process. perhaps most important and health care reform is what i think of as improving the value of care, which is making care and higher quality and less expensive at the same time. it that will be the goal. without that, nothing else works. if we cannot deliver better care cheaper than all of the commitments we have made, -- then all of the commands we have made will not be kept. and commitments we made to medicare and medicaid will not be kept either. that is the bad news. or the good news. better news is what we know is there is an enormous amount of wasted resources. we're starting from a place where we can make enormous progress. .

>> in particular tell you that i believe you have the tools a lot hand to really push the system in the right way. those tools are won, the collaboration that you can foster as in the commonwealth

of massachusetts as we have done in health care using the tools 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 are going to figure out how to do better cheaper, not how to do more in a disorganized way. those are the points that i want to leave you with. let me start by talking a little bit about where is that $70 billion? what is happening that we are wasting so much money? a part of it is administrate quafe 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. duke university hospital in

north carolina has 900 hospital beds and 1,300 billing clerks. i feel like if i am admitted there i should get 1.5 billing clerks in bed with me. what are they doing? they are in insurance provider groups. they are figuring out how to bill, how to deny bills, figuring out how to get them resubmitted and approval, all sorts of things like that, huge amounts of administrative waves that goes on. i will tell you how you can lead the effort to drive it out. inadequate prevention, people show up in hospitals when they don't need to, when we can care for them better on an out patient basis. that is the default activity. people going into nursing homes when they can stay out. people not getting the care they need. when they get care, it is often too costly. anyone who has managed anyone

with a chronic illness will know about the tests that are repeated and services redone because they are not available the first time. medical errors, to give us an exasm, as a country we spend about there are 30 billion fixing medical errors every year. all of that money, if you think about it, we could use for much better things. so what is the common denominator? it is lack of any organization or lack of any way of making the system work. you have people who are healthy who sometimes get sick and then oftentimes need various medical services. the services that they need are all completely disorganized. they go to a primary care figgins who sometimes talks to a specialist. they go to the hospital and then leave the hospital.

huge failures to keep track of people. the cost of that is probably about $10 billion to $15 billion a year, all because people aren't thinking the way that a system does. there is no organization to the health care system. if there's one theme to both what sam was saying and what i believe about the future of health care is we won't get it better until it is better organized, until there is some central organization -- and i don't mean government-controlled organization. something that says our job is to take care of patients, do it in the right way, and in a way that works for them. if you think not about health care, but about every other industry in the economy, every firm that you admire from wal-mart, amazon to i.b.m., you say what is it they do that makes them successful? kind of like every happy family is happy in the same way.

what is it that leads to success in there are really 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 don't know what we are doing. if you want to find out which doctor is better than which other doctor at doing surgery, almost no way to find out with the exception of a couple of states. governor patterson's new york, pennsylvania, or massachusetts. you can do it for scattered situations, but not as a whole. get the information right. that is what every big firm does. they know who is doing about what, why they are doing it, how do we do it better and make it work. number two, make the compensation work out. make doing the right thing be the privateable thing. if you ask any doctor now what incentives do they operate under, it is do more, get paid

more. do it fancy, get paid even more. of course that is what we get. we get more and more things, often without documentation, and then we get into the fights where someone tries to say no. the doctor says but this is what i need to do. and it is all because we don't give them the right information. we don't give them the right incentive. when we say we want to help you do the right thing, help you take care of people before they get sick so they don't need expensive care, they say hal lu yea, and they wind up doing that. the best health care system in the u.s., the kaisers in california, pennsylvania, washington state, the best health care systems integrate, coordinate, pay the doctors a better way, and they get savings that are in the millions of dollars a year from

doing so. why? because they have figured out how to make the money and the information flow. the third thing they do is empower workers and consumers to figure out how to do things better. this is not top-down management. this is liberating information. if you wander around hospitals, and you say to the nurses are there ways you can make the system be better? of course. they will give you 25 answers for how to do it. you say why don't you do it? they will say because no one has ever asked me. you take the most dedicated work force in my industry anywhere, and you stick them in a little box, and you say you do a job. a third of what a nurse does in a typical day is documentation. very 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. so we take the most productive work force, the most dedicated work force, and we stick them

in walls and say don't think innovatively, but make changes, and the result turns out to be a huge waste. how do we solve this? here is what steps i would encourage. number one, push on the administrative cost. the administrative waves is probably about $250 billion to $300 billion a year. we should be able to cut that in half within the next five years. we should be able to save the country $100 billion to $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 people getting together and making it work. you talk to my provider group, they 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. when we had the debate in the past year, we didn't agree on very much.

one thing that everybody agreed on, left and right, democrat and republican, doctor groups, insurance groups, what everybody agreed on was now is the time to tackle this issue. if we get together, and it is going to happen at a state and local level. if you get together and say i am committed, we are going to cut this out. now we are going to figure out how to make it work. let's figure out where the doctors and the hospitals are putting resources. one hospital in massachusetts is spending $200 million to put in a new billing system that will help them get bills submitted quicker. that is something very concrete that is happen at the public sector level. it will be an enormously valuable thing in the system to get rid of that. i would push on that quite strongly. the second thing, you can't do better unless you have the right information, and the information is going to be key

here. you have the capacity to do this. you have the capacity to assemble all the data. remember, in most of your big cities, you have probably only got five insurers, and across your state, maybe 10. you have got med -- medicare, medicaid. you have a small group of folks. you can see who is doing more and mo is doing less. we know how to analyze things like that. what's the best way to care for people? the way i like to think about this question is we have about a million people in the united states who analyze which stock prices go up, which go down, and so on, and we have next to nobody who analyzes medical data and says how do we determine what is the best thing for that particular patient and which way of treating them is better. the federal government has done some of that with its

comparative effectiveness money. we are going to need a lot more. some of that can happen at the state level by getting together and say we are going to learn about this. those doing a substandard job will get better, but they have to come along too. they have to tell us how they can get better. there is money from the federal stimulus funds, the $20 billion out there available this fall. i would -- if i were in your position, i would encourage all the providers to be applying for that. get that money so you can move the information around, because you're never going to get better if you don't know what you're doing. that is the second thing i would do. the third thing i would do is make the money follow 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, and that is what works out well. in reality, what people care about is not who sees them

where, but is the patient as a whole doing well. i want to avoid the contention fights over health care reform which we just had and nobody wants to rehash. but the areas where there were aagreement was we ought to think about ways where 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 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 for a second, who are probably the most expensive people in the health care world. if i were going you advice what to do, one thing i would say is go to the provider group and say whoever can manage these people well and save us money,

we will share that savings with you. the cost is what, $20,000 a person now? find a way to do it for $15,000, save the $5,000, and we will give you half of that. figure out a way to make it be in their interests to save you money. we are going to monitor quality of care. we are going to monitor what you do. we are going to make sure you are not skimping, but find a way to do better. in the best health care systems, that is what they do. how can we do better by them. you it tell folks we are not going to paying for each individual things but as a whole. different things would be appropriate in different regions of the country and the state. the key is going to be to start the process of payment reform. who can start it best? i think the best answer is the people in this room can start it. why? you have a lot of folks who are already involved in what is

going on at the state level. you have the medicaid beneficiaries. the state employees are the biggest group purchasing things in many states. the private insurers are actually quite willing and eager to work with the public sector to make this happen. if you ask private insurers why they haven't innovated, they will say because there is no government there to work with. part of it they were complaining correctly that there was no federal government, partly they were hoping there would be reform so they can't work with state governments as well. the reformers i know are eager to work with state governments. medicaid is now able to -- medicare is now able to do this. medicare can work with the private sector, with what is

going on in state government to make these sort of systemic changes in payments that are then with the information going to filter through. remember. go back to amazon, go back to southwest airlines and i.b.m. they get the right information, and they get the right incentives. that is what this is about, getting the right information, getting the right incentives, and then telling people to go ahead and do it. the fourth thing is i would be quite open to new organizations helping out. this fall the federal government will release standards for what are called accountable care organizations, organizations that are able to bundle large numbers of medicare beneficiaries, care for them better, take part of the savings as profits and leave some for the federal government. physicians will be able to set up medical homes, something sam was talking about in vermont and other areas. there may be even private ownership here in boston. a private firm is partnering

with the largest hospital system in michigan, and blackistone, the largest private he could quit firm in the country is buying detroit medical center. a lot of this innovation can be about how do you bring principals to health care? how do you run something well? how do you take care of a very complicated relationship? i want to give you one other example of how to think about this. i have shown you, and i can give you a list, of all the people who are billionaires out of health care. everyone who is a billionaire in health care, on the forbes 400 list of richest americans, with one or two exceptions, everyone on this list made their money by inventing something you do to people. you stick something in them. they make divideses -- devices,

