governor haley barbour, a potential presidential candidate makes an appearance in new hampshire. now, today's "washington journal." in 45 minutes, massachusetts governor deval patrick. also >> we do not have to choose between a future of spiralling debt and one where we forfeit the investment of our people and our country. to meet our fiscal challenge, we will need to make reforms. we will all need to make sacrifices, but we do not have to sacrifice the america we believe in. as long as i'm president, we will not. ♪ host: president obama unveiled his deficit reduction plan

yesterday. we want to get your thoughts on what is in the plan and the politics of it. the numbers to call this morning -- good morning and welcome to "washington journal." you can also e-mail us this morning. you can also find us on twitter. we will get your comments. let's take a look at some of the coverage of this story. "the washington post" leads with the headline "obama's plan combines cuts with tax hikes."

host: very different interpretations of what this means and opinions in the opinion columns. "the wall street journal" has this article that says, "where is rahm emanuel when we need him?" host: looking at an entirely different perspective, "the washington post" -- "the present

has finally decided to take his own side in a philosophical struggle as the true engine in the nation's budget debate." let's go to arkansas and hear what diane has to say on the line for republicans. good morning. caller: being a republican, i resent the way he treated republicans. there's one thing i would like to ask you. could you possibly get paul craig roberts, an economist, on? he probably has another book out. he is very wise about these things and i think he can contribute a lot to let people know what is going on. host: we will look into doing that.

as a republican, do you feel the opinions are coming down along party lines? caller: i think so. are you still there? host: yes. caller: there's no way the republicans could -- we are not socialists. that's the best way i can put it. host: annapolis, maryland. willie on the line for democrats. caller: this lady on the think hens' side -- i did a great job. this country cannot go any further unless we do something to progress, not hold back. i would just like to say i think he did a very good job. if the republicans are mad, they have to be mad. forget the person that got us into it is ronald reagan. thank you for your time. host: beth is on our

independent line. good morning. caller: i cannot believe some of the things i hear on this show. the main thing i'm concerned about is social security. people worked their whole lives and pay into the system. people who get paid, you know, they burned that. i do not know why everyone runs around calling it an entitlement. they pay into it. they should get it. to you know what i mean? i know people that have worked all their lives and they hit 61 or 62 and they get ready to retire and they die. they never draw social security. i also know there are a lot of people that come into this country that have never worked

in this country and they are drawing social security. maybe they should start checking everybody who is drawing it. host: ok. let's take a look at a comment on twitter. "the new york times" as a breakdown comparing the budget proposals of congressman paul ryan and the president's framework described yesterday. let's look at taxes, for example. host: it also looks at medicare, medicaid, military spending, and

domestic spending. let's look at the issues surrounding medicaid. host: let's take a listen to a little more of president obama's speech yesterday about bringing down the deficit. >> any serious plan to tackle our deficit will require us to put everything on the table. and take on excess spending wherever it exists in the budget. a serious plan does not require us to balance our budget overnight. in fact, economists think we need a face in her approach. it does require tough decisions and support from our leaders in

both parties now. host: the reaction of karl rove in "the wall street journal." host: let's hear what walter has to say in butler, indiana on the line for republicans. good morning. caller: good morning. thank you for taking my call. both sides of the aisle are corrupt. it goes back to the 1960's when we were on the gold standard,

meaning, for every $1 we spend, there was gold to back up our currency. bottom line, whether you are democrats or republicans, two plus two is four. it's not a question of whether the government spends too much money. it is that the government collects billions of dollars each year. it is how they spend it. it all comes down to who gets a piece of the pie. i would submit this to everybody. common sense. bottom line, when the government does not have to be on a budget, when the government can arbitrarily invent and print trillions of dollars of money, and none of this matters. when we pit people against each other, when we have the democrats saying that the republicans want old women to die, nothing is going to matter.

you know when this is going to clear up? the day america says -- we owe nobody any thing. we are the greatest, most prosperous nation in the world. we do not have to barrault from china, which is a brutal country -- we do not have to borrow money from china, which is a brutal country. that will never happen. it does not matter if you are democrat or republican. bottom line, can we afford it? no. we have $146 trillion in unsecured debt. that's all i have to say. we're all going to be scrooge. we are going to go bankrupt. the poor will get poorer. the rich will get richer. if you want an exit, you could

turn around and say, "from now on, all corporate taxes in america are 10%." you would see the largest influx of major companies coming to america, rather than going to mexico, chile, china, and overseas. host: let's get some perspective from republicans in congress. tom price, a congressman from tweeted this. congressman tom price on twitter. let's look at our twitter feed. host: going to another caller in indiana. let's hear from kathleen on the line for democrats. hi. caller: good morning. how are you? host: good morning. caller: i'm so happy the

president stood up to the republicans and said, "you know what? this is not going to happen." i am struggling, struggling, struggling to barely stay in the middle class. we have taken the hit. we are the only people that have taken a hit since bush left this mess. we bail out wall street and we bail out banks. paul ryan and his pretty little words -- you know, we still need to pity the wealthy. oh, you poor wealthy people. pay your share. i'm tired of paying for everything. my son has to leave college because there's not enough money

for him to go to school. he has to drop out after this semester. has anybody asked anybody in congress -- is there medicare going to be there when they retire or are they going to go on a voucher like the rest of us? i'm turning 55. my husband has been a steel worker for 33 years. what is he going to do? paul ryan and the republicans are going to tell them you are going to get medicare rationed? where are these people going to go? paul ryan and the other republicans, ask them if their medicare and social security will be affected? host: let's listen more to speech.t obama's

>> i agreed to extend the tax cuts for the wealthiest americans because it was the only way i could prevent a tax hike on middle-class americans. we cannot afford $1 trillion of tax cuts for every millionaire and billionaire in our society. we cannot afford that. i refuse to renew them again. host: roland in new hampshire joins us. hi. caller: i hear all this stuff about the democrats and republicans. i do not hear anybody talking about immigration. start shipping these illegal aliens out of the country because they are the ones sucking up our money and benefits. not only that, but china has all our money. we should start taxing them when that stuff comes into this country. ok. the incident with the gas prices -- they are buying the oil starts and reselling them.

i did not know why the president does not put a freeze on them. it will make everything grow out of proportion and you will lose jobs. you know, they need to do something about this now. they're like little kids bickering back and forth. we should cut medicaid. we should cut social security. go after these countries we are giving billions and billions of dollars away. that's the problem. nobody gives us money when we are in trouble. we should get the soldiers that cold and let them fight their own battles. host: we are talking about president obama's deficit reduction plan. "the wall street journal" lead with this headline. the story says, "the speech, which appeared to leave republican leaders. , was mr. obama's most substantive steps."

coming to us from e-mail, sue writes, "at least the tone is changing in washington. it is time to put away the credit card." republican inm a florida. good morning. caller: good morning. i am beyond democrats and republicans. when i heard the president said yesterday that the rich does not need a tax increase, that he does not need one -- we, the middle class, are having to pay

$6,000 each. they do not care if that is a republican or democrat paying $6,000. $6,000 is $6,000. why give the rich tax increases that will cost us for people to have to pay more? then they talk about 55. why cut it off at 55? i am truly disappointed. the people are getting help from the government, do they get a voucher, too? i stayed in a hospital for three days and i had a bill of $48,000. what would a voucher do for me? like the other caller said, why

is it that their health care will be there for them for the rest of their lives, but for us paying into the system, it's threatening us? it is good enough for them, it's good enough for us. host: take a listen to chairman of the house budget committee paul ryan and his reaction to what the president has in mind. >> last year, in the absence of a serious budget, the president created a fiscal commission. he admitted he ignored all of its recommendations. now he wants to delegate leadership yet again to a new commission. how are we to expect different results? the measurements of success for the new commission are lower than the measurements of success for the last commission. we need leadership. we do not need a doubling down

on the failed politics of the past. host: congressman paul ryan. "usa today" covers this story and says that paul ryan, the author of the gop plan, it sat in the front row for president obama's speech. "what emergedays were duly lines in the sand." our next call.to we have ryan in michigan.

good morning. caller: good morning. i have a couple of complaints. i'm tired of hearing the republicans complain about class warfare by the democrats. they have been practicing economic warfare for the last four years. i'm also tired of mr. paul ryan demagoguing it. he is offering nothing new. the republicans have been trying to kill social security. the plan for social security was nothing but a poison pill. they were trying to make the fund go bust. it's real simple. they've been trying to kill government since 1980 since ronald reagan. but they are ridiculous. they're going to push us over the edge into the next great depression. host: you can continue the conversation we're having about president obama's deficit plant at facebook.com/cspan.

president obama has an editorial piece in "usa today." he talks about reining in the deficit with a balanced approach. host: he outlines a couple of things. he says, "personal, we need to build on the cuts from -- first of all, we need to build on cuts .rom last week's budget

president obama says reduced spending in the tax code. anthony on the line for independents. hi. good morning. caller: thank you for taking my call. when i listen to president obama's plan and then i heard the republicans, they said something negative about needing leadership. i think what president obama spoke about yesterday was very positive. i have hope for the future. when he was talking about the republican plan, he said they would cut 50 million americans' benefits and they would have to fend for themselves. he said he did not need an extra tax credit of $200,000 and i think he said warren buffett did not need it, as well.

i think it was good for americans to hear. i think he took a leadership role. that is leading. he said these things were not going to happen while he was president. i felt very positive that he took that stance. the republicans came off more negative. they are talking of ballots president obama -- they are talking about president obama poisoning the well. i did not think that at all. i like what he said last night. i thought it was very positive. thank you for taking my call. host: congressman jim mcdermott talked about his viewpoint on twitter.

the: let's take a look at "usa today" break down by susan page and richard wolf. this is how the options for cutting the deficit measure up.

