let's go to joyce, democratic caller in new mexico. good morning. caller: hello? host: hi, joyce. you're on "washington journal." welcome. caller: yes. i have a very big problem with the democratic party. i'm a registered democrat. but i have watched the democrats let themselves be defined by their opponents for the last 12 or 15 years. and let me give you some examples. when bush and cheney wanted to go into iraq, the democrats that opposed that were accused of being not patriotic. when the republicans paid for the war with supplementals and the democrats opposed that, the republicans accused them of not supporting the troops. now, quite honestly, i think there's a lot -- i grew up in texas and new mexico.

i think there's a lot of hidden racism. i admire barack obama. but i tell you it scares me when i think of the hidden racism out there. but let me give you another example of letting the republicans define who the democrats are. host: one last one, joyce. caller: there's a lot of people now who are demonizing nancy pelosi. and i will bet you that the democrats cave. you wait and see. they have done it. if there were a viable third party, not the tea party, a viable third party, i would belong to it. i really don't have much respect for the democrats anymore. host: and we're look at images of the democrats waiting. let's go to the house floor now where the session is getting underway. . the speaker pro tempore: the house will be in order.

the chair lays before the house a communication from the speaker. the clerk: the speaker's room, washington, d.c., november 17, 2010. i hereby appoint the honorable ed pastor to act as speaker pro tempore on this day. signed, nancy pelosi, speaker of the house of representatives. the speaker pro tempore: the prayer will be offered by our chaplain, father coughlin. chaplain coughlin: lord of heaven and earth, by your gracious will, you've awakened us to a new day, and we look upon the responsibilities that lay before us. grant us wisdom to make good decisions, the strength to do what is right, compassion for people we meet along the way, and the satisfaction that we may please you by what we do and say and give you glory both now and forever.

amen. the speaker pro tempore: the chair has examined the journal of the last day's proceedings and announces to the house his approval thereof. pursuant to clause 1 of rule 1 the journal stands approved. the pledge of allegiance will be led by the gentleman from illinois, congressman quig low. -- congressman quigley. mr. quigley: i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the speaker pro tempore: the chair will entertain up to 15 requests for one-minute speeches on each side of the aisle. for what purpose does the gentleman from illinois rise? mr. quigley: to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: the gentleman is recognized for one minute. mr. quigley: mr. speaker, i rise today because the israeli security cabinet is preparing to take a critical vote on a proposal to temporarily halt

construction in the west bank. our israeli friends have offered once again stop construction in the west bank in order to open a door to a peace deal. however, a peace agreement has no chance of coming to fruition if the palestinian authority and president abbas refuse to come to the negotiating table. only face-to-face negotiations from the two sides can come to a deal. the administration must be strong in signaling any move by the u.n. toward independent action will be vetoed. we are at a vital cross-rods. we can choose the path -- we are at a vital crossroads. president abbas must come to the table and justify the good-faith efforts to achieve lasting peace. thank you and i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from texas rise? mr. poe: i ask permission to address the house for one minute. the speaker pro tempore:

without objection, so ordered. mr. poe: mr. speaker, over 2,200 people have been killed just this year in drug-related border violence in mexico and some have been americans. the violence is flooding into american communities. bullets are literally flying across the rio graunda river into el paso -- rio grande river into el paso, texas. people are scared. the united states has a two-part border security plan. one, not to travel parts of america because of the violent drug cartels and, two, sue states that try to protect their people from illegal entry. that is no competent security plan. one real answer is to pass legislation to put 10,000 national guard troops on the border to be paid for by the federal government and supervised by the state governors. how much more violence must occur on the borders before the fed must do the job that the constitution requires, protect the nation? and that's just the way it is. the speaker pro tempore: the gentleman yields back the

balance of his time. for what purpose does the gentleman from wisconsin rise? mr. kagen: to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized. mr. kagen: mr. speaker, i received a message from one of my constituents, one of my bosses. mr. and mrs. elmo roach from wisconsin said, do not waiver on beginning to bring our troops out of afghanistan saving more wasteful spending. redirect all savings to veterans to support their families. sorry to say but we may be ready to retreat the comfort of our retired if the president blinks or compromises. he promised we'd deliver, now we expect him to act like truman or roosevelt, closed quote. in northwest wisconsin we believe that people are more important than corporate profits. we still believe that one single family on main street is more valuable than all the corporations on wall street. we believe our freedoms will be ours for as long as we can hang on to them. i yield back.

the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from indiana rise? >> i ask unanimous consent to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection, so ordered. mr. pence: jobs should be job one in this congress and the next. full employment must be the objective of policymakers in washington, d.c., but after years of runaway spending, borrowing and stimulus it's clear. and the american people know it. we can't borrow and spend and bail our way back to a growing economy. unfortunately judging from the latest round of quantitative easing, the federal reserve hasn't gotten the message. printing money is no substitute for sound fiscal policy. this week i introduced legislation to end the dual mandate of the -- duo mandate of the fed. it's time that they protect the dollar and demand that

policymakers here in washington, d.c., embrace the kind of reforms that will promote real growth. tax reform, tax relief, fiscal discipline, regulatory reform and trade. we can't print money as a pathway to prosperity. i urge my colleagues to join me in ending the duo mandate of the fed and let's get back to growing this economy on principles and policies that work. the speaker pro tempore: the gentleman yields back his time. for what purpose does the gentlelady from hawaii rise? ms. hirono: to address the house for one minute. the speaker pro tempore: the gentlelady is recognized. ms. hirono: mr. speaker, one way we can create jobs, the number one concern for many of my constituents, is by developing clean energy technologies and products made in america. hawaii, the most oil dependent state in the country for our energy needs, is a prime locale for energy initiatives. thanks to a $17 million loan guarantee from the department of energy, a hawaii company called first wind is constructing a wind energy

facility on the north shore. the clean energy generated by this 30 megawatt facility will help hawaii become more energy independent by powering up to 7,700 homes each year. in addition to creating about 200 construction jobs, the project also relies on american innovation and know-how by using wind turbines and battery manufacturers in iowa and texas. i ask my colleagues to support legislation that will help innovative homegrown companies develop clean, renewable energy technologies and strengthen our competitiveness in domestic and overseas markets. i yield back. the speaker pro tempore: the gentlelady yields back her time. for what purpose does the gentleman from new york rise? >> i ask unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized. >> i rise today to honor a great man, army specialist blake d. whipple of williamsville, new york, just

21 years old, blake's life was taken by a roadside bomb in afghanistan on november 5. mr. lee: it was his job to clear the roads of these devices and he did so proudly. blake was a 2007 graduate of williamsville east high school and signed up to serve his country in 2009. blake's parents, dave and kim, expressed concern about him joining the army, as any parent would, but blake's parents sensed his passion and drive for wanting to be part of something bigger. blake was eager to serve his country and was proud of the work he was doing. and i know his family was extremely proud of him. blake was fortunate to be home in western new york for two weeks this past september. he was able to see his family and friends one last time before his life was so cut so drastically short. blake proudly served our nation with courage and bravery, and his life was taken far too short. he will be missed. i yield back.

the speaker pro temre: the gentleman yields back the balance of his time. for what purpose does the gentlelady from -- the gentleman from california rise? >> mr. speaker, i ask unanimous consent to address the house for one minute. the speaker pro tempore: ithout objection, so ordered. mr. baca: when president obama took office, he inherited, i state, he inherited $1.2 trfs deficit, two wars, the recession and mounting job losses that pushed our economy to the brink. since then we have made steady progress by laying the groundwork to create new works. the democratic make it in america agenda, to close the tax loophole that allowed for outsourcing of jobs overseas. and the recently passed small business jobs act provides $12 billion in tax cuts, $20 billion in new lending for american small business. but with the unemployment at 9.6 across the nation and over 14% in california, we must do more. i urge my republican colleagues to come to the table and work

with democrats and the administration. the time for simply saying no is over. we must pass new tax cuts for the american middle class families without the deficit-busting break for the wealthy, without the deficit-busting break for the wealthy. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from tennessee rise? >> i ask permission to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection, so ordered. mr. duncan: mr. speaker, a nationwide revolt is developing over the body scanners at the airports and it should. hundreds of thousands of frequent fliers who fly each week are upset of getting these frequent dose of radiation. parents are upset having their children being forced to be radiated or being touched inappropriately by an unrelated adult. there is plenty of security at the airport but now we're going to spend up to $300 million to install 1,000 scanners. this is much more about money than it is about security.

the former secretary of homeland security, michael chertoff, represents rapid scan, the company which is selling these scanners to his former department. far too many federal contracts are sweetheart insider deals. companies hire high ranking employees and then they get federal contracts. the american people should not have to choose between having full body radiation or a very embarrassing intrusive patdown every time they fly as if they were criminals. we need a little more balance and common sense on this. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from kentucky rise? mr. yarmuth: i ask permission to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized. mr. yarmuth: thank you, mr. speaker. soon we are going to have to decide how to treat the bush tax cuts. we are going to have to decide whether or not to indebt the american people public another $700 million to extend tax benefits for the richest 1% of the country. before we go too far in feeling

sorry for that 1%, consider this -- from 2001 to 2006 53% of all gains, total gains and income in this country went to that 1%. that's right. one out of every $2 went to the richest 1%. that's where the economy has gone. the growth in this country has benefited primarily the richest people in the country and we now have the greatest disparity in wealth that we've seen in this country in almost 100 years. and heed the words of the roman priest who once wrote an imbalance between rich and poor is the oldest and most fatal ailment of all republics. let's keep that in mind when we consider what to do with those tax cuts for the richest 1% of americans. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from virginia rise? >> mr. speaker, i request unanimous consent to address the house for one minute and to revise and extend my remarks. the speaker pro tempore:

without objection, the gentleman is recognized. >> mr. speaker, the great patriots living in the original 13 colonies in the early years of this nation relied on hard work, enduring spirit and innovative thinking to create america. we are in the final weeks of the 111th congress and during this session much of the legislation passed challenged the fundamental characteristics of what makes our nation great. . self-relines, responsibility, taking risks, and making tough decisions. instead we have seen more mandates, burdensome regulations, and overbearing debt and deficits. hardly what those founding patriots intended. after a few months back in america's first district, the message from virginians is simple, stop the spending, keep freedom intact. congress has two choices -- continue on the same path or chart a new responsible path. mr. speaker, congress has the responsibility to work together to chart a new course and allow

this nation to prosper for years to come. mr. speaker, with that i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from minnesota rise? >> to address the house for one minute. revise and extend. the speaker pro tempore: without objection, the gentleman is recognized. >> thank you, mr. speaker. the same challenges that face this nation on november 1 still faced us when we poke up on november 3. we still have too many americans without jobs and we still have work to do to grow our economy and put or country back on a path of prosperity. we need initiatives that make america more competitive. we need to tap into the can-do spirit that made this country so great. folks in my district in southern minnesota know a new clean energy economy means jobs and securities here at home. i hope my friends across the aisle understand that america expects them to do something. they expect them to grow our economy, create jobs here at home, and not ship them overseas and hold wall street accountable. catchy complain slogans might be great to win elections but they won't fix a single problem. they won't create more jobs, they won't put america back to work.

now the hard work really begins and we must be up to the taving. winston churchill once said democracy is the worst form of government except for every other one that's been tried. democracy is hard work. it needs to start right here and we need to put america back on a path to prosperity. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from pennsylvania rise? >> mr. speaker, request unanimous consent to address the house for one minute. revise and extend my remarks. the speaker pro tempore: without objection, the gentleman is recognized. mr. thompson: mr. speaker, today i rise to give credit to a coach who just reached a milestone of 400th career win. it was almost two months ago when penn state shut out temple university 4-0. they were coached by charlene morris, the longest tenured coach in big ten and the seventh longest tenured coach in a single school in division i field hockey. she in her 21st season of the penn state field hockey program. this makes her the only fourth division i field hockey coach in ncaa history to hit the 400 victory plateau.

in 2008, she led her team to the big ten regular season title and named big ten coach of the year for the fourth time. five of her players have been named big ten athlete of the year. she's a graduate of penn state, outstanding field hockey player in her own right. she's a two-time olympian winning a bronze medal in the 1984 los angeles games and she was also an all-american lacrosse player. i congratulate her and her team for their accomplishments. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from virginia rise? >> to address the house for one minute. revise and extend my remarks. the speaker pro tempore: without objection, the gentleman is recognized. mr. moran: i'd like to take a minute to put the republican party plans to put in historical perspective. it was 30 years ago that ronald reagan was elected on the same platform that the government really can't be the solution to any of the problems. it is the problem. he also suggested that any president who submitted a budget that was not balanced should be impeached. for eight years he never submitted a balanced budget.