they make drugs. you stick it to them. let me show you a different list. the list of people who made money off retailing. there are six wal-marts, two home goes. a few gaps, a best buy. some of these you have to be from states other than massachusetts to have visited. in the rest of american industry, not a single person on this list, not a single person, 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 hire quality and cheaper -- higher quality and cheaper. in health care you made your money pie inventing something -- by inventing something you do someone. if we get it right, our best guess is that waste in health care as a whole is about $7

billion a year. you could overwhelm that list with people who can figure out how to coordinate care, streamline medical practices, overhaul the administrative procedures, ensure people get the right care management, the right information flows. that is what we are waiting to do. the reason it hasn't happened is we have stifled it. we haven't invested in the information and we haven't gotten the payment and other systems set up right. if you can find a way to do this right, what we will do is unlock a health care revolution over the next decade that will completely transform the way that we see health care just as a way that eliminating insurance people will change the way we think about health care and society as a whole. i want to talk about one other thing, which is tackling the ee bowsity issue. sam mentioned what i.b.m. is doing. what we do know is that if you make fattening food be more

expensive, people use less of it. there are a variety of ways. i don't want to spend too much time on them here because i wanted to deal with the things probably more immediately affecting you. but there are ways of dealing with that either at the level of taxes or at the level of the work place, kind of wellness programs that i think belong on people's agendas. i keep in mind the words of the famous philosopher jerry garcia. superbowl has to do something, and it is just incredibleably incredibly pathetic that it has to be us. what do we have to do? i think what we have to do is unlock savings. we have to start with the easy money, which is the administrative expenses. and then we have to set up a learning, innovative dynamic system. the way i think about it, as a bottom line, our job over the

next five, to 10 to 15 years is to set up a process where the health care system is completely reborn. and if the health care system looks the same in 10 years as it does now, then we will have failed at our efforts. and if it looks different in the way that everything that 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 would i will stop there. thank you so much for having me. [applause] >> well, thank you, dr. cutler, very much. we appreciate the information and guidance you have presented to us. as many of my colleagues know, this afternoon t health and human services committee will focus on childhood nutrition

and obesity. that is the subject of any reform effort. we have had thoughts from our two speakers and the new report. and obviously health care reform is going to consume a lot of our time and attention for years to come. let's thank our guests for joining us this morning. [applause] >> tomorrow, the national governor's association annual summer meeting focuses on redesigning statement government. you will here from "wall street journal" managing editor, allen murray, and the governor of virginia. that is live at 1:00 p.m. eastern here on c-span. [captions copyright national cable satellite corp. 2010] >> tomorrow on c-span, a kansas senate republican primary

debate. some of the topics, tax policy, arizona's immigrate law and prosecuting suspected terrorists in military trinals. that is 8:30 p.m. around on c-span. also tomorrow, president obama speaks at a campaign fundraiser for missouri state democratic candidate robin cardin hand. also, republican candidate, congressman roy blount talks with businessmen in lebanon, missouri about the economy and jobs. that is at 9:30 p.m. eastern here on c-span. >> for a snapshot of washington and the 111th congress, the c-span congressional directory, a reference guide to every member of the house and senate, the cabinet, supreme court justices and state depoffers at your fingertips. order on line at c-span.org/store. >> now a discussion on conservative women in politics and feminism with national review's katherine lopez.

following her remarks, she took questions from the audience, the event was hosted by the clare boothe policy institute. it is about an hour. >> good afternoon, i am michelle easton, president of the policy institute, and on behalf of the institute and the heritage noundation -- foundation, i want to thank you all for joining us. those of you in washington and all of you watching on c-span in the u.s. and around the world.

>> she has interviewed scores of policy makers, including secretary of defense donald rumsfeld to mel gibson. katherine is well-known as k-low in a popular blog called the corner. she has appeared on cnn, fox news, msnbc to oxygen. she is a regular national radio guest and a guest host. she loves to speak on college campuses, especially on the topic of faith and public life. but she speaks on other topics as well. those of you who are students who are listening here in d.c. or on c-span, maybe thinking i would like to bring katherine to my campus. if so, talk to us here, and we will help you bring her. some of you students may be thinking how do you do that? how do you bring somebody?

how do you put together a campus lecture? we will teach you that, too. we have an all-day training seminar coming up on july 31 in northern virginia. contact us if you are interested in that at all. katherine is an yout spoken critic of liberal feminism, and she has been honored by pro life groups for hero rigs. her articles have been in the "wall street journal", the "new york times," stars and stripes, and catholic periodicals such as our sunday visitor and the national a catholic register. once she was even featured in "playboy." they devoted an entire page to criticizing her so-called cultural hang ups. so now we know there actually are articles in "playboy." [laughter] katherine graduated from catholic university in america in washington, d.c., where she studied philosophy and politics. she was a gutsy and fearless

campus leader and speak out boldly when the man who was president of the university denied his involvement with questionable policies. katherine is a native of new york city, the chelsea section of manhattan, and now she works largely out of the washington, d.c. office of national review. please join me in welcoming katherine lopez. [applause] >> well, thank you, michelle. thank you for heritage, where i once interned and worked. i thank the policy institution for having me here in a relatively cool day. i thought i might talk a little bit today about how women are a threat to freedom. what was i thinking? i wanted to start out that way because i know it might rope you in a little bit on a friday

afternoon and get your attention and out rage. i want to let c-span viewers that no one, not even the interns from brigham young and catholic university are nodding heads in agreement. we obviously have a woman speaker of the house, and i look forward to a man in the slot from another party. the column was a bad reaction, while one of many, i had to the elena kagan hearings. maybe you were watching. i apologize if this is a rerun for you. this particular moment i had a bad reaction to occurred when a senator from minnesota was talking about women's so-called progress. she was mad at republican senator tomko burn, a man, for saying earlier in the hearing that some freedoms had been

diminished in the last decades. that is actually true. the other branches of the government don't seem to mind helping things along with the judiciary. she was relfing in the same kind of political victimhood that seems to effect women working in washington. the attitude helps with their illusion that women are somehow oppressed in the united states despite the facts that say the stfs is a woman. as has been the case more often than not as it haups. talk to the women about to be stoned in iran to death for adultry if you want to know what actual oppression is. one of the women on the committee asked the solicitor general how many women were on the supreme court in 1980. zero was the answer.

how dramatically this was noted. home women were in the senate in 1980. nancy from kansas had been elected to the senate a few years earlier. one was a shameful member in the senator's mind. directing her ire she said knowingly, so as i think about that question, about if people were more -- there is mo question that people had greater opportunities now, although they could be greater state. she praised kagan for being concerned about the same. making sure there are more women in leadership. i humbly submit that women in america really don't need that senator or elena kagan's bean counting skills. three women soon on the supreme court is not necessarily a sign of either oppression or progress. if the senate, which currently

has 17 women had at some time in the future no women, this would not be a sign that american women were apressed or limited in opportunities. it might mean that the senate doesn't look like america, but that has never been a constitutional requirement. that might be a reflection of a little thing called freedom. freedom of choice, which in other contexts having to do with women, liberal feminists are all for. freedom of choice in fact accounts for a number of things . they would like you to believe some things are fundamentally unjust. individual women have different priorities, and collectively women have priorities that are fruits are quite natural differences between men and women. furthermore, bring on the zero, i say, if it means it is not the likes of amy or barbara

boxer. she is in a tough re-election battle this year, against a woman, and diane feinstein. if you're going to have any women in the senate, i want them dash want from them the same things i want from men. actual defense of life in all stages, liberty and the pursuit of happiness. we have seen in the bold breeze of the quote new feminists in politics, being a woman in politics doesn't mean having to deny one's motherly life-protecting nature, which is what women in politics too often do, maybe feel like they need to do, maybe have been raised in school to do. how can you explain that some of the most outspoken leaders against the dignity of human

life in america and the west are women? i have been suffering from deja vu. five years ago this month, a man who was nominated to the supreme court -- why aren't you out raged? >> i am in a majority female crowd here. they are supposed to gasp for air. i will note for c-span, people think i am crazy, but they are not horrified by that fact. the knee-jerk reaction, though, way too many had to john roberts being nominated as george w. bush's supreme court pick reached the same foolishness we saw before the july 4 recess in the senate. the thinking was a woman is retiring from the supreme court, and a woman simply must replace here. many critics couldn't get into any man, never mind one who is

qualified and accomplished as our now current chief justice. you may think i am exaggerating. i wish i were. it is hard to do parody. from sandra day o'connorer herself, her first public reaction to john roberts is he is good in every way except he is not a woman. i am not kidding. at the time i ridiculously wrote that perhaps president bush should have nominated one of his twin daughters to the supreme court instead. please do call me silly. that was ridiculous. but at least i am not a united states senator saying surf things and seriously. then colorado senator ken salazar, now our secretary of the interior, probably about now wishing he had kept his old job, sent a letter to president bush the morning after the roberts nomination.

