wide regulatory system? >> obviously, on the issue of eight banking levy, we decided to go ahead of international agreement. we thought that it was right and should be done and there should be some leadership shown. on the financial transaction tax, i have always felt there was a greater risk of countries or even small groups of countries doing >> the question we will bring is if this was looked at in a way that would not have that effect, we said that last year, something we would be prepared to look at. there is a great danger because you can move transactions easily, that is the risk. let's take two more. the gentleman here and the one in the back. >> given that the liberal

democrats argued strongly against the budget, is that causing tensions in your discussions with a liberal democrat ministers about cuts? secondly, some said this morning about the child benefit that repeats a mistake that was in the briefing, which is the threshold will be $44,000, but in the changes the threshold rate goes to $42,000. do you understand why people think this was put together in a rush? >> obviously we negotiated all of these things in the current agreement. there were a liberal democrat policies they were looking to achieve and there were conservative policies. we negotiated that. that is a very good document.

it is standing the test of time. conversations we are having, that is difficult because we have difficult decisions to make on welfare, education. i have been heartened by the fact that ministers have come to us trying to work together to get a good outcome. the signs are good for higher education that conservatives and liberal democrats have come together. instead of trying to do the easy thing, they are trying to do the right thing. there are not too many tensions like that. i was talking about the saying -- the point i am making is when you have a higher rate threshold

light that and you are trying to reform welfare, it is worth asking is a right to pay child benefit to those families? it is right not to. there are no easy decisions. people who are receiving that money, that will have an impact on their budgets. people live on very tight budgets, but we have to make choices. you cannot simply take all of the welfare changes from one part of the spectrum. and has to be fair. the fact we are asking relatively better off families to bear some of this burden is right. >> will phillip green save the state as much as he and his family have saved the state from paying? >> we will have the answer in a

few hours' time. i have seen the report and it is a very solid report that goes into how much money we have wasted over the last decade. we have made crazy decisions about property, shared services. some of it about the different costs of computers across government make pretty chilly reading. money was spent and there were not enough questions asked about how can we purchase better, if money? philip crane who has run extremely successful businesses has given us good pointers about how to save all lot of money. some of the property examples will turn your head. it is a good report and it will save a lot of money. can i apologize for the late start in my press conference?

thank you all for coming. campaign 2010 coverage begins with a live debate between the u.s. senate candidates in kentucky. rand paul and jack conway were vying for the seat of jim bunn is retiring. then we go to india where there is another senate seat opened up. dan coates is seeking to regain his old job. he is running against brad elsworth. they are succeeding -- competing to succeed gov. evan bayh. the only debate in the michigan race.higan gov.'s

then john lynch is run for reelection in new hampshire. john steven has served as the attorney general and held and semen services commissioner -- health and human services commissioner. >> regulating broadband broadcasting decency and their experiences at the home of the -- helm of the fcc. >> every weekend on c-span3, experience american history tv. 48 hours of people and events telling the american story. hear speeches by american leaders and eyewitnesses' accounts. visit museums, historical sites and college campuses as historians still into america's past.

-- historians delve into america's past. >> president obama called for an effort to upgrade american infrastructure. this came after a meeting with samuel skinner. some reports show the u.s. infrastructure is rapidly decaying. then we will hear from pennsylvania gov. ed rendell. this is 25 minutes. >> good morning everybody. i just had a meeting with ray lahoodithner air, and governors like ray lahood

and economists to discuss one of america's greatest challenges, are crumbling infrastructure and the need to put americans back to work upgrading it. we are also joined by two former transportation secretary is of both political parties. sam skinner who served under president george h. w. bush and norm who served in president clinton and george w. bush. they are passionate about this task. their cooperation and this history proves that this is something for which there has traditionally been broad bipartisan support. sam and norn have been leading a group of 80 experts who released a call to action demanding an

overhaul of how america builds our infrastructure. today, my treasury department has released our own study. these reports confirm what any american can already tell you. our infrastructure is inefficient and outdated. for years we have deferred tough decisions. today, our aging system of highways and rail lines hinder our economic growth. today, at the average american household is forced to spend more on transportation each year than flood. our roads cost us $80 billion a year on lost productivity. our airports cost nearly $10 billion a year in productivity losses from flight delays. in some cases our infrastructure costs american lives.

it should not take another collapsing bridge or failing levee to shock us into action. we are already paying for our failure to act. the locker our infrastructure e. rhodes, the deeper hour -- delong per our infrastructure erodes -- the longer our infrastructure erodes. we invest less than one-third of what western europe invests. right now china is building thousands of roads. over the next 10 years it plans to build dozens of new airports. over the next 28 could build 170 new mass transit systems. -- over the next 20 years it could build 170 new systems. the bottom line is our

shortsightedness -- we can no longer afford to sit still. we need a support system of infrastructure equal to the needs of the 21st century that encourages sustainable communities with easier access to jobs and schools. a system that decreases travel time. a system that cuts congestion. a system that produces harmful emissions and creates jobs right now. -- reduces harmful emissions. the recovery act included the most serious investment since president eisenhower built the highway system. we are talking a smart electric grid and the high-speed internet and rail lines required for america to compete. we are talking about investments

that impacts immediate and lasting. tens of thousands of projects already under way. we are rebuilding water and sewer systems. we are implementing a more stable electric grid across 46 states that will increase access to renewable energy and cut costs for customers. we are moving forward with projects that could affect -- connect communities to broadband the internet's -- to broadband internet. a great many of these projects are coming in under budget. we have already created thousands of jobs, but the fact remains nearly 1in 5 construction workers -- 1in 5 construction workers is still unemployed. that makes no sense when there

is so much to rebuild. that is why i announced a new plan for upgrading the roads and runways for the long term. over the next six years we will rebuild 150,000 miles of roads, enough to circle the world six times. we will maintain 4,000 miles of our railways, a enough to stretch from coast to coast. we will restore 150 miles of runways and advanced a next- generation air traffic control system that reduces delays for american people. this plan will be fully paid for. it will not add to our deficit. we will work with congress to see to that. it will leverage federal dollars and focus on the smartest investments. we went to cut waste by consolidating more than 100 different duplicated programs. it will change the way washington works by reforming the government's patchwork

approach to finding and maintaining our infrastructure. we have to focus less on earmakrs, we have to focus -- less on earmarks, but more on our economic priorities. investing in our infrastructure is something members of both parties have supported. it is something the groups from the chamber of commerce to the afl-cio support today. we will make our economy run better over the long haul and create good jobs now. there is no reason why we cannot do this. there is no reason why the world's best infrastructure should live beyond our borders. this is america, we have always had the best infrastructure. this is work that needs to be done. workers are ready to do it. all we need is the political will. this is a season for choices.

this is the choice between decline and prosperity. our future has never been predestined, it has been built on the sacrifices of previous generations. they invested yesterday for what we have today. that is how we build railroads and highways and ports that allow our economy to grow. that is how we lead the world in the pursuit of new technology. it is what allowed us to meet the global economy in the 20th century. if we are going to lead in the 21st, that is a vision we cannot afford to lose sight of. that is a challenge this country will meet, and with the help of these gentlemen behind me, and strong bipartisan support i have no doubt we will meet these challenges. thank you very much.

[inaudible] >> good morning.

my name is ray lahood. we just had over an hour meeting with secretary timothy geithner are reviewing a report done on infrastructure in america, a path forward for infrastructure. we were joined by the president and he listened to the mayors and governors who gathered with us today. this continues our message that the president announced in milwaukee on labor day, that infrastructure does provide jobs, we will be working with congress after the election on a 6-year bill to begin with a $60 billion opportunity. the report released today co-

chaired by secretary skinner substantiates the idea that infrastructure puts people to work. these opportunities can create thousands of jobs across america. to really emphasize the president possible leadership in lochte -- milwaukee, announcing the $60 billion opportunity. i will ask secretary skinner to talk for a moment about the report. we will be happy to answer questions you may have of any one gathered here. >> go ahead. >> your senior. >> -- you are a senior. >> at the university of

virginia they pulled together 80 experts and sam and i had the privilege of co-chairing that conference. they came up with 10 recommendations. there has been a litany of analysis about transportation issues and how to deal with them. the 10 recommendations were to try to deal with a compilation of what has to be done. we feel very strongly that under the leadership of this president who has been the infrastructure president, that president obama and the leadership of secretary of treasury timothy geithner a, ray

lahood, that they will be able to put together a plan for the execution and implementation of the various facets that have to be put together. in terms of support for the $50 billion infrastructure needs. the important point is how to execute the program and implement what has to be done. we feel the recommendations fall in line with the report from the secretary of treasury today. >> in 1990 we sat here and signed a bill, republicans and democrats working together on building infrastructure. today we have that opportunity again. this president is committed to

infrastructure investment. he is committed to a long-term approach, looking at various options for funding and technology. secretary timothy geithner air has been asked to support that effort. -- timothy geithner has been asked to support that. that will be a basis going forward. we have a real opportunity to do something that is badly needed. that is to invest real money in real infrastructure that will get people back to work, home from work, especially those people who don't have automobiles, to get them transportation they need. >> let me ask governor rendell, because they have been involved in transportation as the former

governor of philadelphia. just say a word and we will take questions. >> we think the president's vision is right on target. this country cannot stop investing in its infrastructure. the six-year is on target. up fronting $50 billion works. it is the best job creator we can do. it puts people to work on the bridges and roads, but also puts people back to work in factories. in pennsylvania in the first year of stimulus orders went up at steel factories by 40% and asphalt factories by 50%. it creates well-paying jobs that cannot be outsourced. we are hoping it will get a bipartisan reception watched

this -- once this election is over. it is the second most important thing the government can spend money on behind military. jim and i authored a piece, this cuts across party lines. >> there are a few issues as bipartisan -- america is not keeping up. we are not even in the lead with china. we have to be competitive. we have to get people back to work and create the infrastructure that will build a strong economy. no one knows that better than the cities represented here. 90% of the gdp created in

america is created in metropolitan areas. in los angeles we taxed ourselves $120 billion over the next 30 years to invest in infrastructure. one of the recommendations as we ought to leverage what public- private partnerships -- i want to thank the two secretaries and the five secretaries here, both democrat and republican who agreed it is time for america to invest in its infrastructure. >> questions? >> infrastructure has become a partisan issue because of the stimulus. if you watch any political at stimulus is almost a four-letter word. how do you keep this thing from

becoming partisan again? >> in the past if you look at the tradition of congress, if you look at the tradition of congress, i served on the transportation committee for six years. these transportation bills have always been bipartisan. the last bill passed with over 300 votes. over 80 votes in the senate. the tradition of congress has been to work in a bipartisan way. there are no democratic or republican bridges. the tradition of congress has been to work in a bipartisan way. two weeks ago i had a meeting with chairman oberstar about the president's speech in milwaukee and about the bill. he and i agreed almost 100% on a

path forward for a new bill and jump starting it with a $50 billion upfront cost. the striking thing for me was that chairman oberstar said we believe there will be republican support for this. if you look at the tradition of the house and the senate on transportation bills, if you look at the votes, they have been done in a bipartisan way. >> you say this is one of the greatest things you can do to create jobs. why didn't you do this a year ago? >> you all know the answer to that. the president inherited a mess when he came here. he tried to address the economic mess, there were other priorities for the

administration. i don't think anybody doubts the president is willing to take on big things and get them accomplished, and persuade congress to pass them. now it happens that transportation and infrastructure has moved up to the top. >> the house is waiting for the senate to introduce the transportation bill. the senate cannot decide how to pay for it. what is your input? >> the president made it very clear at this meeting today, this will be paid for. this will not be put on the dept. we will be looking at a lot of recommendations and we will be consulting with chairman oberstar and the others in the senate who will be working on this.

