honberg. later we will talk about aid to the philippines and what role the u.s. should pay in the international crises. washington journal is next. >> host: good morning. support for showed the republican bill. many stories this morning report that many of those voting to support it are in tough political fights. what you think about democrats supporting this bill? thed you suggest about current debate over the affordable care act? if you want to give us a call over the line the numbers are on

the screen. you can reach out to us on social media as well. the washington post offering a breakdown of total votes. 261 votes say yes in supporting it, that including the 39 democrats as opposed to 157 no votes including four republicans voting against the bill. when it comes to the defectors as they are listed, the for republicans one of the bill to go farther and to deal the

health-care law. again, we want to ask you not only about the democratic support for the upton bill, which the president said he would veto and probably has no support in the senate, but again, 39 democrats in the house

voted for it, giving support to it. your thoughts on that and the condition of the affordable care act as well. in the analysis piece on the front page of "the los angeles house it says that the vote was the latest display of democratic anxiety.

>> of the calls that are lined up, ron from pittsburgh, pennsylvania up first on our democrats line. ron, good morning. caller: i really think that the democrats are voting this way, a lot of them are trying to do what is politically expedient at the moment. rather than have real integrity and vote the way they really believe. at least that is a case of some of them. with others, i think mary landrieu is more conservative than people believe. inpis of limited these cases and these moments of truth really help that.

think that means going forward as the base continues going forward with the affordable care act? really been has blown out of proportion. obviously it is a mistake on the democrats part that they didn't have this website working really well. that is too bad. i think this really has been blown way out of proportion including republicans who never wanted this to see the light of day. i can see why they didn't. if you're to go on the site and look at the plants, their wonderful. this has been way too long in the making. this type of stuff would've happened decades ago at john f. kennedy, had the tragedy not happened. many people early on would've brought this forward. host: that is ron.

is the new jersey independent line. i can understand why democrats are voting with the republicans. newsan on the abc nightly ran a story. he has cancer, he lost his insurance and the doctors he is trusting with his life, the man happens to be a democrat, by the way. obama's press secretary is asked what is this poor man supposed to do, he didn't have an answer. my question is, why would anyone give their personal information, social security number, to a so- called navigator when sibelius convictedhey could be felons. this whole thing is a nightmare and obama should be impeached. 39 democrats voting for it yesterday. listing on the roll call website including ron barber of arizona, john barrow of arizona, a neighbor of california, there were others.

there is a listing of some of the democrats who aligned with the republicans yesterday in support of the upton bill, which the president said will be vetoed should get to the white house. anna, riverside, california. you are on the democrats line. hi, good morning nsa and everybody. can believeocrats what the republicans are dishing when darrell issa says the president did the most monumental error in history, if they can side with someone like that or get fooled by something like that, then you need to go back to history 101 and just look up all the dirty work that is been going on. it is such a shame. peopleocrats are for the are trying to do this for people

and the president. i don't know why anyone would site is. at least try and help with it. instead of siding with the corporations who want to have all the edge on the security -- on the insurance companies. thank you and god bless the people. from here's kathy montgomery, texas on our republican line. caller: i have been watching yhis president obama trey slithered his way out of this. you can keep your 26-year-old on your parents plan. actually, he's going to get rid of that. next year when our employers kick us off of their plan because obama wants it this way, no one is going to be on insurance. no one's going to have

insurance. he is try to push us little by little onto socialized medicine that doesn't work. our family lives in europe. it doesn't work. my nephews can't get simple surgeries that they need. it is always delayed because the government doesn't know how to run things. my advice to people who are getting kicked off the plan, pay the fine until president obama is out of office and i pray to god that our government can get together and fix this mess. we had 39 democrats support this effort yesterday, what you think of them? is just athink it show. i think they're just tried to save their hides. i wish everyone would work together and really we do need a fix with the insurance companies, but no one is doing the right thing. socialized medicine is not the answer. it does not work. reasoningpolitical behind yesterday's vote is something that the editors of "wall street journal" take up

this morning. this vote yesterday and the bill was a discussion of jay carney, the white house spokesperson. he gives his thoughts on the bill and what it does to the affordable care act. >> the president said in his remarks, in his prepared remarks yesterday that he wants to work with lawmakers of both parties who are engaged in good faith

efforts to make improvements to the affordable care act. issue --s particular not supporttely do and oppose the upton bill because whatever the intentions am a house republican intentions toward the affordable care act have been pretty clear. whatever the intentions of that fixing the maybe problem of those who received cancellation letters, it also, by allowing insurers to sell new policies to new customers that don't meet the standards, is designed to undermine the affordable care act in the long run. i think you'd would find if you talked to insurers that they would have serious problems with something like that because it would undercut the marketplace and it would create a situation that would be hard to sustain. here's jim off twitter

waiting in. eighinging otis, prosperity, south carolina. independent line. i want to say that this affordable care act is a great thing for the nation. we have to work together to get it right. if people would look at the massachusetts health care law that was passed while mitt romney, whom most republicans voted for, remember, it took them six months to get this straightened out. this is for a whole 50 states, so it's going to have to take a little time to get it straightened out, but it is a good thing for the country

and we need to fix it, we don't need to get rid of it. think abouto you the political background on what is going on, especially in light of yesterday's vote? caller: caller: i don't care about the politics of this. people aret that being treated right. insurance companies have to own up to what they have to do. you always hear horror stories about people can't get the treatment they want because the insurance companies are turning him down left and right. especially before this was passed, they were turned down because they had a previous illness. so let's forget about the politics. this is not -- excuse me -- a republican or democrat thing, this is for the country. the president meeting with the heads of insurance companies at the white house to talk with executives about proposals.

writers saying that the president had not consulted the president before thursday's announcement

,ere is nancy from missouri kansas city. say.r: i want to i had one of those subpar plans. i'm 62 years old. i don't need maternity leave. i don't need child services. i like my subpar plan. my niece had cancer. she needs her doctors. under the affordable health care act, she won't be allowed to keep her doctors. she will have to choose from the doctors they provide for her. i get to choose my doctors under my plan because i am allowed to choose my doctors under my plan, my subpar plan as they called it. why is the president allowing us

to buy across state lines echo make it affordable. host: how long have you had your plan? caller: i've had my plan over 20 years. host: what is your monthly payment? $175.: host: you haven't received a letter from your insurance company? caller: yes i have. that upsets me. for a democrat and i voted president obama. i voted for claire mccaskill. i feel like i am being cheated. i feel like they went back on their words. host: we will hear from and next to is from plano, texas. the republican line. this is a scheme that obama and the democrats have made to take the cost of the

health insurance away from the federal government because they to agiven health coverage great number of emigrants and other people that really have not been checked into to see if they are really eligible. they just go blind and give it to them over the phone. a retired federal employee, signed older are talking. bit of know a little what i'm talking about. now they have devised a scheme where they will make the american people shoulder the insuranceproviding for the other people that cannot afford it or do not want to afford it and want the government to pay for it. this is not fair to the united

states citizens. .t should be repealed the whole law should be repealed. host: the "wall street journal" looks at the senate side. that in the senate side, democrats having the majority, two independents who caucus with the democrats versus 45 to -- 21ns, cease seats on the democratic side arm play and 14 republican seats. when it shows a larger seat of competitive races, analysis of mark begich of alaska, tom harkin of iowa, mary landrieu who on the senate side is introducing legislation to allow insurers to keep selling plans, carl levin and kay hagan,

all lean democratic. max baucus of montana, jay rockefeller of west virginia, leaning republican, tim johnson of south dakota. going to the republicans racest, mitch mcconnell's is a tossup. saxby chambliss is leaning republican. jo, you're up next, island park, new york. independent line. in life, i observed that don't look at what people say but look at what they do. the republicans haven't signed up for this because they know it is a disaster. nobody really wanted this. , obama astonishing is has not signed up for obamacare. harry reid is not signed up for obama care. este pelosi has not signed up for obamacare. --y should be called the this should be called the on affordable care act.