and tripled our deficit. george h.w. bush tried to correct the situation, the gingrich republicans contributed to his defeat, bill clinton came in, balanced the budget, allowed tax rates to go up to the level they are set to return to finally in january, some 23 million new crobs created, invested in our fiscal and human infrastructure. he had three successive budget surpluses and left with a $5.6 trillion projected surplus. george bush comes in and acts two deep tax cuts, two wars, puts in a $900 medicare part d prescription drug program and leaves with the worst fiscal crisis that this country has faced since the great depression. so there's the historical perspective. the fact is those two tax cuts never should have been enacted in 2001 and 2003. they should be allowed to expire. we ought to reinvest in the human and fiscal infrastructure of this country. thank you, mr. speaker. the speaker pro tempore: for what purpose does the gentleman

from new jersey rise? >> to address the house for one minute. the speaker pro tempore: the gentleman is recognized. mr. garrett: mr. speaker, ever year an average of 115,000 american children live in foster care waiting to be adopted. today i'm pleased to honor november as national adoption month. november 20th as national adoption day. in particular, i'd like to recognize voices for adoption to support adoption. since 1996, this organization has not only helped recruit adoptive families but also supported programs that assist families who have already adopted. for example, voices for adoption sponsors a program called adopted family portrait project. through this project members of congress celebrate a member from their district that exemplifies the values. this year i'm pleased to recognize the campbell family. they have welcomed over 121 children into their homes over the last 30 years. in addition, they have adopted

several children. they also worked for children aid and family services as a specialist in helping special needs children who have been exposed to drugs. in the past, she has served on child placement review boards. the campbells remain in contact with many of the children who have come into their homes as foster children. they also mentor new foster parents and advise those considering becoming foster parents. the speaker pro tempore: the gentleman's time has expired. mr. garrett: bound -- the speaker pro tempore: for what purpose does the gentlelady from california rise? >> to address the house for one minute. the speaker pro tempore: the gentlelady is recognized. ms. chu: our country is one of opportunities where everyone can follow their dreams. we need to ensure that america's young people get the training they need to succeed. we have fallen behind. today only 15% of american students learn a second language and it hinders us in today's global economy. that's why i have introduced a global language early education act.

my bill funds early education dual language programs across the country and it provides the skills demanded in board rooms throughout the world. we know that dual language learners better manage complex situations and problems. that's why the bill also grooms our next generation of executives for success. let's be competitive in this world. let's encourage a second language. let's promote our work force and make sure that everybody can achieve the american dream. the speaker pro tempore: the gentlelady yields back her time. for what purpose does the gentlelady from pennsylvania rise? >> to address the house for one minute. revise and extend. the speaker pro tempore: without objection. the gentlelady is recognized. mrs. dahlkemper: i rise today with a heavy heart to honor the live of a entrepreneur, generous philanthropist and loving husband, father, and grandfather from sharon, pennsylvania. jim, the developer of the club anti-theft device, was lost in an accident in september. he was a patriot. serving his country in korea. he was an inventor who grew his ideas into successful businesses that created good jobs for his

neighbors. he was a philanthropist who gave much of his wealth back to his community. and he raised a beautiful family who shares his values of hard work, patriotism, commitment to community, and compassion for those less fortunate. jim was a renaissance man and his dedication to sharet reached so many in the mercer county region. he will be missed by all and my heart goes out to his wife, family, friends, and the community who continue to mourn his loss. i yield back. the speaker pro tempore: the gentlelady yields back her time. for what purpose does the gentleman from connecticut rise? >> to address the house for one minute. the speaker pro tempore: the gentleman is recognized. >> thank you, mr. speaker, i rise today to direct my attention to the critical status of the country of lebanon. we are perhaps days away from an international tribunal's verdict on who killed former prime minister leb none. that verdict could plunge lebanon into another round of

violence. thankfully this body through the leadership of people like howard berman, nita lowey has removed its regulations on aid to the lebanese army. this is a crucial step. it could be a crucial step should the tribunal decision on who killed the prime minister leads to greater instability in that country. mr. speaker, we must support lebanon as a force for peace and prosperity in this critical region. we need lebanon as an ally to america and to all the countries in that region who are pushing for peace. i have thousands of lebanese american constituents in connecticut. they constantly remind me of the importance of these points and i believe they are right. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from minnesota rise? >> to address the house for one minute. the speaker pro tempore: the gentleman is recognized. mr. ellison: today i rise to call attention to the corrosive and corrupting effect of dirty

money. what's dirty money? that's money that comes into american politics ithe millions, multiples of millions, money that comes in often to fund campaigns and smear, distort, and deliver untruth to voters. and money that was made much easier to come into our political environment through supreme court case known as citizens united vs. f.c.c. we need to take action to make sure that americans know who is funding these messages that are coming across their airwaves. that the identity of these sponsors is disclosed so that people can make a good choice. never let the day come that any public servant has to face a torrent of nasty, nasty commercials over the airwaves without the voters even knowing who paid for them, who sponsored them, and who wants them to believe the untruths put in many of these ads. with that, mr. speaker, i yield back. the speaker pro tempore: the gentleman yields back the

balance of his time. for what purpose does the gentleman from minnesota seek recognition? >> mr. speaker, i ask unanimous consent that debate on passing h.r. 3808, the objections of the president to the contrary notwithstanding, be limited to 10 minutes equally divided and controlled by the chair and ranking member of the committee on the judiciary. the speaker pro tempore: without objection, so ordered. the gentleman from minnesota. mr. ellison: mr. speaker, i ask unanimous consent to take from the speaker's table s.j.res. 480 and ask for its immediate consideration in the house. >> the clerk will report the title of the joint resolution. the speaker pro tempore: senate joint resolution 40, joint resolution appointing the day for the reconvening of the first session of the 112th congress. the speaker pro tempore: is there objection to the consideration of the joint resolution? without objection, the joint resolution is read a third time

and passed. the motion to reconsider is laid upon the table. for what purpose does the gentleman from minnesota rise? mr. ellison: mr. speaker, i ask -- i send to the desk a resolution and ask unanimous consent for its immediate consideration in the house. the speaker pro tempore: the clerk will report the title of the resolution. the clerk: house resolution 1720, resolution providing for the printing of a revised addition of the rules and manual of the house of representatives for the 112th congress. the speaker pro tempore: is there objection to consideration of the resolution? without objection, the resolution is agreed to and the motion to reconsider is laid upon the table. pursuant to clause 12-a of rule 1, the house will stand in recess subject to the call of the >> members will return this afternoon at about 4:00 p.m.

eastern for legislative business, including debate on the bill recognizing the 20th anniversary of the outbreak of the gulf war. another supporting the goals and ideals of national adoption day. national adoption month. and votes also expected on a bill overriding the president's veto of the bill recognizing interstate notearizations. you can see the house live here on c-span. pictures of house minority whip, james clyburn, this morning as he heads into the democrats' caucus meeting. house leadership conferences getting under way today. republicans become the majority, of course, in the 112th congress with the ruts of the midterm elections. republicans and democrats will be choosing leaders today. congressman clyburn is being challenged by the way for his position by current majority leader steny hoyer we will have coverage of the results of those leadership results as soon as they become available. pictures also from the dirksen

senate office building on capitol hill where the senate finance committee has become a hearing on patent provisions. it's chaired by montana senator. they are hearing from medicare and medicaid administrator donald berwick talking about the agency's efforts to protect the medicare program from fraud. it started about a half-hour ago. live coverage here on c-span. >> i need a team. she's saying what kind of disease care, seamless care. it's a net around the patient. if we drop the ball, things get worse. if one doctor prescribes a medicine for mrs. wilson that conflicts with a medicine another doctor prescribed and they don't know it, she could end up bleeding, she could end up in the hospital. and not at home where she wants to be. better care for chronicly ill people means coordinated care. >> we have all heard that. how do we get there? how do we get better coordinated care? >> you need to envision and

reward it. right now we pay for health care in fragments. the new affordable care act offers us a tremendous range of possibilities for making it possible for clinicians to get together to do the kind of care they want. medical homes, health homes, medicaid, these are ways to support the system, to come together to do the kind of work that the chronically ill need them to do. >> would you tell us more about accountable care organizations and what -- how far along they are and what you envision them doing? and what parts of the country? >> it's a really exciting part of the new law, a chance to encourage that kind of coordinated care, especially for chronically ill people. a care organization would be an entity to take responsibility for the care of a group of patients with a primary care base and coordinate services and get rewarded for that those there are bonus payments when things go well in the accountable care world. on a fee-for-service side of medicare, we are not talking madged care. this is gnat natural state. we are writing the notice of

proposed rule making now out at the end of the year or so. very important in that concept is the one size doesn't fit all theory. what accountable care going to look like in a rural part of montana or in inner city manhattan, they are going to be different. we need to energize exploration toward that. that's one of the reasons the new center for medicare-medicaid innovation is important. that will allow us addional possibilities to encourage local settings to devise the accountable care that will work for them. >> i think my time's up. my clock was started too late. >> dr. berwick, it's not your fault or anybody's fault what the schedule of the senate is, but there's at least 70 minutes of questioning here and we have both starting at 11:00. i was wondering -- votes starting at 11:00. i was wondering if you would appear again before the committee after the thanksgiving break so we would all have a chance to ask questions we want

to ask. >> i think, senator, that's the prerogative of the chair to call hearings or not. interesting for to you get a commitment. i can't guarantee when we'll have a hearing. although it is my intention to have a good number of hearings because it's very important for this committee to hear from the administrator about his plans. >> ok. i'll go on to the next point. prior to your nomination, you led a group called the institute of health care improvement or i.h.i. has numerous health care companies as both clients and donnes or -- donors which gives rise to the new position to help shed light on these potential conflicts during her initial confirmation process, my staff asked you to provide three most recent forms 990 including schedule b which details donors and donation amounts.

you agreed to comply with this request. indeed you even agreed to have my staff meet with your i.h.i. chief financial officer to ensure the financial information provided was accurate and complete. it's now november and the information still hasn't been provided. no chief financial officer has come to meet with my staff, though your installment subverted the senate's constitutional prerogative advise advise and assent, did not subvert the oversight. i restate my request in an effort to ensure there is transparency for your potential conflicts of interest and accountability at c.m.s. so the question is, dr. berwick, you stated in an earlier letter that you planned divesting any interest in companies you may oversee and have interaction with c.m.s. is this divestiture

complete and if so, will you provide the committee with records documenting the divestiture? >> thank you, senator. i recall that conversation and when you asked for that information i intended to try to provide it. as it happened it was not in my sole authority to provide that information. and now of course i'm recused from contact with i.h.i. i cannot provide it on my own initiative. what i can assure you is that all of my past activities, my finances were thoroughly reviewed by the appropriate ethics officers under congressional rules before i took office. i was given a ethics agreement to review and sign. i signed and agreed to every single condition. i complied with every single one. i'm fully in compliance now with the conditions of that agreement which were supplied to the committee. >> the waivers were not supplied to the committee. could we have copies of the waivers? >> i have requested no waivers

yet, senator. but because there are a couple of organizations from which i'm recused i think have important potential information for c.m.s. requested and received the right to request a waiver when and if needed have not done so yet. >> let me be specific. you also stated in an earlier letter that you were seeking ethics waivers due to your connection with keyser permanente and the commonwealth fund did you obtain these or any other waivers? that's what i'd like to have provided for the committee. >> i had understand, senator. yes. those two organizations i asked permission to seek a favor when necessary for the conduct of my particular duties as c.m.s. administrators and not particular party matters. i have requested those waivers because that issue has not arisen. >> dr. berwick, health reform was supposed timprove medicare program but these findings, i'm not going to take time to give now but i made reference to

them, takely what the actuary said, indicate some medicaid cuts in the new health care law will move the program in an opposite direction by jeopardizing access for beneficiaries. dr. berwick, would you agree with rick foster when he made those comments about the health care bill potentially jeopardizing health care for beneficiaries whether these cuts will jeopardize access to medicare part a providers? >> medicare not medicaid? >> i'm sorry if i said medicaid, this is all medicare. >> yes. the actuaries estimates are just that. they are estimates. based on his best judgment what we can look now as facts as they are developing. our intention is to increase access to care for medicare beneficiaries, strengthening part a, part b, and c and d. i think those will be more attractive to beneficiaries. i think they'll find themselves in better shape after this act

is fully engaged. >> thanks, senator. i would like the information of the senators indicate the order. next senator rockefeller, then senator hatch. senator rockefeller. >> thank you, mr. chairman. dr. berwick, i would like to ask three quick questions in a row. >> he's going to recognize. he's not going to make a statement. >> i revise my comments. i certainly don't want you to punt, senator rockefeller, i did enough of that in the intelligence committee. i'm suffering from c.m.s.-induced paranoia so i'm going to have to leave. i hope you can feed that as we go further. did the chairman indicate to the ranking member we will have an opportunity, we'll try to have an opportunity to talk to dr. berwick before thanksgiving? >> we should sometime. i did not say when.