there will be a pay for for this. >> would you say what is off the table is the closing of the oil and gas tax breaks? >> i will not get into the recommendations. we know it has to be paid for. i will not listen to all the options. there are a lot of things being discussed. as we work with congress we will be making announcements. >> what about the idea in the scanner report for the long term -- idea in the skinner report? >> you know what kind of trouble i got into for talking about out. [laughter] >> we cannot stop investing, so what do you think of the governor of new jersey's

decision to cancel the new york, new jersey tunnel? >> we will work with the governor. i was with the governor on friday. we had a good meeting. i believe over the next two weeks he will listen to options we will present. so stay tuned. any other questions? go-ahead. >> how many jobs are we talking about? when and where? we are spending five times $15 billion. >> the $40 billion that came under the stimulus bill, there are 14,000 projects going on in america right now. drive down any street in america and what you will see are orange cones and thousands

of people working. they want things -- one thing america knows is our stimulus has worked because they see their friends and neighbors working on roads and bridges, in some systems. we put out $8 billion for high- speed rail. we put out $28 billion for roads and bridges. there are thousands of people working. the idea that our status did not work is nonsense. ask any of these -- the idea that our stimulus did not work is nonsense. ask any of these people. it has worked. >> we took a snapshot on june 30. stimulus-funded projects only. 8600 men and women on the job site. resurveyed all the vendors who provided goods and services.

3600 were new hires. that was with half of our $1 billion allocation. >> [inaudible] in the latest numbers of unemployment -- >> thousands of people are working. we see the full blossom of our stimulus money working very well in transit districts, states getting into the high-speed rail business, but most importantly in the roads and bridges being done. that may ask a couple of days mayors. >> it seems that maybe you folks need to get out a little more. get out into cities and replaces where there are real people working. everybody here has a job.

thousands of people back in philadelphia don't have jobs. you might want to check these programs out to see that people really are working. there is more that needs to be done. that is what this is about. questions seem to be what about this or what about that? americans are unemployed. everyone who has received the benefit from any of the stimulus funding or grants, they are a pretty happy camper. unfortunately we still have too many people unemployed and there is a tremendous need -- if you look at any state report for roads and bridges and highways that are falling apart. interstate 95 shutdown for three days. it had an impact from baltimore to new york.

that is real. and may not have happened right here but it happened in -- it may not have happened right here but it happened in our town. >> campaign coverage begins with a live debate in ky. rand paul and jack conway are vying for the seat of jim bunning. you can see that live at 7:00 p.m. eastern. then they go to indiana where there is another senate seat opening up. dan coates is seeking to regain his old job. they are competing to succeed governor evan bayh. the only debate in the michigan's governor race -- then

at 10:00 p.m., john lynch is running for reelection for a fourth term. john stevens has served as the state assistant attorney general. >> this week on "the communicators," michael paul and kevin martin on regulating broadband and their personal experiences at the helm of the fcc. >> a discussion on the issue of counterfeit prescription drugs. we get an overview followed by a panel on who was hurt when counterfeit drugs become a part of the marketplace. this is an hour and 20 minutes.

>> good morning everyone. very nice. we are looking forward to today. allow me to introduce myself. i am the executive director for the partnership of safe medicine. we are thrilled to have the guest lineup that we do. i want to take this opportunity to thank you all for participating today. it is an indication of the need to address counterfeiting head on. we are grateful commissioner hamberg will be joining us later on. i would like to extend our thanks to our supporters. without their support today's event would not have been possible. they include amgen, lilly,

pfizer and merck. i would also like to thank our members and associations that have helped us through promoting this event. including the national latina health network, tie counterfeiting coalition, men's health network, american pharmacists' association. with all of that we could not thank them enough. we appreciate the effort they have put in through their advocacy and their efforts to educate others on this issue. for those of you not familiar with the partnership, let me give a quick background about urbanization. we are comprised of 60 non-

profit organizations committed to the safety of prescription drugs and protecting consumers against counterfeit medicine. our message is clear, counterfeit medicine does exist. it is up to the constituencies represented here today to take action to ensure we protect the supply chain every day. several years ago we developed the following principles to support quality assurances within these programs and help establish a drug distribution system. this includes protect our supply chain, regulate online drug sellers, and to unify against counterfeit medicine. we believe that the patient safety is a priority number one for our efforts. patients are encountering fake

medicine every day. the packages seem right and tablets look the same, but these are imitations of government- approved drugs created in unsanitary conditions with manufacturing practices that are not saved. counterfeit drugs are often too strong or too weak. is sellers of counterfeits defraud consumers to let them believe they are getting the real thing. these therapies can save lives, something everyone would agree to. they don't care that these products cause allergic reactions, heavy metal poisoning, a growing issue at around the world. criminals producing these materials do not limit themselves to brand-name products, the stories you have heard so long, but are now moving into fake versions of

generic products. these infiltrate our local supply chain around the world. we have seen everything from deadly medicine in nigeria to fake insulin pens, but few of the active ingredients -- this was the focus of a recent fda alert that warned consumers trying to remain healthy during a pandemic. why are we dealing with a situation like this is beyond everyone's imagination. in 2009 the pharmaceutical institute and the ceo -- there were 1700 cases of counterfeiting worldwide. in 531 these products reached wholesale distributors of

pharmacies in 48 countries. although the u.s. has one of the safest drugs supply chains in the world, we are not immune to this crisis. today you will hear first hand from an american victim of counterfeits, all with the goal to address these challenges. we have also brought together security experts, government officials to share your ideas for measures on how we can combat this issue. above all, this must be a public-private partnership that brings together all stakeholders to help educate and protect patients around the globe. that is what the partnership for a safe medicine looks to do around the world. that is what we will hear later on during our lunchtime. this is an opportunity to come together to unite against

counterfeit medicine. whether we work for pharmacy will companies, nonprofits -- work for pharmaceutical companies, must all work together. it is a crisis we must tackle and win, . who is getting hurt by counterfeit medicine? who is benefiting from unsafe drugs? who is making progress against this fight? the moderator of our first panel is dr. shepard. he is a true advocate on these issues. he also serves as the center for formal logical studies at the university of texas -- pharmacology studies. [applause] >> how are you doing? glad to see so many people here.

when we first started we figured if we got 30 people we would be happy. then scott calls and says we have over 100. we hit the nerve. thank you for coming. my name is marv shepard. i have been a member of the partnership since its formation. i have been fighting counterfeit drugs since 1993. i was shocked when the u.s. consulate told me they seized 400 tons of counterfeit strokes in the last two years from paraguay.

that shows you the threats worldwide. there are enormous problems. this panel will concentrate on consumers. we have four panelists that will be excellent. the first is rick roberts from the university of san francisco. he advocates for greater protection for u.s. pharmaceuticals. we have been friends for a number of years. he is a victim of counterfeit drugs. the next speaker is an investigator and editor of "the new york times." he wrote an article about dangerous ingredients from china flowing into the global market. our next guest is director of education at belmont university.

he previously worked on a number of issues during his time at pfizer as director of >> journal relations. -- director of external relations. our next speaker -- she has served 25 years in health care and pharmacy practice. let's get started. we will ask mr. roberts to start us off. thank you. >> thank you, and thanks for the opportunity to speak to all of you. i appreciate the partnership. last night there was a reception

for some of the speakers. as we were meeting each other i s to argue with? -- i asked who are you with? i could have listed other things that i do because that is what i noticed people were saying. that has nothing to do with why i am standing here in front of you. by the end of today i will have taken 37 pills. i take over 10,000 pills a year. i depend on prescription drugs to stay alive. i need them to be safe, so i have a vested interest in what happens here and the discussion that happens here today. i will talk about an experience that i have. i grew up in a small town in northern california.

mr. barry was our town pharmacist. if i got sick i remember my parents would take me to mr. barry, and say this is what is going on. that is what i remember. in seventh grade i decided i wanted to be a pharmacist. mr. barry was very helpful. he let me go behind the counter and answered all my questions. never once did i think to ask how the medicine got to his pharmacy. it would be years before i would think to ask that question. i had this image of an armored truck pulling up to the pharmacy and delivering these drugs safely. i graduated from high school and moved into the dorms at the university of san francisco. taking classes that were

challenging and exciting, and i started dating. i was in this amazing city. life was really good. then we found there was this virus in 1984 called hiv. that is when everybody was getting sick. then in 1988 i was diagnosed myself. i went on the only drug available at the time, azt. we did not know so much about it except we knew it was the one hope we have. my friends were still dying. in the mid 1990 passed things became more hopeful as more drugs became raging in the mid- 1990s's things became more hopeful. thingshe mid 1990's became more hopeful. then i was diagnosed with a

syndrome that caused me to lose weight. i was treated but i failed on the treatments. there was one treatment left, and that was growth hormone. you inject it daily. i was fortunate enough to have an insurance company that approved a 12-month supply. i started injecting it with positive results. so things were good. about halfway through i noticed some stinging at the injection site. i thought i was getting infections. it just continued and there was no infection. the next day i would wake up and do the injection and it would still stand. i had months of experience with this drug and it did not happen. i needed to ask my pharmacist, but it was the holidays.

this drug comes in sterile water and white powder. then you mix it and inject it. the second batch did not stand but the amount of water was not always consistent. -- the second batch did not sting. i thought it was not alarming but a little odd. this time i went to my pharmacy and asked for my pharmacist and said i had a stinging. any idea of what is going on? what is happening? >> he casually said you should go home and check. huge -- you could have gotten some of the fake stuff. i was sure i did not understand what he said. i probably looked surprised. he explained there had been a recall and what was on the shelves had been sent back, but

i should check for myself to see if i had received the fake stuff. i got on the bus and went home. i went on line and found an article that said this drug had been counterfeited and found in major pharmacies. i immediately took some boxes of stuff out of the garbage and scrutinized and found there was a box with some darker ink, and one missing a symbol. i came up with three groups of madison. -- three groups of medicine. on the web site from the manufacturer they listed a lot number that was counterfeit. i matched one.

