guests to boston in the commonwealth of massachusetts for the 2010 summer meeting of the national governors' association. we have over 1000 registrants

for these couple of days of meetings and a very robust schedule planned, and some fun as well. we are especially pleased to have so many people here to pump some welcome dollars into our local economy. we estimate that local restaurants and entertainment venues and hotels will see an injection of about $3 million over the course of the next couple of days, and we are challenging our guests to be that projection and inviting them to do so. i want to thank all of the members of the nga staff, of my own staff, and those who have volunteered and will volunteer over the next few days to help us organize and manage a successful conference. i want to thank our leader, our outgoing chair of the national governors' association, governor jim douglas of vermont, for his

extraordinary leadership and also for his willingness to grant the honor to massachusetts to host this summer meeting. i also want to thank and welcome our incoming chair, the governor of west virginia, who is also here and has been a great friend as well. we are looking forward to his leadership over the coming session of the national governors' association. we are looking forward to a very serious series of conversations having to do with health care reform at the national level and our responsibilities to implemented over the next several years. we will be talking about economic issues we are facing in different ways in each of our state, and every time i have had an opportunity to protests take over the last four years in nga sessions, i have learned things and benefited from the shared with them and tender of other

governors and their staffs. we warmly welcome everyone here to boston. let me turn it over to the chair, jim douglas. >> thank you very much, governor. let me begin my extending my appreciation and that of all our colleagues to you, diane, to your staff, to the host committee and everyone in the boston area who has been so hospitable. we really appreciate the hard work that goes into hosting a conference of this magnitude. it looks easy when you are standing here at a podium congratulating one another, but there is a lot of hard work that goes into it and we are very grateful indeed for your willingness to be our host this year. we travel around to a different location every summer for our annual meeting, and enjoy the

ambience and history and culture of a different place, but we also have a lot of work to do to talk about the issues that are important to the people of our states and share ideas and experiences, both good and bad, so we can do the best job possible for the people we represent. each chairman of the association has the responsibility and opportunity to focus on a particular policy area, and a year and a half ago i decided that healthcare reform ought to be the principal association -- principal focus of the association this year. that was before we knew whether congress was going to do anything or not. it seemed to me we had an obligation to our constituents to help each other come up with innovative ways to reform the health care delivery systems, to contain costs, and extend coverage in the states we sir. some states like vermont and massachusetts have been at the forefront of reform efforts, and we'll forward to assisting our

colleagues in implementing the new federal law that was passed earlier this year. this is a time when states are facing tremendous fiscal challenges over the last couple of years, as we come out of the great recession, states have had to make difficult budget choices. some cases, they have chosen to increase taxes. that have depleted reserves and borrowed more. they have done what is necessary to get through this difficult time. with the addition of the health care reform implementation we are facing, is a very challenging time for governors across the united states. so we are going to spend some time over the next couple of days talking about the economic realities we are confronting as well as implementing the health care reform efforts that are so important. and maybe a little biased, but i think the vermont blueprint for health is a great example of how we can move forward to focus on preventive care, on wellness. vermont has been deemed to help

the state in america for two years in a row now, and we certainly have some ideas we can share with our colleagues. states are the laboratories of democracy, it has been variously said. we are the place where innovation occurs, and sharing best practices is part of what nga is all about. we also cannot print money. we have to balance our budgets. it is with that backdrop that would come to boston this week to share our experiences and ideas with one another. again, governor patrick, i want to thank you for your willingness to be our gracious host. it is an honor now to turn the podium over to governor joe manchin who will assume the gavel of leadership of the association in about 48 hours. he has been a great colleague and partner to work with during this past year and i look forward to his assuming this responsibility at the end of the meeting. >> thank you very much.

[applause] good morning to all of you. thank you for coming. jim, let me congratulate you on the job you have done, your leadership has been unbelievable. all of you in massachusetts should be very fortunate to have the quality of people who are leading this state and the quality of people will enjoy working with it. nga is truly a bipartisan organization and we truly love for best practices. it does not matter what side of the fence we come front. for the common good, how we have the best, practices? we reach out to each other. if you look behind me, you see a balance of three democrats and three republicans.

we have chris christie from new jersey, jody from connecticut's, and jack from delaware. i am so happy to have them with us. we are looking forward to a productive three days. there are an awful lot of good things going on that have to tell you about. during the meeting, we will focus on issues common to all of our states, health care, the economy, education, natural resources, homeland security, just to name a few. our standing committees will meet to discuss policy proposals that will be considered by the full association at sunday's closing from recession. two lovers only six sessions will provide a candid for -- t

wo governors-only sessions. we will really reach out to each other for best practices to help each other. our work will begin shortly. today's opening plenary session will be achieving a sustainable healthcare system, which gm has touched on and we are going to focus on -- which jim has touched on. we will be joined by the chairman of the board and ceo of ibm. he will offer insights on his experience of providing health insurance to employees worldwide. we will have david cutler in the kennedy center of harvard who will also join the discussion and his insight on cost containment and methods of achieving higher performing health-care system.

this afternoon our health and education committee will meet in a joint session to discuss childhood obesity and nutrition. our former colleague from i will will be with us -- from iowa will join the governors to talk about childhood nutrition. this session will conclude with a cooking demonstration by the white house chef. i understand we will have some new chefs when we get done today. this is something we are all committed to, making sure we are able to put good quality home grown food in front of our children in our school systems from our breakfast and lunch programs. tomorrow morning the natural resources committee will meet to discuss ways to capitalize on america's domestic energy. this will include this is a secretary for energy efficiency

at that u.s. department of energy, the executive vice president at american electric power, and the president and ceo of america's natural gas lines. during the same time slot, a special committee on homeland security and safety will meet to discuss ways to improve our country's communications system that connects public safety officials and emergency medical personnel. jamie barnett and charles delhomme, deputy chief of the communications division of the new york police department will take part in a panel discussion on communications. this session will include discussion on fusion centers, featuring burt johnson, principal deputy undersecretary analyst at the u.s. department

of homeland security. on sunday afternoon, we will reconvene for a plenary session on redesigning state governments. allstate's are facing -- all states are facing tough decisions. we'll focus on ways to structure and streamline state government for maximum efficiency. the roundtable discussion will be monitored by the executive editor on line for the wall street journal. saturday we will wrap up with a meeting of the economic development and commerce committee to discuss stake in the economy. and most importantly, the road to recovery. the vice-president at of the boston reserve bank will join the discussion. the annual meeting will conclude sunday morning with the plenary session on the wrist and challenges of the federal budget deficit former u.s. senator al simpson and erskine bowles.

they will share their insights are reducing the federal deficit through sound monetary policies. as you can tell, we have a full schedule ahead of us. i know i speak for all the governors when i say we are ready to get down to doing the business for the people we are all looking forward the opportunity to focus on state issues, share best practices and find solutions to our common challenges, which is what we do best at the nga. i want to thank you all for joining us in boston. we all look forward to taking in as much of the city as we can. i know they want us to leave as much as we can financially with you. he has made that direct response every time he has had a chance to get a microphone. i want him to know, gail is out doing her job this morning. we will open it up to questions, but it first if we

have anymore governors who would like to say something, they are of tremendous assets to our organization, so you can direct your questions to anyone of us who is up here. >> [unintelligible] >> we certainly look to the congress for support in a variety of different ways. in february, 47 governor signed a letter to the congressional leadership requesting an extension of the appropriation. we sent that again to them earlier this year. as you know, it is somewhat at a stalemate at this point. a number of states relied on those additional revenues for their budget for the fiscal year that began a week ago and will have to make some difficult choices if they do not come through with the money.

that will probably be a matter of discussion, but we have taken a clear position on it. we are for it. >> indian ask all 50 governors, i think you will get an answer that -- et ask all 50 governors, with any of the money that flows through the states, it gives us a chance to direct the money to help our people. every governor knows where the concerns and needs are. i think you will find more a reception working with the legislature, but sometimes you will not. they will come to each one of us and say how come this did not happen. we ask for that flexibility to be able to make that happen. >> [unintelligible]