host: let's go to the phones. bill in charlotte, n.c. on the line for republicans. caller: thank you for taking my call. we have people going back and forth on this budget issue. paul ryan's budget and the president's budget. i cannot think this president seriously with as much as we have incurred in debt under his watch. he does not have a budget and a

plan. to be the savior again, just to paul ryan's plan, which is doing something -- it perplexes me how the american public keeps beating up this stuff -- keeps eating up this stuff. they did not produce a budget before the last election. if the american people saw what was in it, they would not have voted democratic for sure. when are people going to wake up and realize the emperor has no clothes. >> we are presented with a vision that says the american people, the the united states of america, cannot afford any of this? it is a vision that says america cannot keep the promise we made

to take care of our seniors. it says that 10 years from now, if you're 65 and eligible for medicare, you should have to pay nearly $6,400 more than you would today. it says that instead of guaranteed health care, you would get a voucher. if the voucher isn't worth enough to buy insurance that's available in the open marketplace, tough luck. your on your own. put simply, it ends medicare as we know. host: president obama speaking yesterday. richmond, virginia, rick on the line for independents. what do you think about the president's deficit reduction plan? caller: i think they're blowing smoke right now. we hear a lot from the democrats and republicans about what they're going to do.

when it comes down to it and they actually have to do something, all they're doing is scratching around the corners and trying to make political gains, both of the parties. we saw that with unemployment insurance and increasing the taxes. both parties got what they wanted and we got more debt. we got more deficit. the same thing happened last week. all they are doing is scratching around the edges and we really are not going to get any change because no one wants to work together to actually do something in washington. host: let's take a look at other political news happening right now. donald trump plans to announce his run for president. ronald kessler says, "if you wonder whether donald trump is serious about running for president, tune in to 'the ."prentice

an article in "the wall street journal" this morning by peter ehner, "the gop and the birther trap."

host: in other presidential news, according to usa today, rick santorum will explore a run for the republican nomination, making him the second republican contender in as many days to make his intentions officials after mitt romney. let's go to the phones. jim on the line for republicans from south carolina. good morning. caller: good morning. the government collects $2.5 trillion income taxes. if you increase the taxes 10%, you only get $100 billion. it's not nearly enough to pay the $1.1 trillion deficit. this is easy match. obama is trying to raise the motions -- raise the emotions

who do not understand simple math. you cannot just vote for this and not pay more yourself and expected to be paid by some bogeyman at the top. we have to get back to simple mathematics. i do not think that mr. obama wants to focus on that. he wants to lead people astray to say, "keep voting for me and i will give you what everyone and you don't have to pay for it." his plan does not go into a drop of paying the current deficit. it's a subterfuge for leading us astray. host: a reminder of the .resident's proposal for taxes

this comes us from "usa today." let's compare that with the republican plan. we have been talking about medicare and "usa today" reports that a new poll that they did shows how popular medicare is. six in 10 said they wanted the government to make no changes. senator nelson weighed in on

twitter with his take on the president's plan, supporting the president's call to reduce spending, but opposes raises in taxes. let's go to rochester, new york. karen on the line for democrats. caller: my drugs cost $25,000 per year. my medicaid is essential, obviously. my drugs are essential. you cannot cut my drugs. that's all i have to say. host: i'm sorry to hear about your diagnosis. what did you think about the president's plan yesterday. did you support that? caller: yes. host: what did you like about it?

caller: obviously, people cannot be cut off from their medicare or medicaid. host: ok. thank you for sharing your story. let's go to michigan. randy on the line for republicans. hi. caller: good morning. good morning. the speech yesterday was nothing more than a bunch of lies. this lady who just called -- i feel sorry for her, but do not worry. they're not going to cut off your medicare. there's no way they are going to do that. president obama wants to tax. watch them give tax breaks to the millionaires and billionaires. he should have backed down a little bit and said anybody making over $200,000, i'm going to tax the heck out of you. the guy from michigan who calls in every week -- he starts off

talking about how smart president obama is. i started looking up some of the stuff he has promised. he has promised anything the people want to year to make him look good. it's nothing but a bunch of lies. what good american would go over to germany and give a speech and run down his country like president obama did and apologize for the united states? host: let's get back to the question of medicaid, since one of the caller's brought that up. this is from "the wall street journal."

host: we have got george on the line for independents from ridgewood, new york. caller: thank you for taking my call. when everything was made in america -- now, we have to take money from china to support america. if we create factories in the united states to make television, and to make plastic, to make products -- if we wait for the rich to do that, we're

going to wait for a long time and they will never do it. rich people are taking their money overseas to invest in things that will multiply faster. they will not open factories here. the united states government must open factories in america but to hire people, to pay people, the people will pay taxes, and then the economy will come back. the only way it will work is to open factories in this country. look at japan after world war ii. they did not have anything and they build the economy based on industrial. host: let's take a look at a couple of comments. this one by e-mail from st uart.

this is on twitter. jack says, "the republicans are trying to fix the debt. let's turn to more money matters happening on capitol hill. the deal that came together late friday night over the current fiscal year's spending budget. joining us on the phone is humberto sanchez, "national journal" budget and appropriations reporter. good morning. guest: good morning. host: it looks like the house will vote today. talk to us about what to expect. guest: the house will take up the compromise legislation that was worked out friday night and is expected to pass. the rule that was approved yesterday sets up a vote as part of the deal on defunding planned

parenthood and the democrats' health care law. those things will go to the senate. the senate is expected to take votes on the c.r. and also those two separate proposals, as well. host: caucus through what to look for as far as -- talk to us about what to look for. guest: the bill is expected to pass. the president wants it to pass and he will be pushing democrats to vote for it. house leaders want it to pass for the same reason. it will be interesting what mix of democrats and republicans come together to get the 218 votes needed. host: former speaker nancy pelosi may vote against the

deal. talk us through who some of the surprises might be. guest: one group of representatives to look at are the blue dogs, the conservative democrats, the fiscally conservative democrats. we have been talking to a few of them and they are reviewing the bill. the have not said how they will vote. they could be some votes -- some democrats could support that measure. you know, you would have to look for moderate folks. also, a lot of people on the conservative side of the republican caucus have also said the bill does not go far enough in there looking to vote against it. host: as of late last night, 12 republicans opposed it in the house, including michelle bachmann.

what does this say for the control and the power that speaker john boehner and leader nancy below sea have within their own ranks -- and nancy pelosi have within their own ranks? guest: on tuesday, we were told that at least 24 republicans would vote against it. since boehner and the white house have agreed to push this through, i think it will be able to find the votes. when push comes to shove, i think they will get the votes needed. this is last year's business. they really want to move on to the budget and the debt ceiling fight. i think people are a little tired of the fy11 business.

host: humberto sanchez, you reported that in order for the deals and proposals to have any significance, eventually, congress has to vote on them. they said down bill -- how are you looking at this to be a clue for other budget battles? guest: one thing to look for is how many of the conservative will vote for this. there will be a lot of spending fights through the year with the budget resolution, the debt ceiling, and the appropriations bills. i wonder, at what point do they lose faith in their leaders? compromise is the only way to govern and get these bills done. that will be an interesting pattern to look for.

host: the senate takes up two bills, one to block funding for planned parenthood and one to block funding for the new health care law. what's the significance? guest: the house republicans initially wanted that in the deal. that was a nonstarter for the senate democrats. the solution was to take separate votes on these issues and both are expected to fill in the senate. -- both are expected to fail in the senate's. host: humberto sanchez, "national journal" budget and appropriations reporter, thank you. guest: thank you. host: taking a look at this article in "the washington post." host: let's hear from a caller

on the line for democrats in north carolina. hi. caller: i believe this is change. the thing that's getting to me is how everybody is sitting here trying to bash president obama about how he is doing everything wrong. people fail to realize that the debt was here before he came into office. they're trying to put this all on his shoulders. isn't this put on previous presidents' shoulders? they act like this all came about when president obama came to office. i need somebody to explain this to me. host: let's take a look at a couple other news stories in

"the washington post." "the oil spill appears to have delivered something entirely different, a gusher of money." other news looking at the oil spill as we approach the one- year anniversary of that, "usa today" profiles michele jones, who lost her husband, gordon jones, who lost her husband due to the deep water explosion.

this obituary piece from "the new york times" today. sidney harman passed away at 92. "he died tuesday night in washington. he was 92. the cause was complications from leukemia, according to a statement by the family that beast' in 'the daily and family members learned of the illness only one month ago." that is all for right now. we will be back in just a moment, where we will talk with massachusetts gov. patrick about health care and his new book. we will be right back.

♪ ♪ >> on april 12, 1861, confederate forces attacked fort sumter, igniting the civil war. this month, the nation commemorate the 150th anniversary. this weekend, american history tv brings you the sights and sounds, with a special look at wartime life in the 1860's, as well as interviews with civil war scholars. get a complete weekend schedule at c-span.org/history.

>> to be a parent means that you are training the people you cannot live without to live without you. >> andrew ferguson was not prepared for "crazy u." >> nothing like that happen to me when i was looking at colleges in the 1970's. it started to dawn on me that this was a very different process. "q&a."day night, c-span's >> a few months ago, i was able tax bill forsk american families because both parties found common ground. the same cooperation has made it possible for us to move forward

with the biggest annual spending cut in history. >> what all the events from the current spending debate to the debate of next year's budget from capitol hill and the house and senate floor to the white house and around washington online with the c-span video library. it is what you want, when you want. >> "washington journal" continues. host: democratic massachusetts governor deval patrick. good morning. guest: good morning. host: adding to your resume, author. what inspired you to write this book? guest: i'm very hopeful person. i started to understand the qualities as a blessing. the book is a tribute to people who taught me those lessons and the teachers who have given me a reason to believe in a brighter

future. the family members who have given me a reason to believe in the power of kindness. the voters, for that matter, who have given me a reason to believe in the politics of conviction. i had a friend pay a compliment to me when he said that the book was a love story in many ways. it is about the gratitude i feel for those kinds of lessons. it's also a way to remind people that any of us have the ability to pass on those kinds of lessons to others. host: "my life is often described as improbable because i grew up in a broken home and poverty." you go through some of your successes. guest: yeah, well, i grew up on the south side of chicago. most of that time, we were on