democrats don't want it, but they want to foisted on us. when they sign up, maybe americans will call. but they don't want it, so i don't want it. it is guy on twitter says here is randy, millington, michigan, democrat line. caller: i would like to thank you and all those folks that we don't see who work so hard to put this program on. i appreciated very much. now is, yes, it had a president that made a missed statement -- that made a misstatement about keeping your health policy if you like it. if i'm going to judge on statements, i would take his misstatement as opposed to the misstatement of 30 minutes away

from a mushroom cloud or the aluminum tubes, centrifuge tubes , guarantee it is a slamdunk him a weapons of mass destruction. everybody out there or a certain group of fellow americans out there that are so giddy about taking or keeping insurance away from 30 million americans and making a big stink that aref that number having problems with losing their health insurance is really kind of phony in my opinion. -- you can stand there and preach and be in love with killing people, but you hate to heal people? there is something wrong with them kind of people. i thank you very much for allowing me to speak and hope you have a great day. your before you head on, thoughts on those democrats who supported the bill yesterday? caller: that one i can't figure

out, pedro. if i voted the in bill, i'm not voting for you. so that five percent pay cut you you have artie lost that. you're not going to get a republican to vote for you because you voted against one bill. it kind of shot yourself in the foot, i think. -- that is my opinion. this is joining us from las vegas, nevada. republican line. think, obama is going to go down as a president who changed healthcare, ok? think we should let people pick whatever they want. we been telling him all along that this was going to happen and it did hurt i'm really proud of him that he said he was sorry or whatever, but this kind of

stuff takes time and he has to be patient with it. it is still going to work for him. really don't i think people should be buying stuff from the government. thanks a lot. c-span is the best. host: dennis is from spartanburg, south carolina on our independent line. have isthe problem i that we sit here and worry about is it going to work or not going to work. let's give it a chance. the people that are ranting and raving about it, they don't support the president. did not support him. down here in the south you have so much hatred for this man. so much hatred that is not called for. i am a veteran. i get all my medication free. that is socialist, i don't care how you look at it. if everyone comes together and

quit being so bipartisan up here and ec and all the other places, i believe it will work. thank you, sir. seen so farou've the rollout of the affordable care act, white is still supported and why would you tell others to be patient? history is either going to play on your side or not. it is the same thing i said about medicare and social security. you have to give things a chance. the only way is going to work. thet doesn't, i will be first to say didn't work. but this man gets no support from nobody. nobody because there is hatred. thank you. and from milwaukee, wisconsin, democrats line. caller: i just want to make a comment and say that i think the health care bill did not go far enough. i think we should have fought

for the public option when they try to pass a bill. things would have been much better and people would have had more options to choose with insurance companies. when obama gets everything worked out, this is a good bill. he would to be patient and remember, republicans have not offered us anything else but the same. for theit was time insurance companies to be regulated. he said republicans and offer anything but what about this from fred upton? caller: yeah, but that is a continuation of insurance companies not being regulated. if people want the same plans and those insurance companies have no regulations, then fine. but that is only temporary fix.

obama has tried to do something permanently. i think we should just be patient and it will work out. it was with cut wisconsin's republican senator ron johnson who delivered the republican address this week in response to the whiteout. he talks about the affordable care act and the need to start reversing the damage from it. here's what he had to say. >> i am asking every american to believe with their eyes and ears are telling them. the federal government is dysfunctional. it is broken, ineffective and inefficient. do you really want washington taking over a greater share of our health care system? getting more involved in your health care decisions? americans are finding out that is a prescription for disaster. obamacare will not fix an important health care system. it will cause more damage for far more people than any problems it will ever solve. now is a time to start reversing

the damage before it is too late. a good place to start would be supporting the bill i introduced into senate called if you like itr health plan you can keep act. unfortunately, the implementation of obamacare has progressed to a point where millions of canceled plans cannot be reinstated. but the freedom of millions of americans to keep doctors, treatments and health plans they do value and still be preserved if congress acts swiftly and decisively. a couple of e-mails this morning. here is mona from florida. our e-mail address is journal at

c-span.org. debra is on the phone. she is from pennsylvania, republican line. caller: hello. i am one of the five percent. my monthly premium i was getting a comparable matrix of what i would be paying in the future, either from $1800 a month for a plan that i enjoyed for what i now will be paying 20 to 50 a month which was an increase of $5,400 a year. is -- i'morable, it tired of everyone discounting the five percent that are having our policies canceled. it is just ridiculous. there'll that this plan, and now we are seeing the consequences of being ill-prepared for aca. that is deborah from

pennsylvania. up next is shannon from canton, georgia. caller: a couple quick winds. first of all, the arrogance that we are seeing by the democratic leaders is off the chart here. the ignorance by the republicans is also disgusting. bottom line, the system does not work. if you do the math, you're not enough young people to sign up to support the system. i'm and try to get it policy for the last four years. never had a problem. my policy is going up to. the problem without insurance is that it was unaffordable for so many americans like me, i hard- working guy with a family of four, it has gone up. the only reason it is going up again is because of this unaffordable health care act. with the math, it is a bad plan, you need to get rid of it.

you can add your comment and add to the conversation as well on facebook. patricia, from hot springs village, arkansas on the democrats line. good morning. patricia, good morning? caller: one more time for patricia from arkansas. and she is lucille from virginia on the republican line. that wei want to say have been lied to more times and this time. es are going li to listen to and believe the president and the people from d.c.. it is time for us to take a

stand and do what is right for americans, not for a political party. americans, not democrats and republicans only. first, we are americans. to what is right for america. , we areime in your life always doing what is right for the republican's. obamacare is not fit for america. they approved it and what they're doing to us -- my daughter has been without insurance for two weeks. her husband had kidney stones, had to go to the house the will, now she has a hospital bill. because of this particular obama bill. it is just not right. we pay for insurance all these years and then now we are not going to have insurance. it is not fair. to americans who are hard workers, who pay for their

insurance for years and years. >> there are a number of stores in the paper this morning taking a look at china's announced change at their child's policy. the "financial times" has this item

josh from alexandria, virginia. independent line. josh are you there? when my time for josh. michael,ove on to south carolina, democrats line. caller: i would like to state first of all that a lot of these people that will going to this plan, it is there to subsidize them and gives them a hand. if you've ever had your child sick and had to wait to go to to aoctor then go hospital, i've seen women go to the hospital on sunday for cold. will be more expensive, to subsidize these people's insurance or to pay for emergency room? all the people are against this and are gloating over this problem with the computers are

the same people that were against the to begin with. they're just using this. the republican party does not care about anybody that makes lesson hundred thousand dollars a year. they always say class warfare, class warfare, but they're winning the war. thank you very much. supporting the vote yesterday, your thoughts on them? caller: it's just another way for them to try to take a chunk out of it a little bit at a time until they eventually try to kill the bill. timesave voted on a 46 tackled have lost every time. they're not doing anything to make us better. they're doing nothing but instructing like they have ever since this man got elected resident. 39 democrats, though, supporting this yesterday. caller: they're scared for their seat. a lot of them are coming up for reelection. the way that the spin machine

goes from fox news and such, these people are pounded and pounded and pounded on it -- everything. host: that is michael from south carolina. the post runs a story by the associated press. "the washington post" has this

story about ethanol use. the administration friday also said it target range for all advanced biofuels of two billion to 2.5 billion gallons. rick up next from woodberry, tennessee, republican line. the only thing i want to

say is now we understand what it meant when president obama said change fundamentally united states. he is spending us into bankruptcy and he is going to tax us into oblivion. this guy, it's unbelievable. we are in much bigger troubles than we ever knew that we were. it is pitiful. i think is absolutely pitiful. michael is up next from all, pennsylvania, independent line. i think that the main problem is that people have to open up their eyes to, let's see, a long time ago, let's go way further back than all of kid andu had billy the yet all these people robbing trains and banks. and now all of a sudden that stopped because it the guns out

of their hands, give them a pen and said we will make you an insurance agent and we will make it a law that people have to get you and pay you. and now with all of this saying that they don't have enough and the budget is low, that is only because her pockets cut deeper. things didn't get more expensive. came on tv out here and said, they made a mistake. now in scranton, they are the property tax is 50%. they're pushing people into having no other recourse but to do illegal stuff to survive. to eat, to have close, to have a home or they want you to go lay in the street and i. this is not the government we were supposed to have to work for the people. suchre separating us in

tremendous amounts, they have is working against each other. the culprit is the ones that take our money before we get it, the tax or money before we get it and then they tax it as we spend it. host: it is 2013. there are two events for you to watch live tonight starting at 7:00. governor martin o'malley. following the live the memory going to show remarks from earlier in the day by the 2012 vice president of candidate paul ryan. and much both as events starting tonight on our road to the white house 2016 series. those events live on c-span starting tonight. stories about iran and what is

, michaelin the senate gordon is saying that the compromise may be near for a nuclear deal towards iran.

that is from "the washington ." jeremy erb writing that is david fitter, senator from louisiana, saying senate democrats are tried to use him as an excuse to delay a vote next week on imposing tougher sanctions. catherine from burlington caller:, new jersey, democrats line. i'm calling in

support of the aca. i think it is too much negative press in the media about this plan. i think we should give it a chance to work and see what happens. if it doesn't work we can modify it and plus 39 defectors from the democrat party, it is politics, all politics. plain to see. you'll have a good day. host: as far as looking forward, how to enough it is working or not. caller: their funding plans for people who are uninsured right now and they have choices and we will know. you can evaluate it. happens if it doesn't work you can modify the parts that are not working. host: the white house said the website would be working by november 30. you think that will happen? caller: i think it will.

i think they can get it up and working well. i have faith that it will. jim from plainfield, illinois. he is on the republican line. caller: i called the navigators and the said that if you miss a myment to check with insurance company what would happen. my insurance company said you miss one payment you be dropped from the insurance. i also would like to know why upy didn't have people sign alphabetically. in other words have all the people's last into the age or one week, the last minute be the second week. my third and last point is them wondering if anybody's concerned that a lot of young people are going to be paying all this be going that should into their iras and they're going to regret it later in life when they don't have any money saved up at her. those are my comments. host: will take more calls.

this is scott from florida. i would say either brother was sitting in the hospital who was sent home was slowly dying with cancer and there is a promising new drug that they're dying to give him but they can't give it to him because of drug companies will make a decision now. it is too late for him now. i still believe in our president. i still love them, but i want to say this is a wrong way to go about it. everything want to say, please a smokescreen all this. pay attention to iraq. the our new terrorist out there with new factions and they are .preading deeply into africa pay attention, people. please, pay attention. host: what you highlight that? scott, are you there? thee going to talk about security matters, especially terrorist threats united states.

