>> we just left a very lively session that steny hoyer headed up. it was very encouraging about a path to how we can not only be economically violable -- viable, but how we do it in a way that does that here in our country. people can make it in america. it is very exciting. 2 hearken back to what john larsen did yesterday when we gathered in the rotunda, part of the comments were getting america moving again, coming out of a decade with three recessions in it at that time. we have come out of a decade with a deep recession in that and would have been a depression without the actions taken by president obama and the democratic concourse -- congress.

there would be no industry without our action. this is about personal fulfillment for individuals. it is about economic strength for our country. it is also about our national security. we are not strengthening our technological base, if we are not, we fail. we need to strengthen the middle class, which is the backbone of our democracy. we have a lively discussion about our prospects for success. to the extent that we can convince the american people that we are here to solve their problems by creating jobs, we will be back. i am pleased to yield to the distinguished democratic whip, fresh from a very lively session with our members, steny

hoyer of maryland. >> i want to thank the speaker. i know that she is temporarily of the leader, -- temporarily it the leader. -- temporarily the leader. we welcome you to our state and this beautiful area of our state did you have brought a group of members to gather that do not have a minority psychology. -- to get the the do not have a minority psychology. -- together that do not have a minority psychology. they are working. make it in america was the subject matter of the panel that we just concluded. participating in that panel they tell us that the american public, nine out of 10 believe

that if we are not making things in america and selling them here and abroad, we will not be the country that we want to be. then, we have the representative of a major american manufacturer, for boehner co.-ford motor company. -- ford motor company. suppliers would have gone out of business. adam will tell you that that was critical for the survival of a ford and gm and chrysler. we have a growing industry for automobile manufacturing. 7000 new jobs will be created

here in america by ford motor company. they have brought manufacturing plants back from india, from mexico, from china. we think that people are not sure that they will make in america. we believe that not only are they going to make it, but america is going to make it in this global marketplace. we have a representative of ford and the president of the union. he says that he was an -- he was enthusiastic about the make it in america agenda. tony brown said that he was enthusiastic. he thinks that we can bring business and labour together. we can bring conservatives and liberals together. we can bring all of our country together on the agenda that we make sure that we make in

america it in both meanings of that word. we are ready to go. we are ready to work with our republican colleagues on an agenda that will ensure that every american makes it in our country. thank you, very much. now, to my friend. >> thank you very much steny hoyer. i am very enthusiastic about where we are as a caucus. i got here yesterday afternoon. i was not in attendance back in 1960 at the inauguration. i was old enough to attend, but i was not old enough to vote in that election in 1960. but it was an interesting thing about life and legacy of john f. kennedy.

i say life and legacy because the new spirit that john kennedy brought to the presidency, which was too short of a presidency, was as such that when his funeral was held -- a little-known piece of history, here. because of the families philosophy, you see that among the honor guard was an african- american that was a classmate of mine from the first grade. i remember how proud we were to see one of our own carrying the casket of john f. kennedy. i cannot tell you what that did to those of us who were coming along.

that stayed with me even to this day. i want to say one other thing. i think that what you saw two days ago by president obama is indicative of where we are as a caucus and a party. while the other side is talking about going back to bush in 2008 or 2006, president obama pointed -- appointed jeff, the ceo of ge to move forward with the job creation agenda. i think at that signals -- that that signals a tremendous new direction for the economy of this country. this president and members of this cumbrous -- this caucus want to say our economy and bring it back to where we see job growth taking place.

now, what we will see with this new appointment is that we will see a surge in the job creation in this country. it signals that he will have much more time to get to this job. we will now go to mr. israel who, i might add, did a tremendous presentation that has already got our members coming -- humming. >> thank you for asking me to

chair the triple c. let me make three points. this morning, our caucus kickoff -- kicked off. our central message is to make it in america. my central job is to make it back to the majority. when we get back to the majority, we can make the -- help the middle class make it here. we can help small businesses grow jobs through entreprenuership and innovation. we will do that in two ways. it will be based on two essential ingredients.

we will offer constructive proposals. the republicans spent four years saying no and not lifting a finger to help. we will offer constructive, thoughtful, economic proposals. we will hold republicans accountable when they do not support the interest of middle- class and working families in this country. we will hold them accountable when they demonstrate levels of hypocrisy. but when they do not uphold the values that are important, we

will let the american people know about and that brings me to my second point. the republicans promised three things when they came to the majority. the promised to create jobs. they promised to reduce debt. they promised they would change the way that washington works. in the first three weeks, they are 043. -- they are 0 for 3. they said they would reduce debt, instead the increased debt two hundred $30 billion according to the congressional budget office. they said they would change the way that washington works, and yet what they have shown is a stunning level of hypocrisy by voting to protect their health care benefits while repealing it for the americans that they represent. we will hold them accountable. they have had a rough three weeks. between now and the next election, we will offer constructive, economic, job- creating alternatives and try to work with them and we will hold them accountable when they do not uphold the interests of middle-class working families and small businesses. thank you very much. let me turn it over to an individual who i have a new appreciation for. in the past three weeks, i have a full understanding of what the next four years will look

like for christmas in holland and -- for chris vanholland. >> i want to welcome the caucus and thank the caucus leadership for selected maryland to most of the the credit conference. i want to join my colleagues in saying that we will work with our republican colleagues in moving the country forward if that is their agenda in terms of getting people back to work and accelerating economic growth. if they truly want to put this country on a sustainable fiscal path, and i want to make sure that we support the middle class in this country. unfortunately, the first few weeks did not present very good signs of it any of those fronts. number one, we have spent the first couple of weeks in their effort to try and repealed the health care bill. millions of americans are learning the benefits of that bill. in the process, they have blown a big additional hole in the

deficit. over the next 10 years, they added two hundred $40 billion to the deficit and a total of 1.4 trillion dollars over four years. that is not fiscal responsibility. those are not our numbers. those are the numbers of the independent congressional budget office. i know that our republican colleagues do not like to hear that, but it is a recipe for but it anarchy and fiscal chaos and a lot of red ink in the future if we are going to totally ignore the numbers of the professionals in the congressional budget office. we look forward to working with

them. this week, they will bring a budget resolution to the floor that, unlike any previous budget resolution has no number. it is a budget resolution without a number. you can only conclude that this is an effort to create an illusion that they are addressing some of these problems when, in fact, there is nothing to be seen. someone asked where the beef is. members of the republican study group just put out a proposal that is reckless in terms of the impact on the economy in terms of jobs.

non-partisan and bipartisan -- bipartisan, i should say sent two messages. we agree that we need to act now to put this country on a sustainable fiscal patrick when the economy is as fragile as it is, you do not/in the way that the republican study group has proposed. that is a recipe for slowing down our fiscal and economic recovery. as my colleagues said, we look forward to working with our republican colleagues if they want to work to get the economy going to get people back to work and to reduce the deficit and help the middle class. unfortunately, the first two weeks have not shown very good signs of that, but we stand ready to work with them. >> as you can see, we are ready

to pick up where we left off from before. that is, creating more jobs for americans. last year, we created more jobs in america in one year than george bush created in over eight years. so, we are ready. we are hoping that our republican colleagues will join us in this effort to help america get back to work. with that, we will take any questions. >> i wonder, madam leader, the republican strategy, if it worked. will you work with them with the political pull?

where are you all sitting during this? >> the republicans just say no policy did not work for the american people. what they said no to was every job-creating initiatives that we try to put forth. from day one, president obama and the democrats in congress created jobs. 3.6 million jobs were saved or created and then the initiatives were taken and more jobs were saved. that was the first act of congress for job creation. every other initiative, they have seen it in their political interests to just say no and the american people pay the price. you do not get any credit for reducing joblessness by 5%. did did not work for america's working families who want jobs and who want to work. i do not think it worked for them. people can sit where they want in the house of representatives. we have open seating. the senate has assigned seats. we have open seating. sometimes it comes down to region.

sometimes the hispanic caucus is here and the black caucus is here. it just depends on what the conversation is at the moment. people will sit where they want to set. -- want to sit. >> i have talked to a lot of members who will be sitting with republicans whether they are interstate or if they have joint responsibilities in committees. i expect you to see a visible symbol of some of the willingness to reach across and work with one another.

hopefully, that will manifest itself in real commitment to building jobs and growing american so that every american can make it. >> i have been sitting next to vice-president cheney for a long time. [laughter] >> if i could break for just a minute, we were joined by representative floyd and bob king. he is one of the leaders of working people in this country and i would like him to just say a couple of remarks, bob king, the president of the united auto workers. [applause] >> i am very appreciative of the leadership of the democratic congress doing this. government business and labour are working together to make the best, highest quality vehicles in the world. the american public does not realize this yet, but we are making america better than anyone else. i am excited about this initiative and excited about working with working-class people. >> one last question. >> can you explain why you voted against the democratic motion to recommit last week?

it seems like a pretty significant vote to break away from. >> the vote was overwhelming. my only view is that i was focused on the fact that they do nothing to bring the deficit down. they do nothing to make health care more affordable for all americans. frankly, i wanted to focus on that aspect of it. thank you, very much. >> looking ahead on c-span, remarks by the vice president at the house and democratic caucus retreat.

>> sunday, our guest is vanity fair calmest and atlantic monthly contributing editor christopher hichens. >> there are treatments that i can see that are out of my reach. &a."nday, on c-span's "q afghanistan, insisting that thehis remarks came at the housethis is about one hour.

>> friends, colleagues, i hope you have enjoyed the last day and a half that we have had an opportunity to come together. we are making every effort to make sure that this retreat gives us, as brothers and sisters, a chance to talk. not only to get to know each other better, to welcome our newest colleagues, those nine members, but also to get ready for the work ahead. we are fortunate that each and

every time that we have this issues conference, we have the highest level of protest patient by our highest leaders in the land and we are very fortunate that, once again, the vice president has taken the time to do with the spirit of want to introduce to you someone who has -- he has been able to do many great things on foreign policy. howard berman, most of you have been able to get to know him over the years and those of you who have been here a short time have seen him do his work. howard is a master at operating at low levels. he was still before stealth was popular by dot -- he was still before stealth was popular by dod. those of you who have watched him on the judicial committee over the years, many of us that admire the work that he did on behalf of immigrants, if you have anything to do with intellectual property, he has made it possible for us to protect those of intellectual

property rights. he has done some phenomenal things. he has been around for some time. there are a couple of things i want to mention that you may not know about howard. howard was instrumental, quite some time ago, in making sure that a gentleman by the name of nelson mandela and many other members of the african national congress finally have their names removed from the u.s. list of terrorist. howard was instrumental in that. [applause] when most people were still avoiding uttering the words aids and hiv, howard was making sure that we had $50 billion dedicated to deal with the ravages of aids and hiv. he continues to do this for us

and i would like to ask our colleague and our friend from california to please come forward to help invite and will come our special guest. [applause] a lot of things come to mind. this is probably somewhat personal to my own congressional experience, but i have to love a guy who spent his entire 36 years, if his whole career in the u.s. senate on

both the foreign relations and the judiciary committee. even more, you have to love a guy who, other than perhaps anthony wiener, tends to speak his mind more than most. [laughter] the vice president of all he has done in the senate whip, he has clearly played a leading role in policy achievements. the effort to facilitate the creation of a coalition government in iraq. the whole guiding of the reset with russia. his deep immersion in both afghanistan and pakistan strategies. one particular recent experience i just want to highlight. in early december, when jon kyl announced that boats should be put off until the next congress, i would have bet a lot

of money that we would never find the 67 votes necessary to ratify that treaty. but the vice president personally and painstakingly went to work with his mastery of the arms control agenda and his intimate knowledge of the u.s. senate and he, one by one, gather the votes to defy the odds to produce a result of that has an importance far beyond the start treaty in terms of russia relations, in terms of nonproliferation goals and global affairs. the foreign-policy challenges that we confront now or breathtaking, but to hear him talk about it is an honor and privilege to welcome the vice president of the united states joe biden. [cheers and applause]

>> thank you, very much. thank you. i want the press to know one thing. in 38 years of being a senator and 36 -- i have never heard said that a leading congressman actually loves somebody who has served in the senate for 36 years. this was worth the trip. there are rumors that i do not stay on message and that is not true.

[laughter] [applause] >> this is the price that steny paid. nancy, you are a great friend. it is great to be here with you. steny, you are not much, but i love you. steny and i agree on almost everything. thank you for your leadership and your courtesy you have shown me and john, you are doing a great job from my perspective. javier, thanks for having me here. before i began, and i am sure you all talked about its, let me say a few words about gabby. those of us who love the congress, we talk about it in ways that i think the public outside this not grasp or understand.