they said to bring it in and we will make good on it. they said there is this other batch. they just said bring it in. so i immediately called my doctor and insisted i see her right away. as soon as i got there i told her what had happened and she said we need to know what you injected. what was it? i said, i don't know. she says, that we need to know -- she says, we need to know. what did you and jack? is it something dangerous? if it was, we need to do something. i called the manufacturer and they said we cannot say anything because we are cooperating with the investigation done by the fda.

i called the fda and they said sorry, we cannot say anything because we are in the middle of an investigation. that week started a nightmare. i had this image they put hepatitis c in those vials. i made my doctor test me because i was so afraid that is what happened. i had no idea what was in those files. -- what was in those viles. that led to months of this, and then they discovered there was a second batch. six months later i found out what was in those badges. i had injected in one batch a low dose of a growth hormone

probably produced overseas. someone with no and mean system does not want to hear the word contaminant. the other thing i inject it was the hormone -- the other thing i injected was the hormone women inject during pregnancy. i gained an appreciation after day for a bath everat month. why i would suddenly burst into tears during hallmark commercials. [laughter] i was a real iraq for a while. -- a real wreck for a while. i found out what it was. then i needed to find out how?

it turns out it is distribution. i know you will hear more about that today. it is a very complex issue. i found out about it through a book called "dangerous doses." it helped me along and in talking to other people and finding out what that distribution issue was. then i wanted to know who are these people? i met some of them in a trial in las vegas. i saw them face-to-face. this was a year after. all those feelings just came back. to hear these guys walk in and i thought i was passed it, and all these feelings came back and disbelief that there are people out there who could put medicine out there for people to take that was not real.

it was not the madison i needed, and something potentially dangerous -- it was not the medicine i needed. they just did not care. at the end their company was penalized and they would not be allowed to open up a company again in nevada, but they still walked out and got in their cars and when home. it was very upsetting. their primary distributor was a group in florida called the walkers. they were this couple, and gary who is a character in the book knows this story intimately. the walkers, these are bold people. they had a company called re

ckes. they handle the drug that i injected. reckes is soccer spelled backwards. -- sucker spelled backwards. these people are really bad people. why did they do it? you will hear more about that, but they make a lot of money. these guys got to walk out and there are some penalties for them, but it was years later before they had to do anything or face anything, other than the fact they could not open another company. i watched an episode of the "sopranos," and there was a plot device. tony soprano says you have to meet with the canadiens. he finally meets with them and

they say we need some people laughed. as says come up -- need some people whacked. you can sell this drug and make a lot of money. it expired but you can make a lot of money. i was traveling through the rocky mountains and stopped at a pharmacy, picked up my prescription of lipitor, and a week later there was a massive recall. thousands of units being recalled. i am pretty good at counterfeits at this point. i have a handle on this. i get the lot number and know where the fda is. i get the number and expiration date and go to my bottle, it is a brown bottle with the number of bills and pharmacy label.

i don't have the original packaging. the pharmacist did not write the expiration date on the label. i don't know what the chances of getting three counterfeits are, but i already received two counterfeits by two sets of bad people. i still have that bottle of potentially counterfeit lipitor at home. i called my doctor and said i am sick. she told me what drug i needed. i am not even in the u.s. and i need medicine. i went to a pharmacy and got the medicine. then i went to the other side of the city and bought the same medicine. then i scrutinized it for hours, and i felt they were exactly the same i took them. i hoped they were not

counterfeit. what am i doing here today? who am i with? me. i am here with me. why, i am hoping as we get through the panels and talk about things in percentages, which can be really overwhelming, that you still remember ultimately what we are talking about are individual people. it is not a plot device in a tv series. this is a real thing that happens to people who walk into their pharmacy to get their money -- to get their medicine. it happens to us. so it is a real problem, and we need to find real solutions. i am thankful this partnership has brought people together today so we can look for those

solutions. thank you. [applause] >> that is a tough act to follow. for 30 years, i have been an investigative reporter, an in- depth investigative reporter. what that means is i don't chase scene in stained dresses or the scandal of the day. i don't want to be part of the wolf pack fighting for my scrap of meat. i gravitate towards the topic that tend to be off the radar screens of other reporters. i prefer this because it gives me time to think and to dig and to think and to come up with stories that when people read them, they will read them. you might say i aspire to be the

alice waters of investigative reporting. slow food, not fast food, fresh ingredients, not recycled. admittedly, in this age of instant news and opinion, you might say my fate may not look very good for the long term. but i have been challenging conventional wisdom all my life. in stories, particularly. it was about a decade ago that i got a call from a public servant i truly admire. the head of a state pharmacy board, of all things to said there are babies dying in haiti and no one gives a damn. david gave a damn and even though these babies were not dying in his state of north

carolina, he cared. and i cared. i decided to do something about it. the conventional wisdom, again, was that this was a story nobody cared about. everyone knew haiti was a last stop on the road to hell. what's a few more bodies? i'm a pretty stubborn guy. when my overseers at "60 minutes" where i worked at the time expressed the feeling that this isn't the right story for you, i'm too stubborn for that. i decided i was going to do this. i was going to be like david and i was going to pursue because no one had pursued it. my correspondent went to martha's vineyard and i went to haiti. i would have at no other way, i should tell you. i fell in love with place.

what i discovered is some of the more horrifying things i have ever uncovered as a reporter. mothers were giving their babies poison. they thought they were giving the medicine to make them feel better, but it was poison. when they didn't feel better and they got worse, they fed them more and more and they died an agonizing death. i went down there and i'm standing in the middle of this and i'm thinking why am i the only guy down here? people know about this. someone needs to do something. i can begin to tell you how heartbreaking a was to be interviewing those mothers. what had happened was some entrepreneur had figured out a

way to make more money by substituting a safe ingredient, by substituting an unsafe ingredients, antifreeze in essence, which mimicked a safe substance which is commonly in madison and household goods. -- in medicine and household goods. i discovered that kind of thing had been going on for decades and very little was done about it. so i had the heart break which is an important part of the story -- to get people to care, i had that. now i had to figure out who the perpetrator was. that was not easy. that is when i came to learn about the global supply chain. our previous speaker talked about the supply chain in the united states. i was learning about the supply chain globally and outworked and who the enablers work.

the enablers turned out to be people and entities you would not expect -- governments were and they rollers. -- were enablers. institutions, it continued to happen and alternately, with the help of a very courageous debbie commissioner of the fda, i was able to figure out where the path led and that path led to china. i remember the deputy commissioner on-camera saying if we don't do something about this, this is going to happen to other mothers and other babies and other people. we must do something about it. even findt, you can

this in toothpaste. 10 years later, everything she says turns out to be true. it did and up in our toothpaste and it did it end up in madison. 10 years later i was in the "new york times" office reading an article bought all of these patients that are dying in panel of. the article said they were dying and it was unclear why, but it was probably just a mistake. some kind of error. i'm thinking it was not. your not going to have an error like that or you put antifreeze into madison. it's not like you have a factory where there's one pot of medicine and one pot of poison and a little bit fell over and it ended up in the madison. -- end up in the medicine.

i convinced my editors to send me to panama and off i went. i discovered it was in fact the same ingredient that ended up in the madison in haiti that had killed all the babies. -- the medicine in haiti. it led me on a path to china. once again nothing seemed to happen. nothing happened in the 10 years in haiti. why? people have other priorities. governments at the priorities. the united states government had other priorities. it's not like our health officials, our government didn't care. they did care. they tried to do something about it but china was a big player on the international stage and there was only somewhat pushing they cared to do. the chinese did not care. these were not there people that are dying. i'm not sure why they didn't care, but they didn't and

nothing was dead. 10 years later, it happened again. as i discovered, it happened in other places around the world -- nigeria, bangladesh, india and happened in the 1930's in the united states which led to significant reform, how we oversaw and regulated drugs. while we recognize the problem in this country, it continued around the world. but there was always the feeling that it could never happen here. so yes, we care because we are a country for the most part of caring people. we don't like to see people suffer. i believe that, and there remains much to be done. i think it all came home to roost when the toothpaste issue

came in. it turned out antifreezes being put into toothpaste by the chinese and sold all real-world. some of that and that in the united states. when that happened, people did not die, but it did grab the attention of this country and government officials in a way that the other stories have not. off another reason for the attitude change and another reason we're having a meeting like this today, i want to believe, is because what happened when happen. it was another kind of counterfeit ingredient. it ended up in this incredibly important drug that so many thousands of americans use and depend on to live the next day. it turned out there was a counterfeit ingredient and that and it came from china to. i am happy to report that things have changed, given even those

incidents in the last 10 years. initially, the pharmaceutical industry was very reluctant to cooperate with me. i could not yet from calls returned. they are in a difficult position. they understand there's a problem but they don't want to undermine confidence. on the other hand they're worried about counterfeiting. they have come to the conclusion that there are opportunities when you work with reporters to publicize this and not scare the dickens out of people but to do the kind of work that will lead to the kind of reform that will make our drug supply chain safer. the united states is paying much more attention. i can say that china is paying more attention. i believe they are. they did execute the head of the chinese fda. that was not my intent when i

got into this story. [laughter] but it is now the standard for that. if there is not an execution, don't apply for pulitzer prize. [laughter] things have changed. the media is interested. the government is interested in doing more. that's why we are having a meeting and i hope 10 years from now i'm not standing up here telling you another sad story about people dying from bad medicine. thank you. [applause] >> thank you very much for coming to a very important meeting. i often look for an opener to

begin my discussions and last night, i was standing outside the hotel before the speakers dinner and i was on the phone with my son, a young family physician in florida. i asked him what he was doing and he said that i'm just finishing grounds and i'm heading home and going to have dinner with the kids. i told him i was a car -- a conference in washington d.c. he said counterfeit medications? there are such things? isn't that illegal? i said what you talking about. i explained to him and said nobody ever told me, a physician treating patients and writing prescriptions, counseling and talking, that there are such things as counterfeit medications. part of my discussion today as we should be telling people, physicians, pharmacists, consumers. part of my question is why are

we telling people? i think i hope stephen banner. that's not me. that's not me. that's not me. i have to go the other way? there we go. how did we get here? counterfeit madisons and unsecured drug supplies have been around for a while and have been practicing since 1973. i'm in the unique position today of not being a pharmacist or university professor, not being a former industry guy but being a consumer advocate. i represent the men's health network which is an interesting

thing to do. at the pharmacy and late man adam, we would come by every week or so a couple of brown shopping bags full of stuff and he would bring them back and vinny would say what every that today? we would go back and do things and every junior was saying numbers -- shaving numbers. counterfeit drugs have been around for a long time. if you thought was bad 1973, you should hear when sol was running the pharmacy a couple of decades ago. the counterfeit drug supply has always been around and has always been a difficult problem. but i think it's exacerbated by many of the issues we face now. one of the fundamental reasons we are in the pickle we are in is become modernization of pharmaceuticals. it's amazing to me that people

pay more attention to what they feed their pets and guys may -- guys paid more attention to what motor oil they put in their car and where they get it from than they do the medicine they put in their body. as we to new -- as we continue to come monetize modern miracles, these products, we have driven down the value proposition to the point where it's like a can of peas. unfortunately, i think. pharmacy has had its share of doing things like that. in efforts to be consumer advocates and to be -- they have spoken of what about the cost of products but they are forgotten one of the reasons the american farmers' association was founded. that was to protect the integrity of the drug supply in

the united states. thisf the reasons we're in commodity business is the dynamics of the market. also those who have the ability to inform consumers that family physicians about the integrity of the drug supply of not focused on the complete message. overall growth of the internet -- not going to tell you anything you dealt know. not just the internet -- there are formal and informal drug supplies all over the world. you know the reasons for this better than i. anonymity is one. when i was at pfizer, we knew have time that viagra, which i was on the marketing team for would be counterfeited. we wrote into the package in sure that people should not be receiving this without an adequate physical.