those topics. at the and good topic for our next segment aired our guest is going nok kostro.anie sac later on we would talk to new law will go into effect by 2014 on how insurance companies and old mental health issues. we will have that discussion later on. first on to point you to our newsmakers program. senator patrick leahy our guest. the chairman of the judiciary committee. with reporters he talks about various things. you may remember he was one of the authors of the patriot act. it talks about government surveillance of data. >> most the time that committee is senator feinstein who also had -- she said that she thinks

isprogram should continue to your disagreement with her on this going to lead to what often happens in the senate which is nothing? >> auto, she and i have talked about a lot to choose a good friend and i have a lot of respect for. i disagree with their legislation that strikes me as more a status quo. how to find the status quo acceptable. let's have votes on it and see where it is going to go. can tell you right now i will not vote for the status quo. i don't think it makes us safer. we have seen because of the leaks that have happened, in some cases we have looked silly by what we have collected. it is almost like him a look at us, we can collect. and people are saying what did

you get? i would much rather have us be more specific about what we do. jo one intelligent services? yes. you want us to go after intelligent services? yes. did we use very good we were able to get osama bin laden? superb intelligence. but it was -- a lot of it was very specific human intelligence and not based on what is, publicly. a lot of very hard work. not somebody sitting at a computer collecting everything. have ain laden didn't listed home phone number and to start calling people. >> this weekend on c-span. go to the white house 2016. -- road to the white house 2016.

governor o'malley is live starting later today at 7 p.m. eastern. on c-span twos book tv, or from five of the finalists for this year's national book award for nonfiction. sunday at one. and on c-span3's american history tv, go back in time to 1996 the internet archives way back machine, sunday at 7 p.m.. >> washington journal continues. week senate hearings this talked about terrorist threats. theof those featured department of homeland security j johnson. president obama's choice for homeland security, our guest to join us about that and other things related to safety the united states, is stephanie san

kostro. how do you explain j johnson? is an j johnson interesting nominee. he does not have much federal experience. he spent two years as a federal prosecutor new york. two years on the air for staff in the general counsel. criminal trial attorney and mostly when you look at his resume, that is the bulk of it. of also a very close friend president obama. he was an early supporter of president obama's first campaign foro he is a confidant the last eight years. we think about having a legal mind in that position? michael chertoff had a

very similar background. host: one of the questions was brought up during the hearing which is about management. he talked about management style and what he wants to do managerially. talk a little bit about his management experience versus the others. guest: i was one thing a lot of experts such as us highlighted is his lack of management experience. as an attorney, as a trial attorney he doesn't have experience managing vast numbers of people. president of homeland security, is the largest federal department to have over two and 40,000 employees and 22 disparate agencies with very different missions. it is management experience and try to align it with the department of homeland security, it is an interesting but not perfect fit for we is done in the past -- for what he has done in the past. hearinghis confirmation

before the senate committee they're telling this week. what he did say was that his top two priorities were one, to fill the vacancies, roughly 40% of the top leadership positions which are political in the department are unfilled. his second priority was to improve historically low brow that the dhs has suffered from. i found interesting because all his predecessors have given counterterrorism the top priority. host: so the fact that he needs a potential nominee to be the head of homeland security, how does he approach the idea of keeping the homeland safe? guest is made some interesting speeches in the past. he is taught but this tipping point of at some point looking at al qaeda and combating al

qaeda. as marvin law enforcement mindset. i think he honestly believes that al qaeda is degraded enough that at some point very soon we will start looking at it from a law enforcement perspective. his philosophy on al qaeda affiliates, not the headquarters of al qaeda but groups like al shabbat or a blue throughout in syria, i wonder what his philosophy towards them is. seem to be focusing on regional interests. about at someones point wanting to do damage to the united states. it was unclear from the hearing how he really feels about that. about ar guest talks lot of things and it comes to homeland security issues. the larger issue of terrorist

threat against united states as well. that is our first topic this morning. if you want to ask questions about those, here's how you can do so. you can also send this e-mail. or you can send us a tweet as well. bouncewyer, how do you protecting the homeland when some of the issues that came up during the hearing were civil rights? j johnson seems to be a very interesting attorney and that when he was talking about unmanned systems more commonly known as drones and drone strikes, he was talking about his time at the department of defense. drone defense even against your citizens. he makes no bones about your citizens combating the united

states being fair targets. how does he feel about using that technology here at home, tracking u.s. citizens, we've had a lot of talk lately in the last six months or so about the national security agency, wiretapping, listening in on phone calls, gathering metadata. what i find interesting is he didn't really satisfy people's curiosity. how do you feel about privacy here at home and that is a very big issue. >> senator rand paul asking those difficult questions. does he have a hand in writing policy when he came to join use? guest: he did at the pentagon. that was for military missions. for my knowledge she didn't have any sort of written policy statement about running is here home. host: one of the things he was asked about the hearing was travel by those the special people and united states that may be radicalized, traveling overseas for who knows what. here's his response and i want to get you to react to it. that we have aze

problem when it comes to suspicious individuals laundering their travel. that is a problem, it is a fact. i saw happen on my watch at dod. i think it is a blind spot. i'm not necessarily saying we therefore need to insist that we track the travel of any -- of every person to leave the country and there are real associatederests i with that. there would be an uproar if we tried to do that. i think it is a blind spot and a real problem. but it is getting to a better place obviously which involves a balance. host: first he said laundering travel. what is that? guest: this is when you use another name when you go over and back. or you may use a name that is difficult to spell so when it is entered in the system it may not be entered correctly. host: twice during statement use the term blind spot.

guest: this is a very interesting area for policymakers to look at because when you think about really tracking people's travel overseas, state department has long suggested to people that if you're going overseas please register your travel plans with the state department website so they know how to find you in case of emergency. this goes beyond that. it goes beyond really just saying as your assistant hate let us know where you're going so we can help you out in a safety situation. this is, we are finding you a little suspiciously want to track you when you are overseas. are you going somewhere for terrorist training at coordinate to meet with certain people and details while you are overseas. as a policy concerned this is a blind spot because you really don't want to ask people to sacrifice her privacy and civil liberties while they're traveling overseas. host: did he express any civil rights concerns? guest: guest: he didn't elucidate what is concerned about. i'm really curious again. i don't think his statement

before the committee really enlightened us as to how he feels about this. host: this goes to the larger idea of information sharing between agencies. i mentioned before terrorist groups like al qaeda. they're also terrorist inspired organizations that aren't yet affiliated with al qaeda and then you come to the loan will problem which is really much more difficult heard when you look at the brothers and the boston area and the bombing, theymay have traveled, but really radicalized over the internet. they learn how to build bombs over the internet. how do you regulate that and what bills does dhs play in that is something that is up for fortion. host: center strategic international studies stro.ephanie sanok ko is first call this morning

from craig. craig is from florida on the democrats line. good morning. caller: yes sir. i would like to know why the president doesn't authorize a first strike on the facility in iran? guest: very good question. the question is whether we do in terms of the region. israel looks at iran as an existential threat and israel is one of our closest allies. however, i don't want to overstate it, but the ripple effects of what a strike against right now thee, president is willing to use the united nations, u.s. sanctions to get the problem. again, we're not entirely sure in unclassified setting what exactly the capability is for iran to launch a nuclear weapon. is nuclear power we're supposed to have a different attitude. it is a little more competent than simply authorizing a strike and i will say that the israelis, again, looking at iran as nexus dental threat, are less

limited in terms of the avenues they want to go down. about the current debate it, especially from senator kerry about the process over the negotiations for nuclear program? guest: i'm watching negotiations very closely only because i think senator kerry is giving up too much too soon. in terms of striking a delicate balance, looking at the new leadership in iran and wondering how they're going to evolve is one thing, but assuming that they're going to evolve in a certain direction is a little shortsighted. i would want to be a tougher negotiator in approaching these questions. thereon the senate side is a call from her sanctions. would you think about that? guest: guest: sanctions affect the people of that country of. also have ripple effects. adding more sanctions when some of the sanctions we have in place are not being fully implemented is a little

shortsighted. remain like to see us with the status quo and use that as a negotiating starting point. host: this is brian from michigan, independent line. caller: good morning. i hope stephanie does not take this personally but i have spent a lot of time in the middle east. cole as a the prime example of why homeland security is another layer of bureaucracy we don't need. the cole went into a hostile portrait we have always known it has been hostile. i spent many of days in that port3 the commander knew it was a hostile port and yet he admits he was down in his state room doing paperwork while taking on fuel. a lot of security measures as far as sending an away team and many things he was cited for. at the end of it, and i don't

wish the man about life, he obviously was not -- he should not have been commander of a warship. he have all the knowledge and the means and all the protection we could ever need. this is a man-of-war. they don't look very inviting but yet he pulls into the port and does what he does. he gets 17 of his fellow sailors killed. he ruins peoples lives through dereliction of duty, not doing his job. out of all of this, in 9/11, we get a thing called homeland security. it is a nice fluffy name and i'm sure you will tell us all how many things you have stopped. until people do their jobs theher it is commander or head of the fbi, the cia and their politicians all working together to keep the so-called homeland faith, none of these layers which are billions and billions of dollars will make it

matter when we have political correctness. my answer might surprise you. say that i think creating a department of homeland security was a bureaucratic move, a reaction to the events of september 11. i will not comment on the cole situation because that was during peace time and not necessarily a homeland security move but rather a military port visit. in the port ofaden. i think you raise an interesting point -- homeland security is nothing new. when the department of homeland security was created, the 22 agencies under its purview already existed. we were actually trying to secure the homeland but not under a unified name of what we were doing. who was in charge? we had several bureaucratic leaders whether it was the department of defense or department of justice looking at different aspects of the homeland.