-- outside does not grasp or understand. one thing about this family is that we live in each other's losses. some bus does some of us are really close to one another. i am sure that those of you in the caucus and seeing her open her eyes, it would make you feel so sad. i want to say to all of you that this is a personal. i know his personal for a vast majority of you that no gabby. i had the privilege of campaigning for her this past year.

like many of you, what a courageous campaign she ran. the phrase that i use in other circumstances is that she has a backbone like a ramrod. i had the great privilege of dealing with a lot of neurosurgeons. over 20 years ago, i had to craniotomies because of a aneurysm in my subarachnoid cadbury -- cavity. neurosurgeons are incredible. we know little about the brain. how little we know about is recuperative capabilities. how little we know how to be able to predict what will happen.

i would give a personal example of something that i went through where i remember asking the doctor, thinking that i would never be able to function very well again. a said that this has happened to me, why? >> he said he did not know why it has happened but that he could tell me from experience what we do know. we do know that in most cases it gets better. we do not know what it gets better. as devastating as gaby's injury is -- as devastating as gabby's injury is, i am not convinced -- attitude and determination is an incredible weapon in dealing with your -- what you are facing. i talked to my neurosurgeons

that i keep in contact with. they saved my life. when things happen, they are the guys i call and ask them to interpret for me. they say that they do not know exactly what happened, but there is every reason to believe, based on the progress she has made, that it could be exponentially greater. no guarantee. from my own personal experience, with no ability to give you any data to sustain what i am saying, i just looked at how quickly she has moved and i am hopeful. i also want to say -- we could get into a debate about what caused the guy like this to do what he did.

one thing that has happened is i think it is not about assigning blame, but i think there is a generic recognition and that we a to change the way we talked to one another. -- that we have to change the way we talked to one another. -- talk to one another. tone matters. [applause] words matter. it matters in terms of how we will deal with the problems in this country, whether we are going to actually respond to the needs of the american people and there is significance.

i want to commend you for your suggestion. all of these things begin with small changes. it began on the floor of the senate back in the early 1990's when some senators referred to the president of the united states in a derogatory term. these things have a way of having ebbs and flows. everybody is sitting together is symbolic and hopefully it is not the arithmetic or geometry, but hopefully it generates beginnings and a slightly different atmosphere. if we do not change that, i am not sure how we deal with the american people who insist on as dealing with it. -- on us dealing with it. notwithstanding the fact of what the press might think, i am happy to be back.

our discussion during the lame duck, i enjoyed it. [laughter] when i walked in, the press gave me a standing ovation and when i left, most gave me a standing ovation. that is more than i get in the senate. i am happy to be back and i am flattered that you asked me to speak. i want to make it clear that i am not vice president joe biden who has had some sort of transformation in what i understand about the senate. i am not here to tell you anything.

i am here to give you insights into what we are thinking about. when we get through my prepared remarks, i am here to listen. i am sure to have a discussion. because we all have to be on the same page. these are difficult, difficult issues that we are dealing with. i was asked to speak about three areas of the world that i have spent an awful lot of time on when i was chairman of the foreign relations committee. since i have been vice president of the united states as well. iraq, pakistan and afghanistan. after spending the last week in those three countries, i thought i would try to be responsive to what you asked me to do and you an update on the

situation as i see it. some of you may remember that before we took office after the election, the president made a pledge. the president made a pledge to bring the iraq war to a responsible and. to responsibly in the war in iraq. some and you know that at that time, the president asked me to go to iraq and make a trip to afghanistan and pakistan and come back and give an independent assessment of what we were about to take responsibility for. at the outset of the administration, the president turned and said that joe will to iraq. i had the honor and

irresponsibility of the day-to- day management of our objective of bringing the war in iraq to responsible end. we have had some incredibly talented foreign policy folks. we have had incredibly talented ambassadors. we have had two generals that are warrior diplomats. one general did incredible job and we could not have gotten where we are politically. general loy austin is a diplomat. they are warrior diplomats. i have had the opportunity to speak with all of you individually about this subject and i know how deeply the feelings run. they ran deeply for me in my days in the senate. they'd run deeply not just here in the democratic caucus, but all across the country. i also know that many of you have doubts about whether or

not we would be able to or what we meant by bringing the war in iraq to irresponsible end. about whether we could actually get it done. it has not been easy. it has not gone perfectly. i believe in keeping president obama's promised to end this war responsibly. over the past couple of years, politics has broken out. you ever heard me use the phrase. politics has broken out. the bottom line is that all of the interests in iraq have finally concluded that they have to have a piece of the action, politically. what they need done cannot be

accomplished through violence. notwithstanding, the continued effort of al qaeda it-iraq and some of the extremist groups try to form what we saw back in 2005, 2006, 2007 and 2008. well insurgents still launched a devastating attacks as we saw last week, iraq is more stable than it has been since the outbreak of war. back in 2006, there were about 1400 incidents a week. we are talking about too many, but we are talking about 100 to 1500 week. -- 100 to 150 a week. there are 150,000 american troops in iraq. we have withdrawn forces from the cities and we have ended our combat mission and we have actually brought home 100,000 combat forces from iraq. [applause] i know that there are doubts

among some about the 50,000 remaining. the 50,000 troops remaining are focused on advising and assisting their iraqi kellie -- counterparts. we have a lot of personnel and the state department and they participate in counter- terrorism operations for it under our security agreement with the iraqi government, we are on track to remove the remaining 50,000 forces by the end of the year 2011. last week, it was my 17th, 18th or 19th visit to iraq. i have lost count. it is starting to feel like a second home which worries me. i have also spend the past 20

months and hundreds of hours on the phone with our personnel and every major political player in iraq representing every single group except the bed dust. i feel like their grandchildren. as you guys know, i know that one of the most famous leaders of the united states congress said that all politics is local. i would amend that. but far be it for me to take issue, but i think that all politics is personal. whether it is in the united states or in iraq.

we have been very engaged. we are able to build the trust in the iraqis. they got to the point where they were asking us to be an intermediary. i was asked to talk amongst them. the relationship built and overtime, an iraqi solution to an iraqi problem emerged three we did not dictate that solution. but the iraqis arrived at the solution to by us being a bridge. not just me, but the ambassador that is a first-rate guy. he has done an incredible job. i met with of them and other

leaders, but i spend long meetings with them an hour in one case and in one case for hours. -- that you are ours -- four hours . this was very difficult. it took a long time. howard administration -- our administration had three red lines that we made clear to the iraqi government and to the region. number one, everyone of the leaders -- the government that they formed had to reflect the outcome of their election. let me say that again. it had to reflect the outcome of their elections. all of you recall that their parliament needed 362 for a

majority -- you needed 167 to govern. three things had to exist. the sunnis and had to be fully represented. the portia -- the shia -- all sudanese had to be a part of iraqia. they ended up with 89 votes. they had to work out a deal. it is not surprising that it took a long time. look along it took the dutch to form their government. it took nearly five months. this is a process. a startling thing about the process that you do not write about or speak about is that in this torturous process of bringing about a new

government, there have been democrats -- there been comments about a democratic government being formed. we almost went to war. on two occasions, they almost went to war with the kurds. hear, he is not able to move within his own province. the you know who supported him to be the speaker? the leader of the kurds. they had to spend hours together. the startling thing is that they went up and sat down and lengthy discussions.

what is that important? >> it helped get them a government. the flash points of dispute boundaries in an area claimed by kurds and claimed by suunnis. they now have a relationship. does this mean it will be settled easily? it is a real serious prospect of being settled. the second red line, each block had to have a major role in the government and the government -- there could be no government, the third red line, no government would have to rely upon sadrists. maliki could have run that government and that would have been a disaster.

another leader could have made that deal along the way. he refrain from it. so, now, not only are there listening -- are they listening, reality has a way of intruding. reality has a way of intruding. in this god awful process that took place after the election, remember, we were told that there could not be an election law. there was going to be a referendum in turco -- be a

referendum. the thing that you guys know, if you tasted, you can feel it. it is here. the process of having to deal with one another has changed the whole dynamic. not just in getting a government. i am convinced that the leaders will stick to the commitment that they made to us and they did. thanks to hard work by top- notch american diplomats initiating this process. the reason i go into so much detail on this with you all is that i know many of you will. i know that you know that none of this matters unless the roots run pretty deep. unless there is some reason to believe beyond the fact that they were able to form a form of government. that is not sufficient. i always kid that the first

election, a democracy does not make. it is the third election that determines whether or not you will have a democracy. so, the roots are deeply planted. that is because of this forced interaction of one another. we started off very rough. with a new government in place, they can begin to attack the significant problems lie ahead, including conducting consensus and further into gritting kurdish forces -- further recruiting kurdish forces, stabilizing the economy, stabilizing the private sector and passing a fiscally responsible budget. the projections are that if democracy is sustained and they are not back at work, they will, within a decade, be producing more oil than saudi

arabia. one of the things where i hope but not come across as lecturing is that it is both a blessing and curse. almost every other nation has been so in doubt, it has allowed them to forgo making important decisions. i am hopeful. iraq's national wealth will finance their needs and when the civilian institution no longer needs our support, iraq will be in very good shape. now, there is going to be a sustained u.s. invasion of the civilian side. we will continue to train their police forces. you all know that. it can be done by the civilians

to read one thing that howard and i talked about walking down the hall is gates and general car right, and others in the military said there is a misallocation of funding for the defense department and the state department on the civilian side. it is going to be very hard with the new republican colleagues, but i warn you that i will be back with you to help us with some strategies without the military. is time for the military role to be done.

the purpose, now, is to sustain these institutions so that they can become a stable and self- reliant nation. that is a civilian undertaking, but it's still cost money now, in lobbying. i apologize. -- i am lobbying. i apologize. the military meets with all of the cabinet secretaries down in the house situation room. -- in the situation room. the secretary of education, the secretary of congress, the attorney-general. that is the time to bring the expertise that we have at their invitation to help them sustain the institutions that they have to build.

we can do that without bloodshed did we can do that without overwhelming costs. we can do that because they need it done. i will give you an example. how did they get a budget last time in their congress? there were seven high level treasury department personnel that were given to the speaker of the corps. they had never run a but -- and written a budget before. it makes a big difference. we are establishing a diplomatic presence throughout the country under the terms of the agreement, we are billing a dynamic relationship across a long, wide range of nonmilitary and not intelligence sectors.

that is one in these difficult economic times, we will need to continue to support this engagement with much lower costs while they work up their ability to maintain all of their needs and beyond as they build their revenue base which they absolutely will. is this worth 4439 fallen angels? is this worth 32,000 wounded? 16,000 meeting care the rest of their lives as long as they live? only history will answer that, but i tell you what, if you go back and do it all over again, maybe we would not do it.

i would not do it, anyway. we were handed a circumstance in be intent on making good on the two promises. one, our military presence there and helping them as long as they want it to build and sustain a government that can actually function and not be a menace in the region. that is a fundamental interest that we have to redeem our sacrifices by preserving the gains that have been made and i believe that we are on track to do that. that is my report on iraq. with regard -- i apologize if i am taking too much time. you have to let me know if i am going into much detail. i will not be offended if you do not want this much detail. i mean that sincerely. just let me know.