we were so afraid of internet distribution, so industry is aware and we have tried very hard to deal with it. the controlled substances issue is huge. lipitor, go up and down the spectrum of regular madison everyone takes, its ubiquitous. while drug supplied from manufacturer to farmers itself might be -- pharmacists shelf life be more secure than an adult other countries, when you get to the internet, is the wild west again. supply an informal drug and alice struck by some of the comments i heard earlier. there are organizations that want to care for the underserved were working very hard to coordinate supplies assembled products that they receive that

low-cost, no cost ed redistribute them to the underserved population. it's for counterfeit and poorly stored medications. it seems to me it could be. we have a global economy and global traveling public. when you hear stories about the folks in haiti or you hear about folks in developing countries, they come to the united states and may bring their medicines with them. they shipped things back and forth. there are many ways medicine gets into this country and it is a very porous system. i was struck by comments about drugs causing resistance in other countries. those folks come here as well.

it's not just the internet that's an issue, it's lots of secondary, tertiary and other supply chain issues that make this a growing problem. i think there is a perception that as the old folks are searching for cheap drugs to overcome fixed-income issues, i was amazed to see 30% of folks who surf the internet -- and these are 2004 statistics. about 30% of them are 25-44. that was amazing to me. maybe one or two of you are amazed by that. its poor people and folks who cannot afford stuff. these are 2004 statistics.

i'm surprised would be -- i would be surprised if it wasn't more than this now. 20% of the people to get drugs from the internet make $100,000. is it really cost or is it the perception of the modernization that drives them to do it? one other set of comments -- i found some out calls -- i think i can read this from my cheat sheet. those indian drug manufacturers are actually u.s. drug manufacturers with branches there. this is from newspapers about why people get drugs from alternative sources. this was published in 2010 in the "arizona republic." you can afford the that medications in the u.s., but there's no reason you should spend the same money we'd go

down there to get. this is a problem. little medication. i go to the caribbean and my wife walks into the pharmacy across the border and picks up some stuff and i scold her and she says ago, stop it. she knows the value proposition is gone for her. this safety proposition is gone. no one has told her there are going to be problems in the way it resonates with her. i can't get through to her, maybe you can't. the family physician refers many of his patients to canadian pharmacies that serve them -- as save them a lot of money. the medical community -- i don't know if this decision in arizona

is properly informed, but i don't think so. it's stunning to me that they are engaged in a campaign -- this goes way back to drugs that predate the act. still, there are drugs that continue to be on the market. i think the fda is moving to remove it. but there remains unapproved nitroglycerin tablets because they have been grandfathered in. without a dossier, there's no quality control. so there are problems. it's amazing that this extends to the american college of rheumatology. they say we don't need the bureaucracy of the fda to file

dossiers. it's unfortunate somebody followed the -- some refiled the dossier because it's going to cost a couple of dollars a dose or a few hundred dollars a year. we believe it saved plot by the pharmaceutical industry to jack up prices and we have no problem with the unapproved drug being on the market. i don't know that organized medicine is standing by the notion that there is some potentially strident problems with the u.s. drug supply. in fact, there is evidence they are tacitly ok with it. i know i'm going to get in trouble for that one. i'm a consumer advocate today, so that's all right. i also the vice chair elect of the caucus on men's health which was just formed this year. just this year, the public health association this year

decided men are a population. know that any of the associations have spent -- i know they are presses resources, talking with the public. it befuddles me. do they think the drug market supply is secure? i don't think that's the case for any of the pharmacy organizations, but by and confused as to why they have not brought that out loud and clear and talked about the need to manage the appropriate costs and don't talk about the importance of obtaining that some from validated suppliers because you put yourself at risk if you did not. i don't understand that. what the do? you don't just want to dump the trail on your doorstep and walk

away. i was thrilled to see on tv a few weeks ago, and ibm at that talks about rfid. so i'm happy to see that kind of advertisement and hopefully some of you know where and talking about. they talk about how ibm, through its technology is helping to protect the precious supply of medication in america. the american medical association has spoken about that. there's a marvelous effort. why isn't this everywhere on every pharmacy in america, talking about the importance -- the internet is here to stay,

it's not going away, it's crazy to think so. we're not going to get the 20 some things that aren't going to get the -- getting their medicine through the internet. we're not going to stop the internet. we're not going to stop consumerism. so why are the signals much more prominent? why is my son -- nobody told me. my brief closing comment as professional organizations, manufacturers, need to work build more strategically to bring that message out so somebody tells them. thank you. [applause] >> how are you all?

i'm very honored to be here with my esteemed colleagues, some of my known for quite some time. -- some of them i've known for quite some time. i had the good fortune when i lived in washington to volunteer as a pharmacist with the whitman walker elizabeth taylor classic. i'm happy to see you here today. you are one of the types of patients that love the most because you know your stuff. thank you. i think i understand the up and down but now. i put some slides together because that other are a variety of people in the audience today and am wearing my pharmacist had as a 30-year member of the american farmers association. i'm sure when we get to the question and answer fortune, i can speak a little bit about a lot of things. but today i want to focus with my pharmacist hat on and talk

about who is getting hurt by the continued existence of counterfeit drugs in the u.s. market. i would submit everybody is getting hurt. it's not just patients like rick but health professionals as well. when it comes to the pharmacy community, patient safety is why we excess. when we have medications that can be sub potent or say things that might hurt somebody in some of help them to the point of walt's experience, that compromises our experience to practice and gets in the way because obviously an investment in a medication is worthless if we don't work with our patients to make sure they get the intended benefits. i will say in the 10 or 50 years i have been involved in this issue that the dynamics of that

have changed lot. the concerns may be different as i continue to practice pharmacy for an independent and chain and relief work in other settings, i may lead to buy prescription supply chain a little differently that i like to buy over-the-counter supply chain or diet supplement chains. there are different issues for each of those supply chains. i believe in the last five or six years since this issue really pop, that business practices have changed significantly in the united states, making counterfeiting a different problem that might have been five years ago. when i met auditor, i'm an auditor for eight company, hired to go into the distribution community and we ought their practices. it is very different that what i

wanted to buy first warehouse. what concerns me is they have changed in a way -- it's almost more nefarious. they are harder to get after. i think that's have increased. we find more involvement with organized crime. you are seeing some global concerns that maybe we did not have five years ago. to me, how do i keep my arms around it? one of the things i do what i worked at many pharmacies -- i don't go to one particular pharmacy, so it's kind of fun. i tried to raise the awareness of the other pharmacists or technicians i'm working with. it's interesting because the interests does vary. i'm excited because our association has been doing a

lot. they have not let the issue go. they have continued to be vigilant with the education that is so necessary. we have continuing education pieces designed for pharmacists. we have been talking about this issue and i'm excited because just recently, our national magazine or journal has started a column called what's in the bottle? i like it because it is getting at some of these more difficult pieces of this issue that we have had before. the issue in september had a column on the perfect crime. it talked about several manufacturers in the u.s. and there was another article on fakes in the pharmacy.

how do they get into the system? what do you do about it? that will be an ongoing feature and i think maintaining awareness is important. business practices that prevent integrity are key. i think examining products -- educating patients, i can't say any more than rick. i just want to quickly address that -- i say the biggest thing a pharmacist can do is if they are offered a deal does seems to good to be true, it probably is. it really is that simple. there are many things pharmacists do and there are guidelines for product distribution.

i think that's a key part of the efforts to help distributors' practice appropriately through standard operating procedures. as a pharmacist, i want to know the relationship have -- to they follow these guidelines? critical they outline the procedures that those sources have in place. there is the wholesale certification from the national boards of pharmacy. it's an important certification. if it is too good to be true, it probably is. trying to only by what is needed rather than trying to stockpile is critical. when you look at the product side, what do i do when i go led

to the pharmacy? i'm amazed when i sleep at night that all across this country, distributors are packing a billion items and it's going to be a my pharmacy the next morning at 9:00. that doesn't mean he can't be vigilant. you need to physically look at product. as the label look different? what did the boxes look like? as a look different? if we change the source of supply, which does happen, more often on the generic side of the business, we have changed who we're buying from, if we get a product that is white, it might be grain and that's a key part of what we can do. when you dispense the product,

take it out of the container and that's another example. that's one of the things that's happening in the pharmacy community. there's a lot of the interesting work flow systems that have a physical picture of the product so while we are going through the dispensing process, i can't open it and check and see if a look like it's supposed to. there have been good systems put in place to do that. keeping track of old bottles and containers is a key part of it. these things should be recycled carefully. we should not just throw them out. opens an opportunity for someone who has less than honest intentions. listening to patients, i think rick's story is profound. i had that happen where patients come to me with medication may have received over the internet or mail-order or another

pharmacy and they are concerned they don't have what they think they should. it has happened to me several times in the last five or six years. it is america a pharmacist month. i think this is an opportunity to educate our patients about medications they are taking. i'm amazed -- i think he's a motivated patient, but he knew how much was in those files. many people at the medication as a commodity. how carefully they check? it's key that we work with their patients to do that. providing patients with a personal medication list as a key part of where we're trying to go as a profession. encouraging patients to double check their medicine and finds

-- call the pharmacist with a fides of the wrong. whenever i work at a pharmacy where we changed a source of supply, if you got one brand of generic or another, i put of a sticker to help the patient know. there are consumers and interested parties to this issue. how many of you here know the name of your pharmacist? not many of you do. this is even less than a poll we did five years ago. 40 percent side of patients knew the name of their pharmacist. how many of you know the name of your veterinarian? everybody knows their dentist or doctor and even their veterinarian or hair dresser. but you don't know your pharmacist.