>> i talked to senator brown about both of those subjects, but i cannot comment and do not have any information about a link between those two. the speaker and i had a meeting with him that was specifically about his support if not on the merits, at least getting it to a vote on the merits on the cloture vote. in the same meeting, he repeated what everybody knows to be the case, which is his support for slots at the track, but one as a condition for the other, that was not the issue of the conversation. >> could you give me your view of whether congress should pass [unintelligible]

immediately, or should they try to find some way of setting [unintelligible] >> we'll probably have some discussion about this over the next couple of days. nga is a consensus basis, bipartisan organization. we need to find that common ground as we did when we sent a bipartisan letter on fmap. i would say this, as jos said, flexibility is key. for some states, it is important, and less so for other states. other types of federal assistance may be more beneficial. the extent that congress can give us flexibility in healthcare in particular, that would be of benefit to most of the states. >> we always extend an

invitation to the president at our winter meeting in february. in my eight years, we always have met with the president and a number of members of his cabinet at the white house. we have a very extensive two or three are meeting in february. we extended the invitation this time as we always do. presidents and gentlegenerally e to the summer meeting, and i am not expecting him. >> [unintelligible] what still needs to happen to break the cycle? >> working out of what is called the great recession, it is the longest and deepest recession in our lifetime.

we know that the economy has ups and downs, and governors and legislators have to react to that. this is a more profound downturn than we have experience in the past. states are in different situations. vermont, i am proud to say, has a balanced budget for the fiscal year that ended a week ago. we actually reduced the couple of taxes in our legislative session this year. we are not relying on additional fmap dollars to fund our state budget this year. other states are in different situations, and i think they have to look at the long term, engage in what one of my predecessors called full cycle budgeting and save for a rainy day and plan accordingly. this downturn is deeper than i think we could have anticipated. that is why you are seeing such tremendous responses in terms of budget cuts at this point.

>> i have put together a commission that i am hoping the next governor will be able to take for the recommendations. what can we do and what should we be looking at, and what are some of the recommendations? restructuring government, which is part of our discussion this weekend, is going to be part of what every governor will have to look at at the next legislative session. i have made recommendations to my general assembly on consolidating -- i cannot remember the number right now. these are not necessarily high paid positions. most of the people there get a per diem costs. we have so many people that come maybe once a month or once every six months, do we really need all of these commissions? can we consolidate some of them and eliminate the duplication of work? some felt very strongly that we

need to keep them in place. we have a number of commissions that have been legislatively created over the years, well intentioned when we had money to pay for executive directors and others, but frankly, we think that those services are a duplication of efforts. we are going to have to make the tough decision to eliminate some of those, and we are not afraid to put them on the table. i have tried, and i think the next governor is going to have to do the same thing. >> the bottom line is, none of us is immune from what is going on in the national economy. that being said, i think we all recognize that we will not be able to attack rejected tax our way to a prosperous the future. we will not be able to cut our way to a prosperous future. in the end, that means we have to grow our way. we have to focus on improving the economic climate in each of our states.

that means being faster, more responsive, more nimble, and more agile. really means we have to put ourselves into the shoes of the people who create the jobs and prosperity in the first place and focus on the things they care the most about. it is really not that complicated. people who put people to work want to be located in communities where there are good schools, reasonable taxes, a highly qualified work force. there are strong linkages between institutions of higher education and local companies. they want to be in places where they feel like their tax money is well spent. as long as we continue to focus in every single day on that, we are likely to make progress. i am guessing i speak for my colleagues as well, what is that wakes me up in the middle of the night is the folks in delaware who want to be working who are not. although we do have an unemployment rate lower than the national average, we still have far too many people who are struggling.

that is why we have to wake up every single day and say how do we improve the economic climate in our states? >> we just went through this in new jersey. we have the highest deficit, and $11 billion budget deficit on a $29 billion budget. we have closed that deficit with a budget that was passed a couple of days early, on june 28, with no tax increases. with a slight tax cuts for corporate business tax as a way to put a downpayment on good faith to our businesses in the state, to let them know we are going to try to move this thing back in the right direction with smaller government and lower taxes. we cannot get through this or have long-term prosperity, in my view, unless we tackle the problems we have with public- sector unions. they have been shielded in my

state from this recession. while we have had unemployment hovering around 10%, we have not had any -- anything but salary increases for the public sector unions. most teachers in new jersey pay nothing for their health care. these are things that just cannot continue going forward. it is not only about making short-term tough decisions, but about making structural changes to the way folks are treated. i think in my state, the people are unemployed or work in the private sector who have had salaries frozen or cut are tired of paying higher and higher property taxes and other taxes in order to increase the salary increases for public-sector employees. . .

we will announce a modest surplus next week because of some very significant budget- cutting. it is not easy but i think it is with citizens are expecting. they're doing it at their jobs and their families. their credit card expenses have been cut back. governments have to do a lot of the same. they're doing -- there are cuts into health care and education, things that governors do not want to do. they get more tax revenues them through economic growth, but, at

the same time, a commission on government reform should really look at every aspect of government, from more consolidation, innovation, of privatizing the abc stores -- these are the kinds of things that governors are now looking at things to do things to make government more efficient and that will be required at every level of government. >> our colleague from tennessee. welcome. >> i apologize for being late. i imagine this discussion is not about handling the slowdown. tennessee is in reasonably decent shape. we have had some significant revenue shortfalls. as you know, we are a sales tax state and do not have a income tax. the sales tax is dependent upon

major ticket sales, automobiles, and housing construction, materials being one of them. so we have been hit difficult there. we have not had some of the issues that you heard about in other states. we have a fully funded pension plan, for example, and reasonably conservative approach to things like pensions and health benefits and the like. we have not dealt with it entirely through cutting. about 20% in all departments, except for corrections, or you cannot do that, we have done funding for k-12. we have had cuts in other areas.

it has been difficult. i have to be honest. there is a healthy aspect to it, too. we have been able to do a number of things and doing them but -- do a number of cuts that have been necessary that would have been difficult to do under other certain circumstances. some areas, we were obviously overstaffed in our hospital systems and the like. so we used it as a way to also get done some of the business- like things that are difficult in government in good times. we had build up -- we had built up substantial reserves in the state. tennessee is a strong place right now. next year, it will be a generally balanced budget. we're using some reserves this year. but we will exit this year with

several hundred million dollars in real reserves. we will continue to provide the services that the state is responsible for. it has been a tough few years, but the buildup and the way in which state government has been handled for a long time in tennessee has made it a lot easier to deal with this issue. >> you have heard from the governors from all different sides of the political spectrum. the bottom line is that we are held responsible and accountable. we have to live within our means, the same with our citizens. we have to make the same decisions they making when they set the table at night. we have to make sure that we will be will to take care of the children, make sure we can do the things we are able to do, and not the point where we cannot enjoy life as we know it. we are responsible for that. in west virginia, we have been

truly blessed and fortunate. our economy is healthy. our reserves are strong. we're still putting reserves and surpluses into rainy day accounts. we are prepared to weather the toughest of the storms without cutting. we are still reducing taxes. we are paying our bills. we have done it responsibly. we have a great attrition rate heavier in state government. we're being very careful and very selective of how we continue to reflects and if we need it or not. we're not making any decisions that the average person in --tern didn't is not making in west virginia is not making every day. these are the things we have to deal with. when you heard me say, about

flexibility, we know we are going to be held accountable every day. they have their right and responsibility to hold their feet to the fire. we need a good partner and we have that with washington. i want to thank you, all the governors. >> we will have to go back to our meeting in just a moment. i want to thank all of my colleagues for being here. the one to thank governor patrick for his gracious hospitality. if i was born in the commonwealth of massachusetts. it is nice to come home, in this sense, for this national conference of the governors' association. thank you all very much. [applause]

>> our coverage of the national governors' association meeting continues with ibm's ceo, a somitano.c zerceo tom >> i would ask my colleagues and

everyone else to find a seat so that we can get the session under way. the governors and guests, good morning. welcome to the 102nd annual meeting of the national governors association. i would ask everyone to please turn off your cell phones and please rise at this time for the presentation of the colors by the 54th regiment ceremonial unit of the army national guard. then police they standing for the pledge of allegiance.

>> i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all.