>> sometime. ok. >> and good faith reasonable -- >> i think the obvious statement by the senator from iowa and my ranking member five minutes obviously i can't do this because i have other obligations i have to leave. and i apologize for that. i would hope we would have an opportunity to do that. i'd like then to ask unanimous consent to submit some questions for the record. >> no objection. >> thank you, dr. berwick, for coming. >> senator rockefeller. >> can the time be put back to the original? >> yes. >> thank you. >> dr. berwick, under health reform the federal government is paying for the vast majority of the medicaid expansion of the health reform. it averages about 95% on a nationwide basis, actually up to 100% in four, five states. between 2014 and 2019. so first question is, states reject this funding and do not

expand their medicaid programs. where else could these vulnerable citizens get coverage? question number one. question number two, if is an interesting one, i think. i want to ask you about the practical impact of medicare when people are uninsured for 10 to 15 years before they sign up for the medicare program as a physician, can you tell us what would happen to ur efforts to improve quality and lower the cost of care if we do not move forward with covering 32 million uninsured americans under health reform? you see the link there. the third question is, could you explain how this law gives states flexibility? everybody says it's government run. in fact, it's state run. exchanges. could you explain how this law gives states flexibility in reforming health care delivery? you refer to that in your

statement. could you talk about how it gives health care providers the ability to innovate and improve health care for patients? those are the three questions. >> thank you. with respect to the first choice states make about their participation in medicaid, my job is to make the medicaid program ever stronger and more attractive and viable for states. i understand states are dealing with a lot of very serious financial issues right now and they are very much on my mind. as you pointed out, the new law gives us the chance to help statesith this transition to broader coverage for people who really need it. just as the same things making the states suffer under the recession are hurting people at marginal income they'll find themselves wh no insurance and nowhere to go without the benefit of this new law in place. we are doing 100% federal match for the newly eligible medicaid beneficiaries. as you say over a multi-year period after that goes down to only 90% and stays there. we are reaching out to states with a 90-10 match.

the 90 cents out of every dollar the states are going to spend to smooth their ebb rollment procedures across these new forms of enrollment. we are reaching out to states with that. we are helping them with waiver authority. and we are strengthening medicaid every day. it's a much stronger program now than it's been before. with respect to the practical impact on medicare of failing to ensure people in the premedicare era, you are right. someone doesn't get chronic heart failure on the day they become a compared beneficiary. their diabetes doesn't suddenly occur. it's been there all along. when people, especially people with these underlying risks of chronic illness, can't get access to health care, their care deteriorates. their kidneys get damaged. their hearts get damaged. they lose their way. and then medicare ends up, as you're right, holding the bag for that. the states are paying for that anyway with the uninsured prior to that. that person who has undetected hypertension or diabetes that's hurting their kidney will get worse and eventually that care

will be given and most states that means the states will pick up the tab a different way. you pay me now or pay me later. the best way to provide care is to anticipate the needs of patients at all stages of life. not just the medicare group. you are right about that. it always is reflected in the care of the chronically ill. an enormous burden on the states right now is the dual eligible population. 9% of americans in the dual eligible population, they account for 40% of the cost in medicaid. and that's one of the reasons states are having these terrible problems. the best thing to do for them is to help them heal, get them better care. that will reduce state -- burdens on states. flexibility is essential to the future. we don't have a one-size-fits all solution here. state by state there will be innovations, we can support that through waivers, demonstration projects now anticipated in the new law and pre-existing legislation. now we have these 23450u wonderful assets in the law. the center for medicare and medicaid innovation and the

center for dual eligibles which will soon be established and that will be able to support states with invan hollenive, locally designed ways to get -- invan hollenive -- inventive, locally designed ways to get better care. just yesterday we announced the possibility for up to 15 states to get grants now of up to $1 million to plan better care for dual eligibles in those states. >> possessions others would have initiative. >> the imagination around this country is extraordinary. it might work. prior to coming here i had a chance to work with thousands of clinicians all over the country and can i see the invan hollenive energies out there. i have -- inventive energies out there. i have met with all the groups and they are raring to go to help physicians discover new ways to better coordinate their care, to get involved in patient safety. we can support them also through the new center for medicare and medicaid innovation. we can now make them more and

more aware of what's possible. the new law has in it capacities for more transparency so we can see where high performance lies in this country among hospitals, among physicians. for hospitals we can talk to payment as well. that kind of transparency builds knowledge and people can begin to learn from each other. that will help physicians as well. >> thank you, dr. birwick. >> thank you, mr. chairman. welcome, dr. berwick. happy to have you here. let me make a brief observation before i ask a question or two. today is simply the first of many opportunities for us to have an open and honest dialogue. on the impact of the new health care law. the centers for medicare and medicaid services, c.m.s., that's in charge of the largest federal health care programs, medicare, medicaid, the children's health insurance program. this agency has a larger budget than the pentagon and its actions directly impact the lives of almost little more than perhaps 100 million americans. since the passage of this new health law, we have seen the

reality has failed to match the rhetoric on everything from the promise cost reductions to americans, keeping the coverage of their choice, etc. i fear this is only the beginning of these impacts and that it's essential that we fully understand the consequences of this new law. on november 2 the american people issued a clarion call for more transparency. it is our responsibility to listen and respond to their concerns. obviously asking us to cover all of our concerns in this hour-long hearing with only five minutes per person is like asking us to drain the pacific ocean with a thimble. this cannot simply be a check the box exercise. although this hearing has been long time coming, almost eight months since the passionage of the health law, i'm glad you are finally here. i plan to make sure my constituents and american people are fully informed of all the important actions being undertaken at c.m.s. i sincerely hope you and your

staff will be willing and responsive partners in this exercise. keep in mind, usually a person makes a nomination, nominee comes up and talks to members of this committee, we have a hearing. then we have a markup. for this $800 million agency, the president just recessed, appointed you without any event. i think many constituents are outraged. i have a high respect for you as a doctor. dr. berwick, as i was reading through your testimony, i came across the claim on page 3 that the new health care will actually increase medicare part a trust fund solvency by 12 years to 2029. i have also found it to be very plusling. as you may already know i sent a letter to the medicare trustees on june 24 of this year along with senator greg on thish -- the issue of double accounting savings. the health care law contains

more than $500 billion in cuts to the medicare program which were claimed by the administration not only to improve medicare solvency but also to fund new estimate -- new entitlement spending at the same time. this is like claiming that the american families can use the same matchable dollars to pay their mortgage and their grocery bills at the same time. it's really nonsensical. don't just take my word for it. here's what the nonpartisan congressional budget office said on december 23, 2009. the key point is that savings to the hospital insurance trust fund under the health law would be received by the government only once so they cannot be setaside to pay for future medicare spending and at the same time pay for current spending on other parts of the legislation or other programs. in fact, your own actuary at c.m.s. also agreed with this viewpoint in his memorandum on april 22, 2010, when he said the

following. in practice the improved h.i. finance kg not be simultaneously used to finance other federal outlays such as coverage expansions under ppaca and to extend the trust fund despite the appearance of this result from the respective accounting convention. so my question is a pretty simple one. do you agree with your own actuary who i strongly believe is rightly telling us that can you not use the same magical dollar to extend the solvency of the medicare part a trust fund, while also using it to pay for new federal spending. isn't this budgetary gimmickry? >> no, senator. in estimating the effects on the trust fund we are following the actuaries are following standard accounting principles. it's been done correctly. it's not double accounting as i understand it. the congressional budget office -- >> wait a minute. >> my understanding is we are following standard accounting principles and that money will

go into helping extend the life of the trust fund. the congressional budget office has also estimated i think $140 billion of savings over the first 10 years of this new law below business as usual and $1 trillion for the decade following that. and we are seeing the results now in a lot of the implementation of the new law we can see some of the savings now beginning to accrue prior to the law we engaged had a bidding for durable medical equipment. we saw costs fall 32% just in that trial. returning something like $150 million back to beneficiaries in those nine trial areas. we are strengthening medicare advantage resulting in lower costs there by working very hard with those plans. >> are you not strengthening medicare advantage. you cut a lot of people out. especially in rural america. >> there's normal turnover,

senator -- >> that's not normal. >> the 99 -- more than 99% of medicare beneficiaries have access to medicare advantage plans under the new arrangements. >> a lot more -- let me -- my time is up. let me jt say this. i have got a lot of questions for you that this hearing isn't going to allow us time. normally you can count on me supporting it. all administration officials if i can. i think the president wants to run it the way he wants. i hope when we send you questions in writing that this administration will permit you to answer a doggone important committee. we overview 60% of the spending in this country. and i want to know what's going on. i want to know -- i want answers to my questions. i just hope that you'll answer our questions when we send them in writing to you and take the courtesy to show them to you

because we clerly don't have -- clearly don't have time in this hearing and we certainly don't have time since you were recess appointed to get down to these questions. i have no doubt you'llble able -- you'll be able to answer them. >> thank you. >> i just reinforce what you said, senator. i do expect the white house and what not to allow full response to the questions. it's far better, in fact your first -- one of your first words are, do it right the first time. so do it right the first time is answering fully the first time. i'm trying to help you out, senator. >> i agree with that. let me just say that this is pathetic. i'm not meaning to be critical because we are in a recess period. by gosh, we ought to have time to ask the most important man in america on health care questions that are relevant and important.

>> we'll have sufficient hearings. senator bingaman. >> thank you, mr. chairman. dr. berwick, thanks for being here and thanks for your willingness to serve in this very important position. i'd like to go back to this office of inspector general report that you referred to on medical errors. i think the euphemism that the report uses is adverse events in hospitals. and i guess what i'm interested in hearing from you, if you could tell me, is your reaction to some of the recommendations. one of the recommendations in the report is that c.m.s. should provide further incentives to hospitals to reduce the incidents of adverse events through its payment and oversight functions. and then another further down it says c.m.s. should look for opportunities to hold hospitals accountable for adoption of

evidence-based practice guidelines. this is something you spent the last several decades working on. i would be interested in your views as to what opportunities you think you have under this new law to make progress on this. >> thank you, senator bingaman. you are correct. patient safety has been an object of my ongoing professional concern and work for well over two decades. unfortunately the inspector general's report was not a surprise. we know that patients are injured in american health care far too often. the good news is we know those injuries are preventable. we can find hospitals and clinics all over this country that are reducing injury rates foe extremely -- to extremely low levels. communication a while ago from a hospital in upstate new york, it almost eliminated infections that i thought were inevitable.

one has gone almost five years. we can really make substantial progress but we have to make it more hospital for hospitals to do that including making it more in their interest. the affordable care act has tremendous opportunities for doing that. there is a lot of focus in that act on health care acquired conditions and hospital acquired infections, that's other names for adverse events. we can make them more transparent, more public. measure them better. post those measurements on hospital comparison so beneficiaries know about that. and tie payment to hospitals to their ability to reduce those avoidable forms of harm and injury. i'll tell you, i have reached out to the hospital community and talked with the hospital leadership, the hospital association's a number of times since i arrived there. they are enthusiastic about this. there isn't resistance. everyone knows we need help every single american. >> let me also ask about a related issue and that is the measurement of outcomes. we made provision in this law

for trying to accelerate the adoption of outcome measures for the health care industry. and i believe the way we've got it, the way the law reads, the first set of acute and chronic measures are required to be released by c.m.s. within 24 months of enactment. the first set of primary care and preventive care measures are due within 36 months. i would be interested in any views you have about the importance of these outcome measures and what you anticipate being able to do in that regard. >> i'm aware of your leadership on that issue, senator. i'm grateful for it. i'm excited by that provision. but the fact in proper stewardship of any exchange what needs to be measured and defined and paid for is what you really want in health care. we don't really want fragments. we don't want pieces of care.