when you leave today, that's one thing you can do personally when you walk out of this room is co by doubt what's the person you've been getting your medicine from, what is the name? it's an opportunity when i work relief. you need to let consumers know that there are risks out there. i like to think we have the safest supply compared to other countries in the world. but that's for a reason. laws and regulations can change to make it less safe and i think the internet is critical. we have been involved in an initiative in minnesota -- they will be using the label to educate people about the dangers of buying drugs over the internet. i think that's critical.

sometimes patients come to us because they get a good deal. one of the things we tried to do is help people who have access issues. if you cannot afford or madison, there are ways we can work with you to do that -- if you cannot afford your medicine. i encourage those of you who are reporting to take this to the consumer audience. are things getting worse? looking at unanticipated events, if you are using injections, the thing -- the stinging at the injection site is a big red flag. to report any of those reactions to the pharmacist -- making sure patients know what they are taking and what they are supposed to do and any

potential side effect, double checking madison to see if it looks, smells, or taste different, trying to develop that relationship with the pharmacist so that we have a complete medication record. i hope as we move forward, developing the electronic health records, that will help us do that. finally, one of the key things i talk to patients about is it is a big risk. you want to gamble with your health, do that if that is what you want to do. when we run into problems, we what pharmacists to report them. if i find out there is something that looks suspect, i can report it to the fda. i can notify the product's manufacturer, which i think is key. i wanted to give you a picture

of the web site to do that. did i go the other way? there you go. with that, i am looking forward to a stimulating discussion and thank you for your attention. [applause] >> how am i going to know the name of my pharmacist? how am i going to know the name of my pharmacist when he is filling between 608 hundred prescriptions a day. he there -- he barely -- between 608 hundred

prescriptions a day. i'm not sure it's a male or female. how do i get a personal relationship and this individual? >> i would find a pharmacy where you can do that. really. there are different places and from practices. if you can not engender the attention of that individual, i will encourage you to go elsewhere. >> i graduated from pharmacy school in the 1954. i do have some experience. how about the others that don't understand this new go to these places and don't get to see them? with the state's permission, they have three tax. there is one pharmacists' supervising three tchs. this is where organization should get behind there

something that should be changed because people are being shortchanged. >> i appreciate your comments. >> as a pharmacist educator, i teach a day school of pharmacy and i teach professional practice and communications. the answer to that is demanded. patients have a right to information. they don't demand it and the pharmacy has not told them we must council. i'm disappointed in the profession. consumers, if it sought viewed as a commodity and it is viewed as an important medical intervention, you should be demanding that attention from the pharmacist. >> i have lots of hands up here.

>> you talked about your son being a physician and knowing very little about counterfeit drugs. do the pharmacists' get any training about counterfeit pharmaceuticals? >> not in my university. i can't speak for all of them, but maybe on the -- may be others on the panel might. not at my university, i am chagrined to say. >> at the university of texas, they get plenty of training. >> say no more. >> they get 10 lectures or more on that. everything from supply chain integrity to worldwide to honor fed problems to lectures to serialization of the numbers, all of it. >> i teach at the college of

pharmacy. the pharmacists at the end of that chain -- [unintelligible] when they have to buy readers and disrupt their normal business practice which could take time and so forth. how long is that bottom to get involved? >> i will take a shot at this. the equipment to read in the technology is not all the expenses. it has been estimated at less than $10,000. it actually save you money in the long run because you can

walk into the back door with a carnival drugs and we will read the mall industry -- read the ball instantly. it can credit your system of the inventory, says all like scanning in bar codes. it's very efficient. the problem is if you did it come as a large quantities of the drugs we use in the u.s. as opposed to mexico. if we want to from packaging, we get all its different and quantities of 30 or 60 that are dispensed. but pharmacists by them in hundreds or 2000's and that makes it more difficult. if you were going to change that overcoming acosta is tremendously higher. high ceilings the direction we're going to go. where going to go of the -- i think that is the direction we're going to go in the future.

i think we're going to go the european direction. >> you have to look at the cost- benefit. you have seen cross-pharmacy in the last decade, you seem wholesale change in the kind of systems we use in the store and the practices with our coding and work for management. there has been a huge shift in 10 years. it requires a lot of parallel processes. because this is across the supply chain, it requires a lot of partnership. it's not like we can implement it at a pharmacy level. it has to be at the manufacturing and distribution level. it's an intensive process with a lot of moving parts. >> many of the wholesalers are on the system now. >> and from the u.s. department

of commerce. i wanted to ask the panelists for some of their views. this discussion raises issues about globally -- the united states and developed countries, there's a problem with counterfeit medicines. once you get outside the united states, the problem is far greater. you don't have the same sort of distribution system. many places rely on street vendors, not pharmacists. public awareness because more of an issue. the partnership for save medicines has been doing great work in that. but i would like to get some input on some of the best ways to deal with this in foreign markets where you don't have the same type of pharmaceutical distribution. >> to is going to try that one?

>> this is with my reporter hat on. by no means will i ever get near a pulitzer prize. but i do report for a magazine and i go to a lot of trade shows. one of the things that struck me at biotechnological beating in may, i went to a panel on counterfeit medicines. i went because they were addressing a globally. i was astounded. one panelist who was very active in the u.s. back in the day -- there was a gentleman who was the senior vp of global security for genzyme. it struck me that when they're developing medications for people in globally, how much this planning for potential counterfeiting has to be part of

their whole product life cycle management and the relationships they have developed internationally with regulatory agencies said the enforcement agencies, i was stunned. many manufacturers to operate on a global basis have this very elevated part of their business strategy now. the second thing i would observe is when you create an economic incentive for someone to make money, somebody will step into that vacuum. i don't know when it will happen, but we are going to be to start addressing some of these global questions about the value and price and things of that nature. there have been some good meetings at panels on that. it has to happen. >> their need to be prosecutions.

there are daddy. i can get a chapter and verse country from country where this has been uncovered, where people are trading in counterfeit goods and almost never are they prosecuted. that has to be a component. we cannot force countries to prosecute people but we have diplomatic relations with most countries in this world and we need to use our influence to make sure law-enforcement authorities respond to these situations because not all the are they hurting people in that country, but as we pointed out, they add up hurting in this country as well. that is at a important component. >> there was something interesting in the paper two weeks ago where are fda call that china for not investigating and prosecuting the people who adulterated the

madison. they said the chinese never went after them -- adults raided the medicine. now they are forcing their hand to see what they will do. that would be good news. >> the question i have goes to the changing relationship between physician and patient. the pharmacist obviously plays a role in in that. a lot of the work we have done that in the developing world, that relationship bypasses that. the patient is becoming the purchaser and prescribe burbank and analyzer and the doctor and all those other components which is great for that information capacity, but maybe not in terms of the diagnosis. could you talk about how that could be adjusted, fixed or

corrected? >> this happened in minnesota. we have an individual who chose to test the system. he was one of the largest internet providers of medication and quite in the face of authorities said he could do this. he was successfully prosecuted. he was 25 or 30 years old and many people in our state were killed ordering medication. it led to the passage of a lot in minnesota which eventually became a national model in terms of describing the kind of relationship he needed to develop a patient in order to prescribe and get medication dispensed over the internet. i think some protections have been put in place to do that. but how you go after people who simply do not want to talk to you about their medication needs

because they are embarrassed? it is backed to trying to build relationships. will you be successful with someone with an addiction issue, i'm not sure. >> we will take one more question. >> i see periodically a lot of anecdotal information in terms of the impact of counterfeit medications in the united states. is there and deep -- is there any entity or agency trying to collect that information so we can get a better idea from a quantifiable standpoint? >> there are too data sources. the fda is one. that information is sketchy at times. it is not up-to-date and it's very difficult to dig it out of their website. the other information on the

extent of counterfeiting is the pharmaceutical security institute. that's a great source of information globally. it does cover north america and the united states. as far as casualties or problems with the drugs or patient problems, i don't know of a source that documents that. does anyone in the audience know? >> i am unfamiliar with a source that looks at it. >> they try to compile ms. draper articles worldwide. quite often, i will take pieces worldwide and keep count of them. i don't know of any official place where it's done.

they encountered 84 deaths with the one problem at the fda. but its newspaper articles -- i don't know of a compendium of source information. >> this was discussed in -- when the world health organization was working -- in the u.s., when we do adverse event reporting through the met watch system, there is a way to flag that she thinks something is potentially counterfeited. anyone can get the data. you can dump it into microsoft access and find things other people thought might be counterfeit. i did that for a quarter in to

douse made and there were 13 records. then the question is how do you sort out? what happened to the patients? but then when you make a global -- you look at the european union. right now, they are changing their laws on pharmaceutical vigilance because they have all these member states. they are trying to improve the system and that's hard for them. then let's bring in the rest of the world. from the world health organization's point of view, and they'll lot of places, these adverse event reports command and and that city on the floor because you only have a handful of people and the regulatory authority. we are faced with the problem of some people after a lot of trading my report this stuff. but it will go into a system

that is not harmonized. even within countries -- you still face challenges there. then you have to get to the point where you can put it together and analyze it and figure out which things will come back from being counterfeit. when you are dealing with this, sometimes the government say if there's going to be a successful case, you have to bring in a victim and demonstrate all of this kind of harm. if you take it that way and set of focusing on the criminal activity, you will never put a dent in anything. you have to start with the fact that criminal activity is criminal. that's my 2 cents. >> any other questions? shall we adjourn for break?

let's have a break. you've got 15 minutes. we are running ahead? that is great. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] >> this week, on "the communicator's" the fcc on regulating the broad canvas -- broadband, broadband indecency and their home of the fcc. . at's tonight on c-span2 middle -- >> middle of high-school

students -- get working on at your -- "washingtonthe ms d.c., through my lens." >> the winner of this race will replace senator jim bunning who is retiring at the end of his term. this is hosted by several organizations including the northern kentucky chamber of commerce, the kentucky in acquirer and wcpo channel 9 in ohio. >> welcome. i welcome you to the campus of northern kentucky university. for the next hour, i will be

moderating this debate in the kentucky u.s. senate race between democrat jack conway and republican rand paul. when will bring the candidates out in just a few moments, but first a little bit about them. jack conway is a democrat. he is 41 years old. he holds a bachelor of arts degree from duke university and is a graduate of the george washington university law school. his work as a legislative aide and counsel for the house banking committee as well as former kentucky gov., he also practiced law in louisville. in 2007, he was elected kentucky a pretty general, the office that he holds today. his wife and he had been married and they have one daughter and they live in louisville. republican rand paul is 47 years old. he attended baylor university and earned a medical degree from duke university. he is an ophthalmologist in

private practice in bowling green. he is also chairman and founder of kentucky taxpayers united. dr. paul has never held political office. he and his wife kelly had been married for 20 years. they have three sons and live in bowling green. the audience here has been instructed to remain completely silent with one exception. that is right now when they join me in welcoming jack conway and rand paul. [applause] >> questioning the candidates tonight is our panel of journalists.