welfare. we shared a bedroom. i went to big, broken, and sometimes under-resourced public schools, but we had a community in those days. if you messed up on the street in front of mrs. jones, she would straighten you out just like you were hers. being able to move forward was being offered a vision for what that might be like and then some resources, skills, and tenacity. host: you write about teachers having a huge influence on your live, both in chicago and you had an opportunity to go to a private school in massachusetts. how did that change your life? guest: in 1970, when i was 14, i got a scholarship to a program

called a better chance. it is an organization that identifies taliban minority neighborhoods -- that identifies talent in minority neighborhoods. my background was pretty non- traditional. i got a scholarship to milton academy. they had a dress code at the time. the boys wore jackets and ties. my grandparents splurged on a brand new windbreaker, thinking that was a jacket. i like to say that i figured it out. it was a radically different world. there were teachers and other adults who reached out and help

me understand how to use summer as a verb. and also, just wonderful doors opened up through that experience, too. host: what is your take on vouchers? you had an opportunity to go from an inner-city public school to a private school where you were given a lot of extra attention. you wrote in the book that high school is crunch time and you were in big classes. guest: i'm skeptical of voucher s. i think most kids are going to get their opportunities in so- called traditional district schools. i mentioned some experiences of my own that were very transformative in big, crowded schools. i see -- i'm very interested in

how we innovate in those settings. we have great examples of that in massachusetts that we're trying to date under some new legislation. host: governor deval patrick is our guest. you can join the conversation. talk to us about your state's finances right now. talk about education. many of us know about the health care law. how are the finances? guest: we are doing well. we have delivered four budgets in four years. they were responsible, balanced, and on time. we have had to make significant cuts, like everybody else, in almost everything. we have reduced headcount and got concessions and furloughs and everything everyone else is having to do. our budgets are balanced. we have invested in education

even at this time we have supported our universal -- at this time. we have supported our universal health care plan. we're growing jobs faster than 45 other states. we have a lot of work to do and a lot of progress to make, but we are making progress. host: a recent story in the associated press says one of the big threats to the massachusetts health care law is cost. "when lawmakers pass the bill, they decided to first expand health care to as many people as possible before figuring out the best way to pay for it." guest: it has nothing to do with our universal health care law. the expansion of health care is adding about 1% to the state budget. medicaid in that period has risen 2% per capita per year. the issue is rising premium

costs. that's an issue across the country. premiums have increased about 130% across the united states in the last decade and it is unsustainable for governments, families, businesses, and municipal governments, as well. i think massachusetts will be the ones to crack the code on cost control. we have some great strategies around this, which we have initiated. some are happening in pilots already around the commonwealth. host: let's get to the phones. terrell joins us on the line for republicans. guest: good morning. caller: good morning. i wanted to comment on president obama's budget plan. it would be a big difference if they had a chance to score with the cbo.

includes thelan bush tax cuts. i think it would be very interesting. if you look at it, he wanted congress to actually do something about entitlements. they want him to lead on legislative process and they want him to sit back and let him do their job. they want him to do both sides. guest: you know, i think there's a classic legislative and executive attention. in this case, the congress wants leadership from the president and also once the president to defer to their role to write laws.

that's not an unusual dynamic. i think the president showed real leadership around deficit reduction. more to the point, i think what he did was talk about what kind of country we want to live in. that's really the debate that's going on in this country and in this city, washington, right now. how we make our choices consistent with a set of values is, in fact, one of the things i tried to write about in this book. host: a recent article in "the boston globe" looks at the anniversary of the health care law in massachusetts. "massachusetts democrats are even rolling out eight mitt romney -- out a mitt romney

sheet cake, but not governor deval patrick." when you praise mitt romney, this is not a political jab at a presidential hopeful? guest: no, my praise for his signing this bill goes back to 2006 when he signed it and i was a candidate for governor. i do not know why we would not praise someone who had a part in doing something that is doing so much good for so many people. 98% of our residents have health insurance. no other state in america can say that. it was paid for exactly how we said it would be paid for. you do not have to worry about losing your health insurance if you get sick. i meet the people who tell me that this has given them a level

of security in their own lives and in their families' lives that enable them to go out and build businesses and move forward with their lives. i'm really proud of this program. i'm proud that our administration had the responsibility for implementing this. it went into effect the day i took office. we have helped to expand this coverage as successfully as we have and we managed the cost as we have done so. host: host: the most controversial aspect is the mandate. critics in your state point to it as a tough sell. there are tax penalties. this year, tax penalties for adults that earn more than $32,000 a year and are considered able to afford health care but refused to buy at is

$101 a month. how was that playing out in your state? guest: better than i initially thought. when i started on the path, i was skeptical of the individual mandate. this was in 2006 when i was a candidate. i also understand this is a basic premise of insurance -- if you spread the risk as broadly as possible we have been flexible -- possible. we have been flexible and gradual. those in great health and shape we had to appeal to them. this was about their care, and their confidence in health security in the future and about the community's affordability. the penalty ramp up, as it is supposed to, and it is meant to reflect with the cost of insurance would be. i would also say this -- we had

70% of our businesses will offer health insurance before the bill went into affect, and it is 76 right now. the favorability in support consistently high. right, a's go republican caller in boston rouge, louisiana. caller: i'm curious, how do you have such wonderful numbers for what you were doing in your state with your health plans and everything, and the final question, how will we ever be able to kick under the thumb of the huge deficit we have if we do not get rid of the federal reserve? guest: the federal reserve? caller: they are printing money

and we have no collateral to pay them back. we will never get out from under their thumb. please answer that question. guest: i do not know that i have an answer for that. i could go back to my basic economics in college and the notion that every sovereign nation has a central bank responsible for monetary policy and managing the currency. the fact that we have sovereignty over our currency is a source of fiscal and financial security, rather than risk in the view of the council of economic advisers that help me, at home, in massachusetts. in terms of our numbers, we have had to make painful choices, just like every state, every city and town, and every household. we have had to cut programs. we raised a modest amount of revenue. we cut spending.

we have also been making the choices based on a set of values, and one of those values is about a generational responsibility. what we do in our time to make sure we leave a better commonwealth for those who come behind us. one of the key answers is investing in education because education is transformed it. that is not an abstract point. we have been investing in education at the highest level in the history of the commonwealth. we have supported the expansion of health care. we have invested in the things that we know create jobs, especially the innovation space where we have a sweet spot because of the concentration of universities and research spots and so forth. we have made those choices because we know educating our kids, securing health care, and helping people get back to work

is the way to climb out of the call and leave a better commonwealth for those that go on beyond -- behind. i'm sorry to go on, libby, the we have done that with vigor. our budgets have been responsible. our bond ratings have gotten stronger. we are the only state since 2007 who has a bond rating that has gotten stronger. the independent rating agencies also recognize the integrity of the way we have managed the budget for these times, not without pain. host: the un and fund rate in massachusetts was 8.2% as of february. there is a projected budget shortfall. guest: there is some news today. the state thursday? -- is today thursday? host: is there news?

a gun agglomerate? guest: -- the unemployment rate? guest: we are moving in the right direction. host: when you talk about building infrastructure, you're a big supporter of the president. you will be on call to campaign and his behalf. guest: if they want me, i am there. i believe in him. i believe in his leadership i believe the number and weight of the issues on his shoulders and face in the nation are heavy and complicated. this is a once-in-a-generation leader that could help. our way and help us lead our way out of this downturn -- help us lead our way out of this

downturn. it is distinctive about our country. host: massachusetts governor, deval patrick is our guest. is the author of "a reason to believe." let's go to laurie. guest: good morning, laurie. you're up early. caller: i have been up since 4:00 a.m.. i have been scared about the cuts. i have been dealing with cuts for a while. i check00 out of my ss and it was only $347. then, they took away renter's assistance. i make $9,000 a year. i'm afraid they will take away the housing authority.

if they cut people that are 50 -- 55 and below, then i am 50, and i know they say the poor and the middle class have to tighten their belts, but i have tightened my dog as much as i can. guest: -- tightened my belt as much as i can. guest: i understand. first of all, i want laurie to know that just like her experience in california, there are people at home in massachusetts that are being touched adversely by cuts at the federal and at the state level. everybody has been touched. the notion that at least at home, that we need to eliminate waste and fraud and abuse, and all will be well and we can maintain the level of services -- we are past that. we have consolidated agencies.

we have reduced headcount. there have been opportunities, i will say, -- opportunities to end programs that might not have been working as well, to reexamine what we want governments to do and not do. that is not all bad. we are passed so much of that, and into the point where where -- where it is and -- impossible to maintain all of the services that we want. one the president yesterday talks about a balanced approach, having to make cuts but raising revenue, and doing it in ways that are fair and consistent with our values, that is the kind of leadership glory and this country needs. host: massachusetts has a projected budget shortfall in 2012. guest: it is about $1.2 billion. we have in the budget i

proposed eliminating the shortfall and our structural deficit which has been around for about a decade. if the legislature sent me that budget, we should be in good shape. host: we have a question from twitter. guest: it is a great question. i get the supposition that if i have not had the opportunity to go to milton academy i would be stuck back home. i write about this in the book. that was -- moving to milton academy was a transformative experience, there is no doubt about that. the values that i read about in this book that give me a sense of hope and idealism were built starting before i went to milton academy from loving

teachers, family members, and the church ladies in their big hats that gave me a reason to believe, and helped me to mention a different kind of life. i will give you an example by -- example. i have an incredible teacher in the sixth grade who has since passed away. for the kids in the class. all of us were kind of a mess. our lives were a mess. the neighborhood was a mess. she taught us to count and say the greetings in german. she tested the first opera i have ever seen. i did not know what they were seen it -- singing about. i love the event, and i love it now. there was a new movie called " the sound of music." she used it to teach us about the rise of nazism.

she made as hungry for knowledge of the world. there were other members of my class that have gone on to build their own lives in positive ways without having gone to the independent boarding schools. my point is there are ways in which each of us has it within our power to pass on these lessons to others, and make a real transformation in lives. host: you read about your teacher -- "our ill-fitting clothes were no excuse. host: you do talk about these people that made a difference in your life that did not have any excuses. they did not accept any excuses. you also talk about opportunities that came your way. in this area of cutting budgets, you kids have the same

opportunities -- the moments where you could grab the chance to advance yourself? guest: i worry about that. when we're talking about cutting budgets, things like the pell grants, i worry. i never believed it was up to government alone to make opportunity, but i think our ability to move in a generation or two from the circumstances i grew up in to the experiences i have had and my children have had is a uniquely american story. it is not called as often as we would like, but it is more in this country another planet -- in any other place in the world. when the president outlines a budget plan, but talks about the kind of country we want to live and, that is the frame in which we should think about the choices we have.