the senator wrote you and i both have two daughters. the profound message we should be giving theam is that their gender creates no limitation toss them. yet i fear that the loss of justice sandra day o'conner from the supreme court, we are sending the opposite message. salazar 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 some sense. salazar's letter was not an isolated incident in congress, as you are seeing. when rumors were flying that chief justice renquist might free a second seat on the court, people wrote to her pleading with her to walk awe way from the court. they wanted her to be named the first woman chief justice. one wonders were they scared

the court would never see another woman? did they think there weren't enough qualified women in the country to be a chief justice? does gender mean that much to them? i don't tell you these stories out of hate or malice. i tell you them because the business of politics are silly. there are very serious people in the building, in the capital and across town. i tell you these stories because i hope the young women in this room, and young men, too, of course, come to washington with a lot more common sense and frankly confidence than we have seen in washington. wiff seen ideology substituting a bit for both, and a lot of talk about freedom and choice really have nothing to do with either. here let me get back to how women might threaten freedom. >> i read something by my

friend jessica in a new book. jessica argues that single women are a threat to freedom, giving new meaning to my dislike of section and the city. women support more than any other group, bigger and more active government. they back the government regulation of business and markets. they belief more than other women and men that government should interveep in their lives to protect them from [busy signal] . they delivered a whopping 71-29% majority for barack obama in 2008. i am not doing this essay justice. it is important, if you have any interest in writing, she is came is one of the best. she wrote the book "tilting the playing field on the folly of the tyranny of title 9 in."

that has become another area of controversy. sports is a good con jent to make the point that this is more than a political thing. it is a cultural thing. she said unmarried women's imbiff -- a traditional marriage declines, the ranks of single women are growing. increasingly the women are substituting the security of a husband for the security of the state. a woman -- a husband who is a plumber can't raise taxes. a husband who is the government can, especially if you want him to help out more raising the kids. i of course am not suggesting that single women are unamerican.

there are not only personal but cultural reasons for why they are where they are and voting as they are. i also believe these things don't have to be givens. the politics of it or the culture of it. it is true there is a transformation that has been happening in our country. it is a long-term one which may be in overdrive at the moment. it is not all women who would like to see it succeed as you are increasingly seeing. the title of this speech, the year of the conservative woman. i believe i creatively came up with it, but i don't think it perfectly describes what is going on right now in america. i think what is going on in much bigger than just that. i think this is an important thing to keep in mind, especially since whether it is a victorious year for

conservatives, this is still an unfolding story. we don't know how the story ends politically or electorally in november. something important is going to happen, and you are seeing it happen now. what you are seeing is the feminist lie is officially up. this is the year that the media was forced to recognize that so much of feminism is a lie. they couldn't quite marginalize, couldn't treat the conservative female as an anomaly or a freak of nature. believe me, the conservative women who have been in town for a while can tell you that they were treated as freaks of nature for some time. liberal feminism is a little bit of a freak of nature, the ideology itself in as much as

it was driven home that it was the way women were and wanted to be. many of your home and community lives were testified that it was different. that american people think differently and the national organization for women. i buy into things like natural law, and somehow, even being born in the 1970's, managed to come out knowing men and women aren't and shouldn't be the same. and again, i think this is clear that this is a big political and cultural moment. many of you may have seen the campaign-like ad sarah palin's plig action committee released. in it she highlights women she has run into along the tea party trail. she plays into all the criticisms of her not being policy-heavy enough, and it doesn't 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 and in that attitude, but i digress. palin says, quote, we don't like this fundamental transformation, and we are going to do something about it. again, this fundamental transformation has been ongoing , as fundamental transformation has been ongoing for decades and now out in the open. the leaders and children of it are now running the washington store. they have long had the keys and got into the big doors in hollywood and other cultural centers where people like the heritage foundation haven't been. but they are not here without opposition, and they are not operating without push-back and backlash. we are seeing that on msnbc. i think and hope we will see more of it in november.

as i say, in some profound ways the feminism lie is up. i see it in college students, in twenty and thirty-smgs and even older women who won better good than the culture told them. so many young people realize that we girls can do anything does not mean everything. they realize that choice and freedom aren't exactly what the women's movement said they were. as jessica points out, they weren't even really about freedom. it was a false sense of freedom. in some but by no means all cases, at least consciously, it was about sexual license. broadly speaking, it was about remaking a reality that really couldn't be remade. not an insignificant number of them would find themselves alone, considering themselves

lucky if they thought to freeze some eggs ahead of time. those are some of the liberating fruits of the feminist moosm. excuse me if i stick with the personal for the moment. the anniversary of the much- exalted birth control pill was celebrated earlier this year. one wrote packages of portable liberation for women determined to break free from their pressors. how did they manifest their freedom? by casual, drive-by sex. whoa. that really showed 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 rakell welch saying the same thing. she wrote margaret opened the first family planning clinic in

1916, and since then nothing would be the sake. birth control methods have had an effect in both sexes. it is only in right-wing nut cases like me who dare to question planned parenthood. a friend has a great chapter in his book on that. planned parenthood has used significant amounts of tax dollars. it is praised by everyone from hillary clinton on down. barack obama did planned harnte hood homage to the white house, so many do. further welch, knocked some of the glimmer off the rose of so-called sexual freedom. the cob accept ushered in by the pill she says has taken the caution and discernment out of choosing a sexual partner, which used to be the equivalent of choosing a life partner.

without a equipment, the trust and commitment between couples of child bearing a little has diminished. someone wrote do -- can't we use our imagination any more? welch continued a woman is a wonderful thing. we are real prize to be won. it is not an easy role but a beautiful powerful one. she talks about other traditional ideas that have been out of style in elite culture, the two-parent family. she emphasized the different rules of mothers and fathers and how they can truly make a formative difference in a wild's life. pope paul the sixth warned of that in 1968, treating fertility as if it was a decease, what would happen.

that kind of thing is usually the stuff of popes, family values and churches. something big is going on when cnn analysts and actresses, and hi, we are on c-span. these are points that no one is looking to be hurtful or judgmental about. they are observations sometimes from painful experience, as in the case of welch, seeking to help when people seem open to something different. talk like this may be the bitterest pill, though, to some groups that have for decades insisted that this represent womens issues and interests. it is more about the way life really is that the femnist never offered. sarah basic message is we don't

like this fundamental transformation, and we are going to do something about it. i was born and raised in manhattan. so when i hear sarah palin talking about the mama grizzlies, she might as well be talking about a cartoon. i still know the creature of which she speaks. many of you are in this room. what she is talking about and is ultimately the explore of the lie that is the national organization for women. it has always been the national organization for a specific type of woman, for the libwalrom. the national organization of the woman who makes the choices we think she should make. the year of the conservative woman is manifesting itself in a big way with these tea parties. 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 but feel the need to organize their

communities. they don't like the transformation, and they are doing something about it. there is a political entrepreneurship about them. the kind of things feminists would hail if they weren't so much about ideology and the empowerment of women. we are seeing more right of center and pro life women candidates. but it would be undercutting what is going on to see the year of the conservative woman as only this. we are experiencing a post feminist movement. we are beyond feminism. we are throwing off the shackles of an ideology and life time that was not our nature. it is about realizing the sexual revolution was a disaster, too. the pill hurt women and men. that pretending women could somehow be men was not only a failed mission but a heartbreaking undesirable one.