what was special about the creation of this department was it took agencies and push them together. i am not necessarily a fan of the 22 agencies they pushed together as a whole because some of them do not fit. theexample, if you take customs and border protection and take immigration and customs enforcement, they seem to be naturally aligned but you throw in the federal management agency which deals with natural disasters and that seems out of step with the law enforcement portion. as you probably know, washington loves bureaucracy and i have been here for some 15 years. i am trying not to drink the kool-aid, so to speak, but i take your point. host: homeland security was one of the topics from jeh johnson. it goes back to the debates about immigration. [video clip] >> i want to know if you will give this committee the exact

metrics that are needed sector by sector so that we can obtain 90% effectiveness on the border. answer yes or no, please. -- toam inclined to get give you journey. >> i am just asking for a yes or no answer. we have our responsibilities here and one of them is to have a secure border. unless we get the right you and yourrom bureaucracy, we are not able to ascertain how we can secure our border. as much as i admire and appreciate you, unless you can tell me you will give us the information this committee has the right to have, i cannot support your nomination. >> i'm inclined -- let the record show, you will not give a yes or no answer. therefore, i will not support your nomination. lot from mr. johnson but because of the topic, what are your thoughts? i love it when john

mccain gets feisty. it is important to him and his state. border metrics are hard. a lot of dhs officials will point to the fewer apprehensions over the last few years. could that be because they are doing their job well or could it be they are not catching people? border metrics are very difficult. hedgingjeh johnson was a bit when senator mccain says i don't want your inclination, i want your yes or no answer. when mr. johnson refused to comply, its because he is very aware of how difficult metrics can be. we have seen a sense on capitol hill of wanting to grow the border patrol and provide them more equipment. the folks in the border patrol i have talked to have said stop, we have to absorb what you have given us and grow where you want us to grow and we want a breather to assimilate

everything you have already done and then we can take a step toward. metrics are included in that. host: our deportation tire in this administration? >> they are but apprehensions , a simple trend is not enough. you have to know that the numerator and the denominator in this equation. if you don't know how many people are crossing the border, you cannot say if you are doing better or worse. you can look at a number of deportations but in terms of how many people are actually coming across the border, we don't know. host: our guest is from the center for strategic and international studies. democrats line, utica, new york. caller: the defense and security establishments are making america less safe by refusing to address new evidence that building seven was brought down with preplanned explosives. those responsible are pointing fingers. would members of your organization willing to meet with the architects and

engineers demanding a new in investigation to view the investigation as to who put them spoke -- explosives into building seven? guest: my organization is a think tank in washington and we work on contracts and with grants for the government as we do for foundations and others. i would be willing to speak with -- all about what exactly what perspective you bring to the table. i would be happy to. next, ournsas is up republican line, good morning. can you hear me? host: you are on. go ahead. go ahead with your question or comment, please. displeasedm very with the security that obama has

brought to this country. our borders need to be sealed. i don't mind people coming in if they come in the correct way. orders and everybody coming in, it has filled this country with [inaudible] that we will have trouble with one of these days. host: the idea ofcells coming across the border -- guest: when you look at who is coming across the border that we know about -- sometimes we have issues with people who come across the border and they depart when they are supposed to when their visas expired and some people overstay their visas and they are here -- it is difficult to come over lawfully and then -- if you are on a list, they will catch you. overstating the visa is hard.

if you have a group of people who come over from where ever and they decide they've got a job here and are on a work visa and they overstay their visa, the paperwork and the bureaucracy to find those people is very cumbersome. what you see it in the senate comprehensive immigration bill as well as the guestworker bill and the employer verification hills pending in the house -- you will see an attempt to get at allowing people in here for and then notasons allowing people who are coming for illegitimate reasons. how would you gauge the concern on capitol hill and other places about would-be terrorists coming in through the border? guest: they are worried about would-be terrorists coming in through the border. we talked about laundering of different names and differently spelled name so the system will not catch them. that is a concern.

i believe nominee johnson mentioned that during his hearing. host: this says -- if you talk to a lot of the current dhs employees, they would love to be overhauled. their morale has been historically low. you've got very disparate missions and no one knows where they fit. theirre now undertaking second quadrennial homeland security review. they did when roughly four years ago and the current one will come out early next year. ont of that will focus streamlining the processes and make everyone feel relevant. it is not an overhaul and having a secretary who is management exactlyight actually be the shot in the arm they need to make major changes. host: do you have thoughts on what overall should look like? guest: i do, one area i think is

useful to consider -- most of what dhs does they do in partnership with the private sector. i would love to see a working group that draws from the best and brightest from the private sector and folks from dhs to come together and figure out if this is a company -- i'm not saying that federal bureaucracy should be on -- run like companies but there is a lot for them to learn. if they can create an advisory group and talk about how you increase morale, how you improve processes, how you improve the organization of the system -- i think that would be worthwhile. host: is there a consideration of some agencies brought under the original umbrella go back to standing on their own? guest: my colleagues have isked about -- fema operating well with natural disasters that it is working -- but is it working well in the homeland security construct?

it is an ongoing debate about which agencies. border customs and protection, immigration and customs enforcement and other organizations like that together makes sense. some of the others, there are 22 agencies under dhs and some of them are not well-suited to each other. we are talking about a lot of things. david from fredericksburg, virginia, independent line, high. caller: good morning. my situation is this -- i have been in virginia since shortly after 9/11. worked directly with operations of this nature. art of the problem i see with the southern and northern border is not purely immigration. that is an issue i am not qualified to comment on. basically, is a

border that is not secure at all. hiring more agents -- you cannot really control these agents, get them where they need to be quickly enough so that the drone cannot really react. you might as well have a satellite looking at the border. on the northern border, that's a whole mother issue. havewsa's sitting out there and all manner of chaos that can be caused. we are looking for these quick fix solutions. i have worked with senator mccain and the state he comes from. this is really a slow stitch. a stitch in time saves nine but you will mean -- you will meet 18 here because there is nothing going on. guest: i find your observations

interesting in that i used to work on the house armed services committee ford duncan hunter out of san diego. he was into the border fence. i have quite a lot of experience talking to people about the border fence, increased border security. you might read core does you might recall that mobilize the national guard to go to the southern border. most recently, i have been very impressed with technology. you dismissed it but in looking i have seen cases in the coast guard -- the coast guard works with customs and border protection and work with the u.s. navy. drones are a good example of being able to be two miles away, watching a target, keeping eyes on the target, until the force can get there. i think it is very much a combination of the manpower and the customs and border protection folks are saying we are increasing our ranks and we have equipment soap please, let's pause and absorb all this.

couple that with technology. i find there is utility in technology. if you go to the southern barter, just border we see statistics. some officers are transferred to monitor. it's a combination of boots on the ground and having the technology and employing it in a way that makes sense. host: the caller brought up staffing. how is dhs affected by sequestration? guest: planning for sequestration has been going on for a while. if you look at the department of homeland security's contract spending which is a way of tracking this thing, contracts are down from 2011 14%. however, customs and border protection has only been cut nine percent and immigration has only been cut four percent which means the bulk of those decreases have been elsewhere in

the department. it shows me the department is focused, even at the expense of the other 20 agencies, looking at customs and border protection and immigration and customs enforcement and using the majority of new money to support them. host: this is jesse from our democrats line, go ahead. caller: let me make three statements -- you talk about terrorism. as an african american, i have felt a victim of terrorism in this country. i don't believe what you are saying is the truth about anything. i was born in mississippi.

i walked down the road as a 10- year-old young man. the klan got after made. -- after me. they wanted to kill me. america should look at itself differently with terrorism. [inaudible] one security man was all over me. he was feeling my belt. how could i have something hidden in my belt? people are carrying knives on planes. sorry first of all, i'm for the experiences you have had you shared with us.