austin,t's head to texas, gerard. republican caller. caller: thank you, mr. patrick, for taking my call. i watched the whole deficit plan two times. i also watched mr. paul ryan to give his speech about what he wanted to do about it, and it is all really bickering. it is like little kids fighting back and forth, and nobody is looking at the real issues. president obama says something about the american people looking out for each other, and he saw -- heat spoke about this church and faith. that is what spoke -- that is what it broke down to. people that have been charging for people for years, it is coming back to them. everybody is not looking at the fact that it is a simple thing

of divide and conquer. look at china. these people are unified. their kids go to school six days a week. they come over here with college credits already. we have the largest drop out rate. in austin, texas, there are closing down schools and libraries. i was a real-estate agent and a loan officer, and i saw how the foreclosure, audit prices -- i saw what happened from the inside out. you had people saying give us this money up front and we will help you, when they were really getting paid on the back end from the banks. -- from the banks. i worked at the banks. i know how the federal reserve works. for me to be an african american seeing all of the stuff happening in front of us, -- i

called the democrat and the independent number like 50 times. i called the republican number one time, and they let me throw. there should be one number that says american's parent everybody takes care of each other. guest: why did you have the different numbers? host: we want to give callers of a chance to weigh in and give different perspectives. we're talking about the budget plan, with different about -- partisan response. some shows, we do not break it down. guest: just to the caller's comment, i sense and i share some of that frustration i do not mean to be disrespectful. it is not a critique. i share some of the frustrations from the caller that we view every idea and we way and

balance and critiqued every idea from the perspective of whether we are a democrat or a republican. it is incredibly frustrating to me to be lectured to about deficit reduction from republicans who were in office and caused the deficit in the previous administration by running two wars on a credit. -- on a credita crowd card. i know that sounds to some as a critique, a democrat complained about republicans, but at some point, we are going to have to see our way to each other to see the greater good. -- see our way to each other to see the greater good. that is what i appreciated about the president's speech yesterday.

i am a friend of the president. i try to support the president. i waited for and wanted the kind of address that he made yesterday because i think it frames it in terms of the greater good. i want him to speak that way and to govern that way, and i want his team to as well. i think that may help address some of the frustration that the caller and i share as citizens. host: governor deval patrick is in his second term. you say you did not plan to run again. talk about life after governor? because i am not running for anything. -- guest: i am not running for anything. host: do you have any intention to work on this issue of partisanship? guest: i am proud to be a democrat. democrats can get on my left nerve.

the reason the improv is because i think there are some values about supporting -- the reason i am a democrat is because i think there are some values above supporting the american dream. i think it helps people help themselves. these are values the democrats stand for, but i think they are american values, and i would love to have the opportunity, so if there is a contribution i could make, to encourage people to come back to that sense of patriotism. i go to the funerals of national guardsmen and women that we have lost from massachusetts in iraq and afghanistan and other places around the world, and i right in the book about how when i first became governor and my staff was encouraging me to go i was reluctant because i did not want to be misunderstood.

if i did not want people to show up -- to think i were showing up for a photo opportunities. i never speak. i do go, and i am glad i go because i think it is important to be present to make sure that the family, and the loved ones know that we acknowledge the sacrifice of their son or daughter, or husband, or spouse, what have you. i am struck by a couple of things. first of all, the unused. they are frequently pals pal is -- of the person that are lost that are having their first experience with death. we asked them to make such extraordinary sacrifice. we seem to have forgotten that there are things expected of us at home as well. if not just to support them in their loss, or when there is a

standoff, but there are things we must do to support our country at home. asking for sacrifice to help solve the deficit issues, to help make a way for other kids in neighborhoods like mine, to rise to the level of the greatest potential, i think these are american contributions that we are capable of, and we need the kind of leadership that president obama is giving us, i think, in order to step up in that way. host: democratic massachusetts governor deval patrick, author of "a reason to believe." scott brown, senator from your state is up for reelection. would you challenge him? d., and i going to run for senate? now. -- and beit -- guest: and i

going to run for senate? no. i have worked in washington before with the clinton administration. i have the job by love right now. i worked really hard to get it. i want to finish out this term, and then go back into the private sector. i missed the private sector, especially on payday. host: kathy, democratic, in michigan. caller: good morning. while i respect your decision to go into the private sector, i think we could use your brain power at a higher level. good on you. i'm from the era where you were playing out in the backyard, your neighbor had the right to work your butt, and i think we need more of that.

one of the issues i now have, i am now 54-years-old, and will be 55 in by july. anyway, one of my concerns and has -- it has always been my concern, our people that drop- off of social security without ever paying a dime -- drop off of social security without ever paying a dime. i know a person who retired with her husband and she never held the job or she paid into social security. when they retired, she got $500 a month. guest: was a survivor benefit? caller: know, when you retire, you get two-thirds of what every your spouse makes. she got $500 a month. if you do basic math, if she gets $6,000 a year, which is not

a lot of money, keep in mind she never paid into the social security system. she never paid her share, nor did her husband pay an increase on his social security to cover her when they did recover. i am 54. i will be in the age group where my benefits will be less and i have to work longer for that. over the course of 14 years, which is what she drew until she died, she got the amount of close to $84,000. host: can i have used some up? caller: my point is i ever for 40 years, and now i will have to work longer, for less money, for a lot of people being on social security without ever having to pay a dime. guest: i got you.

cathy, i have to tell you, even as your birthday made, i do not know all the rules for social security. i believe in social security as a program. i understand the frustration you are expressing about the situation if you were describing. i will say that i think we can address some of those kinds of issues, including, by the way, the retirement age. if there has been a proposal to extend the retirement age two years, which seems reasonable to me. there are things we could do to tighten the program, make it better and stronger without scrapping it, and from that respect i think i do differ with some of the more hard right members of the congress. host: the governor's read which it website is deval patrick.com.

this afternoon, you're talking among the new health-care organization. what you doing to balance your duties in massachusetts and on the national stage? guest: you are always governor, no matter where you are, or on vacation or on duty. i am in touch with my team, which is terrific. my day job comes first. ant: let's go to ricardo, independent scholar in silver spring, maryland. caller: i want to see if you could explain to the people and me better as far as casper, the report that all states have cared from what i understand, there are two from the --

financial statements. one shows the people, and the other that shows a surplus. i looked up maryland, and we have a surplus because you have investments that the states and local corporations make. that is a separate book from what i understand, as opposed to the one you are showing for revenue and so forth. you sounded surprised on that one, so i guess you do not have to much information on that one. guest: i wonder if for you are talking about is the accumulated trust funds for pensions and so forth, of which would show up as an asset in trusts of states and municipalities, but it is not an asset we could spend but i would be guessing.

i'm sorry. host: you are going to wisconsin to wade into the union battle. but guest: not really. we have these dinners that the state party does. i have been invited to a number of them. but am going to a couple. i'm going to wisconsin as well there is an unspoken -- as well. there is an unspoken pact that one governor does not try to wade into the business of another governor's state. we'll take a very different approaches in massachusetts with respect to public sector unions. we have worked with the unions to raise teacher accountability and reform the public schools and the pension plans. we of work with the dunes to help close the budget gap which concessions and -- with the unions to help close the budget gap with concessions.

host: you have done some battles, as i am looking at "the boston globe." guest: we were the only state in america that have uniformed police every construction site. it was just not affordable for state projects, we decided on a blind approach where if public safety required a uniformed police officer, we would do that. the police were really angry about that, but i think it was the right thing to do. host: the last question -- president obama, as he -- has he lost liberal support? guest: i think the president has to be concerned about making his case to all of the voters and

supporters, and i think he understands that he is the president not just of the people that voted for him, but the folks that are in his party, and those that are not. he has to be about the greater good, and he has to explain that to everyone. host: governor deval patrick, author of "a reason to believe, lessons from an improbable life ."r cal cominfe we will be right back. >> let's meet another winner from our studentcam competition. the theme has started producing a video of an event that helps them better understand the role of our federal government. we go to oklahoma to speak with hanna. why did you choose to focus on the nation for your project?

>> we figured we would try something with indians, so we all looked up tribes, and it was the largest in our state. it has a lasting impact on their local communities as well. they bring in a lot of revenue. >> what is the history of the osage people? >> they migrated from the midwest. they were located in arkansas, kansas, and oklahoma, but are mostly in oklahoma now. >> what was life like on the reservation? >> they have an indian presence, with a lot of culture, and museums. and there is the new

jurisdiction over indian land. >> how did the osage people contribute to their -- your community? the biggest contribution is the casinos. provide a 1200 jobs. they also provide jobs through their local governments. how much of their operating budget is provided by the federal government? >> about 50% of their operating budget comes through grants. >> what is the federal government's role? >> they are not doing that much anymore. in the past few years, they have been giving the tried what is called self determination the

tribe determines their own form of government. they have their own tribal government with three branches, but they control it. if they execute all the laws. >> where did you get the title "rising tide?" >> when we went through the interviews, we realized we did not have any idea how big of an impact these people head. they went from being oppressed to being a community that impacts our world more than you expect. they are a community that is growing in strength and is making a huge impact on my surroundings. >> what did you learn from and working on this documentary? >> we learned a lot about the osage and their impact, and this is the longest piece i have ever made, eight minutes, so help me

as far as storytelling, how to inter-mix interviews, and to focus on what is important. >> thank you for joining us, hannah, and congratulations. let's watch a portion of the video. >> what i like to say is that a rising tide raises everybody. the tribes entry into gaming has provided 1200 jobs, and most are for non-osage and non-indians. that provides payroll and supports the economy. the total impact was measured to be in the range of one quarter of $1 billion. we are the largest employer on the reservation, so, again, we contribute to the local community. >> it is the entire osage

reservation. they have created jobs for people to have. that is probably the biggest thing they had given to us, unemployment. >> you could see this entire video and all of the winning videos at student cam.org and continue the conversation of our facebook and twitter pages. >> "washington journal" continues. host: congressman kevin brady is our guest. we saw the deal brokered friday night. how will you vote on it? guest: i will vote yes. i am always hungry for more spending cuts. i think cutting -- the bottom line, and this cuts three under $15 billion for the next decade.