they are scott reynolds, amanda from the kentucky enquirer, and mr. key from nine news. the debate will be carried out under a format and rules on agreed to by the campaigns. here they are. each candidate will have two minutes to deliver an opening statement. then, the questioning began. each cat will get a 92nd response for each question with the first candidate having 30 seconds for rebuttal. all questions will be at the moderator's discretion. each and it will receive 30 seconds for a response. each and it will then get two minutes a piece for a closing statement. -- each candidate will then get two minutes a piece for a closing statement. >> is up to me to strictly enforce time limits, a job which i relish. the order of the opening statements as well as the

questions has been determined by a coin flip prior to tonight's debate. mr. conway is first. you now have two minutes for your opening statement. >> thank you, clyde. thank you to the northern kentucky chamber and northern kentucky univ. for hosting this debate. this election for the united states senate presents a fundamental choice between what is right for kentucky and what is wrong for kentucky. as attorney general, i have taken on the position of crime and drugs. rand paul has said that drugs are not a pressing issue and that nonviolent actions should never be criminalize. rand paul is wrong. as attorney general, i have tried to stand up for our seniors when they have been skimmed or abused. rand paul supports a $2,000 deductible that our seniors cannot afford. as attorney general, i have taken on pharmaceutical

companies when they lied to us about prescription pill prices. i have taken on the oil companies when the gouged us at the top. rand paul is not believed that those companies should be held accountable whatsoever. in fact, he has even said that going after british petroleum is an american. rand paul is wrong. what concerns me the most is that rand paul has said that we haven't followed the constitution in this country since 1937. that date was not selected at random. that is the year that the u.s. supreme court upheld the constitutionality of social security. i do not know whether he thinks that social security is constitutional, but he has also questioned medicare. he questions medical -- minimum- wage laws. he has questioned the americans with disabilities act. he has question fundamental provisions of the civil rights act of 1964. he has questioned worker safety protection even federal mine

safety protections. rand paul would undo all the we have fought for since the great depression. rand paul is wrong, fundamentally wrong. count on me to protect kentucky. this is a choice between white and wrong. mr. paul, you now have two minutes. >> i am a physician, not a politician. i have been married for 20 years and i have three teenage boys that are with me today. i decided to run for office because i became concerned about the mounting debt. i became concerned because the republicans were doubling the debt and the democrats came into power and they tripled the debt. i became concerned because of the rise in spending. the government became the answer for everything. i became concerned that president obama's agenda would support entitlement programs. i became concerned that president obama's agenda was to raise taxes in the middle of a

recession. i became concerned that president obama's agenda to bring cap and trade to kentucky would be disastrous for kentucky. it would cost us tens of thousands of dollars if not hundreds of thousands of jobs. our vision for the country and america is so much different than their vision. president obama's vision is that government is the answer to every economic bill, to every social ill. our answer is, as ronald reagan said, the government is not the solution to the problem, government is the problem. i believe in the individual. i believe in you. i believe in individual to open doors. i do not -- onto penurious -- business owners. our national defense and social security, those are things that government will do. let's keep it to a minimum.

let's recognize that we are running out of money. as we run out of money, we have to have solutions and we cannot simply stick our head in the sand and say that we will keep passing out checks because that is what we are supposed to do. thank you very much to allow me to come to this debate. >> we will get to the questioning now. we begin with scott reynolds. he will have the first question tonight and it goes to mr. conway. >> before all the political, something a little more personal. mr. paul, you have no political experience and you have radical ideas. for mr. conway, it may be the opposite. here comes another smooth talking lawyer that wants to climb that lock -- that ladder and become a career politician. can you tell us why people should give you their vote as a candidate? >> scott, thank you for the question.

this race is not about me. this race is not about dr. paul. it is about the people of kentucky. they are hurting right now. in a way that i have never seen in my lifetime. families are being ripped apart. they are worried about whether or not they can educate their kids or keep their jobs. i remember talking to a hardware store owner on the campaign trail who told me that his hardware store is paid for but he has been turned down for a loan of 22 times in the past 18 months. 15 years ago, 90% of what he had on his shelves was made in america and now 95% is made overseas. i think about the elderly woman who looked at me and said she was an in -- a retired bank teller and lives on a fixed income. she cannot afford a $2,000 deductible. i think about the mothers who have cried on my shoulders as i travel for eastern kentucky that

have told me how their daughters overdosed on oxycontin. is about people. it is about who would put kentucky first. i am asking for your vote for the united states senate because i want to put kentucky first. i have earned your trust and it is about people. it is not about me. >> my apologies, mr. paul, you now have 90 seconds. >> i think that my greatest attribute is that i never have held office. people who have never been in the business world that do not know how to run a business do not know how to meet payroll. i think that being an ounce after -- an outsider is a wonderful actor do. so often, we develop such bland candidates because they talk in circles and they do not present solutions for the demagogue the issues. i think people are ready for solutions. our country faces grave

problems. they want somebody that will discuss these issues and the other free to present solutions. when people say that this could be extreme, i say that what is extremas what is going on in washington. a $2 trillion deficit is extreme. hundreds of billions of dollars in interest is extreme. if interest rates rise 4% to 6%, interest will consume the budget. we must elect people who will tackle these problems, not people who will simply demagogue them, take things out of context and run on something that is not real or not true. i am proud of being an outsider and i am proud of the things that i stand for. term limits, balanced budget amendment, this hardly sounds very extreme. >> mr. paul, thank you. mr. conway, you have 30 seconds

for a bottle. >> dr. paul says that he is for term limits. he is for term limits, but he told a reporter that he would not apply them to himself. i would say that dr. paul's position on the civil rights act of 1964, i think that is extreme. saying that he wants to do away with the americans with disabilities act, that affects the disabled veterans, i think that is extreme to say that soldiers -- i think that is extreme. >> our next question goes to amanda of the kentucky inquirer. >> mr. paul and mr. conway, both of you have said that you are concerned about the federal deficit and that we need to reduce spending. will you tell me three specific ways you would cut spending if you're elected? >> mr. paul, your response. >> first, we need a balanced budget amendment to force them

to. both sides have proved themselves and work -- untrustworthy. we will be forced to make the -- difficult decisions. in kentucky, we have a balanced budget amendment and we have to make decisions. that is what we need. the second thing is we need a compromise between republic tens and democrats that republicans and democrats. we cannot make entitlements off limits. we cannot make discretionary spending off limits. the entire budget has to be looked at if we are serious about balancing the budget. we have unspent tarp items and unspent stimulus items. we have $100 billion and accounted for. the list goes on and on. we spent 2.6 million last year studying why pigs stink. the earmarks are outstanding. do not give me three, did a thousand that we can list. the waste goes on and on. we have to start the real cost

the will part of the insert is that they have been undependable. they have declared everything an emergency. within three weeks, everything was an emergency. rules will help the system. we need rules that say you have to balance the budget by law. >> mr. conway, you have 30 seconds. >> rand paul's solution will not help us in the short run. to pass a constitutional amendment, it will take years to pass. we have to get about the business of balancing the budget. this is an area where rand paul talks the talk, but he has not walked the walk. as attorney general, i balance my budget eight times in the past few years. rand paul says that he is going to balance the entire federal budget next year. he is just not going to tell anybody how he will do it this

year. if you balance the federal budget next year, you will end up cutting 40% in spending. if you receive social security benefits, your average benefit might go from something like a lot hundred dollars down to $700. -- like $1,100 down to $700. with the proposals i am talking about. i am talking about allowing medicare to purchase in bulk, to negotiate prices just let medicaid and the v.a. can. we need to attack medicare fraud. i support closing these offshore tax loopholes and special interest provisions that allow us to shift our jobs overseas to places like china. we could save $130 billion there. i support a bipartisan debt commission. those are five specific steps right there. >> mr. conway. thank you. mr. paul, you have 30 seconds or bottle. >> if you are serious on

balancing the budget, you have to set rules. the rule goes a long way. 32 states have a balanced budget amendment. we do not know whether it takes or five years. if the country is up in arms and goes for this, we could pass it. we could pass it like we pass term limits on the president. we passed it relatively easily in the early 1950's. in regards to term limits, he is against term limits completely. i am for mandatory term limits. >> all right, mr. paul, thank you very much. >> amanda, you have a follow-up question. >> can you be more specific about what cuts are needed in spending to help balance the budget? >> we mentioned $200 billion left over in the top fund. -- tarp fund. we should make private workers .

we spent $120,000 for the average federal worker. let's bring that in line with private pay. let's try it the federal work force. i think there is an enormous amount of solutions. >> all right, thank you. mr. conway, you get 30 seconds to follow what -- to follow up. >> i am looking for the specifics on balancing the budget. he supports a $2,000 deductible for medicare. that seems callous to me. he has called social security a ponzi scheme and will seek to privatize it. i will never balance the budget on the backs of our seniors. >> tom now has a question for mr. conway. >> farmers throughout the commonwealth are concerned about changes coming in the estate tax or the death tax on january 1 with the million-

dollar exemption. with agriculture so important to -- to the kentucky economy, what can you say to kentucky farmers about this issue? what i understand the commonwealth of kentucky very well and i understand that we have 80,000 farms in the commonwealth of kentucky. i am a kentucky democrat. i have broken with my party when a profit. i have taken on the pharmaceutical companies. i have taken on oil companies. on the issue of taxes, i am not like typical democrats. i have said that in a time of recession, it is not a time to raise taxes. s.t's extend the bush tax cut small family farms and small businesses throughout the commonwealth of kentucky need to have some assurance from the federal tax code that they can pass down a family business or passed out a family farm to the

next generation. -- passed down a family farm to the next generation. farmers want to know that the department of agriculture will them. my opponent has said that he favors abolishing the federal department of agriculture. if you abolish the federal department of agriculture, you abolish a sustainable for a comedy from your to your -- system will economy from year to year. rand paul is trying to pull one over on you. three-quarters of the farm bill goes to school nutrition programs for it that is 500,000 kentucky kids on free and reduced lunches in public schools. i am not for that. >> mr. paul, you now have 90 seconds. >> is hard to find out what his position on the tax. he was for them before he was against them before he was for them. he came out and told the press

that he was for bringing back the death tax. he was for bringing back the estate tax. he was one to have a few exemptions and it would not be quite as bad as what we have before, but he believed in the concept of bringing back the death tax. in a major paper in our state, he told them that he was for letting the majority of the bush tax cuts expire. i have no earthly idea what his real position is. kentucky cannot stand to have this kind of ambivalence. you need to know where people stand. i have taken a pledge to permanently repeal the death tax, not for a year, or two years, but permanently repeal it because i do not believe you should tax people simply for the act of dying in regard to all of the other allegations, all of these imaginary positions come forward. getting rid of the department of

agriculture is not my position. i never said that. these positions come up because he wants to run against something but he does not want to run and talk about president obama. he does not want to talk about his support for president obama and all of president obama's initiatives. that is what this election is about and he is trying to run away from it. >> mr. conway, you have 30 seconds for the bottle. >> not only is rand paul -- in 2002, i supported president bush's tax cuts and i am for extending them now. i am not for extending the special interest provisions. the tax cuts that send our jobs overseas. i know that he wants to talk about president obama, but he is want to have to say that a bunch to catch up. >> just a reminder, we are encouraging you to remain

silent so that this process can proceed unimpeded. >> scott has the next question for mr. paul. >> mr. paul, congress has done -- has tried to make it easier for businesses to get loans to purchase equipment. i talked to a couple of business owners that said that they do not want the loans. they are not buying the equipment right now. they are worried about taxes and added regulations on their businesses. what is going to get the unemployment rate back down to the 5% and 6% level? >> the first thing that we have to realize is that we're doing the wrong things. it has been called an uncertainty premium. they passed a bank regulation bill, which jack is for, with 533 regulations on kentucky banks.