i will say that a lot of your opinion is shared by many americans who think perhaps we should spend less money overseas and look more closely at what is going on actually get our social programs as well as looking at how people treat each other. said, from a homeland security perspective, i'm not -- i'm assuming a lot of people who have approached it in the past have not necessarily been immigrants themselves. in many cases, immigrant communities are much more understanding about people trying to fit in and not be harassed for the color of their skin, their religion, and any of that. i take your points and i'm sorry for what you went through. host: from twitter -- guest: when secretary -- when nominee johnson talked about

cooperation and there was another hearing before the senate this week with the acting secretary of dhs, they talked about information sharing within the inter-agencies. and federal, local, law enforcement folks talk to each other as well as hearing information within fusion centers, intelligence and classified and unclassified information and they said the next up was sharing information with their international partners and knowing like with the uk, who are you looking at? maybe other countries like africa and south asia and elsewhere -- who are they looking at? sharing that information and there is a lot of work to be done in terms of determining what can be shared. , a lot of things whichmped no foreign means no foreign release or you cannot let foreigners see and that hamstrung us in many cases. canada/uk desk

after 9/11 and we wanted to secure the consonants. there was so much information i could not share with them and that was a shame. more good work could have been done quickly if we had been able to share. when it comes to drone strikes, when you talk about targeted killings, it's imperative we share information with the host government if they are friendly. then we also need to get their information as well. host: it was in a hearing that the counter resid that -- that the counterterrorism center set there was another attack in the united states pre-listen to the response. [video clip] >> the threat has moved out from the afghanistan/pakistan border region to broad swaths of areas that are largely ungoverned across north africa and the middle east. in some ways, it has become more significant from a geographic perspective and more complicated

from an intelligence perspective. i would not say that the threat to the united states of a 9/11- style attack is greater. in fact, i would say it is lower today than it is -- that was in 2001. the threat of that type of attack is lower than it was 12 years ago. >> i would agree with that. because we took the fight to the enemy and got our act together in the last 12 years in very important ways, the risk of that spectacular attack in the homeland is significantly lower than it was before 9/11. what has popped up in its place in the homeland is the risk of the smaller attacks which are no less concerning and similar overseas. the high jet head is less able to attack us in the homeland so it has pushed more overseas and gotten smaller and more disparate in the homeland. >> i would concur with that. the commentsck to

that the dispersion makes it a bigger challenge in terms of knowing when and where things might happen but that where is more likely now to be overseas than it is to be in the homeland which is not to say that we should drop our guard in any way. host: there is a lot out there but your thoughts -- guest: i do agree with their analysis. the enemy is more dispersed. that makes planning and coordination much more difficult. they have to do their vetting process so when someone comes to them and wants to sign up, they have to do a background check to make sure because we have had american and others who have gone in to work with you as government to infiltrate organizations. that is something they are aware of. from a planning and recruitment capability generation, i would say i think they are a little underselling the threat in the homeland of what we would call

soft attacks. be attacks against soft targets. we saw this in nairobi a few months months ago where al- shabaab took credit and there shabaab least one al- member taking place in that attack and talking about what you would attack a shopping mall. they don't have the defenses. they don't have the security. they are not a hardened facility. it is not like attacking the pentagon or u.s. military base. it is civilians and it should be easy with multiple points of entry and exit. might want to look closely how to best prepare for soft target attacks in the united states. host: the fbi director said we got our act together. you cannot tell what he was thinking but what does that mean to you? he was sayingk that we were very disparate in terms of the agencies and the law enforcement versus the military and that information sharing.

that first step is information sharing within the inter- agencies. getting our act together, in my mind, is being able to share the information and come up with a coordinated strategy to prevent another attack from occurring. i think that's what he meant. host: should we prepare for a decentralized per -- form of terrorism? guest: we have been so focused on fighting al qaeda and their affiliates. there is somebody like osama bin laden out there and you have to take them out. how many times have we killed the number three guy in al qaeda? you would hate to be that guy because he is the one we take out. infiltrate disparate organizations that are more dispersed and, in particular, the use of the internet makes it hard for them to track down. who knows who their target audience will be? will it be the brothers in boston or some kid sitting in indiana or michigan or california? you just don't know and trying

to figure out who is sending the message and who is receiving the message is more difficult in this day and age. creekmore,is from north carolina, on our republican line, good morning. caller: good morning, i appreciate c-span. thank you to your guest. thank god for c-span. security, ineland this area of north carolina -- host: go ahead with your question or statement. caller: right here in -- host: if you're listening to tv or radio, keep going and ignore that. caller: that's fine. around the city of north carolina, of raleigh, the capital, they arrested one guy in a suburb and several people in the south of raleigh in a different community that were,

in fact, supporting the terrorist movement of al qaeda and others. appreciate the efforts the government does to catch these people but, at the same time, i really think they will do with they want to do to catch them. president during clinton's impeachment hearings when he tortured the definition of 'is.' can take any law they is and interpret it anyway they want. we've got to catch these people. guest: i thank you for raising this at the local level. fromple of things we heard the acting secretary of the department of homeland security is that the department of homeland security is trying to work with state and local

analysts so they are better able to identify people in the federaly without the government coming in, letting the state and local folks take the lead and they are working with state, local and tribal and territorial law enforcement come up with standards. you've got the analysis behind it, now what will you do? states, making the local law enforcement folks step up and have a role to play in finding folks who are either sympathizers or supporters or otherwise affiliated with terrorist organizations. what you have seen as the federal government taking a step and assistingng local and state folks and really letting the local and state folks take the lead in their community. host: it says you are one day -- you worked with the

offices of nato policy. where are we as far as working with european partners now on information about terrorism threats especially in light of what has come out in terms of edward snowden and concerns about nsa activity? concern over those incidences affect the larger in from -- larger situation of information sharing? guest: they absolutely do. governments historically have been known to surveillance isn't there closest allies. sometimes with other governments permission and sometimes without. it's a little disingenuous for some countries to say i am shocked and horrified this is going on. it is the scene from " casablanca." " there's gambling going on here?" thean talk about europe and european union but at the end of the day, we will have to move forward.

some of the distractions brought up by the edward snowden case and the nsa wiretapping and all of that is that some governments are saying we are not going to allow corporate interests like google and others to use storage in the united states. we will have to have local stores but then the u.s. government will not have access. that is riling up some of our corporate interests in the united states. we will have to do with those distractions before we can make advancements. when i was the you -- at that united kingdom desk at the pentagon, we talked about creating information sharing with the brits and the australians as the low hanging fruit of sharing information. those relationships have gone much further in the last 10-12 years than we had anticipated. i think that's great but again, i don't want to belittle this by calling these distractions but they are sort of distractions from the bigger picture which is let's share information. host: ohio, independent line,

good morning. i hope you can hear may. host: go ahead. caller: i'm calling about domestic terrorism. it's in line with a couple of earlier callers. topic on c-span a couple of days ago. that is the cause of domestic errors in which probably relates to international terrorism. i will stick with the mystic terrorism which of the problems raised by the failure of our legal system to put in place laws that are native. -- laws that are needed. we don't have a right to go before a grand jury with evidence of wrongdoing by those who harmed us, in particular those the legal system, particularly judges. i have had a prosecutor tell me that if i was able to go before a grand jury and get an indictment against the judge, he would not prosecute it. we have a whole host of legal

reforms and constitutional amendments needed. i would like to c-span provide more opportunities to discuss what is needed. guest: that's an excellent point. we have come a long way since september 11 in putting terrorism laws on the books. in terms of what you are saying in terms of the grand jury versus the judge, that's an interesting point. i am not a legal scholar so i cannot speak to that. but i will say it's an interesting point. host: our last call this morning comes from utah on her democrats line, good morning. caller: one problem with having the police be in homeland security is that for americans, the police are not available. if they have vandalism were there is a land grant, you cannot go to the local police because they don't want to step on those that are doing observation for homeland security.

the second thing is, i don't know if people are aware that there is a second watchlist. who you arest is related to in the middle east. on your first point, it's a fair point -- when i talked earlier about pushing capabilities and analysis to the state and local level, if you only have the same number of people at the state and local level and you're asking them to do new missions and undertake new focus areas, other areas they had focused on will suffer as a result. i think that's a fair point. i am unaware of the landgrab issue for surveillance. i imagine that's a bigger issue along the borders. i am not entirely aware of that issue. i cannot remember what her second point was -- the watchlist. i am unaware of a watchlist. when i fill out what we call our

ss86 - when i get security clearance, i have to fill out who i'm related to. saysunaware of a list that you are a normal traveler but we want to know who you are related to. if you are traveling to countries that are not considered friendly to the united states, that will flag within then transportation security administration as well as the broader department of homeland security and they will track that. i'm not sure about the relatives aspect of that. guest host: how easily will jeh johnson's confirmation go? >> i think it will go well. there is further information about the benghazi attack. they are dissatisfied about the information. we heard senator mccain may place a hold on him and definitely. assuming that some accommodations can be made, jeh

johnson should go more quickly than the proposed deputy of dhs which is been sitting in limbo for quite a while. host: should that happen, what are you watching most intently when he takes the position? >> guest: i will be watching how he creates a leadership team. he does not have a lot of management experience or homeland security, i am looking to see who he will surround himself with. some 40% of the leadership positions at dhs are not filled. that is 18 out of 40 or something along those lines. he will need to surround himself with the team. he will meet counterterrorism experts. he will meet immigration experts. he will meet all the help he can get and i am looking to see who he will bring on board with them. host: thank you for being with us. will take a look at a rule that takes place next july where insurance companies have to treatment till illness

the same as physical illnesses and what that will mean for patients and the insurance companies. later on in the, discussion of relief efforts in the for lapine's. -- in the philippines. all weekend long on c-span two we are taking a focus on ann arbor, michigan. coming up at noon, all of our literary program in which we will feature a discussion of steven t mason, the first michigan governor and the youngest winner ever in u.s. history. >> mason was elected governor. he had already participated in helping to write michigan's 1st constitution. theconstitution called for superintendent of public instruction to oversee the schools. this had never been done in any state. in the union up to that time. that constitution called for a prohibition against slavery

which was pretty progressive at that time considering the civil war was still roughly her new -- lateown the road that was still roughly 30 years down the road. at by proposing the building of the ste sault marie locks. all those many years later, when michigan and detroit became known as the arsenal of democracy, michigan had mason to thank for that vision of building those locks which could then get those ships bringing all that iron ore and minerals down to the downstate steel mills where they could make the planes and the tanks and everything else to help defeat germany in world war ii. we had mason to thank for that. since 1998,ekend

booktv has brought you the top nonfiction authors including hannah rosen. >> women's identities are tied to their work in a way which we may not like or we may find disturbing and unnatural. it is in fact true. when i look at marissa mayer who was chosen to be the ceo of yahoo, when she was visibly pregnant and was asked how much maternity leave does she want to take and she said none. the fact that such women exist, it's not the way i would do that. i took plenty of maternity leave. growing -- that is a kind of woman there can be and the fact that there are some stay-at-home dates who are happy doing that and do not entirely live in portland, oregon, that is ok, too. >> we are the only national television network devoted exclusively to nonfiction books.