-- $315 billion. i would like to see more. we will fight for more. in the paul ryan budget, we will try to make that reality. i think it is a start. it's called where talking about the budget for this year. and as you mentioned, the paul ryan and budget is on the horizon. guest: it starts a path where we do not just balance the budget, we pay off debt. it takes a long time to do it, but we are so deep in debt that reversing the course, i think it is critical that we do that. host: some house republicans are not on board with the plan? this is a tough decision for members? guest: i do not think so. a lot of members like the paul ryan plan for all of the right reason. house conservatives will be proposing a budget that balances

in 10 years. it is tough stuff. it shows what we would have to do estimation. i think that will get support against -- amongst conservatives. it is a bold vision and we support it. host: looking at the vote today, you are a member of the republican study committee that is headed up by jim jordan of ohio, and he is opposed to this deal. guest: i think his frustration is shared by a lot, which is we need to keep fighting for more. it is difficult to know exactly what you could do without shutting down the government, without not paying our troops during a time of war. that was a tough issue four conservatives. i think it is important to continue to push for bigger cuts sooner, which is the message they are giving out. i think some of the criticisms

about its current cuts are sale. -- are fair. not all of them are constituted the why i would like it, but every shot i get to cut real dollars off of the budget, i do not hesitate. host: there is a republican study committee alternative out of new jersey. what do you think about that? guest: i think it will get some strong support to mop. it shows that if we want to balance the budget in the next decade you really have to take a serious approach to social security and medicare, impacting people 59 and younger to have serious cuts in discretionary. it shows you, it shows the value of the -- how deep in debt we are, and what you have to do to balance it within the decade. i think it has real value to this debate.

host: as you look to the conversation going on right now, we started our show by looking at the op-ed pieces responding to the president's talked yesterday, and it was a very partisan response. it was a long lines of democrats largely in favor, and republicans very distressed. do you see this as a time of heightened partisanship? our people digging begin their heels more over this looming budget debate? guest: i did not think so. i think there are dramatically different visions of which direction the country ought to go. the president gave a budget two months ago that did virtually nothing, and the two months later he gives a speech but no plan. our reaction is where is the beef? where is the leadership on this issue? maybe he will give a speech in another month that lays out a different approach on the budget, but for right now, he is failing to lead.

republicans are serious about leaving in social security, medicare, and medicaid, and that is what the country needs. h., let's listen to president obama reflecting on the gop's proposed cuts. >> a 70%, in clean energy. a 20% cut in education. a 30% cut in transportation. cuts in college grants that will grow to more than $100,000 per year. that is the proposal. these are not the kinds of cuts you make when you are trying to get rid of some waste or find extra savings in the budget. these are not the kinds of cuts the fiscal commission proposed. these are the kinds of cuts that tell us that we cannot afford the america that i believe and, and i think you believe in. i believe it paints a vision of our future that is deeply pessimistic.

host: congressman kevin brady, what is your response? guest: i agree with one thing the president said -- we cannot afford this government if we want to have an america we believe in. our belief is that the death, the deficit, and the size of the government we have today is absolutely unsustainable. if we do not make tough decisions and shrink the size of government, the next generation will not have the same opportunities. the president is defending a bloated federal government that is deeply in debt. we think we need to streamline its. we also do not think that the spending out of washington has revived the economy, improved education, or improved the lives of americans. host: congressman kevin brady is in his eighth term. eighthresents texas'

district, says some the ways and means committee, and is the vice-chair of the joint economic committee. let's go to regina on our republican line. caller: good morning, congressman brady. i have a question. what was the cause of the people signing up for social security and medicare? i have two sisters. 65 and 66, and when they signed up, their medicare went up to $115. these are your average workers who worked 40, 45 years. they did not even had $50,000 a year. what is going on? this is part of the obama-care? guest: you have an amazing congressman sam johnson.

i have the honor of sitting next to him on the ways and means committee. you are so fortunate. on the real question of medicare, you are seeing some increases in prescription drug costs and in medicare advantage, which was one of the victims of the president's health-care plan, because they're basically trying to eliminate that plan. over time, you will see 7 million seniors forced out of the medicare advantage plans as a result of that. it will be tougher to see doctors. fewer doctors will be available to see because of the health- care plan. there are real challenges. if we do not address medicare, it will not be there for the next generation. seniors 55 and older will not see a change as they know what, but if we want to preserve it for the next-generation, we need to address it, and a common

sense reforms. we think putting this off, which congress and the president continues to do is the wrong decision. host: catherine, a democrat in huntsville, alabama. good morning. hi, catherine? caller: hello. i am here. host: good morning. hello there. caller: good morning. my question is i am on social security disability. i worked all of my life. my disability is based on my retirement income. i had to stop working due to health reasons. i do not know if you know this, but social security automatically been is disability the first time around for people, -- denies disability the first time around for

people, no matter what your elvises. i worked -- your illness is. i worked in the human service area, which is not a high salary for people. from teachers, to mental health workers, to "community organizers" what ever. my question is this -- because of that, i am concerned that my medicare, and the insurance for it will go up to an extreme amount. it will take one-third of my salary to pay for the medicare that your party is talking about doing. do you look at those incidents? do you wonder about how those people are going to pay, because

i'm not the only one? guest: if you are older than 55, you are not effected by any of these budget reform measures. all of those on the republican side are focused on the next generation, those 54 or younger, who if we do not f will see serious cuts in medicare. it will not be there for them. you are in great shape. there are a lot of scare tactics in washington. they're getting the brunt pretty quickly. i think the biggest reason that we need to tackle medicare is that right now, it will go insolvent in the next seven, to 19 years. this, let's tackle work together to preserve social security for every generation once and for all to make sure you have the peace of

mind as you go into your senior years. i'm serious about protecting medicare for my mother and a lot of other mothers as well. you are in great shape host: let's go to richard, republican in tulsa, oklahoma. caller: hello. host: turn down your television. caller: if there was coined to be cuts in medicare, social security -- going to be caught in medicare, social security, so forth, is congress planet on cutting their own benefits -- is congress planning on cutting their own best -- benefits? guest: what republicans are proposing in medicare are not caught. we are proposing to use a plan

already in place the medicare part d. it gives seniors choices. the government pays the premiums that you pay from copays and all of that. it works very well. it has come in 40% under budget. we provide very high-quality prescription drug care for seniors. we are looking for that model for the next generation for young people coming into the workforce today. they can keep the health plan -- health plan they want. we want the seniors of the next generation to have the same choices that federal workers have -- a wide variety of choices, tailored to their needs, with the premiums paid for by the federal government. if you bring that competition

choice, you strengthen medicare for every generation. members of congress that pay into social security, medicare, and their federal retirement plan, and we have to choose among the plants, my guess is that will be part of the budget reform. host: "usa today" susan page rights -- guest: probably so. this is easy. do not propose anything. do not take leadership. do not take on the responsibility of leading this country. just say now, of any -- to any efforts about getting serious and even adults about this. i am mulling to fight the fight and we think many republicans have decided this is not about the next election.

we would rather fight for a new vision and tackle the challenges like adults than to continue to delay, refuse to lead. we will take that chance. host: let's hear from a democrat. perot in pennsylvania. caller: i have three questions, and i am not trying to look at the television. i'm looking at this gentleman here, and i am wondering, i have listened to the reports, i think it is one and a half or two and half times, and i take it apart. host: a are you talking about chairman brian's plan? -- chairman paul ryan's plan? caller: i am talking about the

part president obama makes a big point about, we did this in the late-1990's, and 2000. i have been battling illness all my life. i am on disability. i can not handle a medicare cut. i'm barely keeping my head above water now. the second question is, i would like to expound on the view of we did 10 years ago, why can't we do it again? second, i was a veteran. i would like to know if this gentleman is a veteran. thirdly, why is all -- is there all this confusing bickering? guest: i am not sure what the report is about 10 years ago. i know that in the path to

prosperity the republicans are proposing to those that are on medicare today, those that will be in medicare 10 years from now, there is no change whatsoever for them. for younger workers coming into medicare in the future, 54 or younger, there will be some more choices and options they do not have today. it will be more tailored to their needs, not washington's needs, just like our prescription drug plan for seniors which is popular and works well. there is a plan for the next generation. i am not a veteran. i wish i were. i am proud to be part of the military family. my brother is an active duty. i think there is too much partisan bickering in washington, but beneath it, i think there is a profound

difference in the direction we see this country going. we see it as one that should be free of debts and deficits, where government has a limited role, not an ever-expanding role, our people have more power. we do not think that a child today ought to have their part of the dead sea for -- part of the debt to be $46,000. the good news is young people do not actually buy luxury sedans for a local sam. what they do is pay the price in higher taxes, higher interest rates, a more sluggish economy. we will see real differences right now. host: atlanta, ga., and jonathan dodd our republicans line. -- on all republicans line.

caller: i want to comment about the debt and taxes. first, what do you think about the idea of every representative agreeing to be hooked up to polygraph machines, and every time they stretched the truth they get shocked. the bigger the law, the greater the shock. do think we would last through the day or the week? anyway. the debt situation i think it is far worse than the american people realize. three weeks ago there was a story that made the news cycle. in the month of february, we borrowed two hundred $23 billion. i did the math. that is close to $8 billion a day. i do not know what the figures for march are yet.