>> let's thank dark color guard and all those who serve our country. [applause] please be seated. welcome again to our annual meeting. first, i would ask for a motion to adopt the rules for procedure for our annual meeting. we have a motion and a second.

any discussions? we have adopted the rules. one of them is that any governor who wishes to submit a new policy would need a three thirds -- a two-thirds vote to suspend the rules. i want to announce the members for the association. we have a number of distinguished guests who joined us from outside of our nation. for a number of years, we have had the privilege of having representatives from the canadian parliament. please rise. thank you again for being with us. [applause]

members of parliament and the general are here again i met the -- again. willaert arab guests please rise? thank you for being with -- will power arab guests please rise? thank you for being with us today. [applause] for the past 11 years, nga has been working with a group of governors with the 36 democratically elected representatives in nigeria to create a form similar to ours for the exchange of ideas and we are delighted to have played a role in that success. they perhaps did not call it the

nga, but they did call it the nigerian governor's form. we're glad to have them here as well. cuellar nigerian guests please rise? welcome. [applause] -- will our nigerian guests please rise? welcome. [applause] i want to thank your host for this annual meeting. as i noted on several occasions, he is no easy task to host a meeting of this magnitude. i want to thank governor patrick and his wife diana and his current staff for an outstanding job and hosting the nation's governors in this historic city is a great privilege for all this. deval, come on up. [applause] >> thank you, jim. it gives me great pleasure and honor to welcome all of my

colleagues, my fellow governors, and your spouses and family and staff, all of our staff, members of the diplomatic corps, guests from around the country and around the world. we have done a lot of good work with you. to make sure that the program under chins and joe's leadership is rich and substantive and that our outside meeting time is fine. we invite you to taking advantage of it, consistent with your responsibility inside, during the plenary sessions. i know who you are. i invite you, as i have more than one occasion, to take the advantage of the many restaurants and shops and other attractions, historic and cultural, that we are famous for here in the commonwealth. we are looking forward to a

terrific series of conversations, both those in the plenary sessions and in their private conversations, which are always so great. it is great to be with you. >> thank you again for your willingness to host this annual meeting. it is going to be a real success. i am confident of your hospitality. all along with hearing on the topic of a sustainable health care system, we will have our services award winners. i am excited at this meeting to chat briefly about the challenges and opportunities that we have in our nation's health care system. it has been an active year, to say the least, in high of care policy -- in health care policy.

our goal is to give each governor the tools you need to give them access to federal health reform while pursuing your own state-based delivery systems. we are releasing a capsule form a year-long initiative. and does approaches and quality improvement and payment reform. a thorough and comprehensive review available to each state is available. activities would not be possible without the great support of the governors on the task ports -- the tax -- the task force. as we look for, the new law

stands to provide substantial changes. they will increase the vital need to contain costs and improve system performance. i think we have a great opportunity and a critical need to drive improvement efforts. we need to tailor federal reform implementation and system improvement in ways that focus on containing costs and improve the quality of care. to be successful, these reforms must build on the state's experience and coordination and oversight and coordination where zero of the state faces considerable -- while the state faces considerable reform. i hope you'll continue to build on the information and guidance we provided over the past year. nga will continue to offer opportunities for information sharing as the state's move forward. to help us continue the dialogue on the future of health care in our country and the possibilities for achieving a sustainable system, we had two

well-respected speakers this morning. they have significant expertise. while they come from different perspectives, my guess is that you will hear some similar themes and new ideas for progress in this important area. we have the chairman, president, and ceo of ibm. ibm is the largest corporate employer in vermont. i have had the pleasure of working with the company many times. the company is a key supporter for our health program which is changing the way we provide and pay for health care in vermont. i know this is exactly the kind of bored-looking project -- kind of forward-looking project that he would support. under his leadership, ibm has made calls to get out of legacy

businesses that the company itself had invented and enter into new ones, leading to growth and innovation. he did this not by the quick and flashy path of m&a, but by the more difficult but lasting path of reinvention buying within -- reinvention from within. i think we can all relate to how hard this is to do. four years ago, he authored a piece in foreign affairs, identifying the emerging model of a globally integrated enterprise. ibm has become the premier example of this new form. results speak for themselves. ibm has delivered record improvement -- record performance.

i am delighted that he is able to be a part of her program. sano.anpalmi e sam paul lozan >> thank you very much. if we believe the "new york times magazine" cover story a few weeks ago, we are now the broken states of america. i will talk a little bit about that. without question, the governors and ceo's must be laser-focused. we face a severe fiscal crisis.

everyone understands that we -- what we confront in this dark moment. but the question is what do we do about it? that depends on your understanding of the present moment in time and how we got here. if you think of it as a cyclical economic slump which happens in a capital-based democratic society all the time, you will be fine. hogger down, rest -- hunkered down, rest for a couple of years. if you do not believe the crisis is cyclical, then you might drive their reform agenda, more regulation and oversight. but if you believe that this is a turning point, not only in the state, but in the context of

what is happening across the world, you would take a different approach. be of the letter perspective. this is not -- what is at stake is not only next year's budget, which is certainly very important. we all live by budgets and we have to accomplish those goals. but america's long-term global competitiveness is at stake. this will create winners and losers. i think the winners in the new era will not be those who played duck and cover, those who concentrate on repairing the current system. it will be those who look to the future. i believe this because i see it happening all over the world, especially in the emerging economies. i see it in the trajectory of global economic growth. i see it in all the market data. and i see it firsthand. i just got back from africa, the

middle east. before that, i was in china. you see it. you see it throughout the world. ibm convened a forum with 100 civic and business leaders from 40 countries around the world. all the mayors of china were pulled by the central government to attend. but we have also held 100 of these conferences around the world. let me tell you. when you look at the ambition, the vision, the innovation that is driving china and the other emerging markets, it is breathtaking. the investments, to build up of infrastructure, to modernize and

economy, wireless capacity, transportation and more, capital flows. is creating a formidable force in the world. it is no longer the low-cost manufacturing capital of the world. you think that it is, you're making a mistake. i would like to think about it from a personal standpoint. what your peers in all those nations are doing, what those leaders in those provinces, municipalities, cities, states, whenever jurisdictional definition you select, what are they thinking about? this came from a conversation we had over there. what choices are being made today? as it is said to the mayor's that date, what is your value proposition?

if you want to live in your city, investing your city and state there. that is the reality. they are leapfrogging over legacy systems and the legacy approaches. they're not just repairing what is broken, but they are preparing for what is coming. if we want to remain competitive, we must do the same. i a understand this. this is easy to say. in some of the meetings i've had with administrations and my colleagues, we have that. lewis, whonow that is harder to do than to talk about. the economic downturn makes any

of this sound foolish for crazy to talk about innovation moving forward. but i also believe that the opportunity is there because i see it in a lot of the initiatives that many of your working on many of the states can use this crisis to take transformational steps, to make your state and our society smarter. as governor, you are absolutely critical to make this happen. you have more impact on america's future standing than any other leaders in local governments. you sit where all of these things come together. you operate the system that makes things work for people or for our businesses. those were they all intersect. in your city and your state is where it all happens.

you're in the trend -- in the position of transforming all that because you have to govern if you use the term that we use in business, you have to operate the company. you just cannot give speeches about vision. you have to run the place. he had to make the plans come together. you have to make ends meet. the states are really where the action is. therefore, one of the greatest opportunity -- where the greatest opportunity is to facilitate this changes there. we need to look at our companies, our organizations, are states in new ways. we need to see them as not isolated entities, but is part of a broader system. at ibm, we know a little bit about systems and i am not talking about computer systems. i mean economic systems, societal systems, and how i

operate. we have designed and built most security systems of the world. we're doing russia's central banking system at this time retail, transportation, space, apollo 13 -- in doing so, we have learned a lot about what is required to do a system that is both functioning, resilience, and reliable. first, i will define a system and i want you to think about this in the context of health care and i will -- it for you. first, there must be -- and i will bridge it for you. first, [unintelligible] then must be able to know the status of itself.

it must be able to adapt as conditions change in real time. elul foot -- every well functioning system looks about the same. an atm system looks very much like a public safety system or the apollo mission that sent the astronauts to the moon and brought them back safely, even though they called houston with a little bit of a problem. similar, very analogous. it becomes clear why other systems are in crisis, like the one we're focusing on today, the american health care system. in truth, when it comes to health care in america, we need to put the word "system" in quotation marks. if it is not a system. is a collection of cottage industries running into each other every day. in theory, i think everyone

would agree on the purpose. if we said the purpose of the health care system is to provide patient care at a high quality and affordable way for all our constituents, your citizens, my employees, we could reach an agreement. we can spend a lot of time talking about that. but we can agree on the systems purpose. it is about the quality of care for our constituencies. it is simple. experience,untryman that should be the design -- patient at times, patient experience, that should be the design. i am a very big player in the health care system. but you need to envision the and state. that is where you are using your design. gov. douglas mentioned a blueprint for vermont.