we want what the health care achieves which is good health, long life, comfort, relief of anxiety. those are outcomes. that's about what happens to the patient. maturing our measurement systems and linking that to payments and we move more towards purchasing what we really want will be better for patients and all our beneficiaries and not just beneficiaries. all of america. that involves investment in the development and use of those outcome measures. they are hard to develop. we are well under way. a lot of the work on hospital value-based purchasing, the medicare advantage star reading system is having more and more outcome mesh shurements. one of which, by the way, is what the beneficiary, the patient reports about their own experience. that's an outcome, too. this involves public-private partnership because the more we can align those measures with what's happening on the private side and private plans and private delivery systems, it will rationalize and make more sensible to the physicians and hospitals what we really expect of them. it involves work with the national quality forum and other

consensus-based entities to help us develop these measures all together. and i have been meeting with all these stakeholders. you are right. that's the direction to move in. >> thank you, mr.hairman. >> thanks, senator. senator bunning. >> iould like to point out that the opening statements took almost 30 minutes. although senator baucus won't make you a commitment to bring you back, i can assure you you will not get special treatment next year. i suspect that the -- you will be spending a lot of time testifying before the house of representatives partly because we in the senate have been shut out. why did you decide to accept a recess appointment by president obama in july? you certainly had a choice to say no. and thatat you wanted the nomination process to work. i have heard the people argued that the nomination had stalled. however that is clearly untrue.

you weren't nominated until april, a mere four months before your recess appointment. and the finance committee which is run by a democratic chairman didn't even hold a hearing on your nomination as of this day. senator hatch brought out some things about -- some early statements about 12 years in 29 and how the bill has helped the medicare, but it also failed to mention that the biggest problem medicare faces, the dramatic cuts to the physician payment rate wasn't addressed in the health care bill and still isn't fixed. on december 1, doctors start getting a 23% cut when they see medicare patients. the cost of fixing this formula is probably somewhere around $300 billion which will require

more cuts to medicare are adding to the deficit for future generations. according to the a.m.a. press release, about one in five physicians overall, or nearly 1/3 of primary care physicians, are restricting the number of medicare patients in their practice because of low reimbursement rates and the threat of future cuts. so as i see it democrats were able to extend to solvency of medicare by 18 years but didn't bother to fix one of the most expensive problems, medicare faces each year, which will require more cuts in the future and make it harder for seniors, seniors to find doctors to treat them. to me this is not success. >> thank you, senator bunning. you asked a number of questions. let me begin with s.g.r., with the physician payment. the president has -- stood firmly behind a call for the

s.g.r. receiving a permanent fix. i completely agree with that. i believe the a.m.a. has requested a 13-month extension of the s.g.r. i -- to give us time to work that out. i hope that congress acts on that and i support the president -- >> we have not had a bill before us. >> it is not acceptable for physicians and beneficiaries to be facing that sort of testimony close of 23% cut. it isn't a good idea. .

>> i was struck by your comments that you and others at c.m.s. will continue to be as open and as transparent as possible. you have to realize that many people may be a little skeptical of this comment. particularly considering the administration that you work for. for starters, your recess appointment was an end run around congress which clearly

wasn't an open and transparent process. the health care reform debate was far from open and transparent. republicans got locked out of any negotiations and democrats ended up having to jam a reconciliation bill through congress to get the final bill passed. in fact, i couldn't even get all members of this committee to support an amendment i proposed that said we needed to have final and complete c.b.o. scores -- just the scores -- along with the legislative language before the committee passed the health care reform bill. so open and trarns parent we haven't been. -- transparent we haven't been. >> i look forward to any forms of dialogue that i could engage with you, senator. >> i will guarantee you this,

you will get open and transparent and it will be on the other side of the house. they will see to it that you are open and transparent because they are going to over see c.m.s. very closely. thank you very much. >> thank you, senator. also we're working on our side of the aisle to make sure that doctors do not get cuts. we're working that right now. and hope to get that enacted. be and we'll find a way. i know, i know. senator wyden. >> thank you, mr. chairman. dr. berwick, you can't find a more important issue in health care than end-of-life care and the approach that i supported is the opposite of rationing. for example, right now traditionally patients had to give up the prospect of curity

of care in order to get the hospice benefit. i don't think that's right. i think they need to have all the choices. and i wrote a provision that's in the bill that begins the program that for the first time we give patients the right to get both the hospice program and curative care. so we start two principles -- empowering patients to make choices and making sure they have all the options, hospice care, curative care, all of the options. are those the kinds of principles thaw believe would really en-- that you believe would really enhance quality of life in this -- >> thanks for your leadership on that, senator wyden, and some of the issues i'm grateful for it. my principle is that every person in america, certainly

every beneficiary in medicare, medicaid, should get all the care they want and need when and how they want and need it. if someone in hospice care wants it i agree with you. as a physician i am. when i saw patients my question always was, what does that patient want and need and how will i get it for them? in this particular case, to be able to offer curative care to patients that's in hospice care -- >> in page 13 you make some very commendable statements about how states ought to have a key role in making sure that there are a wide array of options for innovation in health care. this is something i feel very strongly about, was involved in writing the provision, empowering the states to innovate, and my new fworchor, dr. john, and there will be

others, very much wants to speed up the opportunity for the states to be innovative, to have a chance to champion approaches that ensure we don't have one-size-fits-all health care, that they have an opportunity for flexibility, more choice and more competition. would you be open within the department, because it has to be deaptal effort, to start reaching out now with the governors to start looking for ways to be encouraging of this approach that would give not just my state but every state as much flexibility as possible as soon as possible to be innovative? >> yes, senator, i would. the diversity of approach that we're seeing emerged state by state is consistent with

protecting the trust fund and protecting the well-being of the beneficiaries. we have duties discharged from the federal level. where we've seen this kind of energy is an extraordinarily important thing to do. we are doing it. there's demonstration authorities mentioned yesterday. we have anpportunity multipayer demonstration project was -- which was intended for six states. i extended it to eight states. it's not just states. it's communities and localities that also need the same flexibility. we've seen tremendous examples of it. >> let me see if i can get one other one in. i appreciate the answer because we do want to speed up the opportunity for oregon and every other state to have a chance to be innovative. on medicare advantage, it was pretty clear to us that not all medicare advantage was created equal. >> yes. >> that there were some programs of very exceptional quality and there were some others that frankly some of the

c.e.o.'s ought to be put in jail, some of the hearings that chairman baucus had. so we created in the legislation an opportunity for bonus payments for high-quality plans based on the star ratings in the department. the whole point of this is to drive quality. how do you see bonus payments making medicare advantage more choice oriented and more competitive by focusing on quality? >> well, votes started. i want to give as many senators as possible the ability to ask questions. if you can give that answer in about 15 seconds. >> the opportunity to measure and rate the quality of these plans and attach payment. the star rating system is a strong step in which we reward plans. it's only logical. it will help plans and beneficiaries both. >> thank you, dr. berwick.

senator roberts is next. he's not here. i have senator stabenow. >> thank you, mr. chairman. welcome back, dr. berwick. we thank you you for your leadership and you are here at the right time. i did want to first comment, as you know, the initiative put forth by michigan hospitals has been a real driver in terms of quality initiatives, dealing with hospital-borne infections, reducing costs by saving lives and focusing on quality. i know that's how you're looking at this. also, just for my completion, there was a comment made that we had not tried to forget the s.g.r. and my bill, senate bill 1776, thank you for the administration's support. we could not get past the filibuster, unfortunately. we will keep working on that. i have a few quick items i'd

like to talk specifically about what repealing the new law in services would mean to seniors, to families, to moms and children. we have now a new prescription drug benefit that first of all this year provides a $250 rebate or help to seniors. i know many are very grateful for having that help if they've fallen in the doughnut hole. next year, half of the cost of folks that fall in the gap of the prescription drug coverage for their prescription drugs will be reduced. so 50% reduction. could you speak, dr. berwick, about what would happen in your judgment to seniors for higher prescription drug prices if this were repealed? >> i can't think of a worse plan than repealing this law, senator. it would mean seniors would not

be getting the 50% discount on prescription drugs during the doughnut hole. we would ask $1.8 million, $250 rebate checks they're getting this year. we tell them they look forward to the doughnut hole not closing so they can't afford lifesaving medicines and not have life-savings procedures like madamography, that we're not going to study and approve health care conditions, that we're not going to improve chronic illness care the way the new medical homes would allow us to do, that we're fought going to be more transparent about performance. there's lots of things in this law to make sure that the -- that we're not going to work hard on fraud and abuse and criminal behavior, stealing from the public trust fund or we're not going to extend the trust fund's life by 12 years. it will be over in 2017. it would be a terrible plan. >> so prescription drug costs for seniors will go up next

year if this provision is repealed? >> 50% discount on -- >> as well when we've combined mental health and public health, one of the things that's very important in this new law which was something very important to me was to look at total health. i know that early warning signs of alzheimer's and dementia is often missed and to be able to get the screenings at no cost, to be able to look broadly at mental health and physical health, that's taken away if that is repealed and seniors are more at risk for these conditions, do you think we'll see more cases of undiagnosed alzheimer's and dementa for seniors and their families? >> sure, senator. i was delighted to see the attention to behavioral health and mental health issues in the law. the law includes important steps towards really

responsible screenings for these conditions. we could intervene early and save people. >> and unfortunately taking away services is really not in the interest of families and seniors and/or taking away tax cuts for small businesses in the bill. but we know about 60% of the policies in the individual insurance offered up to this point have not included maternity care. one of the things i am proud about, and some -- one of the thing i'm proudest about going forward moms and babies will be covered. and i wondered if you might just speak to what happens to women and their unborn children if in fact health care reform is repealed. >> well, thanks for your leadership. thanks as a pediatrician and -- yes, the new law allows extension of more services in prenatal care and coverage of children. i think something like 2.6

million children are already covered with getting kids under coverage. the secretary has declared her attention to lead national efforts to get the five million remaining kids covered who are eligible for chip but not in that program. >> thanks for your time. >> thank you. >> thank you, mr. chairman. provision that the senator and i worked on in the reform bill were having difficulty -- it's not your role but we're having difficulty getting answers from h.h.s. but dealing with the whole healthy behaviors issue, do you see -- because the healthy behaviors issue doesn't apply to the medicaid or medicare populations, but do you see ways that we can implement this idea of encouraging healthier behaviors to medicare or medicaid patients? >> oh, definitely, senator. by the way, if you're having response to the issues

important to that, we'll deal with that afterwards. i'll look forward in helping you. >> appreciate that. >> prevention is such a crucial area. it comes out of the behaviors we choose or the conditions of the environment we can alter. and, yes, it does affect elders substantially. and so working with the medicare and medicaid beneficiaries both on choices that they make, helping them discover better patterns of nutrition and choices they make about substances they use, that's very important. the extension in the affordable care act of wellness visits for seniors will allow physicians and siors to be together now to talk about how to stay healthy for as long as possible. and the extension of coverage for children under medicaid through chip and getting some of the single adults into that system -- although that's not accomplished through c.m.s. -- is an important step forward to what you want. >> but the incentive that were

a financial incentive for healthy behaviors, and that's just not preventive services. we tried preventtive services and those don't -- preventative services and those don't save money. they say it costs money but rewarding healthier behaviors we know save money. it's a good model on this and that's the reason we were able to get the part in the bill. do you see ways for financial incentives within the medicare or medicaid program to be applied so that we change people's behaviors? because if we don't change people's behavior the cost of health care in this country is going to continue to skyrocket. >> i think healthy people understand their self-interest when it comes to care. it's crucial. it's an interesting area you're exploring. i'll be happy to talk to you more about it, senator. >> ok. lastly, the other thing -- one of the other things that safeway did is they provided and because medicare and medicaid have these -- this

information that can be applied to the private sector, safeway was a large enough organization to be able to put together enough data for transparency to allow to have their employees help them shop, basically, to become shoppers in the marketplace for health care. for example, around the san francisco area, because they're self-insured for the first $25,000, they pay for things like colonoscopies. well, they just paid it and they looked at a one-year data and paid around $800 for a colonoscopy. as much as $8,400 for a colonoscopy in the same year. and that kind of information, if you could provide cost and quality, transparency in the marketplace you could get more market forces. is that something that you could foresee that medicare and medicaid could provide just in

information -- we're protecting privacy but i'm talking just with outcomes, with cost so that more people can shop and market forces could play more of a role in the health care field? >> senator, i remember we mentioned that to me when we talked in your office. i think in general the whole idea of empowering beneficiaries about information that's available to them, about their options and where they can find the care they need to use that power of the beneficiaries' decisionmaking to help drive quality up across the board is a very important principle and i agree with the importance on exploring that everywhere we can. >> i guess -- can i get a commitment from you that you will within your agency work to try -- to figure out ways that you can make this kind of information public? >> making more and more information available from the medicare -- >> but i'm talking about cost and quality. i'm talking about cost and quality across the board.