if the federal government achieved what they achieved in february in march, that is over $450 billion in two months, nine weeks. that is beyond astounding. guest: two thoughts. i hope i heard you right when you said we would get shocked with a polygraph, and not shot, clearly with gabrielle giffords still recovering that is not a corporate event as a joke. you are right on what deficit. washington people are in denial. average people like you have given up hope that the government will live within its means. there is a way to do it. it will not be easy. that is what the republican

budget for the future is all about. it is not just about getting back to a balanced budget over time. it is paying off the debt. it will take years, but you need to take the first step -- change the direction we are headed today. that is what we're going to try to do this week. host: "the new york times and delves into the budget, saying there are real and illusory cuts, with a vital organizations and groups finding that the budget deal will cut deeply into the dutch -- budget, but other appear to be less tha. host: it talks about some of the cuts like the commerce department. james writes on twitter --

guest: they're not all bogus. it is a fair criticism. we ought to use census dollars. government agencies will use it if congress does not take it back. creating a $5 billion cut, i do not think that kind of caught it is serious, but if you look of the bulk of those cuts, as the article says, they are real. eliminating 40 education programs that have failed. cuts in epa, an agency that is a runaway at this point. there are real impact, and over 10 years, cutting $315 billion from the budget, i think it is a start, but we need to go a lot farther if we're going to get back to a balanced budget.

host: jim points out on twitter that blockers on the right and left are claiming the budget deal is mostly smoke and mirrors. guest: you have to make a choice. matt, ands go to democratic caller. caller: i have a couple of questions about the health care thing. i am trying to figure out what it includes. i have been fighting for my health, and i actually lost my health insurance because i have been taken out of work because of my health conditions. i am trying to figure out what the health-care bill includes because every time i go to a doctor my insurance turns me down because it is a pre- existing condition.

now, my health has progressively gotten worse because i cannot get the help i need. i'm trying to figure of what this includes. and she, i assume he is referring to the president's plan in? -- guest: i assume he is referring to the president's plan, liddy? host: would you do for pre- existing conditions, and also, as we look at cuts to medicare and medicaid, how would you fair? guest: republicans to support addressing pre-existing conditions. that was part of the plan that never got a chance to have a vote as that macedo was rushed through without even most lawmakers reading it. what we foresaw is what has happened. the president's plan has only

helped 3% of americans who have pre-existing illness. i think it is one of the major embarrassments so far of the president's health-care plan. we saw ed as a different approach by putting the richest saw it as a different approach by putting -- saw it as a different approach. we see that a different way. it is a smaller government way, more of a free-market way in li host: our guest is kevin brady up texas where he represents the eighth district. let's go to frank in florida. caller: good morning to you both. i have two questions to you. his fatherand pau

have book introduced bills in the congress. do you support this? will you be a co-sponsored, if you are not already? what do you think about a possible presidential election by dr. ron paul again next year? guest: i am a co-sponsor. people may not know is the financial books of the dead are audited regularly. -- of the fed are audited regularly. what congressman paul wants to get to is a monetary policy of the federal reserve board. i am a little more cautious about that. frankly, i do not want members of congress, with all of their procurable interested in monetary policy in america. with all that said, i disagree

qe2.the fed's efforts of injecting themselves again into the economic areas of the country. i think it will lead to inflation. i think we have already seen it with the lower dollar and has made the cost of gasoline in america go up. i think with the congressman wants to get to is what is the role of the federal reserve board? it is dual mandates, job creation, and unemployment. we think we should have a debate whether having one mandate, a clear mandate, price stability, 2% inflation or below, i think, is critical. as for his presidential campaign, i have not talked to him about it. it certainly looks like he is running again.

he always adds a lot of the debate. host: mike on twitter asks how would you feel about doing away with the bush tax cuts? guest: strongly opposed. the people and professionals that are most likely bringing us out of this very poor economic recovery, if you can call it that, is exactly the wrong prescription. we do not have a spending problem. -- we do not have a taxing problem, we have a spending problem. we will continue to have historical averages of revenue coming in. it will get what it usually gets. the problem of spending has just ofeexploded the size government. that is the big difference between republicans and the president. he wants to tax our way back to a balanced budget. you cannot do it.

today he would have to double everyone's taxes and america in order to balance the budget. even that would not do it. host: jane joins us on the republican line. caller: thank you for c-span, and thank you for your service, congressman brady. i want to first say that i am very comfortable with having bigger risk debates about budget and expense of problem-solving about the way our money is spent, so i thank both sides in congress for doing that. i would like to speak specifically to pell grant money. for me it is not what your cutting, but where it is ending up. i will tell you a specific experience. i work with kids who are trying to go to college. i work with the young man who cell phone, the phon phone or

so he my number. i got calls from every non- accredited college in the country. people would call and call themselves college counselors and they could not string together a sentence that was grammatically correct. so i started looking into this. it was very concerning to me. i found stories of students who had gone to school to become massage therapists and sound engineers and fill in the blank, and they went to a school for a couple of years and ended up $40,000 in debt, the first two years of the pell grant money taken away. then i heard stories where children were ending up homeless. the tragedy is that after couple of years of this, they could not even transfer their credit, because it was not accredited work that they had done. i would appeal to you, if you do

not have time to work on this, to get one of your fellow congressmen to take a very qualitative look at where the pell grant dollars are going, because you know and i know that there is always going to be a fraction of the country that is very good at getting a hold of the federal dollars. this is an example, by the way, where a state-run government college is putting that money to better use. guest: two thoughts. i agree with you, we have to rule out every example of fraud and abuse, whether it is in pale -- pell grants at private colleges or public colleges. those polled grants are important, especially for families trying to get their kids through the first two years of college and beyond. -- those pell grants are important here again i think it is a mistake to make a promise

to young people and their parents that you cannot possibly hope to ever afford and keep. republicans approach is pell grants are sustainable and let's make them affordable as a nation. what worries me, as tuition has gone up, we're seeing people better it either in private or public colleges, the amount of debt they end up with is just staggering. we have some big challenges in that area. thank you for bringing that up. host: marcello and west haven, connecticut joins us on the republican line. caller: i keep reading in the paper that social security is bleeding, indebtedness, and so forth. my social security has been reduced, i do not know how much,

and transferred to medicare. when i see in the paper that social security his is two trillion dollars in the wholhol and all of it is because the government has taken money out of there. that does not show in the budget deficit. but i am paying for it. that is my money. is it against the law to take money from a trust fund that does not belong to them? i'm curious. it probablyn't, but ought to. for 20 years or more government has taken from the social security trust fund, borrowed from it and put in a piece of paper in a filing cabinet saying we will owe this when the time comes due, and the time is now due. last year in the year before

social security paid out more than it has taken in. we as a nation have had to borrow 41 billion two years ago just to make the payments on social security. there is money in the -- there is no money in the trust fund at all. people who say we can borrow from the trust fund, i do not think realize all that money has to either be borrowed or come from taxpayers today. one of the reasons republicans are focused on trying to reform social security for the next generation is that it will not be there. it will not be there in its current form air is the amount -- in the current form or in the current amount. the longer we delay and the more you are hearing all of this year tactics today, we keep putting that off. that is what really hurts the seniors, delaying reforms of

social security to make them solvent. regardingn's plan social security. here is what is on the table. what is off the table is raising taxes to pay for it. in president obama's what is on the table, backing any bipartisan negotiations to strengthen social security. what is off the table is privatization or cuts for current and future beneficiaries. guest: i think the tax revenue we are bringing in is obviously the main part of our budget as a government. and that has, despite the recession, over the past 30 years a pretty constant, 18% or 19% of the overall economy. the problem we have today is that obviously the government spending is so far beyond what

ever we can do that raising taxes will not balance it at all. one point i want to make is the president is not really leveling with people about social security when he says there can or o impact and career ourent future recipients. but the president is not being honest about what needs to be done for the denver generation. if we stay with the system we have today, pay as you go, the major options are to overtime slowly raise the age, and secondly tied social security benefits to cost of living rather than wages, or create a system where younger workers can take a smaller amount and help the money grow over time so that a real account will have real assets to it. what i love about the ryan plan

is it says the time for ignoring it is over. then let's have a debate about the real ideas to solve so security. i think it is a great approach. -- then let's have a debate about the real ideas to solve social security. host: let's go to break, pa., where john is on the republican line. -- burwick, pa., where john is on the line. caller: dick chenney said that ronald reagan proved deficits do not matter. i do not think he ever proved that. i think deficits really do matter. regarding senator grassley. he gave a speech.

he said that there was $84 billion going to the oil companies as subsidies. in pennsylvania we are engaging in the debate on the shale. we are finding out now that these companies, these gas companies are selling these oil leases to foreign countries, and the gas will be shipped overseas. i think one of the alphabet in there is chesapeake from oklahoma. -- i think one of the out fits in there is chesapeake from oklahoma. could you comment on that? guest: what senator grassley likes to call subsidies is the way oil and natural gas has been treated in the tax code since

about 1913. it is like other industries, tailored to that industry the risks of the long-term costs. i think they are exactly appropriate. i think to at this point raise taxes on energy manufacturing is the wrong thing to do. two, this is not a good debate about oil shale and the role it plays in the government. it has and is being done safely. we make mistakes as a nation if we try to in effect strangle that opportunity in its crib, because that natural gas is so abundant and clean for the environment and supports great paying jobs as well. yesterday a number of us introduced a bill to position natural gas as the second draft petition fuel, something we desperately need in this country. i think there is a desperate need for that abundant

resources, and best of all, it is made here in america. chesapeake's relationship, i think they have entered into agreement with other foreign countries. that is not so unusual in the u.s. we have companies and countries that want to invest in the united states and see this as a great potential. we should support investment in america in a major way. host: calller from texas. jeb on the independent line. caller: good morning. thank you for c-span. i have a comment and question. first off, if one were to pay attention to any sort of media that has an interactive element with the community, you hear the general public largely, and actually more soared now than ever before -- more so now than

ever before, we are turning independent. my comment is i think it is a shame that with such an independent voice amongst the people that i really believe we should have a non-party affiliated voice in the house as well. if nothing else, it will help with the debates. regardless, my question is why is it that when we talk about budgets now we talk about them year timeear, 1012- frame? guest: it is kind of like shooting for the moon in space. if you get off this year or next year, you miss your goal by a wide margin. looking ahead to every dollar that is spent or cut, it is critical to set the goal of where we both want the country to be in the future.