there is a thing called patient- centered medical home. we were allowed to be a participant in that. it is free to everyone. the goals are clear. it is meant to reduce costs. costs are down and people are happier and healthier. at the end of the day, we want a healthy work force and we want our cost to go down. it makes a heck of a lot of sense. so we're happy to participate in those kinds of partnerships. a key dimension of patients- centered health care is wellness and prevention. i will repeat that because we may forget. it is all about wellness and prevention. add the ibm, we also substantially reship their health care program. we provide coverage for 450,000 employees and retirees and their family members in the united states. one of the few companies that

still provide retiree health care. it is at a cost that is less than $1.3 billion annually. in 2004, we pioneered a wellness incentives for employees. ibm has several rebate programs. they focus on what to expect, exercise, ied, we lost, smoking, health care risks, a children's health, etc., it's a truck as a result, our -- as such, it's a term -- etc., etc. as a result, people are healthier and use the system was. there is enough security around.

i guess we are ok. [laughter] it is easier to get to a giants game, governor. i think the problem is that, no matter how much efficiency we improve in the system, as a company, as a community, or as a state, it will always be limited because it is not interconnected, because the system is interconnected end to end. this kind of connectivity so basic that we take for granted. consider banking. we take for granted that we can make transfers between institutions. take retail. we take for granted that we can use the banking system or a payment system many world world. the standards are defined and

they are common and they are open and the information flows. when i talk about information flow, i'm not talking about wires. clearly, health care in america, you will agree, fills the day as a test of a well functioning system. -- fails the test of a well- functioning system. they may be instrumented, but there differently in sherman did, from the insurer, to the doctor to the employer. -- but they are different me instrumented, from the insurer to the doctor to the employer. of course, as you know, it is a colossal waste of time and money, but it also produces consistencies and quality and multiple opportunities.

if you see someone with a magic marker -- a friend of mine, they marked his leg. they do not be -- that is so they do not do the procedure on the wrong leg. you cannot make it up. when it comes to the fourth characteristic of a well functioning system, adaptability, i know you are asking yourselves this one. is the health care system in your state have an ecosystem that is ready for what is coming? the man will only increase. population growth, an aging of baby boomers, there's more need than the capacity we have.

it hits the state's the hardest of all. health care costs are expected to explode by 70% in the next decade. any form of gdp function [unintelligible] if you agree on the need for and the lack of a true health care system, how you get there? how do we get to that point in time? ibm works with the top 10 u.s. hospitals in the united states, the top 20 health care insurance companies, the top 30 pharmaceutical companies, and 18 of the top 25 [unintelligible] we have similar relationships in all western europe, china, australia, and i can walk you through latin america.

a lot was required and what i would call a smarter health care system. it is not about a computer chip. it is not about a device or a server or a router. it is the even about the electronic medical records that everybody wants to find the path to nirvana. it is important, but it is not enough. it is about the data. this is becoming more instrumental and interconnected. we are capturing data in an unprecedented volumes. we are receiving these enormous strains in real time. they're coming in multiple forms for rich text and rich media, from self phones and cameras, from just about every system available, supply chains,

water systems, traffic, poultry from the farms to the shelves. the most important point about this is not how much data there is. what is important is what the data can tell us. to capture that, you need to dive deeper. you need to move from the data to smarter data. that is why analytics are so key. analytics are really mathematical algorithms. they create -- they detect patterns. it is the context of the data. uni deceive what it relates to. you need to see it in real time so that you can make the necessary adjustments. as one doctor said, healthcare

and i.t. will do for the doctors' minds what it did for their vision. it will change the way they look at things. where will once extrapolated, we can determine. that is this -- that is the promise of a smarter system. instead of doing 30 random tests, you do the analysis and you may be two of the right tests. so let's talk a lot smarter health care and let me give you some examples. i would like to do this by example rather than droning on from perspective. they have improved the quality of care, delivery of care, and we have taken it up to capacity two hundred% -- 200%.

the use of analytics is used to improve the patient care. you see it in massachusetts where the university of massachusetts is building internal information exchanges that will provide registries and connect faster and safer comprehensive care under cost. i can give you tons and tons of examples around here and around the world. you see a lot of business is doing it. we're working with a major primary care society, the american association of medical colleges, the ama, the fortune 500 companies. it is aimed at helping doctors think about themselves as a

business, but continues quality improvement, but efficiency in the office. they found practices adopting a medical first approach. this to the emergency debt -- emergency room were down 50%. one of the biggest cost to the system are people going to the er for primary care. governors, you have to deal with all of these things and their other examples where think many things are becoming smarter in your states and in our cities. government services, that is something you have to do every day. gov. schwarzenegger in california, alameda county has real time reporting and

caseworkers and find programs associated with a child. they saved $11 million. talk about smarter transportation in washington, d.c. the transportation authority is maintaining all of its assets, including 12,000 vostok's, train stations, 600 miles of track -- 12,000 bus stops, train stations, 600 miles of track, two hundred 67,000 -- 260,000 change orders. that is an example of smart transportation. it connects everything, taxis, buses, light rail, etc. and

they are accurate within 30 seconds. that is by the use of analytics. you can predict the way you need to be in a timely manner. in new york, the crime center where we work with police commissioner kelly and their bloomberg, millions of pieces of information were previously unknown data relationships, leading to 20% drop in crime new york has no been classified as one of the safest large cities in the world. gov. rawlings in alabama, mobile public schools are using analytics. when they are risk, they are identifying them and it just the curriculum to improve any real time way so they can provide the skills required for the 21st century.

the list goes on and on and on . there are a lot of forward- thinking leaders. by the way, smarter systems can help with the economic recovery. for the 10 billion put into smart agree is, it would create a lot of jobs per year. yes, these are challenging times, but i would make the

argument, whether it is health care or elsewhere, we need to invest with an eye to the future. be surprising to you to hear from a midsized company in 90 that this is not really about technology, that this that is readily available. -- that this stuff is readily available. this is about leadership. i would like to close by seeking your help in four areas. first, we have to establish data standards for health care and other systems. so let's focus on health care. this is long overdue. you cannot have things connected if the information cannot flow. you cannot have the knowledge of a patient between primary care and the clinic said the hospitals if information does not flow. it has to be standard. standards have to be established. if it is time to stop arguing about it. i have been to all of those meetings.

we can deal with a three tenths of a percent those an exception. we need these things to be interconnected and the information has to flow if the system is actually going to work. as you know, the obama administration has pledged $34 billion to health care providers to digitize their records. if these are not based on standards and these are isolated islands, may be a colony sorry state or region, we will have wasted the money. and it is not a but giving doctors iphones to call patients. it is about -- is not about giving doctors iphones to call patients. it is about taking the

redundancy and a procedure in the system. on this question of open standards, you need to take an active voice. you just have to request it. it can be done. when they tell you cannot be done, remember, 99.7% of the information can be standardized. that is the most accurate of anything we do in business or government. second, we need to build smarter systems by design. anything as complex and dynamic as the 21st century americans did, you cannot focus on afterwards. it has to be inherent in the design. remember, the depressed -- the purpose, the vision, it has to be in the initial design.

as you do so, you have the opportunity to deal with the key criteria associated with it, zero which is connectivity and analytics and security in many of your state operations. leverage and analytics can have a one-year immediate payback. there are a lot of examples. new york state governor, as you know, i do not live in new york state, they're convinced that i have a property in new york. a smarter state will enable and require formal collaboration. i am not just talking about the familiar idea of the private- public sector thing.