what people charge for various, you know, what hospitals charge for a total hip replacement, all of those things. not just what medicare pays but what, you know, doctors charge and things like that. if we had more of that information available i think we could have a lot better shoppers in america on health care. >> yes, senator. i will explore it further. >> thank you very much. >> you're next. you're in charge. you can adjourn the hearing. >> thank you. i could go on forever. because i think this is an important hearing and i think, mr. chairman, you stated at the opening in your opening comment that this is about legislation that's estimated to save -- you said, hundreds of billions of dollars in the reform of our medicare system. some people are saying, oh, let's do vouchers instead or privatize it or do something else. the truth is this legislation has very powerful tools for reducing the cost of medicare moving forward. and if we get rid of them

somehow we are going to be in a world of hurt. so i just wanted to get your commitment on some of those provisions. one, the rebalancing of away from nursing home care to community based care. our state has saved about $243 million in about a 10-year time period by shifting away from nursing home care. so i want to see -- i think the estimates it is it could save $10 billion federally over five years. how integral you think that shift is. obviously the -- there is also a provision in this legislation that allows people in community based care to hold on to their assets so it really is going to have more people staying at home and having the benefit of getting home-based service. the value index moving away from fee for service to a cost efficiency model. we think that could save anywhere up to $100 billion for a health care system of moving

that 30% of waste, fraud and abuse to a model that's based on quality care. so i'm curious to see how essential you think that is to the success of medicare moving forward. the basic health plan, another tool to give states the ability to negotiate on rates for lower insurance rates for their consumers. and is c.m.s. going to give technical assistance to states on how to implement that and obviously not penalize states who've already gone down that road? the p.b.m. transparency provision we think is probably another good provision that is -- could save as much as 10% on brand named drugs by giving the aggregate types of rebates and price concessions to c.m.s. so that we really understand. so all of those are tools that we put in this legislation. how critical do you think they are, how will you work to implement them, and how can we

get your guarantee that these are the critical frameworks for cost control? >> i agree with you. these are all important levers for doing what i said in my opening statement we can do, making care better and more affordable at the same time. take the rebalancing work and the work we're progressing now on home and community-based services, people don't want to be in institutions, they don't want to be in hospitals. it's better for them and their families and loved ones. it will lower cost substantially. it's a very great example of progressive work. yes, there's new authorities in this law and older legislation to help states try out their forms of home and community based services. i'm totally in favor of that. integrating care through medical homes will save money and using the value index. the idea there is we should pay for what we want. we want quality, we want better outcomes. we want satisfaction on the

part of beneficiaries. why would we pay fragments, little piece by little piece, instead of knowing where value really lies? and we have to have tools. >> how big a component do you think that is for the success of medicare and reducing medicare costs moving forward? a small piece or very large piece? >> very large piece. measuring what we want and attaching incentives and rewards for going there is lorgecal and powerful. >> great. well, we have a vote on. i'm sure we'll have a chance to talk to you again about these, but i think it's very important that we understand that the tools are here. they are already law. we need to get about implementing them. and the more people talk about delaying them the more the delay cost controls and the public will greatly benefit by this. so ihank you. >> thank you, senator cantwell.

captioned by the national captioning institute ---www.ncicap.org--- [captions copyright national cable satellite corp. 2010] [captioning performed by national captioning institute]

>> as the hearing comes to a close, we are going to moving from the dierkson office building as elections are taking place on capitol hill. a live picture outside the democratic caucus meeting room. elections happening right now. house republicans will be meeting a little bit later deciding their leadership for the 112th congress. we do plan to bring you live coverage of any announcements about the elections as soon as they become available right here on c-span. >> see what people are watching on the c-span video library with the most recent videos, most watched videos and shared. it's right here on our homepage. you can also click our special 2010 election tab to the continuing coverage of the mid term elections. watch what you want when you want. >> like all men of great gifts, when they give up power,ven though they may give it up for principled reasons, they --

>> in this final volume on thdore roosevelt, edmund morris examines the final years of roosevelt's life sunday on creep's "q&a." >> a discussion with oklahoma senator tom coburn. he revealed he's in favor of raising taxes if there are spending cuts from today's "washington journal." this is about 40 minutes. radio.org. >> "washington journal" continues. host: senator tom coburn, republican of oklahoma. thank you for being here. a busy week on capitol hill as everyone returns to get down to business. what are you hearing about the influence of the tea party as people return and assess the midterm elections? amst: i don't know that i hearing anything about them specifically other than to recognize the fact they played in the election.

there are several new senators who had tremendous tea party support. i think it has been a healthy exercise for our country because it is focused really on the real problems that we face fiscally and probably institutionally in washington. the bad habits that washington has better challenged by the tea party. host: some of the folks who ran with tea party support in the senate races across the country cited jim demint and u s two of their most inspiration of figures. i know joe miller did up in alaska. not all of t folks one, though. the think the message is still getting through? guest: look, the basic tea party ssage is government is too big, it is outside the bounds of what it was intended, and the spending and the debt are a real risk for the future liberties of

american people. that resonates across a broad spectrum of america. and so, i don't think anybody will lost lost on the basis of what they embrace but that they wereeaten by someone else. america has to come back at -- and look at the basic problems challenging us. host: you can join the conversation -- yesterday the republican caucus in the senate decided to have a self-imposed ban on earmarks. you are a support of that. guest: absolutely. host: w did that gain momentum? that was not always the most popular viewpoint. guest: no, it wasn't. if you go back to 2005 when the bridge t nowhere was challenged

in the senate when we really started this fight on earmarks, and the negative aspects, it has taken five years for the american people to see what is really there. it is interesting, a poll came out that 73% of independents, 52% of democrats and i think 67% of republicans are adamantly opposed to the earmarking process. it is because of the consequential bad things that are associated with them. a year marks in and of themselves are not a bad thing. but what it has caused us to do in the result has been tremendously negative for the country in terms of this budget. host: why not reform the system? senators, members of the hou, who do support earmarks, especially some of them -- some of the democrats are saying it is not time to throw them out altogether.

some said reform the system, get rid of corruption -- guest: they are other corruption, that is the problem. they are the dollar trade that causes people to vote differently than what they would vote for the best interest o the country. the way you get rid of the corruption is to start asking congress to do itsob, which is to oversight the federal government. what happens is, we allows special interests to influence where money is spent. so if you are well heeled and well-connected or you are connected into a campaign organization and can raise money, you can bet you are going to get a benefit financially out of the federal government. that has nothing to do with a free society and a republic form of government. so, what has to happen is you have to stop that process and then the consequences of not having money go dectly to where members of congress might go -- wanted, you need to oversight executive branch agencies to make sure they are

doing a good job. host: 8 editorial says blasting earmarks is a way to avoid t serious discussions about difficult spending cuts and tax increases which is the only way to dig the country out of the financial hole. guest: there is no question we have bn significant spending cuts. i think they are wrong, we don't have to raise taxes. if you look at all of the waste, fraud, abuse, you can knock up to $500 billion per year out of the federal government. the assumption that we have a revenue problem i think is wrong. it is the first that among many to get our house in order. but when in fact bills are passed because people are bought off by your march 2 will for a bill they otherwise would vote for, -- bought off by earmarks for a bill the otherwise would vote for. earmarks a gateway drug to overspending and one of the ways we got in trouble.

forte -- 200 years this country did not do earmarks. this is a new phenomenon. it started in the 1970's. ronald reagan vetoed a transportation bill that had about one engine and 20 earmarks in it. this is a new phenomenon. we operated for two runs it years -- which operated for 200 years. remember, most of tm are never competitively bid. they are not sunlighted, no ansparency on them, so consequently -- and the most important thing about earmarks is the undermine people's confidence in washington. what we need to do -- if our country is going to succeed and get out of this jam we are and we need to rebuild confidence and not continue to tear it down. host: some demrats as saying earmarks can be a way to halt

projects at home that congressional members may have more of a handle on then the fed to do, they complained operation bills are not being passed. that using the authorization bill as a mechanism to get projects pushed through, as senator mccain said, is not realistic because the senate is not moving forward. guest: the democrats are in control so if it wanted to put them through they had massive majorities for the last two years and four years. if they in fact wanted them to get rough it would have gotten through. it is a priority. i think tt is a fairly lame excuse. the fact is, most earmarks, people don't want them to be highlighted, they do not want them to be sunshined. a good portion of what we take money from americansnd then resending it back out, if you look at article one, section 8, of the constitution, a new breed of powers, are not with it.

we are talking about all the way from building a parking lot or for a museum in omaha, nebraska, or a sculpture garden in seattle, you have trouble finding in the constitution the authority for the federal government to be involved in that spirit that is what you see. we are in such a deep hole right now, that unless we start changing the bill in washington i am not sure we get out. host: let us go to some of the calls. christian, republican caller in new york. good morning. caller: thank you for taking my call. senator, you mentioned civil liberties. i got to be honest, i believe that neither of the two major parties are interested in civil liberties. you see that with this airport thing. getting blasted with x-rays, taking nude pictures, getting fondled. i want to ask you, will you help

me and many americans who care about civil liberties in protesting and standing against these measures? this whole war on terror is taking our civil liberties and they are almost gone. gues i think there is a balance. we have allowed the threat of terrorism to cause us to do some pretty significant things. and as somebody who goes through those systems twice a week every week, i am not happy about what we are doing. but i am not sure that you have actually lost a civil liberty if in fact there is a threat of safety in terms of transportation, because there are a lot of other ways to be transported. we opted to fly because it is fast and fairly inexpensive compared to the others. and i am not happy. i opt out every time going through the new scanners simply because i don't want the medical

exposure that is associated. so, i go through the pat down in tulsa, and almost every other airports where they have the scanners rather than the magnetometers. i did you raise a very interesting point of -- think you raise to -- if we give up freedom to be free, what we gain? guest: senator, could go back -- senator tom coburn is our guest, he is a physician. he was a member of the u.s. house in 1995 and stuck to his term-limit pledge. you served three terms. and host: let us go to our next caller, a democrat in tennessee.

caller: my name is arnold joseph white. i co-authored a book called "the crime 9/11 intervention -- 9/11 inter vention." i read a blog that said 50% of americans believe that our elections -- our electoral process is broken and the other 50% believe that it is fixed. this segment that was on before you about the leadership and direction, we need to make sure

that all of our elections have relevance by making them honest. guest: about a 50% turnout the last time. some may have thought there were relevant. we want to create a trust and confidence that we are one to do the best and right thing is in the long term for the american people. washington is an interesting place, because things are not always as they seem. i think over the last 10 or 50 or even 20 years, apathy has grown -- 15 or even 20 years, apat has grown in our country. it has taken on issues that people say, do not do that if you want to continue to be

elected to an office. you are politically not correct if you do it. i think everything oughto be on the table. we should have free debate in our country. many are willing to defend those minority positions can be wrong. i think honest and open debate and i would like to see as get away from long-term service. i am a big believer in term limits. i think that helps u i think it is important that we bring people with the experience in the world to congress. i am not sure that we do that. i think that is part of the reason of what i consider some stupid things are done in waington, d.c. >> senator tom coburn from oklahoma. d when it says that you talk about president obama and praise

him weekly. he may not think much of the obama administration, but he still h some regard for president barack obama, the man. can you talk to us about your philosophy relating to the president? guest: it is not just the president, but reconciliation. countries go to war because they are alienated. i think we cannot talk to somebody or have a relationship -- i like president obama as a person an individual. we became friends in the senate. i am probably out there in terms of opposition to his policy. i think he is a very unique,

smart, bright individual. he is our president we should support him where we can. we should nourish our relationships so we can have a od dialogue. host: we have someone calling us from illinois. caller: there is a new republican house member that first got elected [unintelligible] then when he went for his orientation, there was a problem. he wanted to know if could by the government health plan. when will the hypocrisy and? ?- end th guest: when the health care bill was going through, t members of congress will be under this health care bill that was

passed. we will be in the state exchanges just like everyone else in the country. right now the members of congress have the same options as every other federal employee. i think there are 352 different plans you can choose from. the cost increases in federal health insurance is have been less than the others. that is one problem with the health care plan. host: here is a story from "politico." what do you think about tt? guest: i think it is a little bit misguided. the no. 1 seles -- social issue is we are stealing money from

our kids and grandkids. what are the consequences of the american government? 25 years from now, somebody that is 2500 $1 million in debtn the federal government. -- 25 is going to 0 $1 million in debt on the federal government. we will take and undermine the ability of our children's children t get a college education, own a home, have a car, house their families, because of what we are doing today. when you use the broad strokes social issues -- i am not going to walk away from me being pro- life. we need to look at those issues just like we look at every other issue. what we should do is work on e

most important one. the most important issue on our country is a social issue. what are we going to leave our kids? right now, we will bankrupt them. host: south carolina, republican caller: good morning. i want to say thank you for your commitment to the american people. i am a catholic from a conservative, pro-life, and i thk you for your commitment to defending life as a united states senator and ptective life socially as a doctor to care for it. my question for you today is i am leaving from south carolina. we are very proud of our senator and our new congressmen. our concern is they do not get up there. the new 60 plus mbers that are

conservative do not get up into washington get potomac fev. after the '94 election with newt gingrich, who i hope runs for president in 2012, we do not want them to lose their ground and realize what they were sent to do, and that is to shrink government, lower taxes, and promote the conservative cause and fight for the american people. we know that you have never lost that ground. we thank you. i hope that you can give some inspiration on how we can keep our new guys conservative and true to the conservative cause. guest: i think you have to hold the members of congress accountable. how do you do that? if you demand they have town hall meetings. you go to their offices if they will not. you demand they be transparent with their votes.