i will make the other two or shorter but they are much more difficult. last week, i visited afghanistan and pakistan again. during that time, i was asked to go to afghanistan and pakistan and to come back with what our policy should be. what i fell in them and what i confronted the president with his absolute confusion about our strategic objectives. there are 10 people in iraq. you ask 10 people from other governments in iraq what our rationale for being there, you get tender for ancestor of the today, -- you get 10 different answers. our goals are clear is stated. they are that, number one, we are there to disrupt, dismantle

and ultimately defeat al qaeda and prevent its return to afghanistan and its ability to stabilize pakistan. two, the stability of afghanistan's nuclear power is being challenged by extremists and we should do will be can to diminish the threat. three, our mission in afghanistan is in the service of those to the objectives. -- two objectives. that is not our purpose. it is in the service of those two objectives. let me say that what i can say that is not among our goals --

congratulations to all of our winners. i am now pleased to introduce to

you ambassador ron kirk, the u.s. trade representative and mayor of dallas from 1995 to 2001. he was a strong member of this organization, including heading our committee on economic policy. as u.s. trade representative, he looks at trade as a jobs- creating teller of the economic recovery for our nation. mr. ambassador, we appreciate your focus on job creation, as well as on trade policies that assist small and medium-sized businesses. please join me in welcoming our good friend and supporter, ambassador ron kirk. [applause] >> well, thank you for the warm introduction, but thank you again for your extraordinary leadership of your city but also

your great devotion to the u.s. conference of mayors. it is always one of the highlights of my year when i have an opportunity to come back and be with our fellow mayors. my staff at ustr tells me that just about every other conversation i it begins with "when i was mayor." i think you can embrace the notion that once a mayor, always a mayor. they look like they're about to break out in hives over there. i think you understand. i am rarely at a loss for words, but i was intimidated by two factors. one was the knowledge that you have spent the morning with the president. i cannot imagine there's much more that i can add that would eliminate on any subject that he spoke with you about. but secondly, normally when i speak to a group, i spend most of the night learning about what i am going to say. knowing that i was going to be onstage with tom cochran, i

spent most of yesterday wondering what to wear. [laughter] and i have got to tell you, this is kind of the way i dress. i do not know what effect the new mayors are having on tom. this is downright dowdy for him but you have got to know that we love tom. tom has done a yeoman's work on behalf of the nation's mayors for decades and is one of the most respected voices for urban development and for the partnership between mayors and business, which is why we have this extraordinary business council, but also in helping those of us that the federal level to always be mindful that the roots that are on the ground creating the jobs, leading the path for economic development, often find their way to city halls and the nation's mayors. we appreciate everything that you have done and that you continue to do, and we look forward to working with you. it is great to see so many of you. you know i have during knowledge my mayor, tom lemberg, who was

with you this morning but has made the decision not to run again. and for any other mayors for whom this may be their final formal meeting as a member of the conference of mayors, we thank you for your extraordinary service as well. x i was joking with your president got off the can door of your conversation with our nation's president. and just the tough times that we are in. i very much i felt tom -- i very much i go to tom's sentiments about the extraordinary work and leadership the mayors have had to listen to hold our cities and our country together. it is a sad reality of our business. i was never smarter than when my city had money. [laughter] >> i was a pretty damn good mayor. all of a sudden, the public

thinks we have lost our minds when times get tough, but you know and i know it is this partnership between those of us at the federal level and you that can help keep america growing and strong. that is what this president has been trying to do. we understood from the very beginning that having a strong partnership and investment with its cities and states would be critical to overcome this economic tsunami, from the recent tax cut package to our early investments in the recovery act -- the obama administration has dealt with the economy on the path to greater prosperity, and we have done that by focusing on the lower level off. if we give tax cuts to working families. we passed a health care law that lowers costs, cuts the deficit, then helps to support job growth. we supported improvement to

city's infrastructure through many of your transportation programs and your education systems. we provided billions of dollars toward the budget assistance to many of our cash-strapped states when they needed it. we think it is the wise thing to do to continue these critical investments in infrastructure, energy, education, and inflation so that america cannot stay competitive and well-positioned to attract and create the best jobs here, in the united states. to be sure, there will be a very robust debate, not only in washington, but around the country in the coming months about the best way to do that. one area in which i think many of us have come to believe we could find potential for common ground and cooperation happens to be in the portfolio i am

privileged to serve, and that is trade. many americans have come to begin to except that we can grow our economy through having a robust and thoughtful trade policy, especially by focusing on increasing exports around the world. president obama has said we simply have to do what america has always known for, and that is building, innovating, educating, and making things. we want to create and sell products all around the world with three simple words maybe in america. that is our goal. -- maybe in america. that is our goal. we are moving yet -- we are moving ahead. we are doing that purposefully with the knowledge that if we can reach that goal we can

create an additional two million jobs have a time when you know you're citizens are looking for those jobs. as the part of the national export initiative, i am privileged to serve on the export promotion cabinet along with other senior officials i have portfolios that defect trade. we are beginning to implement measures ranging from the largest to the smallest firms to increase trade finance and assertive trade policy that opens up more opportunities around the world for america's exporters. we think all of these measures will help businesses in your cities at your community's begins to export and expand exports into new markets. why are we focusing on exports? i will leave you with one simple number. 95% of the world's consumers live outside of the united

states, and a great way to grow our businesses is by having access to those consumers. for that reason, the department of commerce runs export assistance centers all across the country. many of you probably have one in your city or not that far from it. we would urge you to make sure to contact them and find out ways to partner with them to help businesses in your community understand the power of exporting. if to learn more, i would invite you to visit our website. we want to build on some positive trends. over the past five quarters of measure the economic recovery, exports are contributing more to our total economic output than consumer spending. that is extraordinary. if consumer spending is almost two-thirds of our economy. exports are only 30%.

right now our growth in exports is injured in as much as consumer spending. through the end of 2010, u.s. exports were off 17% over the previous year, which is putting us on track of meeting the president's goal of doubling our exports within five years. in order to sustain the solid pace of expansion, we know that we have to do more, particularly as it relates to opening up new markets around the world, and fighting for all levels the playing field for american exporters. when i agreed to serve as u.s. trade representative, and made a conscious decision to put a priority on doing as much a domestic travel as i do around the world. many people think one of the benefits of my jobs -- job is the amount of travel involved.

i have done that. and the end of one of my trips, it struck me that i was not going to change some of america's fears about our trade policy in geneva, frank -- paris, and frankly, the car. i was going to have citgo to places like pittsburgh. -- go to places like pittsburgh. i have been to 25 states. i have been in almost 45 cities, large and small. i have been on the west coast and places that look to me and what needs to cut the break because they are the most export-dependent communities in the world. i have also been to places like detroit and maine have that feel like they have come out on the short end of our trade policy. those talks, particularly when i have had the opportunity to

engage with mayors who have introduced me to businesses that have benefited from trade, and those that have been frustrated, have helped to inform the creation of a more thoughtful process. in particular, just about every business owner, farmer, or rancher or worker, told me they understand the importance of our ability to access customers around the world, particularly in the rapidly growing asia- pacific region. they have also been done this in sharing concerns and fears that they believe the united states has held the power end of the bargain. we are the most open economy in the world and have some of the lowest tariffs in the world. i have heard from business that they are not so much against trade as they are not convinced we will have a trade policy that makes sure our partners cheetahs as fairly as we have treated

them. our focus has been on guaranteeing america's businesses that we will fight for them and their workers, and insist that our partners do one simple thing -- play by the rules. we have opened our markets to youth. you have to open your markets to us. we also began the hyper-focus on opening up new markets and where the opportunities are. i want to talk about three of them into the secular trend a lot of our work is focusing on the south east asia region. and being from texas, i know many of you have heard the story about the prolific and bank robber. he was a prolific at robbing banks, but he was also a prolific at getting caught at the judge asked him why he keeps robbing banks, and he said that is where the money is. the reason we are focusing on

southeast asia is because that is a lot of where the opportunity as it did almost 60% of global growth and gdp will be in an area broadly defined as southeast asia. it is important that our farmers -- farmers, ranchers, exporters, have an opportunity to compete and win in those markets. we are focusing on a number of a initiatives that will get us into that market. i will tell you all three of them. one is the recent free trade agreement we successfully concluded negotiating with korea. thank you. you are probably from washington. [laughter] trust me, this can help everyone of your communities. secondly, we have a broader partnership, and finally it is

work we do with the other 25 light-minded countries. let me start with korea. it is one of the largest and most dynamic markets in this rapidly growing region. it is our fifth largest trading partner right now. let me tell you the bad news. four years ago we were korea's number one exporter. today, we are number four and falling fast. that is simply unacceptable, and it does not have ziggy that weight. we inherited a -- does not have to be that way. we inherited a free-trade agreement. president obama as instructed me to fix that. we focused on real disparity is in access to their automotive market, and their market to hours.

i do not have to tell many of you how many cars on our children by with nameplates other than those that are made in detroit. that is okay. what'll we find unacceptable is what other countries do not give their families the same choice we have. we were to remedy that. when we were able to do that in no way where we have a balanced trade at -- in a way but where we have a balanced trade agreement that is being applauded by the american farm and south -- and ranching industry, and for the first time the united autoworkers, and the united food and commercial workers and ford. we have great bipartisan support because we all realize this can help us by selling more to the 3m market, create jobs here. if this is a great -- to dr. rhea market, create jobs here. if this is a great opportunity.

manufactured goods represent almost 85 -- 87% of what we sell to korea. their tariffs will come down dramatically. most will be done away with. whether you are a big manufacturing state, or small, which think this will have great value to businesses in your community. secondly, korea is one of our strongest agricultural markets. we are pleased our exports reached their highest level in history. in agriculture, we went because we are the most prolific agriculture society and the world, and we cannot consume all we produce. agriculture is more dependent on trade than any other industry in america because we have to have markets for them. agriculture will be the big when. finally, we address the growing reality that more and more americans working in the service

sector. his 80% of americans now working in the -- hit 80% of americans now working in the service sector. let me move on and talk of a bad about what we are doing in the trans-pacific partnership. -- talk a little bit about what we are doing in the trans- pacific partnerships. this is an opportunity to draft lead architecture for what we think can be the most broad based regional trade agreement of the 21st century and a model for america's trade going forward. we are working with a group of eight other countries including australia, chile, malaysia, peru, vietnam's, and the goal is to begin to craft what we hope will be the most broadly legalizing trade agreement which the strongest as intellectual property right provisions of any trade agreement that has ever

been negotiated, and hopefully that becomes the architecture for trade in this dynamic region. we have had five rounds already. we are moving at an extraordinarily fast pace because our goal is to see his weekend not be substantially complete by the time president obama holds a meeting of those 21 members of the apec community and honolulu, hawaii, this fall. we are beginning to focus especially on the needs of how we can better incorporate small- to-medium-sized businesses in our trade policy. finally, i want to talk about our hosting of the asia-pacific economic cooperative forum. this is a broad framework of the 21 economies that i spoke of them reside in the southeast

asia region. the united states will host that forum in honolulu this year. since it will give us an opportunity to take practical and concrete steps to take other barriers to trade, many of which prevent the is it fairly some of our smaller and medium-sized businesses from getting involved. specifically we are going to looking ways to improve supply chain performance, so that goods and services can flow more freely. what we are trying to do is simply bedews the cost of doing business across the region for businesses large and small. if to learn more about any of these initiatives, if i would invite you to visit our web site, ustr.gov. we are looking at every venue, every configuration that you can a imagine to support the number one objective of the president to get the economy

going by using our trade policy to help create jobs. the biggest opportunity we have is a stalled 10-year agreement in the world trade organization. it would be the most ambitious, a globally-liberalizing trade agreement out there, but the united states is almost single- handedly insisting that if we are going to do this, we are going to do this right, and it has to have had an ambitious and market.en we think those three economies have benefited more from trade liberalization than china, india, and brazil, and we think that is a good thing, but with blessing comes responsibility. now it is time to invite china, india, and brazil to the local trade table and say you have to make sure we create a more

balanced opportunity in the future. similarly, we are working within our hemisphere to bring in the same discipline and focus to crafting and finishing the trade agreements we inherited with panama and colombia. if they might not have the same economic past, but they are critically important for many interests in this room, and we are committed to working with our partners to successfully addressed the issues remaining in those seven we can move them forward as well. i want to spend a few minutes talking about things other than trade policy. as strongly as i believe in the proper role of law smart trade policy to help get america's the economy growing and job creation spurred, if we know trade alone cannot do that. our administration is also looking at ways that our administration -- our small businesses can compete. that is why we focus on business tax incentives to help those

firms grow. you know as there is the majority of our citizens still work for businesses that employ fewer than two hundred people. we think investing in our small businesses and helping them to grow is a great way to help put america back to work. the president has also put in place a weather% deduction for large capital investments the a 100% deduction -- 8100% deduction for large capital investment. our citizens want to know one thing -- where are the jobs? we are trying to do very thing we can to get businesses to make a critical investments now, so hopefully they will buy the equipment that allows them to add workers and put them back to work now. we think accelerated depreciation can tell more businesses move plans from the drawing board and put people to work.