is really about going shoulder- to-shoulder, looking together to solve these problems, i.e. vermont. i can give you lots of examples. our interests are truly alive when it comes to these types of challenges. yes, we'll have a particular responsibilities to our partners, our regulators, and many in today's world. we need to take a systematic review for them to be transformational. that will require a change. finally, we need your help on policy and ethics. there is increasing pressure on all of us as individual citizens and employees, expectations of sustainable living -- we are entering a world where guidelines are being established and there are a lot of challenges from the

societal point of view. if you think about cameras, yes, crimes go down. first responders of information can respond quicker. but what you going to do with all of that data? who will have it? what will they do with it? do i trust them? those are very real questions. similarly in health care, clearly, everybody understands that, if you could digitize the medical records like the you pc code on chewing gum, it could flow quicker. you would get rid of all the paper in the system. clearly, everybody understands it. but the questions are one and the same. what about privacy of information? what about chronic disease? what about insurance premiums? will i be dropped? ligate covered? -- will i be covered? security is another one. we talk about building smart

breakdancers mark rell and smart sewers and smart buildings, -- s, smart smart read thgrid rail, smart sewers, smart buildings. these are all very serious issues and they require serious work from all state quarters in society. we need to build a port of constituencies. we have to come together and welcome policy frameworks that address these very real concerns or we are not going to be able to progress in many of these areas. let me conclude with a note of optimism. i really do think that the smarter state is not some grand, futuristic vision. i think it is very pragmatic. nor do i believe that making a ibm a smarter and globally

integrated system is done with that any real execution. it is very real. they are deployed by governments here and all over the world. the smarter state is very practical and is refreshing because it is not ideological. i am understand that debates will go on. there will be debates on health care and energy of security and climate change. it is important in a democratic society. whenever the debate comes out, you still need these types of systems. you are still going to need the smarter systems to address these problems. they have to be more transparent, efficient, innovative, regardless of where the public policy debate comes down. it has to be done. so to get there, i believe, us in this room and peers, across

the public and private sector, all to take a leadership role. to me, that is the good news. it is good because we do not have to wait. we are not dependent on anything other than ourselves. we do not need the federal government. we can do this ourselves. we do not need anyone else. someone is going to do it, by the way. someone is when to turn health care into a true system. there are very smart people who have built this field and individuals with billions of dollars in backing. they will go in and fix the problem, but they do not want the implications of not fixing the problem. someone is when to put in place of the key building blocks for smarter education, to prepare our kids for the future jobs, not prepare our kids for jobs that will not exist when they are in their 30's and '40's. someone will institute standards that will allow for cross-system

interactivity. someone will do all that. someone will unleash the scale of expertise on american communities. someone will provide the capacity to identify the key patterns of all of this data. this will happen. someone is going to drive incredible progress in their region, across this country. and when they do that, they will all locked economic growth and profit. economicill unlocke growth and profit. you're in the middle of it. you have to solve these problems. in a way, whether you want to or not, congratulations. you won the election. i think the precondition for change is there. you do not have to sell any of these points that i am making to your constituents.

i think you need to be transparent. i think that is where things break down, in the way, not the need. i would argue that a lot of the work that we have done here and in the world, when they saw the benefits, congestion went down and they bought into it. so when you are transparent and you show them the result, they buy in and they support it. despite the linear challenges we face, i am confident that the states across -- despite the challenges we face, i am confident that the states across america will do what we have to do. this is going to be a great place to continue to have a beautiful future. thank you very much. [applause]

>> thank you so much. we appreciate your perspective and your time today. we have a lot to learn from the experience of ibm and other major employers who are working to hold down health care costs. we are grateful to have your thoughts at this nga meeting. our next guest is dr. david cutler, prof. of a fine -- in the department of economics at harvard university. professor cutler was the senior health care adviser to senator obama's provincial campaign. professor cutler has held positions with international institute for health and the national academy of sciences. he is now a research associate and a member of the institute of medicine. professor cutler is the author of "your money or your life,

strong medicine for america's health care system." as have a great nga welcome for dr. david kessler. [applause] -- david cutler. [applause] >> thank you to my wonderful governor and for everyone having me here. it is a great privilege and an honor to be here. i suspect, given the health reform debate in the past year or 18 months, you feel a lot like -- a friend once told me he felt like, if you took all the health care economists in the world than the them up and to end, that would be a good thing -- lined -- in the world and line them up and to end, that would be a good thing. [laughter] you to give you a sense of what might be done and a few thoughts on how to make it happen in a

productive way. i will follow along some of what sam was telling you in terms of how to make a system and had to get it to drive toward better results. there are several challenges that will come out of health care reform. one of the things is they will all have been at the state level. -- they will all happen at the state level. .

>> making here b. hart -- carry the higher quality and less expensive at the same time. if we cannot figure at how to deliver better care cheaper than -- then all the commitments we have made will turn out not to be able to keep, and those commitments we made long ago to medicare and medicaid, we will not be able to keep, either. that is the bad news, or the good news. the better news is that what we know is, there is an enormous amount of wasted resources. we are starting from but of place where really can make enormous progress. our best guess is that state government spending is about $70 billion a year, about where it needs to be. that is from a situation where health care is roughly one-third

of the budget, we are probably wasting about one-third of that or about 10%. i mean waste in the sense that the system is not working and is generating outcomes that are inferior, higher costs and lower quality. qthe savings from doing things right would be on the order of $250 billion a year. that is the potential for what we should be able to realize. in other industries, the solution is to move things overseas. maybe the clinic has moved to china, and people can just go there. we need some kind of better solution here. i don't know if china will be the answer. maybe china would not be the right place, but we clearly need some better answers. i believe that you have the tools at hand to really push the system in the right way.

those tools are the collaboration that you have had here in the commonwealth of massachusetts, using the tools to collaborate between the public and private sectors, second is changing the way the system operates by changing the information and the rules under which the money flows, and therefore the way in which the system operates. i will expand on each of these. third is encouraging the right kind of innovation that says we will figure out how to do better, a cheaper, not how to do more in a disorganized way. those are the points i want to leave you with. let me start out by talking a little bit about where is that $70 billion? part of it is administrative expense. it turns out the most common occupation in health care, the most common thing that people do, not being doctors, not being nurses, but doing clerical work.

in duke university hospital in north carolina has 900 hospital beds, and 1300 billing clerks. i feel if i am admitted there, i should get 1.5 billing clerks in bed with me. they are in insurance and provider groups. they are figuring and how to build, how to deny bills, how to get them resubmitted, they are figuring out how to get approval, all sorts of things like that. huge amounts of administrative waste they go on. i will tell you how i think we can lead the effort to drive it out. in adequate prevention. people show up at hospitals when they do not need to, when we could care for them better on an outpatient basis. it is not that they like going to hospitals, it is just the default activity. people not getting the care they need. when they do get care, it is

often too costly. anyone who has managed someone with a chronic illness will know about the tests that are repeated or the services redone because they are not available the first time. as a country, we spend about $30 billion fixing medical errors every year. all that money we could use for much better things. what is the common denominator? the common denominator is lack of any organization or any way of making the system work. you have people who are healthy, who sometimes gets sick and then often need various medical services. the services they need our completely disorganized. people will go into a hospital and leave the hospital. one in five medicare beneficiaries to leave a hostile come back within 30 days.

a very large share of those people never saw a doctor or nurse between hospitalizations. huge failures to keep track of people. the cost of that is probably $10 billion to $15 billion a year. all because people are not thinking -- there is no organization to the health care system. if there is one theme to what i believe about the future of health care, is we will not get better until it is better organized. until there is some central organization, something that says our job is to take care of patients, do it in the right way, and do it in a way that works for them. if you actually look not at health care, think about every other industry in the economy. every firm that you admire, from walmart to amazon are ibm, whatever is, and you say what is it they do that makes them successful?

kind of like every happy family is happy in the same way, what leads to success? there are three things. number one is getting the information right. name an industry that ever got better without knowing what it was doing. in health care, we do not know what we are doing. if you want to find out which doctor is better at which other doctor than doing surgery, there is almost no way to find out, with the exception of a couple of states, new york, new jersey, but find out what they are doing right, how to do it better, how to make it work. no. 2, makes the compensation work out. make doing the right thing be the profitable thing. if you ask any doctor now,

esthetics to that operate under, is do more, get paid more. of course that is what we get. we get more and more things, often times without any documentation that is medically appropriate, and then we get in these fights were someone tries to say no and the doctor says this is what i need to do. it is all because we do not give them the right information or the right incentive. when we tell doctors we want to help you do the right thing, help to take -- take care of people before they get sick, but they say is thank you so much, i would love to do that, and they end up doing that. the best healthcare systems in the u.s., the group health cooperatives in washington state, the best healthcare systems integrate coordinate, and pay the doctors a better way, and they get savings in the

millions of dollars a year from doing so. they have figured out how to make the water -- made the money and information flow. the third thing they do is empower workers and consumers to figure out how to do things better. this is liberating innovation. if you wander around any hospital and you say to the nurses, are there ways you can make the system be better? you will get 25 answers for how to do it if you say it white don't you do it, they will say is because no one ever asked me. if you stick them in a little box and say you do a job -- a third of what a nurse does in a typical day is documentation. frequently taking things from a computer and writing them on paper. usually we think about going the other way. oftentimes it is converting

things back. we take the most productive and dedicated work force and stick them in walls and say don't think innovatively, don't make system changes, but just do stuff, and the results turn out to be huge waste. had we saw this? let me tell you what steps i would encourage. number one, pushed on the administrative costs. i believe the u.s. health-care system as a whole, administrative waste is up to $300 billion a year, and we should be able to cut that in half within the next five years. we should be able to save the country $150 billion a year just by streamlining the administrative system. how are we going to do that? a lot of that is going to come from getting people together and making it work. you talk to any provider group, they will say it is so complicated they need hundreds of people in their billing systems just to submit bills. insurers will tell you the same thing.