that is really sort of a key to all of this debate. on your first point, i really do see an independent voice in america, and it is often times attack in washington, but the tea party, i think, is planning a hugely beneficial role in this debate. they're holding both members accountable. back home we have great leadership in our tea party. their average men and women who were trying to make a difference. the one to a limited role of government -- they want a limited role of government and more freedom. i get offended in washington, there is sort of this discussion, and they almost treat these people like they are second-class citizens, but in

truth they are playing a critical world for us. i see that independent voice surfacing in america, and i think it is great. host: sherman on the democrat line. -- hugh, on the democratic line. one last try. are you with us? you are on with congressman greedy if you are. i think we've lost him. let's finish with this. who would you like to see as the gop nominee for president in 2012? guest: i want to see a canada it was willing to be bold and take on the tough issues facing the country. i am a free enterpriser. we desperately need a change in the white house.

if we are going to make some changes and tackle these issues, we have to have a president who leads. i think as a nation we're starved for someone who will lead in these areas. host: congressman kevin brady from texas. thank you for joining us. first, a news update from c-span radio. >> it is 18 past the hour. economic numbers just in. the government says there has been a rise in wholesale prices for the month of march, mostly due to higher gasoline cost. the increase is the smallest increase in the four months. unemployment numbers showed more people applying for the benefits last week. the first increase in three weeks. economists had expected the number to drop. still, applications have dropped by about 6%. that points to a slowly-healing jobs market. debbie wasserman schulze says it

is wrong to ask seniors to pay more for medicare while rich americans are getting large tax breaks. the florida democrat added that voters understand the combination of spending cuts and tax hikes will be needed to bring down the nation's debt and that democrats in her words are ready for compromise. earlier this month, president obama nominated the congress woman to head the democratic national committee. turning to the situation in libya, hillary clinton says the united states is committed to supporting nato's mission. she called on u.s. partners in europe and elsewhere to boost pressure on muammar gaddafi to step down from power. secretary clinton is in berlin for two days of nato meetings. >> this weekend on c-span2, in

the embattled -- politically correct tried to socialism we define how it is at work in the u.s. today. he is interviewed. carla peterson reduce the lives of african-americans living in new york city. you can find the complete schedule at booktv.org. >> follow cspan on twitter. it is the fastest way to the schedule updates and news links. join the viewers who are ready to follow us. it started at twitter.com/cspan. "washington journal" continues.

host: welcome. president obama has a new initiative called partnership for patients. 3 -- the goal is to reduce preventable accidents that kill americans each year. how do they occur? guest: they occur in lots of different ways. that is what everyone is focused on, to figure out exactly how. there are so many different ways that complicated health systems can go awry at different times. we have to figure out why. they can be medication-related, allergy-related. there can be all kinds of different complications. andica's hospitals physicians are very active in trying to reduce all potential arms. if we can figure out the potential, then we can avoid the

actual harm. host: how serious is the problem? guest: i think any injury is one too many. no hospital or clinician is terribly satisfied with an error either. we are working constantly to try to figure out the systems of care. i think one thing that was very important in the announcement of the initiative the other day was the emphasis on systems of care. it is not personnel, lack of knowledge, people not performing properly, it is in the systems, the handoff of care, between sites of care and so on. very complicated system. we have to bring in more together and avoid the potential points. host: there is obvious cost of illness, perhaps even death to a loved one. talk about the financial costs of such errors. guest: if you do not get something right the first time

in any walk of life, the redo cost additional money. if it is a longer stay in the hospital, more money. if it is another procedure, it is more money. if it is a real mission that could have been prevented -- readmission that could have been prevented, that is an additional cost. this whole campaign an ongoing effort is trying to get those things right in a way that you avoid those additional costs. denstock.h umbe just last week the agency for help in responsibility showed our report that showed a 45 per

dozen reduction in the central line bloodstream infections. why is that significant? guest: those are very dangerous infections. it is where a patient has a central line for the administration of chemotherapy or other things. an infection in that area can go straight into the patient's sytem. we have been working with leading clinicians and academic medical centers, state level hospital association and others to spread of best practice checklist kind of approach for the insertion and maintenance of these important central lines. 58% reduction over the time of 2001 to 2009 is huge in terms of the number of patient lives affected, costs avoided from additional care and so on, and yet we still say we still have

too many. aha is sponsoring an ongoing national collaborative to work with all hospitals around the country to see that we can drive this as close to zero as possible. host: let's go to pennsylvania where tom is on the republican line. good morning. caller: i want to hear this man talk to the issue about the business plan that is out of whack at most american hospitals. a to be health care was more -- it used to be health care was more of a situation where people were concerned about this of service that was delivered. now it has become the business model is how much money can we make and how can we maximize our

profit? that is the basic problem with health care in america, the concentration on maximizing profit, rather than supplying the service. guest: first of all, to the premise of your point, the hospital sector is actually the sector with the health care that has the largest non-for profit component. no organization can exist next year if it does not take in more money over its expenses this year and have something to reinvest in the future. hospitals are very capital- intensive organizations. equipment and facilities that have to be maintained so we continue to provide the best possible care for patients and communities. it is not about making money for the sake of making money. it is making the type of margin necessary to reinvest for tomorrow. one thing i would point out is

that hospitals nationwide provide now about $40 billion per year in uncompensated care, so they are doing all they can to meet patient needs, and be fiscally responsible. host: let's look at numbers from healthcare.gov. one in seven medicare beneficiaries is harmed in their care. one in seven patients is readmitted within 30 days. what you learn from those numbers? -- what do you learn from those numbers? guest: we learn we still have a long way to go to that absolute bottom -- to get to the absolute bottom undesirable types of experiences. host: our medicare patients more susceptible? guest: medicare patients are 65 and older, so there are

typically more complications, more illnesses, more free oil. a little less on the support side at home than other patients. they to consume more services and to require more assistance. physicians and others are dealing with more conditions in the typical medicare patient than the younger population. so it is a challenge. they are, for hospitals, a large segment of the hospital admitted population. you are always dealing with medicare patients and their challenges. scott on's hear from the independent line from massachusetts. caller: good morning. as i see it, the problem is to the workload of the doctors and insurance where they have them work 48, 24, 36-hour shifts at a

shot. i think that is where a lot of things are overlooked and not caught. i think that is probably one of the main problems. dr. seem to think that i went through it, i had to work those 36-hour shifts so everyone else has to do it. it seems rather silly. it is like the fraternities the way go throu way they go throug. guest: there is a history of very intensive-medical training for physicians. part of that was to deal with any potential issue in a stressful situation. we are in the midst of a change in that regard. they recently -- there has recently been new limits placed on the length of time that

residents can be on duty. the need for specified rests periods and so on, all intended to address the issues of fatigue and any possibility that the tea to play our role. having said that, a lot of the nation's safety net hospitals. they do see a very challenging patient population. a lot of the inner city problems, trauma, and other things. it is still a very intense experience. they rely a lot on interns and residents as part of the work force. it is teaching situations, but also in support of the other staff. maybe these rules will help. time will tell. host: rich umbdenstock.

yorks look to the "new times." that story from "the new york times" is about va hospitals showing they can reduce cuts and deadly infections. can they have success? the peace starts off by setting an aggressive effort to spread the threat of deadly bacterial infections is showing impressive results and they have broad implications at medical centers across the country according to a report that was released yesterday. what did you learn from these

articles in checking out that report? guest: first of all, the va is doing incredible work in improving quality and safety. they are to be commended. they are part of this overall national mix to find the best practices in all of these areas and then to spread them. we applaud the efforts of the va and welcome their learnings. what we are learning is that a different issue requires a different solution. in this case, the question was whether or not active surveillance of m.e.r.s.a., testing and running lab tests on every patient to see if they have it and see if that can lend additional ways to control would actually proved not to be as much of help as people thought. we're still learning about some of these organisms and their levels of resistance and the best way to control them, but learning what to do and what not

to do are equally important. that is a major contribution. host: the article talks about other things that can make a difference. as you mentioned testing for mercy ersa. what are things that you're looking at as possible game changers'? guest: you have to think of this as an overall culture of safety. everyone in the hospital, even volunteer and the members are all part of that culture in the opportunity to reduce infections. we work very closely with the joint commission on accreditation of healthcare organizations. they have a new center for transforming healthcare in which we are playing a significant role. their first project by selection of participating health care

systems was on hand hygiene. hand washing sounds like such a simple preventive measure, and when done properly and when done regularly, it is. it is incredibly powerful, but we all know we rush about our days from here to there and we do not think about the things we touch and the surfaces we come in contact with. we do not realize that we have to stop and think first about that system, that small set of steps that leads up to a problem that could start with not washing your hands before you work with the patient or before you move to the second patient. there have been huge reductions that we are now spreading across the country. hospitals are actually -- the key to this frankly is

observations that the janitor or vendors or the aid or other positions actually stops someone when they see them not following the proper protocol. it is a support system. it is everybody. host: melinda joins us from arkansas. le, caller: i have been a nurse for 32 years, and i see a big problem now that seems to be getting worse. not only in medical hospitals, but in any kind of facility, anything. the problem that i am seeing, the biggest problem is corporations are not staffing appropriately. they're trying to cut down on costs, which causes a lot of

medical errors. in my expertise right now is psych. the safety factor with only having a very few staff and full house of patients, we are unsafe physically. the patients are unsafe physically, and the corporation will not hire more help. this is going on -- i have to applaud the va, because they definitely staff appropriately. i would love to be able to work in that place, but that is hard to get into. to me, one of the major flaws in health care now is there is not enough staff to take care of the patients. >> let's get a response. >> thank you.

i think you for your career as a nurse. -- i thank you for your career as a nurse. the staffing issue is a huge issue. healthcare is a labor-intensive enterprise. by that i mean on average half to 60% of the hospital's budget goes to a staffing-related costs. i mentioned earlier that $34 billion per year is provided in consumption -- uncompensated care. so we're trying to make that up in other ways. when you are squeezed financially as hospitals are these days, you look to your major cost centers. certainly supplies and administrative overhead and so on, things that may not impact of the bedside, but ultimately

organizations are looking at staffing. non-clinical areas first, but even sometimes into the clinical areas. i understand your point very clearly about the desire to have more clinical staff to take care of patients. what we also experience is a staffing shortage. a lot of times we cannot find the staff. it does not seem to be the case at the moment, because more nurses have come into the workforce because of the economic downturn, but going forward, we have a significant health care shortage. we're trying to find ways to redesign the work. i know that change time is very uncomfortable for all of us, but we're finding a way -- trying to find ways to ease or complement the human element of staffing. we still have a lot of work to do. host: rich umbdenstock.