the banks that failed were fannie mae, freddie mac and bad policy by the federal reserve. they hate all of these regulations on banks. that is making it harder to get a loan. obamacare, 2500 pages. nancy pelosi says that we can read it after it is passed. how appalling. once it is passed, it is not done for. they will write thousands of more pages of regulations. regulations cost businesses $1 trillion. you wonder why businesses go overseas. we tax them to death and we regulate them to death. we have the most business on friendly association have ever had. this election will be about do you want someone to support this president and his plan or do you want someone who will support the market place. support the individual. support capitalism. support freedom. that is how we get jobs.

send less money to washington and keep more in kentucky. >> mr. conway, your response. >> this election is not about president obama. at this election is about jack conway versus rand paul. do you want someone that understands that our disabled but -- what our disabled vets need? rand paul is wrong on a lot of issues and he was just wrong here again. he said that no banks failed in kentucky. that is not true. on top of that, a number of them got tarp funds. there was not enough accountability in not for me. when they say to give us money and give us money, there is no accountability and you cannot look at the bonuses that they took. that is outrageous. here is what happened, scott.

the government bailed out a bunch of big banks on wall street. they came down really hard on our small community banks. it is the $200,000 loans that the small community bank makes that is the lifeline to people like my friend, the hardware store owner. the thing that is troubling about rand paul is that he does not seem to understand the concept of accountability. it is ok to have bailouts, but those banks that were too big to fail have gotten even bigger and now rand paul does not believe in holding them accountable and he does not believe in preventing abuses in the future and he does not believe -- >> mr. conway, i am sorry but i have to interrupt. mr. paul? what do you know who the chief law enforcement officer is in kentucky? drugs are a bad problem in our state. they are getting worse. he has been raking in so much campaign cash in california, he

has not been able to do his job. methamphetamine labs have doubled. prescription drug abuse is up. we have five counties where the average person in the county has for narcotics prescriptions. >> mr. paul, i will have to interrupt you as well. >> command as the next question -- amanda has the next question. >> kentuckians have benefited from a local voice in jim bunning who secured funding for northern kentucky university where we are tonight. if elected, how would you work to protect northern kentucky's interests? would you be an advocate for nku? >> i think he for the question. before i address it, i want to

point out that the allegation that dr. paul just made about methamphetamine labs going up, that is disrespectful to the kentucky state police. they are the ones that have the ability to go after methamphetamine labs. one of his friends try to put up an ad with those allegations and to stations have to pull it down because it was proven to be false. now to your question, i love coming to northern kentucky. i love the spirit of the people out here. i have a dozen members of your cincinnati bengals that have formed beagles -- for a special group. -- formed a special group. i always try to get behind northern kentucky. while working as an aide in gov. patten's office, i helped write the higher education law that gave status to northern kentucky

university. we have to look at this issue. there is a lot of infrastructure at the airport. if you honor me by electing me as the next united states senator, i will come up with ideas to try to get more traffic to that airport. we have to make certain that it is safe to cross that bridge. >> mr. paul, you have 90 seconds. >> i would advocate for bridges for northern kentucky and level and wherever we need them. for roads where ever we need them. i will not simply promise that here is the money and there are no conditions for it that is our problem. do we want someone who simply will pander? here it is, here is the money, there are no consequences. there are consequences to having a $2 trillion debt. this needs to be within the confines of a balanced budget

and not to be earmarked process. the earmarked process has been a stay on our history. people stick things on in the dead of night that are unrelated to the bills. mr. smith gave a lot of money to a representative. that is the kind of thing that the taxpayers are upset with. they want more accountability. when things go through the committee process, we will ask what the cost benefit analysis is. we will ask when was the bridge last repaired. we will make rational decisions on rebuilding our infrastructure. you cannot do that if you are in favor of a trillion dollar stimulus. if you are in favor of a $1 trillion health care plan, that is money that we do not have to fix bridges. you can't be pie in the sky with everyone. you need someone who will have an adult conversation. >> thank you, mr. paul.

mr. conway, your bottle. >> this issue, like so many others, is about standing up for northern kentucky. i would stand up for northern kentucky, central kentucky and eastern kentucky. i am looking for statistics where prescription pills went down. my opponent can't cite what ever statistics he wants to make up. >> sorry to interrupt, but your time is up. we will now go to tom a key who has a question for mr. paul. >> the international airport has lost 50% of its flights since 2007. it has affected passengers, businesses and others. what can you do at the federal level that will reverse this trend? >> we have to leave more money

in the state. that would allow for more businesses to thrive and more people to travel. the airlines do face a lot of hurdles and they are on the edge. one of the things that they are concerned about is forced unionization. they are worried about the secret ballot and expanding the unions were only 20 people can decide about the unions. this is coming out of president obama's of administration. we need a competitive labor, but we need labor that can succeed in our market. toyota it thrives with non unionized labor. gm is failing. we need to realize that we have a marketplace out there and we encourage people to come to our state and that they can hire people for a reasonable wage and businesses will succeed. >> mr. conway, your response. >> i believe the question was about the international airport

and what we can do to make it thrive once again. this is an issue that is important not only to northern kentucky, but important to all of kentucky. my wife and i make our home in louisville and i fly in and out of covington all the time because it is convenient. one of the reasons that toyota came here was because it was a convenient source of international flights. if you honor me by electing me to the united states senate, i will work on this issue. we have a lot of infrastructure there that is being unused. we have to look at getting maintenance hubs brought in for regional aircraft. we have to look a what happened in pittsburgh and the loss of their regional hub. -- and they lost their regional hub. is there something that we can do to make sure that more carriers have access to more gates of that we use all the dates that we have. -- all of the gates that we have.

you need an advocate to bring people together in the senate. we need to figure out this issue. if you honor me with your vote and sent me to the united states senate, i will put together a task force and bring everyone together, democrats and republicans, the way i have done on my cyber crimes legislation, and say that we need to figure things out because there is a work force out there and cannot waste it. >> mr. paul, your bottle. >> it is about a fundamental decision. government says that capitalism failed and they want new regulations. our businesses go overseas because they are regulated to death. they are taxed to death. even in europe, the taxes are lower. we need more taxes and less regulation. we do not need to send a supporting voice, we need to

tell them they are wrong. >> thank you very much. we solicited questions online for tonight's debate. here is one. it has been said that every community hates your marks except their own. -- earmarks, except their own. mr. conway, your response. >> i am against earmark of uses. it should be placed in the bill -- abuses. some your marks affect infrastructure like the bridge project in northern kentucky, like projects in and around bowling green and the army depot that senator mcconnell is filing -- is fighting. i think it is about being responsible and making sure that wit has transparency and make sure we know how federal dollars are spent.

the choice in this campaign, he will continue to say obama, obama, obama. it is about putting kentucky first. we need someone who will fight against a $2,000 deductible for medicare. here is what -- rand paul is for all of these agencies in the government. he said he would not eliminate the agency that pays doctors for medicare because he wants to make a comfortable living. you pay more, he gets more. that is not the kind of representation we need to send to washington. if you send me there, i'll always put kentucky first. >> mr. paul, you have 90 seconds. >> when you talk in circles, someone has to interpret for you. he is against your mar -- but he is really for them. you have these earmarks.

i have talked about medicare running out of money. so social security, running out of money. in the future, we will have to do things. there will have to be changes made. i did not cause the baby boom. a lot of babies were born after world war ii. i did not cause the baby boom, but i am willing to deal with it to figure out how to fix social security for the future. social security spends more than it takes in. it is going bankrupt. we cannot do the same old, same old. we cannot promise how we will pay for them. we have to figure out how to pay for them. alternately, maybe people have millions of dollars and they may have to pay more of a cost for medicare. that is part of what the debt

commission is talking about. step up and be a man and take a chance. say that you are for something. >> mr. conway, you have 30 seconds to bottle -- for it rebuttal it -- for rebuttal. >> mr. paul, i am not want to balance the budget by calling social security a ponzi scheme. i do not know what he just proposed there. he talked about a resource. he was either saying for me except in medicare or a tax. i guess you'll have to answer that. >> scott reynolds as the next question for mr. paul. >> 10,000 miles away, about 100,000 america's finest are in a war in afghanistan. that is something that congress

will have to deal with as well. i am wondering, should we have gone into that war, and what does victory look like? is it just getting out of there as long as there is no huge television -- taliban stronghold? >> this election has been primarily about financial issues. i tell people that the most important vote that i will ever take is whether or not to go to war. i will take that vote and treat it seriously. i will treat it as if my children or -- are going or i am going. i think that we should go to war reluctantly. when we go to war, we should go constitutionally. we have not declared war since world war ii. i think that as a mistake. as a consequence, many people like john kerry say that they voted for the use of force before they voted against use of

force. mandy pandy, either you were for or against going to war. i do not think that our national security was threatened in iraq and i would have voted against the declaration of war. with regard to afghanistan, i would have forced a vote on declaration of war and i would have voted for it because i don't think that we can allow people to train in terrorist bases to attack us. in regard to how long you should stay and when your actual departure should be, ultimately, troop movements are made by the president and his generals and not by congress. i do think that we need to have a national debate over how long is too long. i think that we are very good at winning war, but we are not good at building nations of nations that have never been true nations. we need to debate and discuss. >> mr. paul, thank you very

much. mr. paul -- mr. conway, your response. >> thank you very much. you are right. our finest are serving 10,000 miles away. we have lost about 70 kentuckians in the war in iraq. we have lost 30 kentuckians in the war in afghanistan. just last week, we lost a gentleman named matt jackson. i believe that our families are paying a big price. this is a solemn decision. this is where i felt comfortable breaking with our president and said that he made -- he did not make a case for the surge. afghanistan was the right war to stay focused on going after terrorism and the seeds of it. my concern with the surge in afghanistan is that the true definition of victory in afghanistan will be leaving a nation that is better off than we found it and making sure that it does not harbor terrorists.