one thing everybody agreed upon left and right, democrat and republican, provider groups, doctors groups, everyone agreed that now is the time to tackle this issue. if we get together, it is going to happen at a state and local level. we are going to cut this out, and i am committed. now we are going to figure out how to make it work. let's figure out where the doctors are putting resources, one hospital is spending $200 million to put in a new billing system that they think will get their bills submitted and a quicker. figure out how do we avoid those kind of expenses, that is something very concrete that can happen at the public sector level. it will be an enormously valuable thing for everyone in the system to get rid of that. that is the first thing i would do. the second thing, you cannot do

better unless you have the right information. you have the capacity to do this. you have the capacity to assemble all of the data. in most of your big cities, you probably only have five insurers. across your state you may have 10. you have medicare, medicaid, maybe three or four private insurers. you have worked fairly small group of folks. you can learn what is working. he is doing more and who is doing less? we know how to analyze things like that. what is the best way to care for people? we have about a million people in the united states to analyze which stock prices go up, which go down, and so on. we have next to nobody analyzes medical data and says how we determine the best thing for that particular patient and which way of treating them is better?

the federal government has some of that. some of that can happen at the state level by getting together and saying we are going to learn about this. those folks do in a substandard job, will help them get better, but they have to tell us how we can help them get better. there is the money from the federal stimulus funds for $35 billion out there that will be available this fall. i would encourage all the providers to be applying for that. get that money, make sure that you can move the information around, because you are never going to get better if you don't know what you are doing. that is the second thing i would do. the third thing i would do is make the money all the value. we have things that are very uncoordinated because that is the way we pay for it. we tell doctors, see a patient in your office and treat them and you get paid for that.

in reality, what people care about is not who seized them where, but is the patient as a whole doing well? what has come out in the past 1.5 years, i want to avoid the contentious fights over health care reform that we just had. nobody wants to rehash that. the areas that we ought to think about our ways that we can fix the payment system so that doctors say treating people well is the right thing to do. how do you do that? you move away from paying for each service. you say you find a way to take care of this person who needs it. find a way to do that, and we will make it worth your while. take your dual eligible populations, who are probably the most expensive people in the health care world. if i were giving you an ice, one thing i would say is go to the provider group, and say whoever

can correct reject whoever can manage these people well, we will share the savings with you. the cost is $20,000 a person now. find a way to do it for $15,000. we will give you half of the $5,000 to say. we will monitor the quality of care, under what you do, and make sure you are not skimping on them, but find a way to do it better. that is what really can happen. in the best healthcare system, that is what they do. you can make the repayments as a whole, tell folks we will not pay for each individual thing, but care for this patient as a whole. you can do measures of performance based payment. different things will be appropriate in different regions of the country in different parts of the state. the key is to start the process of payment reform. i think the best answer is the people in this room can started the most. you have a lot of folks who are

already involved at the state level. you have the medicaid beneficiary. you have state employees who are enormous purchasing group. you have the chip population. soon you will have the exchange population as well in many states. you have enormous share. private insurers are actually quite willing and eager to work with the public sector to make this happen. if you ask them why they have not debated in payments for information, they will say because there was no government there to work with. partly they were complaining correctly about the federal government. partly there were hoping there would come a time when there would be reform and they could also work with state governments as well. most of the private insurers are quite eager to start to work with state governments. medicare is not able to do this by virtue of the new legislation. i would push on the federal agencies to make this happen,

where medicare can work with the private sector and state government to make the systematic changes in payment that are then going to filter through. go back to amazon.com a southwest airlines, or ibm. what they all do is get the right information and the right incentives. that is what this is about, getting the right information and incentives and then telling people, go ahead and go to it. the fourth thing i would do is be quite open to new organizations helping out. this fall, the federal government will release standards for organizations that are able to -- care for them better and take part of the savings and leave part of it for the federal government. there may be private ownership series in boston.

one is partnering with the largest hospital in michigan. a lot of this innovation can be about how to bring principles to health care, how to actually run something well and take care of their very complicated relationship. i want to give you one other way -- one other example of how to think about this. i can give you a list of all the people who are millionaires out of health care. everyone who is a billionaire in health care, with only one or two exceptions, everyone on this list made their money by inventing something you do to people. he sticks something in them. that make devices, they make

drugs, you stick it to them. and the show you a different list, a list of people who made money off retailing. there are six wal-mart's, to home depots, a few gaps, best buy. for some, you have to be from states of the massachusetts to have visited. not a single person on this list makes a product you use. every single person on this list made their money by changing the way that you buy things so that it is higher quality and cheaper. in health care, you made your money by inventing something you do to someone. everywhere else, you make money by figure in how to make the system or better. if you get it right, our best guess is that the waste in health care, the country as a

whole is up $7 billion a year. you could completely overwhelm that list with people who can figure out how to better coordinate care, streamline medical practices, overhaul the administrative procedures, in sure people get the right care, manage the information flows. that is what we are waiting to do. we have stifled it, because we have not invested in the information and we haven't got the payment and other system set up right. if we do this right, if you can find a way to do this right, we will unlocked a health care revolution over the next decade that will completely transform the way that we see health care, just as eliminating uninsured people will completely transform the way that people think about the relationship with health care and about society as a whole. i want to note one other thing, which is tackling the obesity issue. sam mentioned what ibm was

doing. what we do know is that if you make fattening food be more expensive, people use less of it. there are variety of ways -- i don't want to spend too much time, but there are ways of dealing that either at the level of taxes or at the level of workplace wellness programs that i think along on people's agenda. keep in mind the words of the famous philosopher, jerry garcia. somebody has to do something, and is just incredibly pathetic that it has to be us. [laughter] so what is it that we have to do? i think what we have to do is we have to unlock savings. we have to start with the easy money, which is the administrative expenses. then we have to set up the learning, innovative dynamic system.

the way that i think about it is that our job over the next five, 10, are 15 years is to set up a process where the health care system is completely reborn. if the health care system looks the same in teen years as it does now began 10 years as it does not, then we will have failed at our efforts. if it looks different in the way that everything is responsive to what people want is happening, then we have a chance of making this be the most productive thing we have done in the economy in the past 30 years. and i will stop there. thank you so much for having me. [applause] >> thank you very much. we appreciate the information and guidance you have presented to us. this afternoon, the health and human services committee will

focus on -- >> could -- focus on childhood nutrition and obesity. we have a lot of from dr. cutler and the new report that was presented. obviously health care reform implementation will consume a lot of our time and attention for a number of years to come. thank you again for joining us this morning. [applause] >> tomorrow, the national governors' association annual summer meeting focuses on redesigning state government. we will hear from wall street journal deputy managing editor alan murray. governor james douglas of vermont, and governor joe manchin of west virginia. that is like tomorrow, here on c-span. >> tonight, a discussion on conservative women in politics and feminism with national

review's catherine lopez. also, an update on the gulf of mexico oil spill. later, president obama campaigns for senate majority leader harry reid and talks about the economy in las vegas. >> the senate judiciary committee returns next week to vote on the nomination of elena kagan as the new supreme court justice. watch coverage on the c-span networks, and learn more about the nation's highest court in c- span is latest book, the supreme court, candid conversations with all the justices, active and retired, providing unique insight about the court. available in hardcover and as an e-book. >> now discussion on conservative women in politics and feminism with national review's catherine lopez. following her remarks, she took questions from the audience. it is about one hour.