end the reason why they voted. -- and the reason why they voted. freedom is not easy. we have to work at it. people tend to migrate to a position of comfort, even in washington. even in a position for a congressman or senator. it is setting up things around you that will help you limit your arrogancend humble you and put you back on the right way. you should be reminded of what you need to be for your members and what they need to be about as well. host: our next caller. caller: why should we trust the republicans? when he mentioned ronald reagan not support of one item when he was president. ronald waken expended average deficit by 186% -- ronald

reagan expanded our deficit by 186%. why should we trust you as an individual when you assist a member of the c-street to take hush money to keep quiet about an affair? guest: i do not think he should trust republicans or democrats or any political party. what you have to do is hold your individual member [inaudible] and a debate the history. you have the most sustained growth that this country has ever seen economically in the past 50 years under the reagan administration. i came in opposing the spending of the bush administration. i was elected on the fact that i was opposing it.

we lel everybody. we label them in lots of different ways. what you have to do is hold people accountable. the labels are not as important as the actions. i think we need to be judged on our actions. host: year is what is set from tulsa world. -- here is what was said from tulsa world. guest: we get all hon of on parties --hung up on parties. we should be passed this time or

we are divided and partisan and bitter. the fact is, none of this helps us retina. we have never been in trouble but we are in today. i am hesitant to speak as plainly about it as i know, because i think it itoo scary. we need to make sure we address the first things first. right to know we are in such a nancial pickle that through all the partisanship -- if we through al of the partisanship out, and said, how are we going to solve this -- as long as we have the partisanship and we think back -- it is really alienation. we heard the gentleman from wisconsin. there was not only faxed he was quoting, but there was bitterness there. when we have that kind of

alienation, where we cannot get past it to solve the problems in front of us, we will not solve the. we all will be worse off, whether u are a liberal, conservative, democrat, or republican. everyone loses. host: we have a caller from ohio. caller: even though i am a democrat, i do admire a lot of republicans. i admire what you said about that you do reach out and you have a relationship with president obama. you are theirst person i thi i have heard a say that. i am going to make some comments really quick. as far as the earmarks in the past, why washere never anybody to make sure those things were done? they took advantage of them and

did what they wanted to do. i agree with you on the limit in washington as far as leadership. we should not only tried to get jobs. -- try to get jobs. i hope it i not like japan where everybody is bickering and nothing is accomplished. as far as the health insurance, i had to retire because i became very ill. i worked for the va medical center. my health insurance when i was with them, it went up every year. every single year. i believe that everybody should read president bush's book, because there are things that peop hav overlooked and the media has overlooked and have

not said what he has said in his book. guest: on the earmarks, when they are not competitive, they are not over cited. here is this a chunk of money that goes to a particular area. we did not get good value for it, whether it was a priority or not. then you never know whether they actually spent the money on the thing they were supposed to spend the money on. host: this is from "politico." was there a mistake made there? guest: you could go the other way. he supported marker rubio and charlie crist. he got elected. i do not think we help anybody

by armchair quarterbacking. this is a free country and you should be able to support who you want. i am not sure anybody has all of that knowledge that they can pronounce that they know what were to happen had somebody else been nominated. i do not think it is helpful to speculate on it. the fact is, what happened happened. there will be another election in t years, and we will see what happens. host: what is your take on the remmendations and how realistic is it? guest: let us set the stage for it. we have to do something. when this came through the senate, i did not vote for it. it was supposed to be set up by the senate and the house to do

this. i think we are a have a decent commission, it is called u.s. congress. there is no urgency for us to become austere. the president set up this commission. i was appointed by our leadership to serve on it. what has been recommended thus far in terms of the co-chairman smart -- mark, it does not go far enough. it needs to be six or $7 trillion to start making a difference in terms of whether or not we can afford our debt, whether we will have a decent intere rate on our debt. right now, we are in a very precarious position both in terms of the liquidity crisis that potentially could come. when people start rolling

against the united states bonds, they will do it like that. what we need is to make sure we had expended the time to getur house in order. we have a treasury department today that is shrugging off short-term notes instead of long-term ones. by the time they want to quote them, it will cost a whole lot more. i think the problems in front of us are of such magnitude that people should be asking us to throw off labels. i have said, i do not think we need increased taxes, but i will take it if we cut spending. we have to look down the road in solving problems for everybody, no matter what it looks like. host: are you surprised at the reaction on capitol hill to the recommendations? are you disappointed? guest: it is hard to know how it is moving forward.

this is why i would love to see this -- the president stepped up and say, i do not care if you are republican or democrat, everyone of us to get out of this problem we are in, we will have to make a sacrifice. it is time for you to stop thinking about you and start thinking about other people. if we are going to do that in have the leadership to do that, i think you could go dn the road with a much more effective resolution to some of our problemsith a lot less bitterness in debate. washington is about protecting the players' individual interest. it is not about doing the best thing for america. we need to be about doing what is best for america and for our kids in the generations to come. there is a lot at risk right now. are in very troubled times. it is going to require real leadership to say i am willing to bend some to do what we need

to do. host: a republican, in delaware. caller: thanks. i am sick of the shenanigans that is going on especially in washington. democrats an republicans are fiddling around and thehinese are straight ahead of us in every category -- medical, transportation, research and development. we are piddlingway our whole system. i would like to see you run for president. i am tired of the republican party filibustering every piece of legislation, all of these lls caught up in the senate. the republicans are filibustering everything against

every bit of change. filibustering is not in the constitution, but yet they choose to filibuster. i would like to hear what you have to sa i appreciate you, and i like you. guest: i am probably where most of the scores should be directed -- scorn should be directed to. i told my colleagues at the first of congress iyou want to create a new program you have to eliminate some program today. we cannot keep doing this. if they are not paid for and if they are not within the constitution, article one section 8 of the constitution, we do not have any business doing it. probably part of the difficulty is with me than republicans in general.

i m part of the cause of the rock that has gotten in the gears here. we have taken the party labels too far. i think we are missing it, both democrats and republicans, if we do not start thinking about what is best for america. s a physician, i am trained to fix the real disease. the way physicians get sued is they treat symptoms instead of disease. they allow themselves to be talked into this is this, and it is not the underlying disease. i see this in a washington all the time. we treat symptoms, because it plays well in quiet things down. but it causes the underlying disease to smolder.

it is like the health care bill. we did not fixhe real problem. the problem with health care is that it costs too much. we did not address that. we address these other symptoms rather than the core problem. that is what i see congress do in all of the time. we have a bill coming up to that lays on more layers of regulations on to the bureaucrats that are responsible, but it does not solve the bill problem. we have agencies that are not doing what they are supposed to be doing. that is the real problem. i am challenging the status quo on that. i think we need to do more of that. we are the safest country in the world. how much more can you spend to make it safer? can we be 100% homeless security? no.

we should be asking those questions, especially in light that we have bankrupted average children. host: not letting things going through in the senate, what you think about the proposal to get rid of that secret hold? guest: if you are holding -- there is a secret rolling hold, which would require multiple senators to do. after 72 hours, it is coming out anyway. i do not have a secret hold. anytime i hold a bill, everyone knows who is holding it. i write a letter every day saying this is the reason i hold your bill. 94% of it passes does so by unanimous consent. there is no debate or amendment

and nobody ever hears about it. it just passes, because we have said if you do not object -- and we all felt we ought to do this, and we will do it unless you object. we should do it the other way. the senate was designed -- i disagree with one caller. the senate was designed specifically to force conseus. until 1904 it took 99 to break a filibuster. then it was moved to 67. [inaudible] to have to compromise. we have not seen that in the past couple of years because of the predominance of one party over another. host st. louis missouri, an independent scholar.

c -- caller. caller: i would like to make a comment about the republicans' stewardship over fiscal policy. not since eisenhower has a republican administration acknowledged the budget, yet these republicans say [unintelligible] i think it is laughable. gut: i think he has a legitimate criticism of republicans. they were voting against what was there. if you want fiscal disciine, it means a lot of republicans that make the tough votes will lose their seats because they

made the right to vote. that is what we ought to be about. it is legitimate to criticize republican fiscal actions. the questi is -- there is very few people that do not have a bias to grow the government, republican or democrat. i have seen just as many republic bills as democratic bills. the bias is >> you did see "washington journal" ever morning at 7:00 eastern here on c-span. house leadership elections are taking place today on capitol hill. this is a live picture outside the democratic caucus meeting room where members have been arriving, departing, and deliberating who is going to lead the party in the 112th

congress starting in january. republican leadership meets -- meetings are expected to happen today although we just learned at a press conference with any announcement about the meeting has been put off until tomorrow. we'll find out if there's anything more to the story. we'll pass along to you as we learn anything. just a short time ago texas democrat sheila jackson lee came to the camera to talk about the meetings going on and how they are going. this is what she had to say. >> i have an update. things are going wonderfully. the caucus is having a very vigorous discussion -- my name is sheila jackson lee and i represent the 18th congressional district. i served as a chairperson on one of our committees. so i obviously will be in another position after this turnover, if you will. but i think it is important for

us to say to the american people that we are having a vigorous and healthy discussion about the importance of a focused direction for going forward and serving the american people. that is positive for our caucus. and members who wish to engage in this discussion are being allowed to do so. we will assume regular order in a few minutes and we'll begin the election process. frakely i expect that our -- frankly, i expect that our leadership team will be elected and i believe we'll have the face of diversity that the american people will respect. i also believe that we will have an agenda that the american people will both respect and understand. there is nothing undermining about democracy and debate and discourse. that's what's occurring now as we proceed. so i just stepped out for a moment. members are going in and out of their meeting. but we don't sense any calamity

or collapse. only debate and discourse and that's important. i think it's important to note th our agenda and our commitment to our mission is no less important than now the potential and the future republican majority in this congress. we do not intend to take any back seat to moving forward on the people's agenda. i look forward to this leadership being ready to move forward with all of us. we'll be ready to move forward as well. i believe i'm going inside to begin the process shortly. >> you haven't shot voted on the organizational rule yet? >> no, we have not. i'm an optimist and i think that the caucus wants to move forward. >> were you part of the secret meeting with speaker pelosi yesterday? >> i was. >> do you believe -- >> i think everything went well.

thank you. >> congresswoman sheila jackson lee from just a couple minutes ago. again those election discussions happening right now. house republicans also meeting this afternoon. their news conference following their meetings. we underit's been postponed until tomorrow. again we'll have live coverage of any announcement about the elections as soon as they become available right here on c-span. this morning on "washington journal," oregon congressman earl blumenauer joined us. he is in those caucus meetings right now, but he joined us to talk about today's elections and he offered his views on a possible extension of the bush era tax cuts. this is about 20 minutes. >> "wa" continues. host: thanks for being with us. talk about your support for nancy pelosi and who should be the minority leader of the house. guest: democrats would not have

made the majority a hat and the progress they had -- history will look at -- they had and the progress they had. history will look at this. she took a lot of heat for making tough decisions. $2 billion spent to vilify her. democrats understand her skills, accomplishments. i suspect she will be the overwhelming choice of the caucus, not that we do not need to do things differently. are places for other voices, but she has done a good job for the american people. history will show that, and it will be reflected in the vote today. host: scoring the lame duck session, there was an area of grievances. -- during the lame duck session,

there was an airing out of grievances. what do you make of it? guest: there was some discussion of the election. what i found touching was people being proud of being part of history. a person after person said we knew it was controversial voting for health care reform, but they knew it was important to the country. about one person said they would have taken any of those votes differently. i wish the american public could see it. i think history will show that they are right. host: only five blue dogs remain in office. what message does that send to your caucus? guest: it had nothing to do with their votes on energy or health care. those that voted against it are

gone. part of it is the economy. when the economy is bad, the people in charge appeared the burden. there are a number of serious where they made inroads into seats that were -- number of areas where they made inroads into certain seats. host: republican caller. caller: good morning. i live in oklahoma. the democrats did not listen to us. the majority of the country did not approve of the health-care. then george bush's record caused all of these problems. i have to correct you. democrats being in charge of congress the last two years of george bush is where most of the problems started.