we also think -- thank you. [applause] >> we also think the same thing is true of the two-year extension of the research and development credit which will help cover the cost of employees involved in research. our innovative businesses thriving on this, and our the administration is committed to this success. as you travel around the united states, as many of you mayors have the opportunity to travel across the country, we just want you to know that the obama administration is here to go with you, has and what to support you every step of the way. he said you conference challenges in your community, and you draw the strength, and inspiration that we learn from one another, and notice that i said "we." not only do i feel like i am a

former mayor, i also feel that you all our fellow ambassadors as well. every day there youth advocate for jobs-creating opportunities on behalf of your citizens, neighbors, workers, and businesses, you are an ambassador. every day you were to build relationships with your governors, congress people, and on the international level, you are an ambassador. every day you move one step closer to closing that deal to bring that new job to your community, to open the factory, to bring in that new investment, you, in fact are had an ambassador. whether it is through helping to facilitate the investments in an elevation, through stronger trade policy we hope to build a stronger partnership with you, our nation's mayors, to rebuild our cities and help put america

back to work. he is an honor and privilege to serve u.s. the u.s. trade representative. is an even better as a privilege to the able to call you friends. -- it is an even better privilege to be able to call your friends. thank you. [applause] >> thank you. no mere's ambassador. thank you very much. would you take any questions, sir? i think it would be very helpful. we always want to make sure we have a dynamic dialogue. on a microphone is coming. >> thank you. thank you, representative ron kirk. i think you are doing a fantastic job terrorist i would ask you if you would not mind working with the treasury the

part -- fantastic job. i would ask you if you would not mind working with the treasury department. if they are coming hard -- coming down hard on banks scared every time i talk to a banker, they tell me they have to go back -- banks. every time i talk to a banker, they tell me they have to go back early from a break. he is stifling banks. in turn, they cannot lead to businesses. could you somehow let the president knows to have the treasury kind of -- >> i will share your comments. i will tell you, and i will use one of my lessons i learned as a mayor pivot to what i think as one of the bigger success stories. the first challenge was to

stabilize the banking system. the asset recovery program has worked spectacularly well. the money has been paid back. police say the banking industry. we kept america from -- we save the banking industry. white america from bankruptcy. -- we kept america from bankruptcy. i know secretary geiger and others are critically focused on ways through both the sba and others to get capital flowing. that is one of the reasons i outlined the things we were doing specifically to give small businesses access to credit. i hear your concerns. i would be happy to share it with the secretary. >> good afternoon. my name is linda thompson. i and a first-time mayor here. your presentation was brilliant.

i just wanted to give the president of great complement done his ability to try to move the ball forward with getting other countries too lax in their care of -- terrace. -- tariffs. how quickly do you see this turn around? a lot of those countries are dictatorships. they have been indoctrinated to other people. how quickly do you see this turn around? the goal of all of this is to help our economy, and mayors are impacted by the way the national economy is. whatever happens on the international level would ultimately help us, is that correct? >> that is the idea. you asked a number of complex questions.

i do not know that i will speak to the dictatorship element. when our administration came in, and i'll always as to what was it in my background -- i am always ask what it was in my background that made the president looked at me as a trade ambassador. -- look at me as a trade ambassador. when you are in there, you are the leading advocate for economic development in your community. many of you are used to travel around the world doing trade promotion. most importantly, mayors do not talk about macro economic policy. mayors talk about jobs. we are at ground level where we cannot engage in washington speak or diplomatic speak. americans want to know what we can do to create jobs. we try to bring that practical sense of urgency to job

creation. secondly, i thought the hidden asset i brought to this job was my wife. i grew up in texas. i was blessed to be elected the mayor of dallas in 1995, the year nafta went into affect. not everyone looks at the same, but for some cities, it was an economic boom for us. but, i married a girl in -- from cleveland, ohio, and not some, but every one of three top -- relatives are working for ford, gm, or chrysler. why i am telling you this is because from what the barry -- very beginning was -- we were informed by the fact we cannot be dismissive of those effected our trade policy.

we have focused on enforcement and adjusting trade assistance paid the reason i told you about my travels was because it was important to me to speak with mayors that are pro-trade, and those that are concerned, and let that be reflected in our policy. i think we are beginning to make great progress. u.s. the when we can see a difference. -- you asked when we will see a difference. i sit with members of congress to tell me with private they have a program implemented that they worked on for 20 years. has a mayor, i would like to get two weeks sometimes. knowing how critical it is for businesses on the ground to solve problems, and solve them quicker, and i set down with my legal team, and said what is every legal dispute with the wto? we had a dispute with the european union that had been

going on for 15 years. they have lost our beef out of that market. i said how many ranchers are still in business if they are waiting on us to solve something. we did not do that in every case. in three months, we got the trade dispute resolved, and our imports into europe have gone up exponentially, and we have done the same thing in many cases where both were tried to solve problems by smart enforcement and open up the markets. he even with the visited -- with the visit of president hu jintao, which were able to facilitate sign up with the purchase commitment -- facilitate china's purchase commitment. we are concerned to making sure we get to selling things right away, but we need your help to build a compelling case to your

citizens that are frankly skeptical on whether trade means everything -- anything but cheaper t-shirts and electronics, and are not as convinced we could create the jobs part >> -- jobs. >> ambassador, i know you have to go. let's get one more question. >> i am the mayor of oakland. oakland exports almost as much as we import from china, and there are our largest trading partner. we find that a lot of the chinese delegation's visit our city first. what struck me at this conference is that several colleagues are asking me for help in the midwest with investments they are getting from chinese capital. i thought maybe the white house could help us by providing some regional conferences with

mayors, to help give them the technical assistance. the sun just the requests i have gotten, i have given advice -- chest and the request i have gotten, i have given advice that i have found that the chinese are going into the central valley, and apparently the midwest. i did not know that. i traveled to china and the trade delegation both times. i think if we could advertise or publicize investments, including the imp -- in the midwest, there are very public- relations sensitive. i would bet you that is that an accident that they're investing in areas that are having problems. >> first of all, we're very proud of you and thank you for stepping up. just in case you did not see it, have your staff review -- google the china-u.s. state picture there is a fabulous picture of

you and your fellow mayor coming in. yours was not as much a question as it was an answer to we very much want to partner with mayors. -- answer. we very much want to partner with mayors. i do not want to get too far ahead of us, but i think we are looking to do a similar forum. will be in minneapolis in february. if any of you want to learn more common or invite us, you can either go on export .gov. i can assure you we are working collaborative lead to the export of an initiative to try to make this as simple as we can. nothing helps do that better

than a partnership with you. thank you for your time and your attention, and thank you for your great leadership of the nation from those cities. third -- nation put those cities. [applause] secretary. so, mayor warren. >> thank you. is a real pleasure to be here with all of you and introduce the secretary. before i do, i just want to mention a couple of things. first of all, thank you

president and tom corcoran for leading the effort of protecting the funding that we know is home for him to us as miles. -- as mayors. i was pleased this morning with the psident's steadfast support. hisupport has been critical of the past few years, and obviously, the secretary's. is really going to be up to us as mayors to take the lead on telling the story of how important the funding is, and how critical it is. it reaches across the aisle. if it is a bipartisan program that benefits republicans and democrats on the ground, and it is a real engine for economic recovery, which is very important at this time, and it really touches the most vulnerable in our cities and communities. if we will be engaging members of congress, senators, over the

next several weeks. i will be asking for your help in an effort to tell their story as we go into the next budget around. i also want to mention i am very pleased in working with the secretary staff. they have offed technical assistance so, we will be working withhe secretary and others. we must take the lead on this. i am really pleased to introduce shaun donovan, secretary of the u.s. department of housing and urban development this afternoon. since becoming the head of the nation's housing department, secretary shaun donovan has attended several conference of mayors event, including our seattle leadership meeting, and most recently the press conference releasing the 2010 hunger and homelessness survey. under his leadership, we have seen the strengthening of many

housing and community development programs, including the community development block program, the home program, and homelessness programs. we look for to continuing our work with secretary shaun donovan. please welcome secretary shaun donovan. [applause] >> thank you. setti warren, so great to be with you. thank youo much for the fantastic work you are dng. he has been great to get to know you and work with you so closely, and for your leadership, second on the role you have,ill be so important. as always been important, but it will be particularly important in the years ahead of us. president, elisabeth, it is wonderful to be with you. thank you for your leadership.

it has been such a wonderful, wonderful partnership we have formed to work so closely with you, and i just want to say personally on behalf of myself, the president, thank you for your leadership. really has been remarkable. see why. [applause] -- thank you. [applause] >> it is such a great honor to be back with all of you. as almost two years to the day that i came in the midst of the transition about to have the inauguration literally the day before to join you at the national building museum. one of the things i said later is i had been working for one of the nation's great mayors for the past five years, for mayor bower board in new york city. i was looking forward to -- mayor bloomberg in your city and i was looking for to taken them nine new role of working for all

the mayors across this country. it is such my pleasure to join e men and women who understand the importance of putting aside our differences to solve real problems on the ground that make a difference in people's lives. he quoted a number of mayors. i would also like to quote the mayor of our city who said "there is no republican or democratic way to take out the trash." maybe he should have said clean up the snow, given the respect -- experiences in your city. i will tell you that my commitment to what you do in local government stands true. in fact, i am wearing today my cufflinks that are in new york city man hold covers from the sewer system that remind me that what i do every day it is served at all of you, work with you,

and help you deliver the desperately-needed services that make your city work -- city's work each and every day. wonderful to be with you. i want to talk today about the partnership and tools we have been developing to make sure you can do exactly that. the me say a few words before i start on that about where we are in this moment in the economy. the president said this morning that we have seen a difficult two years. we have seen it around the country,, but again, you are the closest. you are the people of your constituents will find, not me, not the governors, not the president himself, but you. you are the ones said they will find. when we have experienced these last two years has been nothing short of the consequences of the greatest financial meltdown that this country has experienced since the great depression.

just two years ago, and we too often forget how far we have come, 753,000 jobs were lost, each month in the first quarter that the president came to office. 22 straight months of job declines. 30 straight months of home price declines. we took the dramatic and urgently needed steps that we needed to at that time to keep families in their homes, our housing market afloat, and to provide the critical assistance they you long did it through the recovery act. to date, nearly 4 million american families have had their mortgage as modified to be able to stay in their homes, more than twice as many foreclosures as we have seen in that time. we have stopped the slide in home prices, and most important

of all, we have stopped the slide in job losses. in fact, every single month of last year we saw a private- sector job growth. in total, over 1 million jobs in 2010. but, i also do not need to tell you that we still have a ways to go on this recovery, just as the president said this morning. whinnies to exonerated job recovery. that is ourob number one. that is why this biptisan tax package that was signed to law just a few weeks ago is still a critically important. in 159 million americans will get a tax cut worth $1,000 to the typical family making $50,000 a year. 12 million families will benefit fr a $1,000 tax credit. 8 million students and their families will benefit from a

yearly $2,500 tuition tax credits to make college more affordable. 6.5 million families, which include 15 million children will benefit from an expanded earned income tax credit. now, the council of economic advisers estimates that just the full year of the extension emergency unemployment benefits will create 600,000 jobs this year. what anyonexpected with a relatively weak hand to play and an enormously large amount of presre, we were able to deliver a package that was focused on high-and talked, jobs-creating tax cuts will have read repercussion -- real repercussions for our economic recovery, but also particularly for our housing markets, which

has traditionally been an important piece of recovery. because of this pacge, businesses in your community now have new tax incentives to buy. the expensing provisions alone could generate $50 billion in additional investment in 2011. helping our construction industry by the new equipment it needs to create good-paying jobs in your communities. there is also a tax credit for upo $2,000 for builders of residential homes that are more efficient. it extends the tax credits that will ensure more than 6000 affordable housing units are able to be completed in support of some 16,000 construction- related jobs in a community still recovering from hurricane

to train and read up. most importantly, -- country not, and reach out. most importantly, they will not add to the long-term deficit at all. because of them, and independent experts now expect another 1.5 million jobs will be created in 2012, -- in 2011, listing our communities and our economy alike. on the day it pass, i was walking to the white house and ran into gene sperling. he said you know, there are not many days you can say you got something done that day that will raise the growth of the entire american economy by a full percentage point. think about that. when million 0.5 jobs is what is expected by economic experts across the political spectrum because of that tax cut package.

it is remarkably important for all of us in the work we are doing to create jobs in our communities. of course, you have been hard at work helping our economy and our communities recover throughout these entire two years, and many of the tools you have been using were provided through the recovery act, and i want to particularly thank all of you for the remarkable work you have done in getting that recovery act funding to workinin your communities. indeed, one of the reasons we provided almost three-quarters of our $13.6 billi of recovery funds direct to localities is because we believe you best understood the needs of your communities, and you knew how to inshore that these dollars quickly -- in short that these dollars quickly got to the people and the neighborhoods that needed the most, and you have delivered beyond even our

high expectations. with your leadership, think about this. recovery programs have already completed renovation of 358000 homes are around this country. give yourselves a round of applause for that work. [applause] >> and, these homes, the renovations, the additional homes you have helped to build our to green standards and with energy efficiency improvements that save money for residents, her owners, and save money for taxpayers, because they typically pay back our investment, whether it is in public housing or other affordable housing in three two five years typically through lower utility costs.