>> good afternoon. on behalf of the institute and the hectored -- and heritage foundation, i want to thank you all for joining us. those of you here in washington and all of you watching on c- span in the u.s. and all around the world. today it is my pleasure to introduce you to catherine lopez, who will be discussing the successes and prominence of conservative women across the country who are standing up against the obama administration's big government, big spending policies. catherine lopez is the editor at large of national review, and a nationally syndicated columnist. her columns cover issues as diverse as feminism to the war

on terror. she has interviewed scores of policymakers, including secretary of defense donald rumsfeld, and mel gibson. she is well known to readers of her popular blog. she has appeared on a wide array of television program from cnn, but news, ms nbc, to oxygen. she is also a regular national radio guest and she loves to speak on college campuses, especially on the topic of fayed and public life, but she speaks on other topics as well. those of you were students or listening here or on c-span, please talk to us and we will help you bring her to your campus. some of these dishes may be thinking, how do you do that?

-- some of these students may be thinking how you do that? we will teach you that, too. we have an all day training seminar coming up on july 31. please contact us to your interest in that. catherine is an outspoken critic of liberal feminism and she has been honored by pro-life groups for her writing. her articles have been in the wall street journal, the new york times, stars and stripes, and many other publications including catholic periodicals. once she was even featured in playboy. they devoted an entire page to criticizing her so-called cultural hangups. so now we know, there actually are articles in playboy. catherine graduated from catholic university of america in washington d.c., where she studied philosophy and politics. she was a gutsy and peerless campus leader and spoken out

boldly with the man who was president of catholic university denied his involvement with some questionable policies. much to his chagrin, catherine was able to prove otherwise, and he was not a leader at that school for very much longer. catherine is a native of new york city, the chelsea section of manhattan, and now she largely works out of the washington d.c. office of national review. please join me in welcoming capsulacatherine lopez. [applause] >> thank you, michelle. thank you to the clare boothe luce policy institute for having me on such a relatively cool day here in the swamps of the potomac. i thought i might talk a little bit today about how women are a threat to freedom. what am i thinking? and i thought that my rope un a

little bit on friday afternoon and get your attention. i want to let c-span viewers know that no one, is nodding their heads in agreement. the opening was not entirely and characteristic. my latest column ask, who needs a woman speaker? we obviously have one, the speaker of the house, and i look forward to a man in january from another party. the column was a bad reaction i had to the elena kagan story. this particular moment i had a bad reaction to occurred when senator amy klobuchar was talking about women so-called progress. she was mad at center tom coburn for saying earlier in the hearing that some freedoms had been diminished in recent decades. if you are paying attention,

that actually is true. the other branches of the government's do not seem to mind helping things along with the judiciary, but i digress. senator amy klobuchar was rambling -- some of you have seen it in your schools, the attitude helps with their ideological delusion that women are somehow oppressed in the united states, despite the fact that say the secretary of state is a woman. talks about -- talk to the woman about to be stoned to death in iran for adultery. center " which are asked solicitor general kaydin how many women were on the supreme court in 1980. 0 is the answer. how dramatically this was noted. how many women were in the

senate in 1980. it was made clear again and that it was 0, which was later corrected. one was clearly not only the lonely but that number in her mind. she said, as i think about that question, there is no question that women have greater opportunities now, although they could be greater still. she would then praise kagan being concerned, making sure there were more women in leadership. i have to submit that women in america are really do not need their been counting skills. three women on the supreme court is not necessarily a sign of oppression or progress. the u.s. senate currently has 17

women. if in the future they had no women, this would not necessarily be a sign that american women were pressed for limited in their opportunities. it might mean the senate does not quite like america, but that has never been a constitutional requirement. a hypothetical future of women might be a reflection of a little thing called freedom, freedom of choice. catch phrase is only work when they are ideologically convenient. freedom of choice in fact account for a number of things, liberal feminists would like to believe things are fundamentally unjust. individuals have different priorities, and collectively, women tend to have properties that are free of natural differences between men and women. furthermore, bring on the zero, i say, it means it is not the

likes of amy klobuchar, barbara boxer, who is in a tough reelection battle this year against a woman, and dianne feinstein. if you were going to have any women in the senate, i want and then the same thing i want from them in their, actual defense of life in all its stages, liberty and the pursuit of happiness. we have seen in some of the bold decrease of that new feminist being a woman in politics does not mean having to deny once motherly, like protecting nature, which is what women in politics too often do. maybe they feel like they need to do, maybe have been raised in school to do at this point. how do you explain how some of the most outspoken leaders are

women? the supreme court confirmation hearing has me suffering from deja vu. a man was nominated to the supreme court -- why are you not outrage? i have a majority female crowd here. you are supposed to gasp for air. people think i am crazy, maybe, but they are not horrified by that fact. the knee-jerk reaction which many had to john roberts being nominated as george w. bush does the first supreme court race exactly the kind of foolishness we saw just before the july 4 recess in the senate. the thinking was, a woman is retiring from the supreme court, and a woman must replace her. so many critics just could not dead into any man, never mind one that is as qualified and

accomplished as are now current chief justice. you may think i am exaggerating, and i wish i were. it's hard to do parity at a time when that means to rule. the reaction from sandra day o'connor herself in her first public reaction, she said he is good in every way, except he is not a woman. i am not kidding. at the time, i ridiculously road that perhaps president bush shouldn't have nominated one of his twin daughters to the supreme court instead. please call me silly, that was ridiculous, but at least i am not a united states senator saying such things. then ken salazar sent a letter to president bush the morning after the robbers nomination.

-- after the roberts nomination. he wrote, you and i both have two daughters. the message you are giving them is that their gender creates no limitations for them to live up to their god-given potential. i fear the loss of the justice sandra day o'connor, we are sending the opposite message. he did concede that the fact you have not selected a distinguished woman in the mold of sandra day o'connor is not a reason for disqualification. thank goodness for small pockets. his letter was not an isolated incident in congress. rumors for flying that she justice rehnquist might free a second seat on the court, more women defenders road to justice o'connor pleading with her to reconsider walking away from the court. they wanted her to remain the first women chief justice. one wonders where they scare the

corps would never see another woman? the gender matter that much to them? i do not tell you the stories out of hate or malice. i tell you these stories because politics is not always serious. there are people all across town even now -- i hope the young women in this room and many like you, and young men, too, of course, come to washington with a lot more confidence and common sense than we have seen in washington. i think we have seen ideologies substituting for both. a lot of talk about freedom of choice. let me get back to help women might threaten freedom. i just read an essay by a my

friend in a book called a new threat to freedom. she argues that single women are a threat to freedom, giving new meaning to my dislike of sex and the city. she writes that single women support more than any other women and more than men beer and more activist government. they believe more than other women and men that government should intervene in their lives to protect them from big business and powerful interests. they delivered a whopping 71-29% majority for barack obama in 2008. i am not doing the as a justice, and i urge you all to read it. she wrote the book called of tilting the playing field."

tyvon 9 has become another mess of the feminist mine under which -- it should not attract women in large numbers. sports is a good tangent to make the point that this is more than a political thing. it is a cultural thing. in the essay she writes that unmarried women ambivalence about individual liberty goes deeper than any single candidate. traditional marriage to client and the ranks of single women are growing. liberty is a casualty in either case, but a woman -- a husband who is a plumber cannot raise taxes, she writes. a husband who is in the government can, especially if you want him to help out more raising the kids. i am not suggesting that single women are un-american or how

anyone hostile to the message could easily spend it -- spin it. i believe these things and do not have to be given. it is true that there is a transformation that has been happening in our country. it's been a long-term one, which may be in overdrive at the moment. it is not also given that it will succeed long term and is not all women who would like to see it succeed, as you are increasingly seeing. the title of the speech is the year of the conservative woman. i don't think it perfectly describes what is going on right now in america. i think what is going on is much bigger than just that. i think this is an important thing to keep in mind, especially since whether it is a victoria's year for conservatives and right of center women, this is still an

unfolding story. we don't know how the story ends in november. i still think regardless, something important is happening. we are seeing it happen now. what we are seeing is this year, the feminist bly was officially up. this is the year the feminist was forced to recognize that so much of feminism was alive. this is a year they could not quite marginalized, could not qcz,u5zuquite treed the conserve female as an anomaly or a freak of nature. believe me, a lot of women who have been conservative in town for a while in this building can tell you that they were treated as freaks of nature for a very long time. liberal feminism is a little bit of a freak of nature, the ideology itself. inasmuch as it was driven home