do you plan on dealing out the state of california when they keep electing the democrats to keep control in that state? guest: great questions. i think it is clear that may be people do not like obama care, but if you break it out in terms of what is in the bill, people love the fact that there are no longer lifetime limits, their children can be on health care policies and insurance companies cannot cancel your policy when you get sick. when you look at what is in the bill, people love it. you have to pay for some of the things. overall, the elements that are there, people like. with all due respect, that health care bill has things that we fought for, being able to stop runaway entitlements building -- spending for

medicare and making it work better, they are in the bill and will stay in public policy because the american people wanted it. host: reviews on tax policy. guest: i hope the president puts down a marker in clear terms if he is feeling we cannot afford $700 billion borrowing from the chinese and others to extend more of these tax benefits to americans who need it the least. he should say, i will veto it. he can stop this conversation right now by being clear about what he is for and what he is going to do. the american public would much rather have a lower deficit then be able to move forward with these tax cuts for people who need them the least. i would like to give a desert to every friend of mine, but if we

are serious about the deficit, we need to get serious about this. we should be talking about reform. if we had $4 trillion to spend, let's get rid of the alternative minimum tax. let's invest in renewing america so we create jobs and move forward. host: he was first elected in 1996. he represents the third district of oregon in the portland area. we have a caller from georgia. caller: the spineless and america -- of america will not say this. what we create from research and development and the fda is with my money. our corporations go over there, and people think it is for the

labor, not realizing that they are trying to build their constituency. now they are getting research in redevelopment to india. this stuff belongs to america. research and development. this is the money of the taxpayers. guest: what we did with the economic recovery act is invest more in american research right here. the national institutes of health. in my community, we have a university that has money that is being used for life-saving and enhancing research. we put money in research for energy. we have not done enough of that. china and india are moving past us in terms putting this in place. high-speed rail. china is investing more in that

than everybody else in the world. we will have it in the united states, but the question is will it be research, develop, build, financed by the chinese and repaid them for the privilege or whether we do it in this country. we made a small start toward investing in high-speed rail here. this is one example of what we need to do to get control of our destiny. we have to rebuild and put americans to work. host: did progressives get more power in the house with the recent election? if nancy pelosi returns to leadership, does it give progressives more power? guest: what has empowered everybody is that there is an opportunity for us to move in ways that will surprise people. i have interacted with a few of the new people coming in, who

have a very different views. i think there is an opportunity to reform agricultural spending in this country, to reduce costs, and help farmers and ranchers more. some of the people that ran under the tea party banner believe in that. there is an opportunity to have different alliances to solve america's problems. host: maine, independent line. caller: this is the first time i have called. lucky me. how long will it take for americans to realize they made a big mistake by voting republican in the midterm elections. the democrats were almost bringing us back to the middle where we belong. if everyone would compromise, we would have a great country.

when will people -- how much damage is doing to our economy by according almost $2 trillion? guest: we are in a very fluid political situation. we have had some successful elections in a row. this was not a vote for republicans, but against the party in power. this is the first wave election in history where the people who were tossed out had higher approval ratings from america than the people that replaced them. we are not as a congress able to deal with problems, putting people to wor continues some of the processes in place and do so in a way when there is actual cooperation. there will be a another way the election coming in a couple of

years. we should not look at the next election, but look at the opportunities we have now with the deficit reduction commission recommendation, with new people in congress, and a new sense of urgency built on the foundation that we have to move forward. otherwise, the next election will not matter. host: st. petersburg, florida. caller: good morning. i do not believe the problem we are having is with congress. i believe the fbi has fallen asleep at the switch. i do not understand how a politician can go in and become five or 10 times richer eight years later or spend more money on a campaign than he can possibly make from winning an election. host: you are saying corruption in government? caller: yes, the fbi and the judicial system is not doing

enough to correct the situation. guest: one of the things i have been pleased to see is that there has been a series of investigations and indictments around the country. it has been going on the last half a dozen years. there was an indictment in metropolitan washington. i do think that investigative authorities, law enforcement, federal and state have been doing a better job of holding people accountable. i am sorry they have to do it. host: a house panel on tuesday found charlie rangel guilty of 11 counts of ethics violations. guest: i think that is an

accurate assessment. it will go to final adjudication with the overall commission. it looks like they will sustain that. that is a sad commentary. i think it brings disgrace upon the house. it is unfortunate and inexcusable. many make sure that we deal not just with the forms, but also avoid that activity. it is shameful. host: a formal censure would be a public event. should he step down? guest: the irony is with all of this out, he was renominated henry elected. that -- and we electre-elected.

that is a choice he has to make. host: a democratic caller from buffalo, new york. caller: good morning. i want to say that i am from one of the porous states in the country -- poorest states in the country. people in america should step back and look at what the republican party is doing to the american people. we are so far in debt to the chinese. we need to support the president. our unemployment is high, but the republicans do not understand that we are a poor nation. guest: i agree with you in part and i disagree.

we are not a poor nation. we cannot afford to pay twice as much as health care as anybody else in other developed nations. we cannot afford to waste as much energy than anyone else in the world. we cannot afford to spend more on the military than the next 17 countries combined and spend millions from western germany. we are rich, but we do not have exhausted all resources. -- inexhaustible resources. there are great opportunities in china, but that is why we need to stop wasting money in these areas but spend money in investing in renewing america and put people to work in and coast togon snf

coast. host: next caller. caller: i have a plan for your earmarks. some have driven billions of dollars away. if i have a checkbook and billions of dollars in a bank account, i could go around and help families that are facing foreclosure, and getting the mortgage holder and homeowner together, writing them a check, putting it on you too, given the government a better reputation than the republicans and democrats in congress in general has. we can cut out these middlemen and put it on youtube and the start from the grassroots, and something like this would really help people. guest: some interesting points

that he mentioned. in terms of the earmarks, i put my request online. i am proud of the money i have been able to help my people get to build a streetcar line and help with environmental protection. to help with community revitalization. it is transparent. they have made a big difference. i would rather help my committee then rely on the george bush should ministration or the obama administration or the clinton administration. that is. to happen if we eliminate all earmark activity. -- that is going to happen if we eliminate all, the mark activity. i think -- earmark activity. we have to deal with keeping people in their homes right now,

modify the terms, and everybody would be better off. the simplest way to do that is to change the bankruptcy laws so that individual homeowners are treated the same way that businesses are in bankruptcy. if that happened, we would be able to work these things out fairly quickly and not have the terrible loss and devastation to individuals. host: republican in florida. caller: if the middle class gets the tax cuts and the rich people do not, how does that affect my state tax? is it going to go sky high? guest: in terms of the inheritance tax, the proposal that was on the table that the president talked about and what we had passed through the house was to keep it the way it was last year, which would allow a

family to exempt all together $7 million for a couple. what has happened, and i have been told by attorneys and financial planners that if somebody with $7 million worth of tax exemptions can protect $50 million, they do not need a another break, but another attorney and accountant. we are talking three tenths of a percent of the people that will pay an inheritance tax anyway. george steinbrenner passed away with dennis state of $1.5 billion i think. -- with an e state that was $1.5 billion i think. it is appreciated capital. that is what people like warren

buffett and bill gates support instituting an inheritance tax at a reasonable level. when looking at a huge budget deficit going on in the future, having a reasonable inheritance tax that started with >> see what people are watching on the c-span video library. with the most recent videos, most watched videos and most shared. click our special 2010 election analysis tab to view our continuing coverage of the midterm elections. watch what you want when you want. >> like all men of great gifts when they give up power, you know they give it up for principaled reasons. they hanker for it the moment

they give it up. >> in the final volume of his award winning trilogy on theodore roosevelt, ed war more -- edmund morris exams the final years of t.r.'s life. sunday night at 8:00 on c-span's "q&a." >> house members have been shuttling in and out of their caucus room this morning on capitol hill. house leadership elections are under way today. this is a live picture just outside a democrats' meeting room as deliberations continue over who is going to lead the party in the upcoming session starting in january. republican leadership meetings still expected to happen today although we are hearing a press conference with any announcement about that meeting has been put off until tomorrow. we are still tracking the story and we'll give you more as we get it. up next t.s.a. administrator john pistol had a hearing earlier today. he admitted some travelers will be subjected to both the enhanced imaging and pat down in airports. testifying before the senate transportation committee. this is about 90 minutes.

>> a live picture outside the democrats' caucus room as we

await the results of leadership elections taking place. the democrats expected to make their announcement first. we expect also to hear from republicans at some point although we do hear, we have heard in the past, half-hour or so, that the announcement of their leadership elections will be delayed until sometime tomorrow. we will try to get more on this and pass it on to you as quickly as we can. this is live coverage of the house leadership elections on c-span. now a remark from t.s.a. administrator john pistol at a hearing today admitting some travelers will be subjected to both enhanced imaging and pat dos in airports. this is 90 minutes.

>> this hearing will come to order. my opening statement and then as i explained tot distinguished witness i have to go rescue the health care bill in the finance committee where it's going to be assaulted on all sides. so byron dorgan will take over as he should. so my statement. turn on the tv, pick up the newspaper in the past 48 hours there have been a steady stream of stories about airport screening procedures on patdowns, full body scanners, comments from spouses in all directions. i appreciate people's concerns. i understand there's a frustration. i realize some of these screening procedures appear invasive. our witness and i had a terrific

long session at the beginning of this week and we went into a lot of this. the new patdown procedures embody the emnormously difficult task, and vo voidly difficult task of balancing the need to protect the public and need to maintain their prifecy. how do you do that on a patdown? well, one of my first questions for you who i think is doing a great job, concerns these procedures. and how you came to develop the new security regulations. i do recognize the threat that we face. i used to share the senate he intelligence committee. i'm still a member. i can tell you the threats are as we indicated the other day in our conversation extremely real and extremely ongoing and it's evolving every day and they only -- something hasn't happened because the intelligence has been so good and that won't always be the case so we have had kind of a lucky run here.

we can't expect that to last. we face a deadly and determined enemy who seeks to do us harm enemy without and within. it's easy to put together a package ticket underwear and shoes whatever. you never know. the problem is you always have to know. t.s.a. always has to know. so considering the events of this last year, a terrorist boarded a plane bound for america on christmas day, he carried a deadly explosive onboard. should have gone off, didn't go off. federal agents uncovered a plot to bomb multiple subway stations in washington, d.c. the terrorist goal, to kill as many people as possible. again, good intelligence gathering, prevented this from happening. it should have happened. it didn't happen. we were lucky. good intelligence. authorities recently disrupt add plot to blow up planes over the u.s. using bombs hidden in cargo

. again excellent intelligence. stopped this plot which should have worked from moving forward. we cannot be complacent, therefore. our transportation system remains a prime terrorist target. not just air, transportation, too. all forms. we must continue to bolster our defenses against a determined enemy who will not relent, will not go away, and in fact will increase. and as terrorists methods evolve, therefore so must the t.s.a.'s. t.s.a. has massive responsibilities and multiple missions. they move a half a billion people through the u.s. aviation system every year. screen billions of pounds of domestic and foreign cargo. as best as they can. protect our ports and our diverse public transportation systems.

all of this with the prospect of not enough money to do the job that they would like to do. i do not doubt the difficulty of their mandate, but the agency must remain somehow well resourced. we are not talking theology or ideology here, we are talking about protecting the american people. it gets to be a very different deal. sort of like fisa. a lot of democrats didn't like fisa. they said it invaded privacy too much. maybe a whole lot of really bad things didn't happen because there is fisa. so we have to just go back and forth on these things. the agency must remain well resourced as i indicated and they must remain nimble in their response to new and emerging threats. we must take appropriate action to close any security loopholes. while making sure our global transportation system continues to move people, freight, goods, faster and faster and in an effective manner.