throughout the fall, we are marking 15 years of booktv on c- span two. >> "washington journal" continues. host: joining us now is ronald on national illness. good morning. guest: thank you for having me. host: when it comes to insurance companies, how do they typically treat mental illness? guest: is starkly, they have not cheated mental illness well at all. they have covered mental illness and substance abuse at levels far lower than other medical benefits if they covered it at all. there has been a number of insurance companies that have not covered mental health at all. the typical scenario is someone has the onset of an illness, maybe late teens, early 20s, and maybe they are covered on their family policy and their family finds out and are shocked that either there is no coverage of all or there is very limited coverage. that starts a cycle of years and

years of frankly suffering and misery and having to rely on the public mental health system which is grossly unfunded and inadequate. working and fighting since 1992 to try to get equity and fairness and parity in health insurance. starting in 1992 with some state , and which were limited then the first federal law in 1996 which was limited and then the wellstone domenici parity law in 2008 which is a comprehensive parity law. that was expended in the affordable care act to apply to all of the health plans available to people through the new health insurance exchanges. we have been waiting for five years for regulations to actually define what parity means and those regulations were just issued last week and we could not be happier. host: the law in 2008 was signed

by the president. what does it do? guest: it requires health insurance companies to cover mental illness and substance abuse disorders at the same levels as they cover medical surgical benefits. that applies to co-pays and deductibles. it up lies to -- it applies to what is covered. it applies to the criteria that insurance companies used to decide whether to approve or deny care. it applies to the information provided to people if, in fact, there is a decision to deny care. the onus is on insurance companies to tell them why. when that law passed in 2008, it only applied to health insurance that was available to people through employment. was only large employers, employers who had 50 or more employees. as i said, when the affordable care act pass, that was expanded

to all the plans available to people through the health insurance exchanges, not only -- that includes people who purchase their own plans, individuals who purchase insurance. most insurance in this country now is subject to these parity requirements. host: the law signed in 2008, we just received information about a law. when does it go into effect? guest: the regulations issued last week go into effect july 2014. this is where things in washington get confusing as many of your listeners and viewers now. rules thatnterim were issued a few years ago. those rules are currently in effect that the final rules create clarity about what is required and what is not. those final rules on the go into effect until july 1, 2014 so insurance companies have time to make adjustments and change

their policies accordingly. host: here are some of the details from this rule we are discussing. what does that last part maine? -- when you you are go into a hospital whether it is for a medical procedure, the treatment of heart disease, or the treatment of mental illness, insurance companies have criteria, medical necessity criteria, clinical criteria that they used to decide how many days they will cover and whether they will cover that inpatient treatment at all. it is the same with outpatient treatment.

historically, people with mental illness of oftentimes been denied care and the insurance company has said you don't need our clinical necessity criteria. it might be a psychiatric emergency so you have someone under emergency circumstances who may be at risk of suicide, for example, who was hospitalized in a day or two later, the insurance company says we will not cover you anymore. then the person is released and they still may be very symptomatic and that risk and yet they have no options available to them. now the insurance companies -- the onus will be the burden, if you will, speaking as a lawyer, will be on insurance companies to say why they are denying care , provide information about why they are denying care and allow people who appeal those decisions. it is leveling the playing field. it is not necessarily going to solve all the problem's in the mental-health system. . we have lots and lots of problems, lots of limits on access to care for people with mental illnesses. it is a huge step forward. it is symbolically a huge step

toward because, for the first time in this country, we are recognizing that mental illnesses like schizophrenia and bipolar disorder am a posttraumatic stress disorder experience by our veterans returning from war and substance abuse disorders are real medical conditions worthy and deserving of the same type of treatment as heart disease, cancer, and diabetes. we are talking about insurers having to treat mental health issues like physical illnesses. you heard about the new rules and we will talk about them and the numbers are on your screen. you can also use their twitter address and their e-mail. if i am an insurer come if someone is physically sick, there is a point when they are

not sick. i offer coverage but can you apply those same type of standards to mental illness when a person is affected and becomes not affected? i would think it becomes a longer process for the insurer than the average physical illness. guest: i don't think it is simplistic. that's a great question. mental illness like schizophrenia, bipolar disorder, major depression, posttraumatic etc, areorder, chronic conditions. it's not that you provide treatment and the conditions are cured. through timely and appropriate treatment, the conditions can be effectively, the symptoms can be reduced and recovery for people as possible. we have many people in our society with mental illnesses who live, work and live productive lives and function very productively in society and it is you not unique to mental illnesses. condition. a chronic

epilepsy is a chronic condition. multiple sclerosis is a chronic condition. heart disease is a chronic condition. you might have an acute emergency and require emergency treatment. maybe that emergency is alleviated but the person needs a chorus of rehabilitative care and follow-up care in order to stay healthy and that's true for mental illness as well. creating ally not burden on insurance companies, a new burden on them. they in fact already cover many illnesses that are chronic in nature. these are no different. host: the national institutes of mental health say about that he 5 million americans have some type of mental disorder. of those, 45% have two or more disorders. guest: that's correct. the economic ordinance of mental wellness -- the world health -- hasation has said classified depression and other

serious mental illnesses as among the most costly of all diseases. those costs are not only attributable to the cost of treatment but the cost of lost productivity. ,he tragedy is that many people if they get appropriate treatment, they can be very productive. they can recover. they don't get the treatment. like with any other illness, if you don't get the treatment you need, your symptoms and condition will worsen. the costs we pay in society like and otherctivity systems left respond to people who don't get timely mental health treatment like jails and prisons are full of people with serious mental illnesses who are not inherently criminal but they have symptoms -- in the case of schizophrenia, they have delusions -- if they are not treated, it can worsen and lead to contact with law enforcement. the amount of money we are spending in corrections, in our

emergency room's because people do not get care until the situations become emergencies, the amount of money we spend on homeless services -- it is something we cannot afford as a country. the solution lies in timely, early intervention. this law will be a major step forward in facilitating that. host: our first call is from fair lawn, new jersey, on our independent line. caller: good morning. i've heard a lot of talk about mental illness. i want to know why nobody is actually talking about the dangerous effects of the ssri drugs that people were given. how come everybody is having these -- is giving these same drug. everyone of these mass killings, these people have been on these dangerous drug grid how come nobody talks about the dangers of these extremely dangerous drugs? guest: that's not really documented that all the mass

killings are attributed to ssri. this law will help ensure that people get more than just medical treatment and medications will not always be the first resort for people. people made rehabilitative services, people make counseling, peer support has become an important part of her mental health treatment system. through the enactment of this law, we will see people having access to those kind of services. we will not rely just on medication. medications are in fact an important part of treatment for many people. yes,any other disease, there are side effects and you have to monitor the side effects doseske sure it those are that are appropriate and you don't necessarily keep people on medications on their entire life but medications are an important art of the continuum along with talk therapy and rehabilitative services. is from newmarket,

new hampshire, on our democrat line. caller: i want to thank tom for what he said. i have a situation and i would like to ask a few questions. i have a grandson who is being treated. he has been on 40 different medications in the past 10 years and diagnosed as schizophrenic. the only time i see signs of the schizophrenia are when he takes his medication. it's a massive shot at the beginning of the month. then he has all the side effects listed in their. it sounds like mental illness when you're taking the medication and if he comes down off it, he becomes himself. i have not seen him off medication in 10 years and neither have they so they don't really know what he is really like. all they know is what the medications have done to him. the medication put out as thousands of dollars. they might pay two dollars and medicaid pays for the rest. piggy he has been made

bank. he is not dangerous but i understand what tom said about these drugs being dangerous. he lives in a building of old people and mentally ill people, all of them are on $700 disability payments and cannot work because these medications interfere with your ability to be dependable. there is no therapy. he is allowed 15 minutes for a medicaid appointment and that's it. when he talks, nobody listens to him because he has a guardian. he is considered not able to express himself and not to have the brains to express himself. he is totally disregarded. host: we will let our guest answer. guest: you are describing a situation that sounds -- i'm not a psychiatrist so i will not try to second-guess any treatment -- it sounds like there may be needs to be a consultation. is, like with any other