that it was the way women were and wanted to be. many of your home and community lives will testify to just this, that it was alive, that american women think differently than the national organization for women. i buy into things like natural law, and somehow being born in the 1970's, manage to come out knowing that men and women are not and should not be the same. that view is not as easy to dismiss on the national stage as it used to be. i think it is clear that this is a big political and cultural moment. many of you may have seen the ads sarah palin campaign committee released this week. they are powerful images. she plays into all the criticisms of her not being policy heavy enough. it does not seem to bother her. i hesitate to make what is no

doubt a highly charged observation, but there is actually a winning obama-like confidence to the video. palin announces in the video, we don't like this fundamental transformation and we are going to do something about it. again, the fundamental transformation has been ongoing for decades, and now it is so undeniably out in the open. the leaders that are now running the company store, where people like the heritage foundation have not been. they are not here without opposition. they are not operating without push back and backlash, and we are seeing that on ms nbc. i hope we will see more of it in

november. in some profound ways, the feminist life is up. i see it in college students and even older men and women. i cannot believe i am saying beyond 30 is older. people who want better goods than the culture sold them. so many young women today realize that we girls can do anything. it does not mean everything. they realize that choice and freedom are not exactly what the women's movement said they were. as jessup points out, they were not really even about freedom. it was a false sense of freedom, but by no means all cases were about sexual license. it was about remaking a reality that could not be remade. a number of them find themselves alone, considering themselves

lucky if they thought to freeze some eggs ahead of time. excuse me while i speak with the personal for a moment, because that has been part of the cultural transformation. the anniversary of the birth control pill was celebrated earlier this year. feeñthey are -- how did they manifest their superiority, their freedom? by casual, drive by sex. there really shows those stupid boys. she gets it. many of you are too young to know who she is, but it was a bit of a remarkable thing to hear actress raquel welch said similar things recently. first of all, she wrote, margaret sanger opened a first family planning clinic in 1816,

and nothing would be the same since then. the growing proliferation of birth control methods has led to a sea change in moral values. normally, it is only right wing nut cases like me who dared to question planned parenthood and its history. the inherited -- planned parenthood is currently a recipient of not an insignificant amount of tax dollars. welch, in her memoir, not some of the glimmer of the rows of so-called sexual freedom. it has taken the caution and a sermon of choosing a sexual partner, which used to equal

choosing a life partner. without a commitment, the trust between -- no one seems immune. she asked, do we really have to go so far where nothing is happening unless we are getting graphic? can we not use our imagination anymore? a woman is a wonderful thing. we are a real price to be one. it is not an easy role to play, but a beautiful and powerful one. the late john paul the second call that the feminine genius. she talked about other traditional ideas that are out of style in the current culture. she emphasized the different roles of mothers and fathers and how they can truly make a former to difference in a child's life. pope paul vi warned about that in december of 1968. making these points is usually

the stuff of poes and family values think tanks and churches. something big and real is going on when it is cnn analyst and actresses. these are points that no one is looking to be hurtful or judgmental about. they are observation sometimes from painful experience. seeking to help us at this moment when people seem open to something different, something that has been under the radar. talk like this may be the bitterest pill for some groups that for decades have said they represent for decades so-called women's interest and issues. the feminist revolution never offered this. the basic message is, we do not

like this fundamental transformation and we are going to do something about it. i was born and raised in chelsea, manhattan. when i hear sarah palin talking about mama grizzlies, she might as well be talking about a cartoon. another creature of which she speaks. what she is talking about is the exposure of the lie that is the national organization for women. has always been at the national -- the national organization for a specific type of woman. this year of the conservative woman is manifesting itself in a big way with the tea party. the sam adams alliance reports that at least 45% of tea party leaders are women, some who have never had a career outside the home or feel the need to organize in their communities.

they do not like this transformation and they are doing something about it. there is an empowerment happening. the kind of things you think feminists would hail if they were not all about ideology. we are seeing more now than ever more right of center and pro- life women candidates. we are experiencing a post feminist movement. we are beyond feminism. we are throwing off the shackles of an ideology. moving beyond feminism is mort than just the so-called women's movement. it is about realizing the sexual revolution was a disaster, too. the pill hurts women and men. pretending that women could somehow be men was not only a failed mission but a heartbreaking, and desirable one. it is the relation -- i was

talking to a hero of the pro- life movement. in many ways, it comes back to what women want, the perpetual story when it is a slow news cycle. obviously women what a world where marriage and family are supported, human life, elderly parents, babies are welcome and celebrated, and want to be unable to care for that life without backbreaking hardship. not impossible tax burdens and a sense of being caught up in an unbeatable bureaucracy. the video does not spell out such things, but i think that is what she is aiming to portray an those images. it is a fresh wind, and as hot

as some of these issues are, as overwhelming as that obstacles may seem, it is a good time to restart your adult lives and careers. increasingly i see young people who see such clarity in the cultural fault. -- in the cultural fog. your non fighting the era seemingly on your own. you are a whole country of women. i feel bad that we are picking on ms nbc. while it would be nice, you do not need carly fiorina note to win in november to affirm this. i would love to see prolapse jean martin in the senate.

-- pro-life. with the best candidate when, man or woman. there is alleged more i would like to say to you, but that is what we have syndicated columnist for. please feel free to read and engage. please go for that and bring good sense to your campuses and communities and may even hear. many summer you will run for office. -- maybe some of you will forgo that and raise some sensible children. you do not have to compromise family for career to be happier successful. whatever you do, good luck, and know that you are not alone. thank you very much. [applause]

but spot a great analysis, katherine, and what a great time we are living in to have great conservative leaders like katherine and some of the women she has talked about today, and many of you as well. thank you so much. that was a new, fresh look at where we are today. we have a little bit of time for questions. i would ask you to wait until the microphone comes to you, and give your name and affiliation. where are our mikes? do you want to call on people, or do you want me to call on them? we will just wait one minute until we get our microphones. it is standing room only. for those of you have not seen the sarah palin video, it is on youtube. it is really wonderful.

it just makes you feel warm and fuzzy inside. there is not a lot of substance. it is a feel-good kind of video. it is something that republicans do not do that well, and there is something to it. >> our site as finally figuring out how to do some of this step. >> losing does that to you. losing is a good motivator. >> you talk to people all over the country and all over the world. you have recently written on kenya. as you look at the work and what of the american people, what would you say to the top -- or the top two or three issues that

people need to be educated in concerned about and raise questions about? >> the obvious one is the economy. that is on everyone's mind, whatever their political persuasion. the people i thought to probably are slanted right a bit. they want to repeal the health care plan. they aren't talking to me in this believe about social issues that are under the radar -- they are talking to me about social issues that are under the radar. the actual existence of abortion measures in the bill were denied, and they did it in such a way that they were being truthful about it in their wake. i think they deluded themselves

into believing it is just another health care issue. i hear a lot of that from people who are concerned. you hear this in a lot of candidates. i have heard this from a lot of people who tell me they have considered running for office for the first time in their life. they are concerned about the identity of their country changing. people are concerned about socialism reaching our shores and a big way. a lot of people are enthusiastic about it. i think that is a lot of what is going on right now. the tea party movement, it is set up and being reported that it is an economic phenomenon, people caring about the economy, which is obviously true. these are right of center people all across the board issues.

people forget that scott brown, when he was elected, was not just talking about health care. he was talking about the christmas day bomber. he was talking about putting terrorist on trial. and he also defended the pro- life kind of record that he had as well. he was a right of center candidate, it is eckman if we are all nervous about which way he is going to vote on the banking bill. people forget, and conveniently it works into the storyline, but people forget that. >> we have so many bright young students in the audience here and on c-span, too. it was not long ago that you were -- now you are a

tremendously respected communication vehicle. what did i switch to give to students on campus now? some are active and son will be active soon, to have tremendous professional success? what were keys for you to move ahead as you did professionally? >> i think a big part of it is humility. a lot of people -- i think you succeed however things turn now, but i see a lot of young people come to washington and not on the door of national review and say i am here to be the next bill buckley. none of us are going to be the next bill buckley. we all have our own past, but be willing to make some coffee. willing to make some coffee.