with funds from the program, you have helped us prevent or end homelessness -- homelessness for 750,000 people. they might have otherwise been homeless if it had not been for the homeless prevention and rapid rehousing program. once more, as you reported last year, it is fundamentally changing the way communities respond to homelessness. we had a chance to do the release this year of the hunger and homelessness report. that progress is not only occurring in central cities, but al suburban and rural places, which is so critical because we have seen an increase -- of family homelessness of over 30% in those areas in rect years. most importantly, our recovery

at programs have been creating hureds of thousands of jobs. in the third quarter of last year alone, when most people thought the fact of the recovery act would be declining, you created 27,000 jobs with programs from the recovery act. none of this would have been possible without your leadership care if i want to congratulate each and every one of you ought -- leadership. i want to congratulate each and every one of you for putting that money to work, creating jobs, more quickly than anyo had expected. you also met behind our recovery act funds for our neighborhood stabilization program, o $4 billion critical to help renovate homes in your communities. despite a tight deadline, 99%

of that money was put to work on time, and that the 18-month deadline that was set by congress. our wonderful assistant secretary for community planning and development joins me with her team ban sinking you for the work you have done. we know it has become an essential tool in your toolbox, lping you to rebuild, not only homes, but entire communities that have been devastated by this crisis. that is why we were so closely with congress to provide an additional $1 billion of neighborhood stabilization funding in the dodd-frank wall street reform bill, and dad built on an additional $2 billion in the recovery act. we know that the extraordinary challenges your community is facing using these funds, from

staff shortages during this time of enormous budget cutbacks, if you having to establish individual relationships with financial institutions, to having to negotiate the best price on homes one house at that time. that is why it was not just enough to provide you with 700 -- $7 million in funding, is why we went out with private sector and nonprofit partners to create the first look partnership, to give you and your grantees exclusive access to foreclosed homes in your communities for two weeks before anyone else could bid on them, and to allow you to get discounted prices that would allow you to stretch those dollars even further. because of this, in total, we expect neighborhood stabilization to be able to reach more than 100,000 homes around this country. if you look at the areas that w have targeted, it is a huge

impact. we estimate that about 20% of all of the foreclosures in the neighborhoods targeted can be purchased or renovated with the funding we have provided, and, because we have been able to set up this first look partnership, 188 communities around the country have been able to save over $26 million, an average discount of about 13% over the market price of those properties coming to foreclosure. this has been a tremendous partnership. with the project continuing to get under way, with neighborhood stabilization $3 a hitting in the mark -- 3 dollars hitting the mark in march, and with the sample -- the fragility in the housing market, we expect a big jump in the number of

homes you can acquire in 2011. of course, at the same time these tools are helping to repair our economy, we fe and on the gin and certain the budget situation for the foreseeable future. -- we face an uncertain budget situation for the foreseeable future. we need to work together to be closer partners that we have even become over the past two years as we face the difficult budget ahead of us. i mentioned earlier that you have done a remarkable job wh our recovery funds. you are creating jobs, homes, anopportunities in your communities, and one of the things as the most important is the funding that s provided during the recovery act. [applause] >> in fact, 300 bearers are around this country, --

neighbors around this country, have a ready drawn down and spent every single dollar that they have in funds that were received to the recovery act, and dozens more of you are about to reach that threshold. i want to say very personally, having led the housing department in new york city, i know how critical the funds are to you and the work they you do the ground, and i know that this has then the primary focus. you are the president's talk about it this morning. i also want you to know that i was the largest user of a whole program in the country in the new york city, and that we will be reaching a remarkable milestone in the history of the whole program -- its 20th anniversary, and we will reach right about that time it having

built or renovated its 1 millionth home in this country. is a remarkable reco of ho --ement forethought for the home program. we have the third largest programs in the country. you do not have to tell us the importance that the funding has to york communities. how those dollars can wh leverage the critical resources you need to build economic infrastructure, and to help your community strife. still, while president obama has not even released his 2012 budget proposal, some are suggesting we cut $100 billion from domestic programs this year, in 2011. let me be clear. this administratn is serious

about reining in our budget deficits, and you will see that in the president's budget. he told you there will be tough decisions that need to be made, but we are absolutely committed to making the strategic investments we need to insure the economic future of this country, and cdbg is one of those critical and vestments. it is a critical catalyst. -- investments. it is a critical catalyst. [applause] >> iis a critical catalyst for economic growth, helping you everywhere across this country big retail businesses across your -- bring retail businesses to your community, and to rebuild your economies in so many different ways. our data from the recovery act shows that cdbg has created the most jobs per dollar of any program that was funded at hud

by the recovery act. [applause] >> i fact, is about twice the average of our programs overall. let me be perfectly clear. when it comes to cdbg funding, i hear you, and president obama here's you loud and clear, and we need your help to get us the jobs that i just talked aut. get us the story. get out the real story of cdbg, and how it creates jobs in your communities. that will be critical to winning the battle to ensure next cdbg remains a proud and strong investment in every community across the country. you have rightly focused on how important cdbg is, but it is not

the only area where you need to make your voice is heard. hud programs to provide safe hous andn which just funding the same number of people each year costs more money as rental costs, utilities, and operating costs rise. just to serve those 4.5 million people, and because they make up such a large share of hud's budget, that is a growing cost that is critical to meet. insuring that we continue to support those residents will be a priority, and that is why you and i have a big case to make anotheinnovative initiatives that we have put in place together to follow the innovative things that you have been doing in your communities, and to support the work you are

already doing to prepare your communities and your economies for the future. the first of these is the sustainability and green jobs. i do not have to tell this audience how important this is to our economy. green construction spending already supports more than two million jobs, and generates more than $0 billion in gdp and wages, and over the next four years it will support nearly 8 million jobs, generate nearly half of when dollar trillion in economic activity. on tuesday, i joined the mayor of milwaukee to promote green cities and green jobs during the emerald city conference. when i heard was crystal clear. sustainability is not just about green roofs and energy- efficient buildings. if it is also about where those buildings are located with respect to transportation and the rest of how we build our

communies. in short, america must find a way to connect housing to jobs think about this. today, for every dollar the average american family earns, they now spend 52 cents on housing and transportation combined. they have become american families to the will biggest penses by far. if that is why this past october i was so proud to announce $140 billion in hud funding in over 100 of your communities around the country. demand for our two new sustainable community grant program was remarkable and exceeded expectations. 78 million americans live in the 45 regions that one goes -- that competition. stl, we were only able to fund up one-quarter of the applications that we received.

for our community challenge grant program, the funds will leverage over 50 million in additional state and local private funding. these grants represent the most significant planning in generations. planning our communities smarter means parents will spend less time driving, and more time with their children. more families willive in safe, stable communities near good schools and jobs. more kids in your communities will be healthy and fit, an indeed, one of the things that is so critical about these investments is that regions who embrace sustainable communities will have a built-in competive edge in attracting jobs and private investment. of course, the grants we provide were not just about central cities. more than half of the applicants came from small towns and rural

region winners included rural counties in central florida, at election communities in western north carolina, and native american tribesn washington state and south dakota. this commitment extends to rural america with the $25 million rural innovation fund which supports large-scale innovative approaches to addressing the unique -- to addressing you make rural issues including poverty and concentrating housing distress and bolstering our capacity to really change the game rural america. one thing that is so important is that we don't take the old federal one size fits all approach pretty you know better than anyone that the needs in your communities vary dramatically. it is so important as we think about the threats that we may have to this sustainable communities agenda going forward is that this is not about the federal government telling you or creating an

unfunded mandate for y. this is about us supporting the vision you have for your community. rural, urban, or suburban. this is a critical tool. i was so pleased this morning as i spent time with many of you at the white house to hear how excited you are from macon, georgia to salt lake city, utah and so many other places so excited about this sustainable communities agenda. it is long past time that the federal government understood that we need to speak with one voice on housing and transportation policy and finally, we're beginning to. help us ntinue that momentum that we have built. another area where we have to make our case is transforming our public housing. i talked with many of you earlier this morning about the enormous challenges you feel in creating mixed use, mixed income communities and in bein innovative with puic housing.

despite the enormous desire and need in your communities, our rules a half century old prevent you from doing what you need to do in your communities. it stops anyone but the federal government from being able to finance the improvements that you need in public housing. these rules have not just stood in the way of building better housing. my own experience in new york trying to bring groceries course to public housing and trying to bring schools and services was like banging my head against the wall far too often. because of the barriers weut in place. are transforming rental assistance a proposal would change that by providing you the power and the tools to bring in private financing, to bring in home and cdbg financing and to

create the kind of vitality and market to supplant we have seen elsewhere in the affordable housing sector. you know this is not just the theory because you have seen it. i talked to mayor anthony potts from charlotte this morning who lives in may hope 6 3 development. you have seen a remarkable transtransformation that hope 6 has provided. we will not transform public housing with a half-dozen grants per year. we have to change the system more broadly. otherwise, with the status quo, we will keep losing public housing, 10,000 units of public housing each year. during the time that i am talking to you today, we will lose another unit of public housing because there is a need for 20-$30 billion of capital in

public housing around this country. we think our transforming rental assistance initiative could bring over $25 billion of private capital into public housing. most importantly, it would create 300,000 construction jobs around this country. , renovating public housing, building the communities that yo know your cities need. i want to say that this is one of the most important bipartisan issues we could have. hud secretary jack kemp who created hope 6 knew that. we now have legislation that was introduced by keith ellison from minnesota, the rental housing and revitalization act th would bring this kind of transformation to all public housing. we need your support. you know the results it can have on the ground. we need you to make your voice

is heard. lastly, let me say that there is no greater opportunity for bipartisanship and forgetting real results than the issue of home was necessary when i was housing commissioner in new yo city, mayor bloomberg and i work with the republican governor. ii also like to joke that i know bipartisanship because i work for all three parties and that was just under one mayor in new york. [laughter] we worked closely with george pataki to enter into what we called new york, new york iii, a $1 billion investment to create housing for the homeless. hocould we get a $1 billion investment? that was because mayor bloomberg, as a businessman, george pataki, as a fiscally conservative governor knew that

this was not only the right thing to do for the homeless themselves, it was the right thing to do for the taxpayer. they knew at the real cost to the taxpayer was not just the st of housing and services that support housing provided. the real cost was the revolving door of emergency rooms, shelters, jails, that would result if we did not do anything. we have learned that it is actually more expensive to put a band-aid on homelessness than it is to solve it. the bush administration realized that as well. thanks to its leadership, that key mbers of congress like senator jack reed and congresswoman judy bakers who has just taken over as chairman of our authorizing subcommittee and countless local leaders, and the last few years, the support of housing model has help communities around the country reduce chronic homeless and as an people in our streets that we

thought would always be homeless by 1/3 and five years. a 1/3 reduction in chronic homeless ness. in fact, that progress, your workout the local level open the door to a federal plan that president obama announced last year that will finish the job of ending homelessness. it is the culmination of a decade of work and it commits the federal government working with you to ending chronic and veterans homelessness in five years and family and children's homelessness in a decade. let's be clear, despite was not started in washington very it was started by you and your partners in communities around the country. you were the ones who said and showed that we could end homelessness. you set out to prove it. with this plan, we will not only take on this fit, with the federal government supporting your work, we will wind this fight. [laughter] [applause]

next wednesday i will join thousands of volunteers in 4000 cities to conduct a national one night count of homeless persons and families. this account is essential to have in the clearest possible understanding of the scope and breadth of homelessness and of measuring our progress toward ending it. york residents can find out more about how to volunteer at hud.gov/homeless account. we urge every community to participate because this is important to measure what works and what we need to do better. you heard the president this morning y that the key to -- the key guiding principle in these budget fights ahead of us is we need to demonstrate what works and stop doing what doesn't. we need the data in cdbg and homelessness to show what works. we are urging everyone of you to join this count. i will personally be on the

street in washiton. i would urge all of you to get your communities out to help us. some wonder whether we can make progress in the country this divided. whether the issue is tax cuts in programs like cdbg that create jobs, putting people to work to rebuild our housing, proven strategies that end homelessness or new tools that help communities that share problems finally starts airing solutions, i am confident and we cannot only make progress but history. insuring we do starts with the men and women on the front lines of our communities. it starts with the leaders here today in this room. it starts with you. thank you for the opportunity to be your partner in that fight. thank you for everything that you do across this nation every day. i look forward to continuing our work together in the months and years to come. thank you. [applause]

>> mr. secretary, we thank you for being here. one of the things that the mayors would like is if you could take one or two questions. ere's a very pressing question on the mind of all the mayors. if you could address that and we will go to the floor for questions from them because we have other members who will be speaking. the document that i hold here and wi be up there, the republican study committee issued their spending reduction act. can you tell us what is the process and what does this mean? we see reductions in the community development block grant which says it is -- it is an elimination. can you talk to us about that please, mr. secretary? it is right up there now.