women aren't a monolithic liberal voting block. i was talking to someone from the pro life movement about the year of the conservative woman thing. she said it comes back to the what women want question. it is a perpetual story when there is a slow news cycle. she says women do want a world where marriage and family are supported, elderly life, marriage, babies are welcomed and celebrated and one is enabled to care for that life without a back-breaking hardship, and hard work brings results. not impossible tax burdens and the sense of being caught up in a big bureaucracy. that video everyone is watching doesn't spell out such things, but that is what she is aiming to portray. that where we are. it is a fresh wind, and we need it in more ways than one today,

this week in washington. in this sense, as hot as some of these issues are, as overwhelming as the political and cultural obstacles may seem and are, it is a good time to be starting your adult lives and careers. increasingly i see young people who see such clarity in the cultural fog. you see what doesn't quite work, sometimes in your family, in your communities and churches, clearly in your culture. and you are not fighting the e.r.a. seemingly on your own. you're a whole country of women, and even msnbc has had to realize that. i feel bad that we are picking on them. i don't need carly, or sharron, or niki or jane to win in november to affirm you. in fact, i would love to see pro life gene norton in the is not.

maybe i am missing it, but i don't here a lot of lecture or your sectionist nonsense coming out of the conservatives. may the best candidate win, man or woman. there is so much more i would like to say to you, but that is what a weekly indicated column is for. please go forth and bring good sense to your campuses and communities. maybe even here. maybe some of you will run offices. maybe some of you will forego that and raise some sensible children. you don't have to compromise family for a career. whatever you do, good luck, and know that you are not alone. thank you very much. [applause] >> what a great analysis, and

what a great time we are living to have great conservative leaders lickliter katherine, becky, like some of the women she talked about today arcs many of you as well. thank you. that was a new fresh look at where we are today. what a great talk. we have a little bit of time for questions. i would ask you to wait until a microphone comes to you, give your name and affiliation. where are our mics? wait one second for microphones. katherine, do you want to call on people? >> sure. it seems easier. we will wait just one minute until we get our microphones. they are going to run out and get them. it is standing room only. >> for those of you who haven't seen the video, it is on youtube. it is really wonderful. it makes you feel warm and

fuzzy inside. >> which is what i mean when i say there is an obama-likeness to it. it's a feel-good kind of video. it is the kind of thing that, frankly, republicans don't do that well. there is something to that if you want to win. >> our side is finally figuring out how to do some of this stuff. >> right. losing does that to you. >> losing is a great motivator. >> let me, if i can, go ahead and ask the first question. you talk to people all over the country, in fact all over the world. you have recently written on kenya. in is -- this is a lady with lots of expertise. as you look at the american people, what would you say are the top three or four issues, knowing that there might only be one principal one, but what are the top three or four issues that our people need to

be educated about, concerned about and raise questions about in their own communities? >> well, i think the obvious one is the economy. that is on everyone's mind, whatever their political persuasion. and the people i talk to probably ared right a bit, and they want -- probably are slanted right a bit and want to repeal this health care bill. they are talking to me in disbelief about social issues under the radar again being transformed by this congress by court issues like abortion, marriage and things, that aren't even -- during the health care debate, 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.

i think they deluded themselves into saying it was just another health care issue. people are concerned. you hear this in a lot of candidates. i have heard this in a lot of people who have told me that they have considered running for office for the first time in their lives. they are concerned about the identity of their country changing. it is the s word. people are concerned that socialism is somehow reaching our shores in a big way. there are a lot of people enthusiastic about it. we are like wait, wait, let's have a debate about this. i think that is a lot of what is going on right now. that is a lot of what is motivating the tea party movement. i have been struck in going to some of these tea parties myself, it is being reported that it is an economic phenomenon, people care about the economy, which is true. but these are right of center people on 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 terrorists on trial. these are right -- and he actually also defended his pro life kind of record that he had as well. he was a right of center candidate. even if we are nervous on how he is going to vote on the banking bill, he is an independent guy and wasn't formed by the heritage foundation. conveniently they have worked it into the storyline, but people forget. >> i will ask the next one. the mics will be here soon. we have so many bright young students in the audience here and watching on c-span, too. not that long ago you were a student leader at a catholic university.

now you are the editor of a big vehicle. 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 -- and it can work either way, i suppose. you can succeed -- i think you succeed however things turn out. i see a lot of young people coming to washington and sort of knock on the door of national review and say hello, i am going to be the next bill buckley. i am sorry to say you are not. none of us are going to be the next bill buckley. we all have our own path. but be willing to make coffee. be willing to write unsigned

editorials. it is not all about your bye line or you. care -- by line or about you. >> examine your conscience and make sure you are in it for the right reasons and figure out why you are in it. because there are plenty of things you can do. hard work and humility i think is sort of the key. >> and now we have microphones. wait until katherine gets to you with the mike before you ask your question. >> give your name. >> i am penny. the buds about the sarah palin video is that it is the first political video she has made as far as running for president. my question is do you think that is true, that it was the first step in her seeking the highest office? and if she does, do you think she can win?

>> i talked about humility. my answer in all humility is i have no clue. my sense of however good my sources are is she is not quite sure whether she is running for president or not either. i have no real idea, but my answer is i don't know. i think that she is probably taking advantage of this opportunity for good reason. she has been able to in a big way highlight this sort of phenomenon, and she has been part of the -- a key part of the media having to acknowledge the existence of the pro life conservative woman. women. i think that republican convention image of her talking about trig and talking about her life in politics and the rest, it was a jarring moment for the

media. i think she's running with that. and by running, i don't necessarily mean for president. i don't see it as a bad thing at all. i think it's a good thing. i think that video was a good thing. i understand there are lots of complicated issues. there are legitimate criticisms and all the rest. but that's a good video. what she's doing right now i think is a good thing. so thank you. bring it on. but i don't think everything has to be about presidential politics either. we're a ways out. anyway -- right here in the middle. >> hi. my name is cin contin-- christi intern at the heritage foundation. you mentioned single women are detrimental to women in general

because they largely vote very liberally, or for liberal candidates. my understanding of the feminist movement is that it's really to rebel against patriarchy. right now there's nothing more patriarchal than the government. for example if a husband told his wife you have to put a quarter in the jar every time you have a coke, that she would not have it. even then you can choose to marry a husband but you can't choose to be taxed. >> mike bloomberg the mayor of new york may be the most patriarchal figure in the world by that definition. >> my question is what does it take for women to realize that? do you think there's an issue that's -- >> i think you're assessment is exactly it. this is what i mean by young people get it. you see that's going on and you

see the lie, basically. yes, no, the fact single women -- government has replaced a husband for them, that's not freedom. that's not liberation. one would argue that's the opposite. you definitely need to read the essay in the book "threats to new freedom" because it speaks to you. i do think that the great news is people are onto it. people are seeing, again, by the example of sarah palin flaws and all. everybody, all candidates, show me a perfect candidate. he's got a really ad man. i think the media being forced to cover these people, these women, conservatives in general. you have the "washington post" having to hire as "the new york times" did somebody to follow conservatives, as if we're an

exotic species, but we're increasingly not an exotic species because we're everywhere. i think the big -- i think the big advantage of the media covering -- having to cover the whole list of women we've listed is other people see, oh, yeah, i'm not alone. if i had a dollar for every person in my life that basically said to me, i love rush limbaugh. i turned him on during the clinton years and realized i wasn't alone. other people thought like me. i think that's the phenomena. in part people are feeling like their country is being taken away from them in ways. they are also seeing, wait, politics is for me, too. i see these people who reflect my views. maybe i'll run for a local whatever or organized group.

it's a good time. it's a good time. here in the front. >> my name is marr hy hamm. the economy and family are so linked, most are -- i went to a speech by patrick fagan who used to be here about how most income in this country, most wealth is generated by middle-sized companies that are family owned that ling between stable marriage, stable family life and prosperity as being another issue. it isn't just about the economy, it's the economy as fueled by the family. >> yeah, i think that increasingly people see, maybe young people see it better than others, that these things are

linked. a dependence on government is often coming from somewhere else. it's not just an attraction to government or ideological commitment. it's come from somewhere. i like to point out that so many leaders in the pro-choice movement, they have stories that explain why there are defenders of abortion rights, for instance. you come across any issue and you see how experience, academic or personal experience, perfectly explains where somebody is. yeah, i think increasingly you find that. there's a lot of important resempl on the left and right. people making this point exactly include pat fagan, of course, jennifer morris does a lot of this about the economy and family. academic stuff that i think increasingly academics will find

useful and start working w it won't just be new things we talk about at heritage foundation conferences and things. i think that's absolutely true. again, i was sort of struck by the first time i was at a tea party, you'd see the random family resempl sign or a pro-life sign and you would see families together at the rallies, families with special needs children. you saw a cross-section of america. it was hard to miss that. it was a different scene than i had been seeing watching the tea parties, those racist awful people on msnbc and cnn. it was a different crowd in reality. any other questions? in the back standing up there. >> i'm lindsey, advice chair of