disease, the diagnosis has to be appropriate. the treatment has to be appropriate. if someone is on medications and their symptoms are not updating or getting worse, that is a suggestion that that particular medication is not the right medication for them. let me address the side effects for a second. the antipsychotic medications and it sounds like that's what on, they do in fact have side effects for the older antipsychotic medications have neurological side effects. the newer medications don't have the neurological side effects but they can have metabolic side effects. or,it might have weight gain diabetes attached to it. it is not a reason for someone who has schizophrenia to not use antipsychotic medications. it is certainly a reason to monitor the person carefully, to evaluate what impact those medications are having on the person symptoms and watch carefully for side effects and

if there are, change the medication. what you and tom both talked about is that, historically, and in the last 20 years or so, psychiatric treatment has been limited to medications and 50 minute medication monitoring visits and that is important because of the limits that insurance companies private and public like medicaid have placed on what they will cover. with this law i am talking about -- we we are confident will have to work very hard, our work is just beginning -- we will have to work very hard to make sure that people get treatment for people and that involves more than medication. host: what will it look like? will it require several hours long? guest: it will vary from person to person. counseling can be very helpful to people. -- other people who

have been diagnosed and recovered and who can help guide the person in coping with their day-to-day challenges they face -- rehabilitative programs to help people regain some of the cognitive functioning that may have been affected by their treatment, by their illnesses and treatment -- inh schizophrenia particular, there are positive symptoms and negative symptoms. the positive symptoms are the ones were most of us are familiar -- delusions, hallucinations, people receiving something -- perceiving something that is not real. there are also negative symptoms like affect on memory and the ability to interact with others. historically, the the medical have been more effective in treating the process of symptoms and reducing the positive symptoms than they have the negative system -- symptoms. where a time where there is a

lot of attention being paid to therapies that focus on cognitive rehabilitation. host: why are they listed as a positive? guest: it is a term that psychiatry has used. those are the symptoms that are most obvious to people. the negative systems, the cognitive systems and others, are not as obvious to people but they are very disturbing to the individuals themselves who are aware they are having trouble functioning. they are aware they are having trouble interacting with others. it is a reason why people are hesitant to take medication. i keep bringing it back to the parity law. one factor that has impeded the evolution of effective treatment for schizophrenia and other serious mental illnesses has been the limits on what was covered. it has been just medication in

recent years. i don't want to give the message to anybody that medications are not part of treatment. they really are and there are many people whose lives have been saved through psychopharmacological treatments. psychopharmacological treatments on the medications come in and of themselves alone is not enough. host: this is john from orange, virginia, republican line. caller: good morning and thank you for your time and expertise. can you address the subsidization by the state and federal government to put our people and school students on ritalin? can you address the correlation with the mass shootings and the pharmacological drugs these people were on? guest: the ritalin issue, there has been some focus on adhd in recent years. the treatments for those disorders and some young people

are treated with ritalin and other medications that have been developed for those disorders. like every other disease, you have to diagnose accurately and, in some cases, prescribing those medications is appropriate and sometimes it is not. one will enhance clinical treatment and hopefully lead to better diagnoses and better treatment plans. let me talk about the mass killings. i want to start off i saying that if you look at rates of violence in this country and look at shootings generally were killings generally, there is very little correlation between mental illness and violence. there is some indication there peoplea small subset of who are at greater risk of if they, particularly are abusing drugs but most people with mental illnesses are not violent. most people with mental illnesses are more often the victims of violence than the perpetrators of violence. the mass tragedies --

these mass tragedies have gotten publicity with good reason. they are harvell. they shocked us. -- they are horrible and they shocked us. 80re have only been about since 1983 in this country, these mass tragedies that seem to have no rhyme or reason. they seem senseless on the victims are not known to the individual who perpetrate them. there appears, in some of these mass tragedies, appears to be a correlation with mental illness but sometimes we jump to conclusions without knowing all the factors. if we look at new town and we are coming up to the one-year anniversary of the sandy hook tragedy, we don't really know -- we still don't know that much about adam lanza. they say he was diagnosed with best burgers syndrome. we don't know if he was on -- aspbergers syndrome.

we don't know what kind of medication he was on leading up to the tragedy. there is not always a correlation. in the more recent case of the navy yard shooting in dc, there is some indication that the shooter may have been prescribed antidepressant medications at one point or another area it is not clear he was taking them at the time of the tragedy. we don't know what his diagnosis was buried there is some suggestion it may have been psychosis. if it so i know it's very easy to conclude but there's absolutely no documented evidence that makes cause violence. there's no -- to the extent that certain individuals may pose a risk of violence, medications can reduce that risk. and these claims that there's a correlation with ssri's or antipsychotics, they're made by individuals who really proffer

very little evidence. >> a viewer asked about how many of the mentally ill are product of learned behavioral issues rather than deevet? it's a nurture versus nature question. guest: there's no doubt. first of all, it depends on how you define mental illness. but what scientists will tell you -- then again science is evolving -- the brain is a very complex organ. while we're starting to learn a lot more about brain disorders like parkinson's disease, like traumatic brain injuries, like stroke, and schizophrenia, the fact is that we have not identified biomarkers for those conditions or diseases like we have for some other medical disorders of the body that affect the body. the brain is the most complex organ in the body. any scientists will tell you that. so there's a lot of work being done on understanding genetic factors, there's a lot of being

done on understanding biomolecular factors. but there's a long way to go. what causes, for example, schizophrenia? is a biological? is it environmental? well, the leading scientists, the leading experts will tell you that there are biological disorders in that the biochemistry of the brain is impacted. but that environment can certainly be a triggering or exacerbating factor. so if you have someone who maybe is genetically predisposed to schizophrenia or another serious mental illness and the person is in a very stressful situation, maybe they're a young person who is in the military, maybe they're a young person who is dealing with very stressful academic environment, those can be triggering factors. and let me mention another

factor that there has been a lag time in this country -- more and more evidence that the symptoms of these mental illnesses develop much earlier than we used to think. it was always thought it develops late teens, early 20s but in about half of them the symptoms emerge by age 14. the diagnosis may not occur until ten years later. somebody may be showing warning signs but not receiving any accurate diagnosis or treatment. so the science is still evolving. it doesn't mean that these aren't real disorders. they are real. actually, if you talk to experts on other medical disorders they'll also tell you that the science in those areas is evolving. host: our guest, the policy and legal affairs national director, nami.org. a little about the organization. guest: we are the largest advocacy organization for people living with mental

illness in the country. we are created in the 1970s. it was a grassroots movement. primarily of families at the time. families of people who had been diagnosed with serious mental illness who found the system . s not very helpful so our office was created in 1979. we have 1100 affiliates around the country. we have chapters in every state. many, many local affiliates. we do advocacy, education, and support. so we have a number of educational programs for people designed to try to help them. educational programs for peers. so people with mental illnesses themselves, we have a program called peer to peer which is very helpful. for families we have a program called family to family. in virtually every community or in most communities, large

communities certainly, we have support groups available to people. and we have a website and i would like to encourage people to find out more about nami or may be impacted in some way by mental illness to go to our website or to call our help line. we have a 1-800 help line in which we get tens of thousands of calls, frankly hundreds of thousands of calls and nquiries a year. that is a way for you to find out about local groups in your area and where you can go for help. host: there's the website you just saw. good morning. caller: i would like to know about how title 3 affects this issue. title 3 guarantees people with disabilities access to goods and services in the private sector.

you would think that would impact this issue of health insurance and care in the private sector. i don't understand why it doesn't address this issue. guest: that's a really great question. in fact, after the americans with disabilities act passed, many of us including me -- i was already working for nami at that point -- title 3 might give us an opportunity to try to combat some of the discrimination that occurs in health insurance and in long-term disability insurance and other benefits of employment. unfortunately, the ada was drafted somewhat ambiguously when it comes to insurance. the americans with disabilities act is a landmark civil rights law. it has helped millions of people with disabilities in this country including people with mental illnesses. there were some political deals that had to be made to get the law passed. the law was passed and signed

into law by the first president bush, very much a product of strong republican supported. one of the deals that had to be made was to not include coverage of the benefits of employment. so we actually bought brought a number of cases shortly after the ada was passed to try to challenge these limits and unfortunately we lost most of them. host: atlanta, georgia. caller: the reason i called is because a lot of people are talking about the issues that i know something about. i was a son with asperger's and adahd. -- my son has been arrested. they all come from video games. he was playing grand theft auto and stole his mother's car and almost killed a boy. he was playing a video game.

an hour later, he nearly killed two people behind him. and the boy beside him he ran off the road, had a head-on collision with the car coming the other wafmente my son ended up for a year in prison with vehicle homicide. he got out of jail. we sat down and talked. i asked him if the video game was a problem. he said if they don't do something about the violent video games, the problems are never going to end. he told me when he was sitting in jail he couldn't understand why people kept denying that to be the problem. host: there's a viewer who adds ff of twitter. guest: yes. let me say i'm not an expert on the correlation between video games and violence generally in this country. i've certainly been appalled by some of the video games that are depicted in tv commercials,

like i think most responsible adults are. but i have to tell you that i have heard that video games in and of themselves don't cause violence or criminal behavior on the part of people who most -- most people. so video games may have been -- they were certainly discussed in the context of the sandy hook tragedy. so there may have been a multiplicity of factors. a oung man who clearly had history of autism spectrum disorder, asperger's syndrome, which can impact on judgment particularly if the person is not receiving appropriate therapies. and the person -- from all reports, the individual being very isolated, not being plugged into any treatment, not having any sort of support system, not having much hope in

his life. he had tried college but had not succeeded, had dropped out was living in an isolated situation reportedly without any friend. maybe if you add video games to that mix it may be a factor. but video games in and of themselves, while i think we should have a national debate about whether some of those violence and or racially charged video games should be permitted, i certainly as a parent think that, they do not -- there's no -- i've not seen any evidence that they in and of themselves cause these violent acts. >> the rules that go into effect next july, do people with individual plans fall under these rules as well? guest: yes. through the health insurance exchanges. many of the people who are going to be purchasing insurance through the affordable care act. host: does the act super seed what's done by the law that goes in next jill or complement each other? guest: it reinforces it. it expands it.