this was out yesterday and everybody has gotten a copy and everybody is greatly concerned. >> thank you. i'm glad you raised this question. we have been talking a lot about what the president's budget proposal will look like for 2012. thpresident spoke you about this morning. i particularly want to thank you, mayor warren, congressman frank, so many of you who stood up just yesterday to say cdbgs a critical resource. your voices continue to be heard. it is not only a question about 2012. this is an immediate question about the 2011 budget. because of the short-term continuing resolution that we got in decembe then ends in march. we will have a debate even about whether cdbg continues to be funded for the remaining six monthsf the fiscal year this

year in 2011. this will be a critical discussion. this document does not surprise me. i was running the largest cbdg program in the country in new york city when it was proposed during the last administration that cbdg be eliminated completely. after that, there were proposed cuts of up to 2/3 of the budt. this is a real immediate question that we all need to work on. the process here in is that the current year's budget needs to be passed in march. it may be a continuing resolution. it could be something that cuts substantially. you have heard a proposal of $100 billion reduction this year in domestic discretionary

spending, not in 2012 but in 2011. that is what we need to make sure of. as we look at 2012, we need to focus on protecting cdbg this year. we also need to protect the other critical resources that we provided. >> mr. secretary, can you take one more question? we appreciate you being here. >> i can take one question. >> mr. secretary, i am the mayor of beverly hills. you would think that beverly hills would not have many problems. that is not always the case. we have the same problem like any other city. we have developed something that may be a challenge to what you can do for the rest of the cities. we have small city of initiatives. it goes way beyond. we have been able to create 175

initiatives which has helped us be a small government. we have water-solving problems and home-selling problems and all that. i want to challenge you to create that and move up into small cities, small communities because it would really make the government small and pay back in the long term. the paradigm has changed to small cities >> thank you. i want to go back to something that i said earlier. one of the misperceptions, i think, about a lot of the work we are doing on sustainability, on linking housing to transportation, but in some of the other way is trying to make our communities more sustainable is tt this is a big city issue. the york, chicago, and l.a. are

dealing with this. that is what is interesting is that i've traveled around the country with the president and vice president and others and there is incredible support for this agenda of sustainability in every community. urban, rural, suburban, every geography, and we need to make sure that thats heard and what is heard is that we are supporting your vision because we learned with our urban renewal and many of the historical programs that hud and other and this is created is that you cannot have a one-size- fits-all policy. what was a different about this process we put in place for sustainable communities is we are asking you to tell us what your communities should look like. if it is a small cities initiative, we want to fund

that. it is focused on art space community development and that the best way to the general economic activity, wwant to fund that. we are here not to dictate to you what your community should look like but as a real partner. i think that is something that mayor becker and die from salt lake were talking about this morning. there are many inongress who think of federal planning support as modele on the urban renewal approach. this is a very devin approach based on your vision whether it is a small city's approach or anything else. we need to make sure particularly the newest members of congress that they hear that and understand that this is reaching every region, every size community and it is about your vision, not about the federal government dictating it. it is a partnership approach. thank you all so much. [applause]

i look forward to seeing you

the right and on left. our interest is in the health reform bill that was passed last spring. if -- and there are some major defects in that bill that we think are so serious and severe that congress will have to reopen the health care law and make major changes to it, even if there are no critics around. i want to briefly go over 10 of those major problems in the bill and then each of our speakers will address certain parts of it. number one is an impossible mandate. all this will be required to have a health insurance plan that will -- a cost of which will be growing at twice the

rate of our income. you don't have to be a mathematician or an economist anknow that, if you are forced to buy something, the cost of which is growing at twice the rate of your growth of income, eventually, it will crowd out everything else that you are buying. barack obama did not create this problem. this problem has been going on for four decades for the last 40 years, a heth care costs have been growing at twice the rate of growth of our income. the united states is not the worst case in the world. in fact, we are just under the european average. so this is a problem for t entire developed world. but even though barack obama did not create the problem, the bill that we passed makes it worse because what it will do is lock us into that very a sustainable path. if we continue on the path indefinitely into the future, by about mid century, today's young folks will reach retirement age

and health care will have crowded out everything else that they consume. i suppose that that is not the goal that we want to reach. the problem with the bill is that it takes away from the private-sector many of the tools that are now there that allow you to control the health insurance cost, and letting the package of benefits, more cost sharing, all of that goes away and walks into a path that is unsustainable and undesirable. then we have is our system of subsidies. the hol down the street has a lot of workers that are making only $15 per hour. they are the maids, busboys, the custodial folks, the garden folks. according to the congressional budget office, if these people make it over to the health

insurance exchange that will be set up under the new health law, there will be able to acquire a health-insurance plan for a family that costs $15,000 and the government will pay almost all the premiums. then if they have a lot of out- of-pocket costs, the government will reimburse them for those and the cbo projects that the total benefit they will get is about $19,000. on the other hand, if these employees stay with the hotel and get their health insurance from that hotel, the only subsidy they get is the subsidy that is currently in the tax law, which means the ability of the hotel to pay premiums with untaxed dollars. but since people at this way is little to not pay income taxes, we are only avoiding the payroll tax. the ability to do that is only a little more than $2,000. they could have something for free worth $19,000. where do you think people will

end up? economy tells me that they will find their way into the exchange. if the marriott employees do not do it, but the others do, marriott will find it very hard to compete in the marketplace with labor costs that it% higher an all its competitors. i do not know what firms will do, but i can conceive of a world in which firms completely reorganized to take advantage of these new subsidies. the strange thing is that, if marriott has an employee that makes 9000 that -- $90,000 or $100,000, that employee gets no subsidy if he goes into the exchange. if he gets his and assurance from the marriott, however, rriott gets the subsidy with the current tax law, the ability to pay prelims with pre-tax dollars, avoiding the payroll tax. but for the higher income, also state and local income taxes. those subsidies are about equal

to half the cost of the insurance. so a higher-income employees once his intered -- once his insurance from -- once his insurance from the hotel. what will employers do? end entirely independent contractors and such? there will be decisions that will not be good for the job market, not the kind of labor market situation that gives employers conference and lets them know what will happen. we have health insurance exchange that creates perrse incentives for the insurers. you charge everybody the same premium, regardless of health care costs, everybody's incentives are distorted. the person that has health problems and will look at the premiums and say that heal insurance looks cheap to me and

they will tend to over insure. the person who is healthy will look at the premiums and think that it is way too high and some will decide to under- insured. centives for the plans are to avoid the sick and attract the healthy. here in washington, at open season time in the late fall, what kinds of ads do you see in newspapers? you see as a young healthy people with children and the implicit message is that temecula put the people in these ads, we want you in our plan. -- the implicit message is that, if you look like the people in these ads, we want you in our plan. if you have aids or some other difficult-to-treat condition, consider us. remember the phrase "you are in good hands with all state?" they have a catastrophic seen

and they say, we know that you do not care about health insurance until you have an accident. but when the really bad thing happens, they say, we will take care of you. in health care, however, it is the other way around. we give health insurance companies an incentive to attract the healthy and tell the sick or potentially set that we hope you do not get sick at all and we wanted to go someplace else. you do not want to erect a health care sense of -- a health care system that avoids people who has problems. one that is better is the medicare advantage programs where they tried to recruit senior citizens with high health care costs because they know they will get a premium that is much higher than the premium paid by everyone else. we have in this loppers incentives for individuals. we have a fine for being uninsured, which is, quite

frankly, not great enough if you want to make the premium completely independent of people's expected health care costs. in massachusetts today, people are going bare when they are healthy. they are signing up for health insurance after they get si. the number of people who do that is increasing each year. it is a small problem for massachusetts right now, but it will be a huge problem for dallas were coming in dallas, they find that medicaid patients end up in the emergency room. it does not matter so mh to medicaid because it is taxed pair -- it is taxpayer-funded anyway. bluecross will not survive very long in the healtinsurance marketplace. we have made promises that we cannot possibly keep. according to the congressional budget office estimates, we will ensure about 32 million people who would otherwise be uninsured.

if the economic estimates are correct, those people go out and try to double the amount of health care that they have been consuming. we have millions of people, 90 million in the last estimate, that will have access to preventive care with no deductible and no copayment, benefits that they did not previously have. let me give you some idea how bad that is. economists at duke university estimated if everybody in america went out and got the preventive care that is prevented -- that is recommended by the preventive care task force that will set the standard for the new health plans. the estimate was that the average primary care physician in the united states would have to work more than seven hours every working day to ride these services, essentially providing services to help the people, leaving little time left over to take carof the sick. what i'm describing is a huge increase in the demand for care.

in this legislation, we did little or nothing about the supply. early on, there were versions of the bill that had line-item expenditures to produce more doctors and nurses and so forth. but all of that was zero out on the final passage, probably to keep the cost of the legislation down. the cbo that probably figured, if we do not have many more docts, they cannot deliver more care, and we cannot spend more money. but what we will have is a large increase in demand, no change in supply, and a huge rationing problem. in this country and other countries, we do not primarily care -- we do not primarily pay for care with money. we pay it with time. please stand by

paentst cases, medicare phag have trouble finding people who will serve them. the elderly may be there as well. if medicare payments to drop below medicaid, the elderly may behi the low-income families in getting their care. there are large burdens here for these dates, where it will be -- for the state, where it will be difficult for them to meet them. this legislation does nothing to solve the problem of

portability, which is the biggest problem that most people have. there is no legislation that produces affordable health insurance. it regulates both the patients and doctors. if we really want to solve health care problems, we want to get rid of waste in the system and higher-quality care. many patients and doctors who will do it. but there will lead to a gifted and had incentives to do so. -- but there will be no incentives to do so. every patient, every doctor, every nurse, and every hospital the administrator will have to do just that, lower costs and raise quality. i want to turn the program over to my colleagues. this program is co-sponsored by the heritage foundation.

robert moffitt who is here today was very kind to put this program together. >> thank you for the chance to be here during the since -- during this event. obviously, this is a central piece of legislation and one that ought to be examined very closely. i want to echo the remarks that the john made about the impacts of the law from the perspective of health policy. but i was taught that, when one looks at legislation, it must lookt it in the context of the nation's problems. the top two problems in the nation today is an economy that is badly underperforming and the need to generate jobs for americans and a federal budget outlook which is coming in and of itself, so threatening as to really cast in doubt the future prosperity and freedom of americans. this legislation is quite

damaging from the perspectives. first of all, the health care sector is now moving to one- fifth of the economy. everything john set about improving inceives in that sector would constitute improve economic policy, and getting higher quality in care and less cost and improvements in efficiency. those are things that we ought to support as a matter of economic policy in the united states. on top of that, there is sspill over to the rest of the economy. you can save $500 billion in taxes over the next 10 years. i do nothing that anybody in the room would say, if you want to create jobs, should we raise $500 billion in taxes over the next 10 years? some of those taxes will show up in the form of reduced incentives there is a so-called medicare

tax, a surtax on investment incomes for high-income americans. that is a pure trackincrease inx on marginal tax rate. it will have the same kinds of entities that were the subject of so much discussion and recent debate over extending the 2001- 2003 tax laws. small businesses and entrepreneurs in america will create new firms and generate job growth. indebted in this bil is damaging incentives for those individuals. there are all sorts of inputs into health services that will lead to higher costs to those services when held some -- to those services. when health services are more mix and sift -- more expensive, there will be higher premiums. you will see the bottom line show up in every small business in america. every businessman will have to do the calculation that says i

have to pay my workers less to cover the cost of the premium increases i am seeing. there will be some workers, those in particular with minimum wages, where you cannot lower their cash to offset the premms. we will see those jobs go away. again, it will be the low-income workers were primarily damaged by this bill and the economics at -- economic incentives that are in it. this is a recipe for less less jobs in america. it is a recipe for slower economic growth. that is just putting the500 billion in taxes in. there is nothing about sending out checks for $1 trillion worth of seven cities that will generate job growth in the united states. nothing about that has ever been a successful path to economic performance. i believe that the nature of the subsidies -- i want to echo what john said -- in addition to the real efficiency costs and the

growth impacts of this bill, there is some deep and fairness associated with how these subsidies are distributed. the example he gave was a rare one. there are two pele who are otherwise intical. you have one woman making $70,000 and gets her entrance from air her employer and gets the tax benefit fromhe employer-sponsored insurance. another woman making $70,000 goes to the exchanges and get $7,000 in federal subsidies. that is an industry that is so profound that it will not be allowed to persist. one that i am deeply nervous about is that a future congress will fix that in every by givi everybody $7,000 and making the bottom line cost so much more expensive than it already is. want to turn to the budgetary implications. they're very closely related to the economic incentives. there are many ways to look at the budgetary implicatis. the first one i would ask you to begin with is the last one.