question on twitter -- guest: i would say the promise is accurate. hospitals take care of very challenging basic conditions -- patient conditions. they are very open to the public. we do encourage visitors. we have lots of suppliers and others coming through the organization. we are constantly open to the elements i guess you would say, the clinical elements. the environmental elements as well. we are convinced, and we are already showing that there can be improvements made in more improvements to be made relative to what we call hospital- associated conditions. we are in favor of not only finding those opportunities, but actually even changing the financial mechanisms to reward

better care and better outcomes, not just volume of care provided. there are many dimensions to this. how the system is organized, and how we handle the transition of care between hospital and nursing homes or nursing home to home health and so on. how we handled the transitions from independently-practicing physicians. it also gets to how we are organized as structures, and how we are paid in incentives. it is a multi dimensional challenge. it is all what people refer to as health-care reform, the actual transformation of the health care system. host: john, republican in florida. welcome. caller: i am retired veteran. in i have worked in the private sector, and now i work for the d a. to touch on a couple of points.

we are definitely understaffed. because of pergolas lawsuits we lost a great amount of doctors. -- because of frivolous lawsuits, we have lost great doctors. what i would like to say is that the lady who called in with the nursing service, she is right in the number of ways, but i would have to disagree with -- i am try to put this in a way that i do not get in trouble because i work in west palm beach, but it just went out of my mind. what is your concern? caller: my concern is frivolous lawsuits and the reasons why hospitals have to make money is that you cannot reinvest and hospital and have better mri machines because people do not

want old machines. this costs money, and you cannot do that if you are not making money. guest: certainly the point you make about lawsuits, defensive medicine as it is called more broadly, definitely adds to the cost. it was a major feature not discussed in the legislative debate, a feature that we believe very firmly needs to be addressed. it is a highly political and contentious issue, but your point is exactly right, it definitely adds to costs. all study showed that. we have to figure out the right balance between appropriate patient protections, but also incentives to allow conditions to do what they feel needs to be done, but not overly so in order to protect themselves from some potential lawsuit. it is striving positions out of

practice, which further aggravates the shortage -- it is driving physicians out of practice, which further aggravates the shortage issue. we will keep pressing the issue. you are right, to the point that you make, it everyone wants the best technology, the bus services, the most highly- trained staff. help is very expensive. we have to find ways to lower the cost without adversely affecting the quality. mhost: our next calller. the morning. caller: i am a wife, and the mother. i have two jobs. i wait tables and a sales clerk.

i work all of the time, every day. i have approximately one day off per month. and i have been working since i was 15, and i am 33 now. i am one me -- one of the many u.s. citizens that assumed they would not get a social security when they do end up retiring, even though they have worked their whole life hard at hard jobs. one thing i wanted to say is that in regards to welfare, and without welfare, i know my family would not be able to eat, and my daughter would not have health coverage. my husband and i do not. we cannot afford it. there is no way we would able to afford it. unless we may double what we make now. that would be a giant step. the more money we make, the food

stamps get taken away. they take away. has anyone given some serious thought to during the clinton administration when welfare reform happened and he was able to bring down the number of people on welfare to 35 years. something like that. it just amazes me. has anyone given any generous consideration to that sort of attempt to do that sort of -- try that? > guest: actually really framed what the debate has been about in health care, certainly at some allies, and now brought about into reality by the affordable care act. it was how do we take care of, how do we provide coverage for

so that we can take the best care of everyone in the country, including those who do not have private insurance or do not have the means to obtain it? that is what the debate was about. really the debate over the health care reform bill is not about the need to change the organization of the delivery system of health care or the payment incentives or transparency about quality and outcomes in patient satisfaction. it is really not even about insurance reform. it is really about how to provide coverage and pay for that coverage for the now 50 million or so americans who do not have coverage. the american hospital association supported the health reform bill imperfect as a this, because it provided coverage to 32 million more people. it will still leave about 23 million or 24 million people and

coverage of the end of the decade, but the only way in an insurance-based system that we can be sure that we provide direct care of the right time and right place for everyone is for everyone to have access to the system. we have been very supportive of the system, and that is where the expansion of coverage is needed through medicaid or through the new state-level insurance exchanges with the voucher support for individuals, that is where that comes in. and host: we're looking at a new obama administration initiative. the goal is to reduce preventable medical errors. help patients heal without complications. matt writes whether hospital- cost debt is the number one cause in the u.s.? guest: no, it is not.

cardiovascular disease is the number one cause of death. well we work on knowing -- while we work on knowing and providing better care, we also have to make sure the environment in which the care is provided is conducive to the best of comes as possible. that is where this campaign comes in. the american hospital association in the other national hospital level -- national level hospital association have endorsed this campaign and went to work together with the department of health and human services to again and continue to spread the new knowledge that we have gained in the past five years or more about how to address these issues, and to discover the new ways of addressing these problems and use our reach out to the nation's 5000 hospitals to spread the new knowledge as well. host: we talked about earlier,

central line at blood infections. we talked about mersa. what are some other concerns or major problems that are happening in hospitals? guest: we have been very successful in addressing ventilated-induced pneumonias. that is another direct route into the body, which makes it a very important thing to manage from the patients' safety point of view. we have been able to reduce benefits -- and the later- induced pneumonias. another place is urinary infections. the proper insertion, maintenance of those catheters, and how long a catheter dwells in a patient. we are learning all about how to look at all of these

interventions, both for their clinical value, but also for the potential harm they represent, and manage them better. one last comment, another area of course for hospitals is surgery. what are the safest surgical practices, and how can you involve the patient in that as well? patient identification and their surgical site. a lot of effort under way. host: joan, a republican calller. good morning. caller: i have a few comments. when i had been to the doctor before, there was a problem with the were not taking down my information correctly. i got the doctor's report back and it was the exact opposite of what i said. another problem is with the

insurance. why when insurance is so expensive -- if you did not have insurance, for an mri, i got a bill for $9,000. with the insurance it was $500. why is there such a difference in the cost? i also want to makeak comments about things earlier. i did get accepted to social security disability first time. obviously i am injured enough. i want to know with me being 40, will i be affected? i would like to work. i had a very high-paying jobs, but i cannot work. i am really concerned i will not be able to provide for my family. if i did not have disability insurance, we would have lost everything. guest: thank you very much. number one, about correct information.

any time two people exchange information, how it is heard and recorded. we have found that by going to a couple of different steps, the investment and electronic medical records, but that is still not good enough. it is having to the patient check that information as it is recorded, so that you are a quality check in that sense, but also a partner in the process. we are changing our prophecies in that regard to involve the patient more. -- changing our policies in that regard to involve the patient more. every item has a cost. and it is the cost, plus whatever the appropriate margin is to eventually replace that

scanner, to reinvest into the scanner. now, if the insurance companies paid less than the cost itself, much less the extra margin, and that is the case in medicare and medicaid, they pay less than actual costs, that has to be made up somewhere else if you hope to replace that scanner sunday. unfortunately, for those who are not on medicare and medicaid and not part of a group purchasing plan like a commercial insurance plan who just pay out of pocket, you wind up being charged the most. american hospital association and the nation's hospitals have a very strong principle in helping you with your financial ability to pay. yes, you might be charged a large amount, but what people end up paying through a financial assistance program is much less than that. i understand the sticker shock between the two.

third point, ideally we want to keep the coverage gains that have been achieved under the affordable care act. some of the proposals talk about taking away the coverage is,. host: let's go to north carolina where kurt is on the independent line. caller: good morning. i will make this really quick. i just have one question about this new super bug going through the hospitals where you can get it by shaking the doctor's hands. i got a pretty bad hospital in this town. it has a bad reputation for getting people in them and

giving them an infection and letting them die. my late -- my right legs pulled up. he gave me some antibiotic and paying bills and came back a week later. my gut is still swelled up. he sends me upstairs to a surgeon and pull some pouss otu oout of it. host: we are running short on time. what did you learn from that experience? caller: they work together to jerk you are around. they kept me in there for three days because it was possibly 72 hours before this thing. we might have to cut your leg off tonight is the only way they got me in there. andismissed myself and went to another doctor and he said there was nothing wrong with your leg. guest: hard to try to deal with that type of individual

experience with so many complicating factors, but let me just say, and i am not a pharmacist or physician, but the proper use of antibiotics is a very important issue for the health-care system today. a lot of the patient care improvement process seas or what we call best practices, clinical practices have to do with the appropriate and timely use of antibiotics. i happen to be the child of a former chemical engineer who worked in the antibiotic world in the early days, and i have seen through my lifetime how quickly the system dispenses antibiotics. what we're learning now is how resistant these bugs are. they have grown to r resistance. more antibiotics are not the answer.

the wrong antibiotic in the wrong timing can also create problems. i think your example shows how it can then escalate through the rest of the system. the proper use of antibiotics, the proper use of all drugs and the interplay between the antibiotic and the bug, but also drug to drug, are things that we have learned a lot more about recently, and those are the practices we are trying to implement. host: a tweet from a viewer -- weighing in on their opinions on how some of the health care stuff is handled. let's go to idaho. tim, republican. good morning. caller: good morning. i want to say the veterans administration in salt lake and the university of utah is one of the best facilities that we have in a five-state area.

you walk into the place and there is hand sanitizer there. every certain distance there is more. i have had three surgeries there and have never felt any pain. why isn't the government training more doctors and more nurses and asking for time in return? guest: the whole issue of the cost of graduate medical education and other clinical programs is the answer to your question. i said that backward. the answer to your question is the issue of cost. going into the health reform debate, just to put it in that vehicle around the bill, we have said the nation needed up to 30,000 more positions. the proposal was to