i did not hear enough about pakistan in that equation. i did not hear about how regional partners will help us make that a reality in the future. it is pakistan that harbors the most dangerous terrorists and nuclear material in the world. i am not only concerned about declarations of war, i am concerned about nuclear material. that is what is so disconcerting to me that my opponent said in october 2007 that it would not affect our national security if iran acquired a nuclear weapon. i will make sure that iran is not acquire a nuclear weapon. >> mr. paul, it is rebuttal. >> when you are on both sides of the issue, he was for the iraq war before he was against it. at least stand up and make a stand for the believe in something. if you were for it, stand up and say it. tell us what you are changing your position. if we ever turning this

over fast enough to the afghans to patrol their streets. >> mr. paul, i am sorry. i will have to answer a. >> amanda with the kentucky inquirer has a question for mr. conway. >> this is for both candidates. october is breast cancer awareness month. dr. paul, i know you were criticized for commenting on breast cancer. i will be the chance to explain that. to each of you, i would ask, do you believe that funding for cancer research should be handled on the federal level? if you are elected, would you support federal funds for cancer research? >> i will get to that in a second. he is trying to make fun of my answers. notice what happened is an ago. on october 1, 2007, rand paul said it would not be a threat to

the national security of you not state's -- of united states if iran got a nuclear weapon. that.ld not rebut i was pleased to go with my wife to waterfront park and participate in the wall for the susan coleman foundation. breast cancer research is very important. dr. paul's comments were to take everything down to the local level. he says we should fund breast cancer at a local level. a conference call was held that said that he does not get it. that is exactly what i am saying to you tonight. he just does not get it. he wants to rail against health care. i understand that. some of the health care changes that we have made have put

screenings in place. people like my friend who has had a kidney transplant and had trouble getting health insurance, he cannot be denied under this new health care plan. rand paul is for repealing everything. he also seems to have this fundamental view. goes back to what i said tonight. he says we have not all the constitution since 1937. he does not think the federal government is involved. the federal government can do too much. the federal government should be in the business of sending money to places like the university of kentucky for breast cancer research. >> mr. paul, your response. >> it is hard to argue with somebody who oversimplifies every issue. not all federal funding for breast cancer is local. it is the same for the drug issue. it is not all federal or all local. it is a balance between state and federal. the more we do federal with every issue, the more distant it

comes by she becomes from the people. with regard to iraq, -- iran. iran is invalid -- emboldened. iran is a threat with their nuclear threat to the middle east. i have never said otherwise. >> mr. conway, you now have 30 seconds rebuttal. >> first of all, you have said that otherwise. he said that on october 2007. i want to go back to dr. paul's philosophy. he talked about not following the constitution since 1937. he says that we need a health care system that we have before world war ii.

i guess he wants to barter for health care and go back in time. >> it is time now for a question submitted on-line. a viewer writes to us -- the bush tax cuts are about to expire. what is important, reducing the national debt or reducing taxes? >> both. part of the problem that we have had as republicans is that we have often done a good job cutting taxes. the bush tax cuts came about when republicans controlled all three branches. they were the right thing to do. they give predictability to business. they get more capital funds to business. they should have cut spending. i ran in my primary and stood up and said that we as republicans did not do a good enough job. the democrats are doing worse, but we as republicans did not do a good enough job to cut spending. it is not a revenue problem.

it is a spending problem. we have to cut spending. we have to be serious about it. we have to look at every program in the budget. all across the board. does that mean we will eliminated or cut social security by 40% or whatever he is the one on about? no. look at every program and see if it can be done at the federal level for the local level. this test needs to go through every individual program in the budget and we need to be serious about it. it is the only way we will ever get our house in order. >> mr. conway got you have 90 seconds. >> thank you. i have said that raising taxes is something that we should do in a time -- is not a thing we should do in the time of recession. we need to get back to the rules that were in place in the clinton years when a democratic president actually turned out to republican president and said that there is a economy.

that is what we need to get back to. we also need to have a jobs plan. i am a different kind of democrat. i actually have a jobs plan for it if you go to my web site, you can see me and you can look at us talking about it. the difference between the two candidates appear tonight is that i actually have a jobs plan. rand paul has no plan whatsoever my plan calls for a 20% tax credit. the college a hometown tax credit. estimates are that that would create jobs. rand paul's plan for jobs, here is what he said. he said that some people are just want to have to get a job with lower wages and we will have to have some tough love. that -- those are his words, not mind. that is not a jobs plan. that is callousness. at the same kind of callousness that would call for a $2,000

medicaid deductible. i will stand up with a real jobs plan and get this country and as commonwealth back to work. >> mr. paul, you now have 30 seconds. >> i want to understand where we are on this issue. you are for the -- you were for the tax -- of the bush tax cuts originally. you wanted to make sure that they knew you were the liberal democrat to support obama. you were against the majority of them. your exact words a couple of months ago. now you are for some of them. i am not sure exactly what is going on because i know that he specifically said that you were for bringing the estate tax back. >> all right, gentlemen, thanks. because of where we are in the debate at this point, the next question is posed by tom a key and each of you will have 60 seconds to respond. >> residents continue to struggle with unfunded mandates

in the no child left behind legislation what should be kept in? what should be kept out? >> mr. conway, your response. >> first of all, i want to go back to dr. paul's last answer. he said i want to be a liberal democrat terry i do not want to say that drugs are not a pressing issue. he said that states should be able to legalize marijuana. on the issue of education, the federal government makes up about 20 percent of our education budget. i do not want to do away with the federal department of education as my opponent wants to do. if i were to ask the audience here tonight to raise your hands if you know someone who has further their education with a pell grant, i think many of you would raise your hands. dr. paul does not seem to understand that. he doesn't seem to understand kentucky.

he doesn't seem to understand what it is like to struggle to further your education. we need to stand up and help some of our failing schools, but i am not for being callous and letting the federal farm of vegetation. >> mr. paul ? >> no child left behind was a huge mistake. the republicans passed it, but it really went against our philosophy of believing in more local control of schools. interestingly, the teachers hated it. many teachers will hear that i am opposed to no child behind. -- no child was behind. -- no child left behind. it took control out of the local hands of superintendents and principals and teachers and parents. we need to take control of our schools locally. someone threw up their arms and say that he is want to get rid

of federal involvement. there still might be student loans at the federal level, but should we have more federal control or less. >> mr. paul, thank you. 30 seconds, mr. conway. >> his view of the future is that there might be federal loans at the federal level. i am asking you, think of people who needed federal loans and federal help to further their education. doing away with that, doing away with helping people further their education, that will never be an option with me. we have very different views about what it means to put kentucky first. >> mr. conway, mr. paul, thank you both. we are at the point of our program where we will turn to the candidates for closing statements. they each have two minutes for

their closing statement. we begin with mr. paul. >> if you, very much for having me. i am proud to be a kentuckian. i am proud to be american. i am proud of the american way of life. what does that mean? it means our way of life is different than other countries. i am not proud of the cuban system. i am proud of the american system. people fly from all around the world to come and have their health care and our great country. we need to be proud of the system that created that. we need to not have a president who flies around the world and disparages america, disparages our way of life. america is of freedom. government is restrained by the constitution. not meant to restrain you, is meant to restrain your government. franklin once said that those who give up their liberty for security will have neither.

we need to remember that. we have a lot of problems. at every turn, there is a fork in the road. you can go one direction or the other. you can go the direction of more individual freedom, of less government, of more individual or say thatrial shship the government has the answer to everything. government does not do things well. when they passed the stimulus plan, it was reported that 77,000 dead people got it. does that not just a paul us? we run these massive deficits and are struggling -- aulos -- appaul us? if your mother got it and she was deceased and you wanted to send it back, there is no provision to send it back. 17,000 criminals got checks from the government. we need more local control. is it going to be all local vs.

all federal? obviously not. >> i am sorry, we need to turn to mr. conway for a two-minute closing statement. >> thank you, clyde. thank you panel and thank you for the american people. this election is about who is one to put kentucky first. i appreciate the discussion of cuba. this is about who is going to put the commonwealth of kentucky first. the special interests in washington have enough people standing up for them. you need a united states senator that has experience, as i have, a holding people accountable. we need to hold wall street accountable. my opponent has a world view where he says that the constitutional does not allow the federal government to do all these things and the end result is that he would have no federal

government holding the bankers on wall street accountable and making certain they never do this to us again. as for attorney general, i have gone after the drug problem. i have gone after the pharmaceutical companies that gouged us. i have gone after the oil companies that gouged us. i want to take that record of taking a public office and treating it as a public trust and i want to do that as your next united states senator in washington. do you want the united states senator who understands that drugs are a pressing issue? do you what the united states senator like me who understands that sometimes when activity is nonviolent that it ought to be a crime? do you want the united states senator like me who will stand up for people who cannot stand up for themselves like those people who benefit from the civil rights act? i ask for your vote because i am not for a $2,000 deductible for

medicare like my opponent. i will never balance the budget on the backs of seniors. thank you for having me here. i ask for your vote. >> mr. conway, mr. paul, thank you very much for agreeing to be with us tonight so that the voters might assess you vote. things as well to our panel, scott reynolds, amanda, and tom a kemckee. i also want to thank our sponsors, the northern kentucky chamber of commerce, northern kentucky university, the kentucky inquirer, and this includes our broadcast. from all of us, thank you again for washington have a good night. -- for watching us. have a good night. >> >> the candidates for u.s. senate in kentucky debate again

at the university of louisville. we will have that live on c-span at 7:00 p.m. eastern. mr. conway was elected attorney general in 2007. mr. paul won the republican primary with nearly 60% of the vote. our live coverage of campaign 2010 continues in a few moments with the first of three debates among the candidates for senate in indiana. in one hour, the only debate between the candidates running for governor in michigan. at 10:00 p.m., a debate between the new hampshire candidates for governor, incumbent john lynch and republican john stephen. and later, political strategist look at how the campaign is progressing. in pennsylvania, senator arlen specter is campaigning for a man

he lost to in the democratic primary. we spoke with chris britton with the philadelphia daily news. >> i think that arlen specter is acting strategically. he is still very popular here in philadelphia. i think that this is a chance for joe to raise some last- minute cash. no one knows that better than arlen specter. he was behind in the polls going into the may 18 democratic primary and with the help of a rather devastating political campaign commercial, closed the gap and beat senator specter quite handily. he will raise the money he will need if he is going to have a shot against the former congressman. >> so, the eventin