set up two new open-ended income of programs that will grow at 8% per year as far as the eye can see. that is faster an the economy will grow. it is faster than any notion of revenues will grow. we will set two new programs that will grow faster than the economy for as far as the eye can see and we're supposed to believe that it reduces the deficit. it is impossible to make that claim with a straight face. we have cbo estimates of budgetary impact which showed a deficit reduction from the bill. but i do not think it is widely understood that this particular estimates and the nature and that thoserules -- thu particular estimates are forced by the nature under which the cbo has to follow the rules.

if you take away those rules and look at this in any realistic fashion, our estimate is that the bill would reduce the estimates by $500 billion the first 10 yrs and $1.50 trillion in the next 10 years. that is an important thing from the future the economy to the fairness perspective. the rules are so offensive and has to do every young person in the audience. this bill is the biggest generational money grab in history. it forces every young american to buy insurance, thereby pay for the cost of those who are older and sicker than them, and then, having done that, when they get to the end of their working careers, they will inherit the tllions of dollars in debt that this bill will produce and will be saddled with paying that off as well.

from any perspective of fairness, that is simply wrong. it comes at a time when it is also dangerous. everyone has heard a lot about the budget outlook. regardless of which one of the particular forecasts you look at, the united states is in the fiscal situation that is unprecedented in its history. over the next 10 years, we are likely to run deficits that averaged nearly $1 trillion by the end and zero of -- an average over $600 billion each year. at the end of six years, we will have over a dollar trillion in deficit. we wille borrowing just to pay for the interest. that is a recipe for financial disaster. all along that path, we will meet the technical criteria for downgrade. that is the fiscal outlook before they passed this legislation. this legislation will make it worse. i stipulate that intducing a damaging bill to a stiffest --

to a dangers fiscal situation will not generate jobs. thank you. [applause] >> thomas miller is a former senior health economist and is now with the enterprise institute. if you're interested in health policy and you look at the journals, it is hard not to find tom miller everywhere you look. let's give him a warm hand. [applause] >> thank you very much, john. there is a lot of repeal-and- replace work to be done. you can also find them at our website. coming soon also, with my co- author and others, "y obamacare is wrong for america."

look for it. today, john asked me to focus on something else -- how to improve the health care delivery system and health care quality through u.s., political, and other ways and means. we have to give chase the way we think about the issue. there should be health outcomes and value. helter quality is too often viewed in process terms, -- health care quality is too often viewed in process terms. there is no single setting. it does not mean there are not institutional process no- brainers. that is just nothe big story on how to get better value. we also need to reach beyond the

conventional health care delivery system. a de range o actors shape it. two different individuals should have exactly the same health insurance and differences in health, both initially and after getting the same diagnosis and it can be vastlyifferent depending on where and how they go to for treatment, how to make decisions as patients, and a host of other factors earlier in their life that brought them to that particular point. " we always forget to loo for the health outcome keys that are lost from the health care fundinlampposts. let's be more humble abou providing simple guarantee answers.

the patient protection and care act is promising what is unbelievable and what is all too predictable. in the flyover land of the law, the unicorns and health care delive reform miracles, or science fair projects that never got out of the exhibition hall, we have various 3 iterations of repackaged centralized command and control edicts from the usual sources who issued the previous ones that failed outright or aggravated the systems pre-existing chronic conditions. the latest cliche is that every idea for dealing with health care is -- they managed to leave out a few importt ideas, like choice, competition, personal responsibility, truth in

labeling, market pricing, respect for personal preferences,ncentives for better performance and decision making, double entry bookkeeping, and even arithmetic. most of the quality of experts who tried to sell the message borever that most americans do not hear or believe, yes we believe the health care costs are too much, even though you only see a fraction of the full expense directly or there are too many barriers of getting more of what we want when we wanted, but a vast majority actually think that the health care they receive is excellent or good. that is partly why you will hear politicians talk a lot more in public about high health care costs or spending on the uninjured and the patient protection affordable care act provisions. the reality is that our health care system, although excellent in many important ways, is not

perfect. different approaches cld increase its value. with some more on his choices, it could push forward in a more competitive and transportranspat marketplace. the meter is running on my time. first, throttle back a good bit of the overbearing regulation. two, guarantee a socially acceptable floor of health care services for the less fortunate, but stopped attending to subsidize some much of everyone else's bill when it mostly becomes more wasteful rounds of dollar trading. 3, stop pretending that all care must be high quality and can b high quality and available to everyone all the time. instead, let's encourage more competition in seeking and delivering care whose value continues improve from whatever it is in the moment.

you cannot just imagine the merkel of a totally unfettered free market -the miracle of a totally unfettered free market. policy changes can help private parties compete in measuring and reporting tter have different parties in the health care system performs so they can be rewarded. i have written about this in greater length elsewhere. the new law is not totally barack -- not totally moronic. but it is on aonsensus standards that, by the time they are derived, they're too weak, too unrealistic, or to outdated, and perhaps all three of the same time. while other provisions drive to a more concentrated health care marketplace, it is less competitive and more politically

dependent. we cannot expected to be perfect. we cannot measure everything or even most things. but we should use what is best available within limits of current data and measures while acknowledging those limitations. we should also shut up about quality when we do not kw one way or the other. decide what you really want to waste your money on. we need information much more about provider performance and about insurers and the insurance they offer. and about physicians, not always that the group level, the information needs to be a combination of measurable health outcomes or intermediate markers for them. it is the value combination that matters, not just quality, cost,

or price alone. this whole area is complicated, contentious, a evolutionary, and full of caution and caveat. but we ignore it at our peril without beginning to engage. basic sweeney are to do aggregate data and -- there are basics we need to do to aggregate data and assess it. thank you. [applause] >> thank you, tom. michael cannon is at the cato institute. some months back, he recruited a university of chicago professor to show us how we really ought to be handling the problem of pre-existing conditions. we had a lively discussion of it at my blog. i have asked him to tell you about it today. please welcome michael cannon.

[applause] >> thank you, john. thank you all for coming. i may ve to leave before the question and answer period. if you have any further questions about my remarks, i encourage you to visit the cato institute web site. you may have heard today that the department of health and hun services released a study that says that about half of non-elderly americans have a pre-existing condition and repealing the health care law known as obamacare would mean that those folks who have trouble getting coverage. but, in obamacare, it guarantees that those folks would get coverage and the care that they need. there is problem with that. a government survey conducted just a few years ago found that only 1% of americans had ever been turned down for health insurance. that is consistent with other research. research by the rand corporation looked at lightly regulated individual insance markets, such as california's, and found

that lots of people with pre- existing conditions get injured even when the insurance company has the ability to deny them coverage or to charge them higher premiums. it is a tricky thing, reall to get people to keep the promises that they make too sick people. this is true whether you are talking about pollock health let's look at the record. there was a long- term promise to sick people. employer-sponsored health insurance. if you know that history come you know that is market is a creation of government. in the 1940's, the government through a series of accidents decided that emoyer-sponsored health insurance would be exempt from payroll taxes and income taxes, which created a huge tax

break. have a corresponding penalty -- purchasing on your own -- if you want to purchase it on your own, it can cause people twice as much for the same or less coverage compared to getting that through an employer. this is the horse the government decided to back. but if you think about it, your insurance plan for your employer does not provide you a long-term promise to take care of you when you're sick. they only provide medical care so long as you are still connected to that employer. if you get sick and cannot work, you lose that health insurance and you run your own. the individual market, researchers have found, even with various regulations, fines or secure health insurance than employer-sponsored health insurance. for people with high costs

illnesses, they are likely to keep their insurance than that they had it through an employer. that is the situation the government created when it decided it would increase access to health insurance. nine out of 10 people with health insurance or in this employer-sponsored health market where you do not get a guarantee that you'll be taken care of over t course of a long-term illness. w about another khmer -- government solution and? we heard about the medicare program 20 years later. we're going to provide secure health insurance for people in old days so they created the medicare program for peopl over age 65. yes, medicare provides secure access to health insurance for the time being. they do it in part by being completely fiscally unsustainable. we cannot continue to provide access to the medicare that seniors had been accessing in

medicare forhe past decade. in aition to that, one of the ways that medice is so financially unsustainable is that 33% of medicare spending does not provide any value, does not make patients healthier or happier. that is where rearch shows as. and cses most of

this sort of thing happens wherever we see these obama care style price controls. it happens in states like new york that have had these price controls on the books for quite some time. it happens in the employee benefits program. it operates out of the same price controls as obama care. this sort of discrimination will

reach you if you are rich, poor, or anywhere in the train. one have is the share of americans that would be hurt immediately by obama here price control. and many overtime will be hurt by these price controls. how do we keep the commitments we have made to the sick? this innovation and other innovations will be possible. some that we cannot foresee will be impossible as long as obama

care and government price controls remain on the books. thanks very much. [applause] >> robert is a senior fellow at the heritage foundation. he has been involved in the health-care field for as long as any of us can remember. he is a tireless worker. if you e-mail him at night for the weekend, he will probably into you. he never quits working. let us give him a warm welcome. [applause] >> thanks very much. ladies and gentlemen, there is a lot of work to do. we are faced with a great task in front of us. we are entering the second phase of the great national health care debate that will go on for quite some time.

let me go over a couple of issues that are facing the country such as the challenge of entitlement. this is january 2011. over the next 18 or 20 years, medicare is going to experience the largest single demand for medical services probably that we will see, something we have never seen before in terms of the tremendous demand for medical services in the medicare program. the size of medicare will double in the next 20 years. at the same time, as you all know, we are faced with a potentially critical shortage of positions. not only primary care

physicians, but other doctors as well. the law acknowledges this and starts to pay physicians more in certain underserved areas, but the gravity of this is greater than most of us -- and most members of congress really appreciate. one of the striking fact about this debate has been the hostility collectively of the medical profession, forget the representatives of the medical profession. the hostility of the medical profession itself to this wall. there is a reason for that. americans and doctors are becoming demoralized. more and more of them recognize that they do not have controls over their professional lives. they are more govern by regulation. they are faced with an expansion

of government payments. medical malpractice problems have not been properly addressed. getting back to medicare, there is something else that is remarkable. while we are seeing massive expansion in coverage and at the same time a tremendous position in public costs in health care, medicare is at the same time undertaking record-breaking deductions in payments to doctors and hospitals and other medical professions. the centers for medicare and medicaid service says this will result in a savings of $575 billion in the initial 10 years. what does this actually mean? we have never actually been here before with a tremendous demand for medical services, and once the most growing in such a significant reduction in medicare payments.

without medicare reform, payment deductions will threaten the access to care for seniors. that is not my point of view, but that is the view the centers for medicare and medicaid services. after further legislative intervention, the projected measure of savings will not enhance the solvency of the program. indeed, there was this wonderful letter addressed by senator jeff sessions in alabama of january 22, 2010. he said the unified budget shows that the majority of the trust fund savings under the will be used -- ppaca will be used. without an escape valve for senior citizens, the provisions

of the law will guarantee that we are going to see greater access problems over time. if we were to go down this road, we will what access for senior citizens that they do not have today. it does not make sense to cut medicare advantage and reduce their access to those private plans or to maintain the existing limitations on senior citizen's ability to go outside of the medicare program. we have to go in a different direction. ladies and gentlemen, we are entering today and tomorrow the second stage of this great national debate. one thing we ought to keep in mind is that congress has a

responsibility for one of the largest programs, the medicare program, and they have to get this financial house in order. medicare has an unfunded liability of over $30 trillion. any member of congress who knows how we are going to handle this financial challenge. does anybody know? the truth is, nobody knows. we are faced with this. many of you are young people. you will pay the price for inaction in this area. there is a way out. you have to think about restructuring medicare, changing get from the existing open- ended entitlement that exist today to a program that is based on real, competitive insurance and adjust premiums and subsidies to get away from what we have today. we should provide beneficiaries

with a wide range of choices in healthcare plans and options and make sure that in a future medicare system that we will expand access to physicians and reduce the number of physicians who refuse to take medicare patients or except new medicare patients. there are ways to do this. my view is that many of you are enrolled in a program that is quite good in terms of organizing health-insurance benefits. the key element is it is driven by a two or free market principles. many of you can do what many americans cannot do. if you are dissatisfied with your health insurance package, you can fire your health insurance plan. that is not a bad option. it is not a bad option for the future of our senior citizens as well. they have to depend on us to make good decisions to give them

access to the quality of care they deserve. thank you ladies and gentlemen. [applause] >> thank you, bob. that was very informative and very good. i want to open up the floor for questions. if you will tell us who you are directing your question to. i saw a hand up. let me just begin by asking this question. do the panelists believe that senior citizens realize what has happened to them under this legislation? what do you think will happen with the medicare provisions? will we go forward? we carry at out the way the law is written or will it have to be changed? who was to take this? >> i will go first.

i thought it was very interesting that both the actuary of cms and the director of the congressional budget office both publicly stated in formal, official correspondence to the congressional leadership that they did not think that the medicare payment deductions were sustainable over time. both the cbo and the cms actually. we have not gone here before at this level on payment reductions. i think whether this survives or not -- it is highly unlikely in my view that they will survive. >> let me address this question. what happens when you have a bill with the huge expense and the way you thought your going to pay for it does not pan out? >> nothing good.