young republicans. >> there are young republicans in d.c. >> my question, you mentioned feminist discourse. the second you addressed particularly here today in the 1970s almost reversed the first wave movement. the first movement focused on our minds and getting the women's movement out into the political discourse. the second wave movement put the focus back on our bodies. and i was wondering what advice you would offer to young women today who are looking to have a strong voice in academic discourse to kind of move that back in the other direction? >> i think what mary's question was getting to is the point that they are just integral, the personal and intellectual. i don't know if this answers your question but tell me if it doesn't. i think the answer is just live your lives and live your lives

with the world values that you raised on or believe in. people will see that it will be reflected in your work. it will be reflected in who you are and how you're living and what you're doing on friday night. people notice that i don't know if it sounds really simplistic but it really kind of is that simple when vast amounts of people are doing it. when you have, for instance, people in hollywood, that have moral values and they want to have moral values, slowly i think that shows up in movies and i think you see that a little bit right now where they are not -- you have explosively christian or family oriented movies. but sometimes you see a movie and you think, wow, those are decent values. wow, that movie doesn't offend me. that's a beautiful story. that's because i think you have more and more people in

hollywood who are just trying to live their lives and be successful and make some kind of entertaining contribution to the world. so i think that's how you do it, not a grand academic answer or anything but i think that's the solution. you certainly have to vote. that's certainly part of it and be educated as you vote. >> hi. i have a question about your professional career, how you got into an editorial position. i'm sure you have both men and women working underneath you. have you felt pressured at all to kind of adopt a more masculine managerial approach, has it been tough to embrace being a woman and be in a position of authority over men and women.

>> at some point during negotiations about a micro phone, i think i gig he would and said, oops. that's to say i have not embraced a more masculine approach to my public persona. no, when i first started, i think there's a little of this still, but based on this room it's probably not the case, but i don't think this is representative. i would show up at things at 21 or whatever, because i was sort of in the conservative movement earlier than most and earlier than i probably recommend. and there would be like two women. i remember i was in new york for a period and it would be wendy and myself at sort of every conservative event. that was it. so it never bothered me. i like men, so it wasn't an

issue. i don't feel oppressed. i wasn't looking around at a room full of oppressors. again, not a grand academic -- as i said before, if you're confident, if you know what you believe in, if you're at what you're doing for the right reasons, i don't think those things bother you that much. yeah, you might be working in an office of all men. sometimes you don't really notice. sometimes you think that's cool. but it's -- i think more often than not it's just your office. it just isn't an issue. now, sometimes issues come up, of course. i'm realistic. but generally speaking, and again if you have confidence and you're not going to be pushed around or taking advantage of, it's not that much of an issue.

right here in front. >> hi, i'm rachel with the independent women's forum. >> hi. >> i was wondering if you could talk about why you haven't seen the right youth gender party, is it because it as much with the conservative males or is it because palin sort of ushered in this new movement and do you think that we'll see a corresponding decrease of the use of the gender by the left in. >> i think using race and gender is what the left does. i think one of the important points about sarah palin and the conservative woman of the moment means is take it's actually not

that new, that sarah palin didn't invent it. it's been going on. women have had these views. women have run before. at this particular moment and maybe inspired by sarah palin, although, frankly, the grief that she got and the negative attention she got would discourage me from running for office, but god bless people who do it anyway. i think the important point is that it isn't all that new phenomena. we're just at the point where people have to take notice. the left has to take notice. the left is nervous about it. the monopoly that groups like national organization for women have had on so-called women's issues, their time is up and they know it. and i just think you'll increasingly see things being shaken up in that regard. and i think it's a great thing.

and being a free market type, competition is a great thing. so just generally speaking for civics, it's a good thing even if i didn't believe it wases a great thing for america. >> my name is charlie kuhn and i'm with the u.s. chamber of commer commerce, heritage -- >> i used to be with heritage years ago, too. >> one thing that seems important to me to stress is that if the conservative movement is going to have any impact, then we have to make sure particularly in this upcoming election that we elect

conservatives. otherwise we'll have more health care, we'll have more government, we'll have more spending, and it seems to me when i look at this room full of women, it's like not just vote yourself, but get other people to vote. that's the only way that we're going to change washington, d.c. >> right. yeah. and i think your view there is reflective. 45% of the tea party leaders supposely being women and survey after survey showing that these are right of center people who are leading and involved in the tea parties. i think what you're finding at least in the beginning, i forget what they're calling it, not the first wave or early adopters i think is what they call it of the tea party movement such that it is, they were people who

hadn't voted in recent elections. i think they'll vote this year. will they vote next year? will they vote in the next presidential election? can we keep them voting in and by we, i mean people who are kefshed about the future. and i think in our candidates, too, there may be some purity testing going on right now, but there's a strain of it that's really good, a rig or. exactly who are you? we're it thought going buy into anything just because you say you're somebody and are you going to follow through. if we do have that male speaker of the house i'm looking for come january, what are the republicans going to do with the house? we know what happened last time. so that is a key. and i think this agenda that they're putting together is an important thing and it's a more important thing in terms of follow-through. i think you're absolutely right.

anybody snels one more in the back there. >> thanks. rachel also with the acn republicans. 2010 -- >> so are you going to get rid of that bag tax? that's all i want to know. there's a 5 cent tax on paper bags in d.c. >> and the d.c. republican party has reusable shopping bags available on their website. >> i don't want to look like a bag ahead anymore. >> so in 2010, it's a year where there are such substantive issues for candidates to run on in terms of policy, so i'm curious if you think moving forward to november we'll see more of our female candidates being sort of the lead and is that trend of going to the personal ever going to -- if it's not going to come back in 2010, is it ever going to come back to running on substance 1234. >> we live in a celebrity

culture. if you're a good looking male or female, things happen. i mean, scott brown. how many times did you see him on vogue -- cosmo. cosmo. obviously i'm a subscriber to both as you can tell from my great color palette. i think that's the culture we live in and that's what it is. but when you increasingly have more women in politics -- but te the same dynamic is true of men. after a while it's easy to obscure the substance in the pretty package and the message that you don't you do want to gt of people, but i think to some extent that's just always going to be there and in our media culture, you just have to try to fight through it and be smart about your messaging and bringing those points. again, scott brown, pretty

package and all. he actually talked about substance, too. and it wasn't just the people's seat. there are policy issues he talked about on the campaign trail. and frequently nikki haley or whomever is talking about those issues. they just don't necessarily get covered. but places like national review exist to help cover the actual policy issues a little bit more than "newsweek" perhaps ever will. but i do think it's sort of part of life in american politics or any politics. goodness knows we don't even do it to the extent that, say, england does. >> thank you so much. >> thank you so much, michelle. >> what a great talk. we appreciate you coming back to talk to the conservative's women's network. first we have our limited he had tigs claire booth coffee mug with her famous saying- >> no good deed goes unpunished.

that is true. >> and our limited edition tote bag. >> and from the heritage foundation, we'd like to give you a vase here with a let freedom ring bell on it. >> excellent. >> and you so often write about letting freedom ring. this will be good reminder and also remind you of the heritage foundation. >> and we often publish heritage foundation authors. so this will be there to remind me to call again. >> thank you so much for being here. there thank you. >> another great conservative network meeting. look at that rool full of ladies. doesn't it make your heart feel warm. listen, we have more people here than rsvped. we're delighted you're here. we might run out of food, though. so if you did not rsvp, maybe

could you wait until the end of the line and next time do it in advance so we can have plenty of food for all of you. anyhow, we love having you here. we're thankful you're here, we're thankful that c-span has recorded this and is playing it and probably will play it again. so be sure to have your friends and family watch. michelle, last word? >> great to be with you all. talk about not -- when becky and i came to town in the early '70s, not many conservative women around. but, boy, how things have changed. >> that's exactly right and rear happy about it. so god bless you and have a great summer. great summer. thanks for being here.

. . .

>> it's all in the wrist. ok? get a little water in there. turn it up a little bit. >> don't use that noif. >> magic, my chicken is cooked. thank you. all right.