i continue to have concerns about general aviation. we discussed that. general aviation has gotten off pretty easy. i don't like going out to dulles airport and just walking right on to an airplane. not a patdown, forget it. they don't even look at me. so clearly existing system of international cargo security needs a fresh look, which i know t.s.a. and d.h.s. have started to do. we must also incorporate new technology that will make it harder for terrorists to exploit our transportation system. it's complicated, is it not, senator lautenberg? as i have already stated but i think it's important enough to say again, the balance between security and privacy. it always faces you, haunts you. director pistol, it haunts you. it's a delicate one. i believe t.s.a.'s committed to

achieving this balance to the extent that it can. i would urge all of us to consider that these procedures are in place to protect us from a very real risk. they are not there just for the doing of it. in the coming weeks i'll be working with my colleagues in congress to make sure that t.s.a. has the resources it needs to address key security concerns. that's going to be tough in this atmosphere. but on this committee we have to sort of gather ourselves together and decide this is important. i thank you for being here today. very much. i think you're doing a terrific job. you have been at the helm of t.s.a. for only several months now and i know it's been a demanding time for you. so i look forward to hearing your thoughts, which he won't, because i won't be here and i explained that tow, so i apologize for that, and so i

will vacate the chair, turn to my co-chair, senator hutchison, and ask senator dorgan if he will assume the chair, thank you. >> mr. chairman, thank you. certainly i will look forward to working with you on the re-authorization of transportation security agency. mr. pistol, the last time you were here we said this is going to be a tough job. i -- and now you're finding out. and i agree with so much of what the chairman said. your job is just enormous. not overwhelm are rewee looking now at the cargo issue, which this committee has been very active in trying to assure that cargo, which is in so many of our passenger planes, as well as

bringing goods into our country that we need to know what they are, we have been active but we have not been able to address that to our satisfaction. and now with the situation with yemen, it's very clear that once again we dodged a bullet, if you will, but we've got to have procedures and i hope that we are going to be working with our foreign countries where there are gateways into america through aviation that we will beef that up. i know that our committee is going to be very active in that area. secondly, we are going to have to have intelligence gathering to do that when we are at risk of so many airplanes coming into our airports with cargo,

sometimes cargo only, sometimes in the passenger planes, we've got to have intelligence gathering that should be part of your either cooperation or direct control. of course you're from the f.b.i. so you understand that need. secondly, i mean you got to be hearing the outcry about the invasive uses of patdowns now in the airports. there has to be a way that you can figure out how to do what's necessary, because we all see people in the airports going through with long skirts and lots of cover-up possibilities, and that's what you're trying to address and we understand that. there's got to be a way, however, for a privacy concern to be addressed because it's legitimate. and i know that you'r aware of it but we've got to see some

action. i know the secretary is as well. i have heard her say that she is concerned about the privacy. i think we've got to do more. the outcry is huge. i will just end by saying that -- i have two more things to say. one is i have also mentioned before that i'm concerned about our ports, which are also entries into america, and our trains, our surface transportation. we've got to make sure we are doing everything we can before the originality of our ene comes forth rather than always playing catch-up which is what we seem to do. it's good that we learn from the past. that we learn from the mistakes. that we learn from the new iterations of the plots. however, we've got to start anticipating through

intelligence what they are up to before it happens. the last thing i will mention is that it's my understanding that you haven't made any decision about changing the federal law that prohibits screeners from striking. i hope that you with all that's on your plate, i hope you will not try to change what is the law in this country. i think if you did decide to go the other way, that there would be an upheaval in congress and there would be great efforts to prevent it from happening. i don't think that's a fight that we want right now when we should be concentrating on all these other issues that both the chairman and i have mentioned. with that i'm glad you're here. i appreciate your being here. and i think that in your short time you are getting your hands around this, but our job is to have oversight and tell you what

we think needs to be a priority and hope to work with you on that. thank you very much. >> senator hutchison, thank you very much. we are going to begin some votes here in the senate i believe at 11:00 today. we have only one witness, mr. pistol. what i would like to do, i want to make a couple of comments then call on colleagues for two minutes or so for opening statements if they choose. and then we'll hear the testimony from mr. pistol. i want to just mention that the history of all of this goes back to a hydrogening -- hijacking and the determining of metal detectors to keep guns out of airplanes. then we saw the growth of the terrorist threat creating a shoe in the form of a bomb, or arming a shoe as a bomb, and then fashioning liquids that could be used as a bomb in air. then a bomb disguised as

underwear or underwear carrying a bomb. now various more sophisticated things on the freight system on airplanes. so we have evolved with a series of threats trying to respond to the threats to make sure that we have safety in the skies. i think -- i have a series of questions about the freight side and general aviation, about the work to make certain that those who work at airports are properly screened, but i think the most recent issue of full body imaging and law enforcement-style patdowns with intimate touching or what is described as intimate touching i think those are very legitimate questions. as you know the law enforcement style patdowns were just initiated nationwide in october. so we have only -- this has only been a month. not surprising to me there would be a lot of concern and anger by some and protests by others about this. and i think it's important for

us to have a pretty full and complete discussion about what does this mean? i would ask the question, and i will, mr. pistol, have you had that type of patdown that many americans are now protesting? has your staff had that patdown and perhaps have u.s. senators had that patdown? what's the impress of -- impression of all that? we must make sure people don't get on airplanes with bombs and blow that plane out of the sky and kill people. i understand that. the question is how do we do that in a way that doesn't go to the n.t.r.th degree -- nth degree to invade people's privacy and do things people find unacceptable as they try to get on a plane. these are important issues and we appreciate your being here to be able to discuss them with you today. your job is a tough one. you and your agency must succeed. we insist that you succeed and want to make sure that we do everything we can to help you succeed on behalf of the interest of the safety of the american people. let me call on my colleagues for

-- if it's appropriate, for them two minutes, opening statement, so we can get to the witness as quickly as possible. senator lautenberg. >> thanks, mr. chairman. mr. pistol, congratulations go to you and your team for the good work done with the cargo coming from yemen. all those these packages were addressed to chicago synagogues, investigators now believe the bombs were meant to blow up mid flight over the east coast. the vulnerabilities in our system remain. and just 65% of cargo on international passenger flights bound for the u.s. is screened, well short of 100% screening mandate for cargo on passenger aircraft. right now at d.h.s. receives cargo manifest information from cargo only aircraft just four

hours before arrival. that means that we may not learn about a bomb until it's well within our borders. and rob -- the former administrator of u.s. customs says it makes sense to have the cargo information predeparture so cannot only deny entry on arrival but potentially deny access to the airplane. so while we want to strengthen aviation security in the united states, my colleagues have talked about the humiliation that accompanies these patdowns, we got to talk about that, there are clearly areas that we can identify. so too often we think of t.s.a. we think only of aviation security. but we were reminded last month when the f.b.i. arreste a man who was plotting to bomb four metro rail stations in northern virginia, and one of the most important transit facilities is

the d.c. metro system carrying a million passengers a day. and we can't make any mistakes. passenger and rail transit systems are prime targets for terrorists throughout the world as we have seen in london, madrid, mumbai, and russia. we need to devote more attention, more resources to securing our surface transportation networks against these threats. the threat is real and we can't afford to be anything less than vigilant about it. once again, mr. pistol, congratulations on a job well-done so far. >> thank you very much. america online mr. chairman, i'm going to submit my comments in writing so hopefully we can expedite the process to get to the witness. thank you for the opportunity, though. >> thank you very much. senator isakson. >> thank you, mr. chairman. i'll also won't make an opening statement. through you i would like to make a request of chairman rockefeller and ranking member hutchison.

although this is an open hearing which is appropriate and should be, i think at some point in time in the near future we should have the administrator in the committee in a classified setting to understand the information that has led up to the changes in the procedures at the airports. i make that request through you to the chairman and ranking member. >> that request is noted. i might note this committee has on a previous occasion, been a long while now, had a closed hearing in which secret material was presented to us about transportation security. senator klobuchar. >> thank you very much. i endorse senator isakson's idea. i think it's important. obviously there are some things why they'd a procedures are implemented. some things we are not going to be able to talk about in public for security reasons. i appreciate that. i want to first again thank you for the role that t.s.a. played in securing our nation. certainly these recent incidents with the bombs being sent to synagogues illustrated the

importance of this screening. i'm eager to work with my colleagues. i know work's going on right now, i know secretary napolitano and changes have been made in terms of countries that can no longer send in its cargo, but also i supported stronger screening in the future both with this committee and judiciary look forward to working on these issues. i want to say a few words on passenger screening at my own risk given the calls that have been coming into our office on these screenings. i appreciate the steps forward you have made. i have been a fan of the advance imaging technology. one, i think it's going to show things we didn't know about before. that's very important. and it's a deterrent to some of these activities. secondly, as someone who has a hip replacement, i have been patted down in front of my constituents on every single flight i have taken, i kind of welcome this advance imaging technology where you don't have to have a patdown. i hope in your remarks you will discuss the role of that advance

imaging technology that he sow that people do have a choice in airports. i know they have them in ours now in minneapolis if they want to go to the line with the advance imaging technology, they can do that. if they want this patdown which we know we need education with the public so they are not caught offguard anti-fact they are always offered a private screening i think is something that has to be out there. clearly people are going to feel uncomfortable with this. i think they have to understand that this is being done for their best interests and safety given some of the terrorist activity we are seeing across the country. i want to thank you for your work. >> thanks, senator klobuchar. senator mccastle. >> t.s.a. is a dammed if you do and damned if you don't, mode. i certainly appreciate that the american public command safety and security on our commercial airplanes. and there is a price we pay for that and that is sometimes uncomfortable price for the american flying public.

i have gone on in other committees and this committee about the ridiculous notion i could take my mascara on an airplane and i understand that this is obviously much more serious to many americans in terms of intrusiveness. but i think we can do a better job on public education and like amy, i have had my love pats every single flight. i have taken, which is at least twice a week for the last four years of my life, because i have a knee replacement. so i am wildly excited about the notion that i can walkthrough a machine instead of getting my dose of love pats. i think we've got to work on this. make sure that the traveling public has choices. make sure they understand the risks that we are trying to address. and then i think we can -- the majority of americans i think -- i hope will become supportive of the measures that t.s.a. is trying to do to keep us safe. i want to take the remaining time in my opening statement to congratulate the department of homeland security.

we have a tendency -- >> we'll leave this hearing at this point and go live now to the democrats'caucus area where members have been having meetings. >> 129 to move forward. i think this was a very, very important process for the caucus to go through. i feel we have had more meaningful discussion in the last two days about the role of rank-and-file members and the concerns we have where we believe that we need to make changes to go forward and recapture the majority. this is, i think, a good beginning to that process. obviously i would have hoped to prevail, but i think the 68 votes is a substantial message and i'm pleased with the results. >> what message is that? >> first of all i just want to say how proud i am to join congressman defazio and

congressman wu, congressman pascrell and so many others who assisted us today in this really historic vote. i think in terms of what was achieved since yesterday congressman wu was able to get a ruling that allowed all of our members yesterday to speak for almost six hours. i cannot remember in my 28 years here in this congress when we had that kind of open dialogue about where we need to move our country in order to heal this economy and to meet the expectations of the american people and adapt our leadership structures in order to meet those concerns. then today we won the vote for a secret ballot and that was unexpected. and i really want to thank all of our colleagues who allowed that. it was quite a significant moment this morning. and then we did have the vote as congressman defazio stated, we received 68 that favored

deferring the elections until later in the month as we did in 1994. but there were 129 that preferred to move forward. i think many of us made our point. my focus continues to be on the economy and structure that we have within our own caucus. the republican caucus will never deal with the jobs and economic challenges of the american economy, how we restructure ourselves. the speaker, all the leaders were there. they listened respectfully. there was a lot of eye contact and a lot of understanding that happened. i feel that the dialogue we had, the several hours that we spent on this now have been very constructive as we move forward to meet this expectation of the american people and that is jobs and moving this economic recovery forward. >> thank you, marcy. after my election a few days ago

, i have a lot of sympathy for the 60-some colleagues who are not returning and now i know what it feels like to lose an election. but we are ready to move on. we are ready to move on with a process. we will select a leader at this and we will unite behind that leader because i think the record of this congress is an incredibly strong record. we kept this nation out of a second great depression. we passed landmark energy legislation that is still before the senate. we passed financial regulatory reform that ends too big to fail and ends credit card rip-offs and ends taxpayer bailouts of wall street for good. the most important thing that we have done is actually a pro-job, pro-economy piece of legislation that's absolutely historic. we passed health care reform that is -- that has been the goal of many congresses since 1912. this congress achieved it. i believe this congress in

historic terms will be one of the great congresses in american history. but that debate will be held by historians at later point in time. today we are ready to move on. and i believe that -- well, i think i can speak for all of us, i'd like to be able to speak for all of us, that once we select the leadership, we will unite behind that leadership because there are serious differences in policy and values. but i will say this for myself, i look forward to working with the new republican leadership in january, and i look forward to working with the administration and the united states senate to craft the legislation that the united states people want us to accomplish because they did not send us here to govern by grid lock -- gridlock. they do not want subpoenas to substitute for civility. i look forward to working to accomplish those goals for accomplish those goals for organs and the american people.