[laughter] this has been the history of entitlement programs in the united states. they are washed with fanfare that includes their budgetary soundness. over time, enrollments expand to over what was originally envisioned. the incentives are such that no one is ever going to go into programs that cost people to scrap and safe. that has been the history of medicare and medicaid. it is likely to be the future of this law unless we change course. we have enormous structural deficits that are so large and so troubling that they literally threatened the capacity of the u.s. economy to provide a higher standard of living in the future that we have now.

that is something we simply cannot do. >> we had economic imbalances. we can also devalues health care. we can do that explicitly or indirectly. >> if yes, sir? >> michael cannon mentioned that about 30% of the spending in medicare is wasteful and is spent on care that provides an upper limit -- no particular good to anyone. does that not suggest that there is a lot of people out of medicare? i do not know if you solve the study that was published last month looking at el paso, texas, and looking and variations in medicare spending. they found variations in private spending.

they solve they do not exist in private spending. the administration -- a lot of the plans for obama care were based on the idea that this same fact existed in private insurance. what does this suggest about the future for the law, about reform, and otherwise? >> it was measured crudely as an aggregate. over 15 years ago, people were rediscovering it. there are more variations in private health care then there are in medicare. the tendency of research is to go with the data is. we had medicare data. it showed a kind of crude variants. we talked a lot of theories around it. it is true that the nature of

the medicare program lends itself to more of that waste and variation. it is a miserable element. there are principles we are not willing to go to. but the money in the hands of consumers. we had that pretty much distorted. we do need some type of market to see what is better and what is worse most of the time. we are building a message that may not tell us that, but it is the general direction in which to go. you can find it right here on the map in this particular area and get that passed pruett -- get that passed politically. >> let me add one thing to that. tom's answer was very good. there is 30% of waste in medicare. maybe it is more.

if the hospital bill said what it was, you could get rid of the waste. what we mean when we say there is waste, there is an efficient hospital administrator that could have done this for 70% of the cost that was expended. unless they have an incentive to go do it, they will not do it. we will not get rid of waste unless it is in someone's self- interest to do it. >> do you believe congress should attempt to fix this legislation? the think it is possible to fix this law or do you think tweaks as a whole cannot make a difference and the whole thing has to be repealed? >> i will take a shot at it. the issue here is what is your vision for the future of health care in america? what i think the law represents is a very specific vision of health care policy. we know our colleagues very well

disagree with us. frankly, this is their vision of what the health care system should look like. they believe, many of them very strongly, that health insurance plans should be public utilities. they should be heavily regulated by the federal government. the federal government should make the key decisions in allocating resources in the health care system and making decisions about how it will be covered and how it will be financed. that is not my view. i think my colleagues here share my view point. the bill does represent the point of view. having said that, i would say in answer to your question that you actually cannot build a system based on eight free-market principle of consumer choice and competition on a foundation which is fundamentally incompatible with that vision. a foundation that is built primarily on central planning

and bureaucratic legislation. again, that is not a personal opinion. that is what the law does. i understand our friends on the other side have a very different vision on this. let me make one observation before i stop. in the early 2000's, the idea of a health insurance exchange became very popular. the idea behind that was competition among private health care plans. someone has written on this issue. at the university of california, a number of analysts said this was a great idea. what we should do is have a health insurance exchange with a taxpayer financed public auction. what was the purpose of that? it was very publicly celebrated. it was a way to get to a single- payer health care system by undercutting private health insurance. that is the in the spirit that

is the vision. we have a different one. >> this was a package deal. it was not all you could eat, it was all he could stomach before regurgitating it. you could always talk about a few advertisers. the problem is, you have to have the entire meal. pulling only one part out of this -- the danger in pulling apart the most a notches features of this, we are in a plan for time. the design of this legislation was to institutionalize the early seeds that are going further and further. that is why this whole thing has to be pulled up quickly. it does not mean nothing remains. it means we have to get to things that makes sense.

>> this is for the entire panel. after the repeal vote, the house is set to vote on a resolution. are you confident that with the goals directing committees to come up with replacement legislation will make the structural changes you're talking about? >> i think there is good reason to be optimistic. what people forget, given the events of the past year, is if you dialed the clock back to the beginning of the debate in the united states, it was a tremendous amount of bipartisan consensus about the need to reform, it was a tremendous amount of consensus on what reform should look like. the cost differences should be equalized across the states. none of this was in dispute.

there is no reason to be at all skeptical about the notion that you could go out and find common objectives. it is also the case that there was a tremendous amount of bipartisan agreement on the delivery of reforms. where there was great disagreement was in the nature of the insurance reforms and help to cover more people. this legislation is by and large about the latter at the expense of the former. we could go back and do much better on a bipartisan basis by concentrating on the real problem, which is the delivery system and not a massive expansion of check writing. >> if yes, sir? >> given the likelihood that there is going to be a lot of foreign -- a lot of movement of the state level in creating

exchanges, does it make sense for one state or multiple states to try experimenting with some of the models you have outlined here? >> the law does not allow enough of that experimentation. states will have to be more aggressive. there is some leeway, but you get into this plea bargaining game. it does not actually turn it around. i will be speaking tomorrow at the national congress on health insurance reform. there are different ways to do exchanges. states have to put something on the ground that will not fit into the parameters that washington told them to do. we need to give some examples

and see which ones we actually prefer. it makes sense to the people on the state level. >> the only thing i would add is that the administration seems very desperate to get something to work. i think that is why they gave this to so many workers. they do not want to be embarrassed. they want to see some good things happening. that makes me think they might be willing to be flexible. yes? >> you alluded to the medicare physician payment cut. how are we supposed to fix that? how are we supposed to get more doctors? >> does anybody want to take that one? >> let me take a shot at it.

i honestly think that one of the most serious problems facing the country is the demoralization of the medical profession. physicians are disspirited. many of us have an opportunity -- it is a great privilege for me to have an opportunity to talk at professional medical meetings where members of the medical profession are gathered. they talk among themselves a lot about the profession and how they can function in this environment. the environment for independent medical professionals is becoming increasingly hostile. you are expected now to go to work for a hospital. you are expected to join a large practice. at the same time, you are expected to a absorb a massive number of people who are going to be getting care under medicaid. you want to talk about the big change in terms of insurance

coverage, roughly half of the people that are going to get health insurance is much to get through medicaid. talk to physicians about what that means. it means every single time a patient walks into a room, the patient is going to -- you are going to incur a financial loss. it also means that more and more people are going to end up in hospital emergency rooms. this has been completely overlooked in the health care debate. the degree to which medicaid is a driver of hospital room overcrowding. i think the situation is very serious. the only way to change that is to change the fundamental underlying financial structure of our health insurance system where we basically have an opportunity for people to buy health insurance that is best for them and enter into the kind of relationship with a position that used to be the norm. what i am saying in effect is

pretty radical. i am is saying that we need to make one of the goals of health care reform the restoration of the traditional doctor-patient relationship. not all people want that, but many of us do. that is what the president has spent so much time saying in form after forum that if you like the relationship with your physician, you'll be able to keep it. the problem that we are stuck with is that you may want to keep your relationship with your doctor, but your doctor may not be able to keep this relationship with you. >> i think the goal is a one-to- one relationship between the physician and the patient. we are moving towards that ratio. >> dr. burgess is here with us today. there are 20 physicians in the house of representatives. is that right? >> 20 our doctors.

>> i hope to hear from all of you in the debate that starts later today. [unintelligible] >> we are glad to see you there. [laughter] >> you mentioned a couple of new entitlements. one is the requirements for reserves. there are two classis that only had to spend $5 for premiums. you talk about sustainability of the program. >> it is a new long-term care insurance program whose basic structure on paper is take premiums in what you were. it is like a payroll tax. we have seen this kind of structure before -- social security, medicare.

they are in deep trouble given the way they are structured. just to quote someone who would know a lot about this, it was called a ponzi scheme. the with the program is set up, it will have an abnormal amount of adverse selection. some people will have well above average costs. the premiums will come nowhere close to paying those full cost. the private sector will get into a death-spiral. will just be shoveling more revenue into it. this is, i think, one of the worst parts of the bill. it is not one i see any way to redeem. do you try to fix this or do you repealed? you just have to repeal it.

it is unworkable and dangerous. >> the surprising thing is that we had this commission set up by the president to tell us what to do about unfunded entitlement programs and then we pass a bill that creates another one. the present's on commission recommended repealing the class act. i think that is a very telling recommendation coming so quickly after the bill became law. >> one of the debates congress has had is about your marks. one of the arguments is that lobbyist come up and get special treatment. now we have hundreds of waivers being sought by the department of health and human services. is this another prescription for political favoritism? >> i find this incredibly troubling. there are 220 odd waivers we have seen already.

it just simply cannot be implemented as written. what is more troubling is that you cannot figure out the grounds by which these waivers are being decided. they can affect the competitive balance in the industry. there appears to be no particular transparent process by which a large group could get a waiver simultaneously. i consider this what the troubling aspects of the law. >> i would like to second that. we have time for one last question. >> [unintelligible] there is a lot of focus on coordinated care. i am curious whether you think that focus is good. can a consumer-directed oppressed do with those issues? >> coordinated care, managed- care, evidence based in madison

-- evidence based medicine -- you think this will work? >> if you throw enough ideas and money at something, something will stick it out. we do not want to start innovation because we do not have a feedback loop determining what works and what does not. you're trying to manage this from on high. you're calling it innovation. will there be incremental gains? sure. the fastest route to innovation is people spending their own money. what's the fundamental problem with our government health programs is that we sent a message to consumers that they can have all the high quality care they want at no cost. when that turns out to be nonsense, we tell providers to cut it out. we demonize doctors. we do not pay them. that is what they are

discouraged. you can break that fundamental mismatch. it is not one to work. >> here is the last word. for 25 years we have been doing pilot programs in the field of education try to find out what works so everybody can copy it. for 25 years, it has not work in education. it probably will not work with health care. thank you for coming. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] >> this afternoon on c-span, a town hall meeting on u.s.-canada relations.

speakers include canada's ambassador to the u.s. that is today at 4:00 p.m. eastern. >> this eat it -- this weekend on bookedtv, bill crystal talks about the neo conservative movement. also, 52 women look at their work on the civil rights movement. gordon brown on coming back from the economic downturn. find the complete schedule at booktv.org. this weekend on "american history tv" historians to discuss the first age of terror. that is from the american historical association conference. learn of the century old positions. greg karr explains hal former

slaves escaped and started new lives. experience american history tv on c-span3. you can have our schedules in mailed to you. >> a medical briefing on the condition of arizona rep gabrielle giffords. doctors say she was successfully transferred -- transported friday from tucson, arizona, to houston, texas, for extensive rehabilitation therapy. they are optimistic about her prognosis. this is about half an hour. >> good afternoon. i am the head of corporate communications. i am very happy that all of you are here today. we have enjoyed working with you these past few days that they

had been quite a whirlwind of activity. this is our first news conference. we anticipate holding additional briefings as the medical team has additional information to report. with that, i know you are anxious to hear from the doctors. it is my pleasure to introduce the president of the memorial hermann health care system. >> thank you, beth. welcome to memorial hermann. thank you for being here. shortly before 2:00 p.m. today, congresswoman giffords and her husband, captain mark kelly, her family, and her staff arrived here. we completed a successful transfer of care. i had the privilege of reading

them and can tell you that they have looked forward to this day as gabby takes the next debt on the road to recovery. we are honored at memorial hermann was asked to place such an important role in this next debt. before i introduced the physicians, i would like to of our texase cdeo medical center operations. stand and be recognized. thank you. i would also like to introduce to you the ceo of the tier memorial herrman hospital. seated next to them as my colleague and good friend, the president of the university of texas health