>> anyone want to do a little salt an pepper on this. >> yes. >> you got to have a little salt. >> you are going to taste that one. all right. we are good.

all roit. a little rice. there we go. that's per. >> i'm left handed. >> me too. that's no excuse, you know. one of the things we are encouraging schools to do is include more fruits and vegetables. that's the challenge. finding creative ways to make sure that our kids are eating the amount of fruits and

vegetables a day. it's one reason the first lady created the chefs for schools. we can make food fun and exciting. these kids were eating green beans and tomatoes. i never tried this before but i

really like it. or i usually hate this, i really like it. that is a perfectly healthy, very affordable school lufrnl. in a minute, you are gooding to be able to taste as well. >> chef, i wanted to built on your point about the power of involving kids in the preparation. tomorrow, the first lady of massachusetts, my wife, diane is original noising a lunch. they will be served food grown, harvested and cooked by local children who are a part of a program bringing this into their lives. urban kids by the way.

about a third is given away to a local soup kitchen. it spawned gardens across the

countries. governor's there's a lost different ways to show case things by showing up, highlighting the issues, planning a dparden at the state capitol. those kind of actions can really go a long way. >> so many people say to us, i saw what the first lady did and mrs. o' mally did. it's a movement that takes on one person saying that example sends ripples.

it gives people the ability and the chance to be a gardener. this is a real connection with that and being healthy. with that, any questions. let's give the chef say big hand. >> thank you. thank you. >> i think the governors are having a plate brought to you. thank you chef stienberg nor bringing our illustration to life today. where is he? back there cooking.

let's give him a round of applause. >> our only work today is about done seeing as how we cooked the meal. i want to thank you for participating. i want to say to our special guests thank you for everything you have done. with that, this will be concluding the part of this meeting. as you all get a chance to eat, we will stand adjourned. thank you.

[inaudible]

>> remarks from the national govern chairman of vermont and from virginia on how their states have coped during the recession. this is about half an hour. >> good morning and thank you all for coming. it gives me great pleasure to welcome you to this kickoff meeting of the national governors association and to welcome our governors and their staffs and families to the 2010 meeting of the national governors association. we have over 1,000 reg i strants for -- registrans -- ts

for this couple of days of meetings and we will have some fun as well and we are happy to welcome so many people here to pump some 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 days arrived -- and we're challenging our guests to beat that projection and inviting them to do so. i want to thank all of the mechanics of the n.g.a. staff, of my own staff and those that 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 leader ship and also very personally for his willingness to grant

honor to massachusetts to host this summer meeting. i also want to thank and welcome our incoming chair, governor joe manchin of west virginia, who is also here and who has been a great friend adds -- as well and we're 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 implement it over the next several years. we'll be talking also about economic issues that we are facing in different ways in each of our states and every time that i've had an opportunity to participate over the last four years in n.g.a. sessions, i have learned things and benefited from the shared wisdom and the candor of other governors and their staffs and with -- we warmy welcome everyone here to boston and

with that let me turn the podium over to the governor of vermont and the chair of the national governors association, jim douglas. >> thank you very much, governor patrick. let me begin by extending my appreciation and that of all our colleagues to you, to diane, to the host committee here, to everyone in the boston area who has been so hospitable . and we really appreciate the hard work that goes into hosting a conference of this magnitude. it looks easy when we're standing here at a podium congratulating one another, but there's an awful do the of hard work that goes into it, and, deval, i'm very grateful indeed for you -- your willingness to be our host this year. we travel round to a different location every sirm and enjoy the ambiance and culture and history of a different place,

but we also have a lot of work to do over the next couple days to talk about the issues that are important to the people of our states and to share ideas and experiences both good and bad so that we can do the best job possible for the people we represent. each association has the opportunity to focus on a particular policy issue and a year and a half ago i decided that health care reform would be the principal focus this year. that was before we knew whether the congress was going to do anything or not but it seemed to me which had an obligation to help each other come up with innovative ways to reform the heal care system, to extend coverage and contain costs in the states we serve. some states like vermont and massachusetts have been in the forefront of efforts and we look forward no -- in assisting our colleagues in implementing

the new federal law that was passed earlier this year. this is a time when our states are facing tremendous fiscal challenges. as we come out of the great recession, some states have raised taxes, depleted reserves, borrowed more, done what is necessary to get through this difficult time and with the addition of the immortal implementation of the health care reform measure we're now facing it's a very challenging time for governors across the united states -- the united states. so we're going to spend some time talking about the challenges we face as well as implementing the health care efforts that are so important. i may be a little bit biased but -- but i think the vermont blueprint for health care reform is a great way to move forward.

vermont's been deemed the healthiest state in the union for two years now. states are the laboratory of democracy, it's been famously said, the place where innovation occurs. we also unlike the federal government can't print money. we have to balance our budgets. it's with that backdrop that we come to boston this week to share our ideas and experiences with one another. again, governor patrick, i want to thank you for your willingness to be our gracious host and look forward to sharing some ideas with our colleagues over the next couple days. it's my honor to turn the gavel over to joe manchin of west virginia who will assume the responsibility in about 24 hourds. i look forward to his assuming this responsibility at the end of the meeting. joe? >> thank you very much. good morning to all of you and

-- that will be a first -- good morning to all of you and thank you for coming. to jim, let me congratulate you on the job you've done, your leadership ond the participation of the n.g.a. has been unbelievable. to deval and tiean, all of you in massachusetts sl -- should feel very fortunate to have the quality of people that are leading this state. the n.g.a. is an unusual organization. it's truly bipartisan and we truly look for best practices. it doesn't matter which side of the fence we come from, the bottom line is for the common good how to we reach best practices? if you look behind me we're going to see three democrats and three republicans. governors -- >> four now. got one more the

>> jody from connecticut. we have bon -- bobby from virginia and our friend jack from dell -- del. -- delaware. i'm so happy to have them with us. we're looking forward to a productive three days. these days are jam-packed and there's an all of lot of good things going on. i'm going to get right to the business of telling you about the meetings. during the meeting we're going to focus on issues common to all of our states. health care, national resources, job security and homeland security just to name a few. next sunday is the plenary session. two governors-only sessions will provide a forum for candid discussions. with wee -- in my experience, we meet twice a year and they've been great meetings. the governors-only sessions are

really interesting, it's where we really reach out to each other for best practices to help each other. our work is going to begin shortly. today's opening plenary session will be achieving a sustainable health care system, which jim has touched on and we're going to focus on health reform implementation. we're going to be joined bit chairman of the board of i.b.m. samuel will offer insights from his experience providing health insurance to hundreds of thousands of employees worldwide. then we'll have dr. david cutler, auto -- otto eckstein professor of applied economics in the kennedy school of government at harvard university will also join the session, adding his insights on cost containment and methods for achieving a higher-performing health care system. this afternoon we will meet in

joint session to discuss childhood obesity and nutrition. thomas j. vilsack, our former colleague from wawarks will join us to talk to -- about childhood nutrition, especially as it relates to school meals. this will conclude with a demonstration by the white house chef. sam casss -- is going to be with us, highlighting the healthy, locally grown food. this is somebody -- something common to all of us, wanting to find ways to put good quality local food in front of our children. and the session on energy includes nicholas atkins, execute -- executive vice

president for generation at american electric power and regina hopper, president and c.e.o. of america's national -- natural it was alliance. during the same time, the committee on security and homeland safety will meet to discuss how to improve our operating systems, and systems that connect our police, firefighters and medical personnel. jamie barnett, chairman of the commission's on homeland safety. and the chief of the communications division of the new york city police department will take place in a panel discussion the this session will feature bart johnson, analyst at the u.s. department of homeland security. on sunday afternoon we'll reconvene for a plenary session on redesigning state

government. as jim said, all states are facing tough fiscal situations. this session will focus on ways to restructure and streamline state government for maximum efficiency. this roundtable discussion will be moderated by alan murray, deputy managing editor online for "the wall street journal." saturday we'll wrap up way meeting of the economic development and commerce committee. this group will discuss the road to recovery. the vice president of the federal reserve bank and of boston's new england public policy center will join the meeting for that discussion. the annual meeting will conclude with a plenary session on the lisk -- risks of the national budget deficit. erskine bowles will be on hand to share insights on reducing

the federal deficit through sound monday i -- monetary policies. as you can tell we have a full schedule and quite a workload in front of all of us. we are ready to get down to doing the bives the people. we are all looking forward to sharing best practices and finding solutions to our common challenges, which is what we do best at the n.g.a., and i want to thank you all for joining us in boston, the beautiful birthplace of our country and i know deval and diane want us to leave as much as we can financially with us. he's made that direct response every time he's had a chance to get a microphone and i've listened well and i want him to know gail is out doing her part this morning. we're going to hope up -- open it up to questions but first if any of our governors would like to say something, they're all here and tremendous assets to

the organization. you can direct your questions to any of us up here. >> what about the discussion to ask congress to pass the legislation to extend the medicaid spending or any other efforts to get congress to help states with their budgets? >> we certainly look to the congress for support in a variety of different ways. february 1947 -- in february, 47 governors signed a letter extend:00 a two-quarter of the appropriation. we sent that to them again this year and as you know it's in a stalemate at this point. a number of different states have relied on those revenues for their fiscal years that began a week ago and are going to have to make some difficult choices if they don't come through with the money. that probably will be a matter of discussion but we've taken a

pretty clear position on it and we're for it. >> if you ask all 50 governors i think you'll get an answer that basically as much anybody. as we can as governors to have with any of the money that flows through the state, give us a belter chance to be able to direct it and help our people. every governor knows where their concerns are and where the needs are. if that's done you might find more of a reception than you might otherwise. governors are held responsible. they'll come to each of us and say why did this happen? we have the anybody. to make that happen. [inaudible question] >> i talked to senator brown about both of those subjects, but i haven't -- i can't

comment on any and don't have any information about a link between those two. [inaudible question] >> in a meeting the speaker and i with him that was specifically about his support if not on the merits of the sentence of s mf -- s-map at least getting it get to a vote on the merits on the cloture vote and in that same meeting he repeated what i think everybody knows to be the case, which is his support for slots at the track. but one as a condition for the other? no. that was not the nature of 9 conversation. -- of the conversation. >> could the republicans give me your comments on whether congress should pass unemployment benefits and medicaid money? or should they try to find [inaudible]

>> well, we'll probably have some discussion about this over the next couple of days as governor manchin mentioned, n.g.a. is a consensus-based, bipartisan organization so we need to find that common ground as we did when we sent that letter on f-map. i would say this as joe said, flexibility is key. for some states, f-map is important. for -- for other states it's less so and other types of federal assistance may be more beneficial. to the extent that the congress can give us flexibility in health care in particular that would be of benefit to most of the states. ma'am? [inaudible question brble] >> we extended an inviptation

to the president at our winter meeting which is in february. we always at least in my eight years have met with the president and members of his cabinet at the white house. so we have a very extensive meeting in february. we extended an invitation this time as we always do. presidents are generally not accustomed to coming to the summer meeting and i'm not expecting him. are you, deval? [laughter] sir? >> most governors are in their third year now of cutting spending, increasing taxes. what still needs to happen to break this cycle? >> well, we're coming out of what's call the great recession. the longest and deepest recession in our lifetime. we know that the economy has ums and downs and governors and legislators have to react to

that, but this is a more profound downturn than we've experienced in the past. states are in different situations. vermont i'm proud to say has a balanced budget for the fiscal year that ended a week ago. we actually reduced a couple of taxes in our session this year. we're not relying on additional f-map dollars to fund our state budget this fiscal year. but other states are in different situations and i think they have to look at the long term. engage in what one of my predecessors call full-psych -- full-cycle budgeting, to recognize the ups and downs of fiscal fortunes and save for a rainy day. but this downturn is doper than could have been anticipated and that's why you're seeing such tremendous responses in terms of budget cuts at this point. >> thank you, i was actually just listening thinking what

we're doing in connecticut. i've put together a commission that i'm hoping the next governor will be able to take some of the recommendations, for example, on unfunded pension liabilities. what are some of the recommendations? because restructuring government which is part of our discussion this weekend is really going to be part of what every gennifer is having -- going to have to look at ne -- in the next legislative session. i made recommendations to my general assembly on consolidating, i can't remember the number now, but boards and commissions. these are not high paid. most get a per diem cost. but when you have so many people that come once a month or every six months do we really need all these boards and commissions? can we in fact consolidate some and prevent duplication of work? some passed. others -- others felt very strongly we needed to keep them in place.

in the same vein we have a number of legislative commissions, small commissions that have been created over the years, well intentioned when we had money to pay for them but frankly we think those are a duplication of efforts. we're going to have to make the tough addition to eliminate some of those. i've tried. i think the next governor is going to have to do the same thing. >> jack martell from delaware. the bomb line is none of us is immune from what's going on in the national economy. that being said, i think we all recognize that we're not going to be able to tax our way to a prosperous future or cut our way to a prosperous future. in the end what that means is we've got to grow our way. we've got to really focus on improving the economic climate in each of our states. that means being faster, more responsive, more nimble, more

agile and it really meens we've got to put ourselves into the shoes of the people who create the jobs and the prosperity and focus on the things they care most about. it's not really that comp mycated. people want to be located in communities where there are good schools, reasonable taxes, a highly qualified work -- work force and reasonable costs of doing business. they want to be in places where they feel hike their tax money is well spent. i think so long as we continue to focus in every single day on that, we're likely to make progress. i know for me and i'm guessing that i speak for my colleagues as well, certainly what wakes me up in the middle of the night is the folks in delaware who want to be working and who are not. although we have an unmovie. rate lower than the national average, we still have far too many people who are struggling

and that's why we've got to wake um every day and say how do we improve the economic climate in our state? >> we just went through this in new jersey. we had an $11 billion budget deficit on a $29 billion deficit. we closed that deficit with a budget passed early, june 28, with no tax increases on the people of new jersey and with a slight tax cut and corporate business tax as a way to start bringing a down payment on our good faith for the businesses in our state to let them though we're going move back in the right direction, which in my view is smaller government and lower taxes. but we can't get through this and have long-term prosperity in my view unless we tackle the problem with public sector unions. the fact of the matter is the public sector unions have been she'll -- she'lled at least in my state from the recession.

while we have had unemployment hovering around 10%. but we have not had anything but salary increases for the public sector unions, with the teaches -- teachers insinuating they should pay nothing for their health care. in my view it's about making structural changes to the way folks are treated and i think at least in my state the people who are unemployed or working in the private sector who have had salaries cut or frozen if they still have a job are tired of paying higher property and other taxes to fund 4% and 5% raises for public sect orr employees, free health care and rich pensions. that tension is reaching a boiling point because of the recession and in my view we have to confront that head on and i suspect other governors are having to confront that at

well. but if we don't get to this core issue i think we're going to be confronting these problems for a long time, to get back to the premise of your question, if we don't confront those core issues. >> i think there is a growing sentiment among the citizens of this country that the rate of spending and the rate of growth is increasing spending that at every level of government is unsustainable. .

i think the citizens expect real bite tightening -- belt- tightening. they expect the government to do a lot of the same. governors have tried not to cut education and health care. we have a couple of commissions we have put together in virginia on job creation to expand the free markets and get more tax revenues through economic growth. at the same time, the commission on government reform will look

at every aspect of government, for consolidation, innovation, technology, privatizing that abc stores to get more revenue. these are the kinds of things governors are thinking about, looking at new ways to make government run more efficiently and reduce operating expenses, and that will be required at every level of government. >> we are joined by our colleague from tennessee. welcome. >> thank you. i apologize for being late. actually in a reasonably decent shape. we have had some significant revenue shortfalls. we are a sales tax state. we do not have an income tax, and this has been a slowdown that has been a serious issue. sales tax is very 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 in the way our state has been managed over the years by governors of both parties, have not had some of the issues you have heard about in other states. we have a reasonably conservative approach to things like pensions and health benefits and the like. we have not dealt entirely with it through cutting. about 20% of all departments, except for corrections where you cannot do that, and we have kept the funding for pre-k through 12 education and tact, at the cost of cuts in other areas. it has been difficult. i have to be honest, there is a

health aspect to it, too. we have been able to make a number of cuts that are necessary and really need it to be done, that would be difficult to do under other circumstances. some areas that were clearly overstaffed, for example, in the hospital systems and the like. we have used this as a way to try to also try to get done some of the business-like things that are difficult and government in good times. we had billed the in the last few years -- we had built up substantial reserves in the state and we have used them to hell add where we are. tennessee is in a strong place right now. whirley next year it will be genuinely balanced. we are using a little bit of reserves, but we will accept this year with several hobert million dollars of real cash reserves and the bank and a genuinely balanced budget and

continuing to provide all the basic services that the state is responsible for. it has been a tough few years, but i think the build up and the way in which state governments have been handled for a long time in tennessee very carefully has made it easier to deal with this issue. >> wrapping up, you have heard from the governors of all different sides of the political spectrum, and the bottom line is we are held responsible and accountable. our citizens live within their means every day. we have to make the same decisions. we have to take care of the children, make sure we are able to do the things we have been able to do, and not cut to 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 are still putting reserves and surpluses into rainy day accounts, growing at to unprecedented levels. we are prepared to weather the toughest of storms without reducing taxes. we have done it responsibly and we basically have a 10% attrition rate every year in state government. but we're not cannibalizing anything, we're just being careful and selective with how we continue. it does not disrupt anybody's life. we're not making any decisions at the average person and west virginia is not making every day. for that, we just got an increase in our bond rating, which we are so proud of. we have gone from one aa with moody's, which helps tremendously with our financing. we know we will be held accountable every day. the citizens of our state will hold our feet to the fire, and

have a right and responsibility to do that and we're up to the challenge. we need a good partner. that is what we have in washington. that partnership brings us this, and we have good things to happen in the future. i want to thank all the governors who are here. >> we will have to get back to our meeting and a moment, but i want to thank all my colleagues for being here, and thank you, governor patrick, for his gracious hospitality. i was born in the commonwealth of massachusetts, and it is good to come home to this meeting of the national governors' association, and i look forward to sharing ideas, stealing a few, and improving the lives of the people in our states. thank you all very much. [captions copyright national cable satellite corp. 2010] [captioning performed by national captioning institute]

>> ways to reduce healthcare expenses. this is an hour and ten minutes. to ask everyone to please be seated so we can get through art opening session on time -- are opening session on time and give adequate opportunity to our guests to make their presentations and lead the discussion about health care reform. i would ask my colleagues and everyone else to please find a seat so we can get our session underway. governs and guests, good morning, and welcome to the 102nd annual meeting of the national governors association.

we will begin with the color guard. i ask everyone to please turn off your cell phone andlease rise at this time for the presentation of the colors by the 54th regiment ceremonial unitf the massachusetts army national guard. pleaseemain standing for the pledge of allegiance, led by operation iraqi freedom veteran marine sergeant liz thompson.

>> 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.

>> thank you to the color guard and sergeant thompson, and all those who serve our grea country. [applause] please be seated, and welcome again to our annual meeting. first, i would ask for a motion to adopt the rules of procede for our annual meeting. gov. manchin moves. governor patrick seconds. any discussion? all in favor say aye. the ayes have it, we have adopted the rules, one of which and a governor who wishes to submit a new policy will need a three-fourths vote to submit the roles and must be submitted no later than 5:00 p.m. tomorrow.

i want to appoint the members of the nominating committee for next year's executive committee and officers of the association, gov. herbert, governor martin and others. we have a number of distinguished guests who have joined us for our annual meeting from outside of our nation. for a number of years, we've had the privilege of having representatives from the canadian parliament, and we are honored and deliged to have them with us again today. for our canadian guests, please rise. thank you very much for being with us again. [applause] members of parliament and counlors general, we welcome them. we have delegation of arab ambassadors organized by the national u.s. arab chamber of commerce. i had the privilege of meing some of them last evening, as

you did. investor -- ambassadors. willaert arab guests please rise. thank you for being with us today. [applause] finally, for the past 11 years, we have been working with a group of governors of the 36 democratically elected chief executives in nigeria to form a forum similar to ours for the exchange of ideas, and we are delighted to have played a role in that success. they perhaps hopefully did not call that the nga, but instead call it the nigerian governor's the forum, and it is a privilege to have them with us as well. willaert nigerian guests please rise? welcome. -- will are nigerian guests please rise? welcome. [applause]

thank you all for being with us this year. i like to thank our hts for the annual meeng. as i have noted, it is no easy task to host a meeting of this magnitude, and i want to thank on behalf of all our colleagues, governor patrick and his wife, diane, his great staff of the massachusetts coast committee in hosting the nation's governor and his associate -- in this historic city is a great privilege for all of us. please come out. [applause] >> thank you, jim, and it gives me great pleasure and honor to welcome all my colleagues, fellow governors and spouses and families and staff, all of our guests, members of the diplomatic corps, guests from around the country and the world to this summer's nga meeting in boston. we have done a lot of good work with you and the staff to prepare for you and make sure

that the program under jim and joe's leadership is rich and substantive. and that the time outside our meeting time is fun. there is a lot to like about boston and the commonwealth, and we invite you to take advantage with it consistent with your responsibilities inside during the planning sessions. i know who you are. and i invite you as i havon more than one occasion to please use and take advantage of the many restaurants, shops, and other aractions, historic and cultural, that we are famous for and rich in in the commonwealth. we're looking forward to a terrific series of conversations, both in the plenary sessions and our private conversations, and welcome. let usnow if there's anything at all that you need. thank you. [applause] >> thank you again, deval, for

your willingne to host this annual meeting. it will be a real success, i am confident, and we appreciate the hospitality. we will also recognize our distinguished services award winners and are 15 and 20-year corporate fellows. i am excited to chat briefly about the challenges and opportunities we have in our nation's health-care system. in has been an active year to say the least in health policy and we all need to tackle this critical issue for states. over the past year, we have made real progress of moving to prescription reform agenda forward. our goal was toive each governor the tools that you need to begin to implement aspects of federal alth reform while continuing to pursue your own state-based delivery system reform efforts. in front of you at your place is a report we are leasing today as a capstone for my yearlong

initiative. it is a report that reviews the evidence available at highlights stat approaches to delivery system reforms, including care reform and payment reform. that is a thorough and comprehensive review of the options available to each state. the initiative activities would not be possible without the. support of governors on the task force. i think governor's mansion, barber, lynch, and others for their input and support and our initiative funders, without whom it would not have beea success. the new health care reform alt stands poised to make substantial increases in the number of people who have health insurance. these will increase the vital need to contain costs and improve system performance. i think we have a great opportunity to drive system improvement efforts as federal result. federal reforms are are implemented and teller federal reform implementation in ways that focus on ways to contain

costs and improve the quality of care. these reforms must build on states' experienc and coordination planning, oversight, and innovation. well we faced challenges of implementing federal reform with the current budget situation, we have the experience and insight to push forward if given the appropriate flexibility. i hope to continue to build on the information and guidance which provided of the past year. we will continue offer opportunities for affirmation sharing and advice as states move forward. to help us, we have two well- respected and knowledgeable speakers on the topic. they have significant expertise with the effects of the health- care system on our country in the best ways to accelerate the improvement. while they come from different perspectivesmy guess is you'll hear similar themes and new ideas for progress.

our first like to introdu the chairman and president and ceo of ibm ibm is the largest corporate employer in vermont. i have had the pleasure of working with the company, with sam, and members of this team. the company is a key supporter of our blueprint for health program, changed the waye provide and pay for health care in vermont. i know that this is exactly the kind of forward-looking project that sam would champion. he was appointed chairman and 2002, best knownor leading o of the most ambitious transformations in the company's 99 year history. ibm has made tough calls to get out of legacy businesses that the company itself invented and enter new ones, leading to future growth and novation. he did this not by the flashy path, but through the far more diffict and lasting path of reinvention from within. while running a state

incorporation are different endeavors, i think we can all relate. another difficult task anyone in leadership struggles with these days is being able to adapt to an ever-changing economy. four years ago, sam offered a forward-looking piece on foreign affairs identifying the emerging model of globally integrated enterprise. ibm is a premier example of this new form, becoming far more efficient and effective across its 400,000 employees and 170 markets where it does business. the results speak for themselves. ibm has delivered record performance the past six years. today we will hear about his latest vision of how our world is working, especially in the complicated area of health care. i'm delighted he is able to be part of the program. that's all welcome sam. [applause] sam.t's all welcome >> thank you, governor, a very flattering introduction.

quite humbling for me to be here, and good afternoon to everyone. it is really an honor to speak to you. we come together at an interesting moment. the states are at the epicenter. if we believe the new york times magazine cover story article, we are now the country of the broken states of america. i will talk a little about that. without question, governors and ceo must be laser focused on issues. we all understand it we fe a severe fiscal crisis. everyone understands we have confronted an historic moment. nothing more needs to be said. i think the question is, what do we do about it? that answer depends on your understanding of the present moment in time and how we got here. because if you think about as

cyclicalconomic slump which happens in a capital-based democrat side, you ride out the storm, hundred down, across the board, spread the pain, after a couple years to get through it. if you believe the crisis was not cyclical, caused by growth imbalances in the system, the my prescribe a reform agenda, more regulation and oversight, you pay, and benefits. but if you believe this is a turning point, not only in the state of the united states but in the context of what is happening across the world, you would take a different approach. i happen to be of the latter perspective. i believe that what is at stake is not just the next year's budget, which is certainly very important. we all live by buets. like you, i set them,