when the parity law, the paul we willstone-petedom inchi act, passed, it adplid only to insurance that was available if you were employed and your employer hired 50 or more people. so large employers in this country. that's a significant number of covered lives in this country. but when the affordable care act passed, congress expanded parity and includes in the expanded and applies, the requirement, to all plans purchased through the health insurance exchanges. and also, to all medicaid, all managed care plans through medicaid. there are going to be a number of people with meltsdz -- mental illnesses added in the 26 years and the district of columbia that are actually expanding their make programs. let me make one more point. the affordable care act

included an additional very, very important provision related to mental helts and substance abuse. there are 10 essential health benefits listed in the law that insurance companies are required to cover. one of those is mental health and substance abuse disorders. so the law says number one health insurance plans have to provide mental health and substance abuse coverage. number two that coverage has to be on par, equal, of that with medical surgical benefits. host: william from ohio, independent line. good morning. caller: good morning. i was watching tv and your program really inspired me. i'm kind of ill here. i take a lot of pills and everything but i see anybody on the west coast, they get marijuana and everything and

all these things. but we don't have it here. what is good for them is good for us. isn't it? and i just -- it baffles me that these people can play with us like that and we're not getting -- you know -- our fair share of things that in life for everybody. guest: i'm really not equipped to talk or debate the benefits or lack thereof of medical marijuana laws. there's been some discussion about marijuana and what impact it might have on mental illness. and i think that science is still evolving. there's some early suggestion that marijuana may -- for people who have a predisposition for schizophrenia -- so not for everybody. but if somebody has a predisposition for schizophrenia, that marijuana may in fact trigger the onset

of symptoms. there's no evidence whatsoever that marijuana worsens the symptoms, worsens the hallucinations, delusions. we also know that the rates of cooccurring mental illness and substance abuse disorder are very high. that significant numbers of people with mental illnesses use illegal drugs or alcohol. why is that? well, because almost as a form of self-medication. people may not have access to psychiatric medications and may in fact be using -- smoking pot, smoking marijuana, drinking alcohol, or whatever as a form of self-medication. to sort of quiet the voices. so again, the science is really evolving in this area. i think we have a long way to go to really understand or determine if in fact there is any sort of relationship. host: new mexico where james

joins us from. on our republican line. good morning. caller: good morning. i'm calling to follow up on the last caller's suggestion as per medical marijuana. there's such a high demand for it that we're now in short synthetic g -- marijuana doing more damage than the real plant. now, marijuana is less damaging than the pharmaceuticals that are there today. and more available to the poor. host: our guest addressed that. let's move on to texas. caller: good morning. i'm retired director and i have a son that just got his phd and ote a paper that showed that mental illness, looking at the

mri's, they were actually able to see the deformat in the frontal lobes in lots of schizophrenic and bipolar people, actually see the damage in the brain. so it's not a myth. and also, living in texases bothers me a lot is that texas tends to put the mentally ill into prisons like you talked about earlier and costs more to put them in prison than to give them the proper medical help. guest: that's absolutely correct. thank you for your call. that's very important information. first of all, some of the scanning technologies used for research in fact do show profound differences in the frontal lobes of people with schizophrenia. and people without. for the most part, historically -- again, i'm getting into some territory i'm not a real expert on. but in the past, research used

to be limited to post mort m brains but now with some of the scanning technologies they can look at the brains of living individuals. for example, identical twins, one who has and one who doesn't have schizophrenia. and the differences are pretty profound. the caller is absolutely right. some people -- we have certainly some who suggest that mental illnesses are not real. anyone who has experienced a mental illness, anyone who has lived with a mental illness would never say that. and anyone who has really studied this objectively in a scientific way would never say that. now, with regard to what we call tragically the criminalization of people with mental illness, the price we pay, as society, is staggering. people with mental illnesses -- and again it's usually because people don't have access to treatment and they certainly don't have access to treatment until their situations become emergencies.

so in other words, there's preventive care, early identification and intervention is in short supply. and oftentimes continuity of care is nonexistent. so a personal literally in many parts of the country, you have to wait until a person is deemed to be dangerous before there can be any sort of intervention and oftentimes .hat is through involuntary and jails and prisons are absolutely the worst possible place you can put someone with a mental illness. their environments, even though many of our correctional systems try very hard to provide treatment, the sheriff from chicago has been outspoken in his concerns about the numbers of people, the amount of money his system has to spend on people who should be treated by the mental health system. but many simses are ill equipped to address the needs and respond to people who are

experiencing psychiatric systems by putting them in solitary confinement. which for someone who is hearing voices and putting them in solitary confibement is akin to torture. host: you said the public health system may not be adequate to cover these kind of illnesses as well. guest: we started out at the beginning of the recession, 2007 and 2008, mental health services were already already in short supply. in many parts of the country. we have cut 4. billion from the public mental health system. not even talking about medicaid. talking about state mental health dollars. so we know that only about 40% of all people with serious mental illnesses are in this country have access to any treatment at all. because many of those individuals have not had access to coverage through insurance,

have not had -- and if they had insurance, the insurance was inadequate -- that they had to rely on the public system. if you go to any community health system you'll encounter long waiting lists and oftentimes the criteria is that only the most severe cases will be treated. so if you have schizophrenia but you're relatively stable but you know you need to be in services and support, you're oftentimes unlikely to get those until you detier yorrafmente now, think about how many people would be having heart attacks, dies of heart attacks in this country if we had a system that required people to be having severe chest pains before we provided them with any treatment. host: ronald hanberg, the policy and legal affairs national director. thanks for your time. guest: thank you. host: the united states has pledged $20 million to help relief efforts in the philippines after the incident there.

our next guest is going to talk about that and other international efforts to help out.

host: joining us now is sharon waxman with the international rescue committee, the public policy and advocacy vice president. good morning. guest: thank you. host: what's your organization and tell us a little bit about it. guest: the international rescue committee is one of the oldest humanitarian and relief

organization. our roots are back in europe in the 30's and 40's and today we operate globally in 40 countries overseas, providing rescue relief and life-saving care. and we also operate domestically. we do refugee resettlement here in the united states in 20 offices across the country. host: the reason we asked you on is because of relief efforts going on following the hurricane -- the typhoon. plenty of photos in the paper this morning. what's important to know about people interested in offering help? what's most important for them to know? guest: the most important thing for people to know is that organizations like the international rescue committee are on the ground in the philippines doing assessments, trying to assess what the greatest needs are of the people whose lives have been completely de stated. they have had their homes and

communities destroyed. the most important thing people can do is give cash to relief organizations like ours really gives our aid workers the ability to have flexibility on the ground and respond in real time. host: as far as the donations, how much is used for administration purpose and how much is used for direct relief? guest: all of this information is on our website. and in our case, more than 90 cents on every dollar that someone donates goes to programs and services. very, very low administrative costs. host: for the actual dollars donated, what happens on the other end. give us some examples of what's done and how do you best help? guest: in the case of the philippines specifically, we have teams on the ground. we're going to be operational with programs this week. we've done assessments on the ground talking to people, talking to communities that have been devastated. and identified three areas for

great need. one is in clean water. and sanitation and high jean. water systems are enormously contaminated, the water table levels are still very high and it's very difficult for people to get clean water. so we're going to start by bringing communities -- we're going to be working in the west of the country in clean water. the second area we're going to be working with is health systems. hospitals and clinics have been destroyed. and we need to be on the ground working. importantly with the fill pino people to help rebuild their hospitals and get their health care systems up and running again. the third area is livelihoods, to help people get cash into pocket, give them cash for work programs so that they can begin to rebuild their communities with -- and earn an income at the same time. host: we're talking about international relief efforts in the fill pins. our guest, the international

rescue committee. if you want to ask questions, you can do so. the numbers are on the bottom f your screen. it seems like a lot of organizations like yours there at the same time. how do you work with each other and not against each other in a sense? guest: that's a really great question. the organizations on the ground -- we learned a lot from haiti and other disasters. the organizations on the ground really understand that the purpose of our being in the country is to really help the people and that the imperative of coordination is greater than ever. so we have a coordination system on the ground. the international rescue committee's teams in the philippines are in constant contact with our sister organizations as we call them. we have phone calls every 48 hours to determine who is doing what, where the greatest need is, so that we have our services that are complementry and that we're working together

rather than against each other. one area that the international rescue committee is working in is an area in the western part of the country along the path of the storm where there are not a lot of other organizations. we made a decision that given the enormous devastation, we were going to move west where communities had a lot of damage, a lot of destruction, but didn't have as much service. so we're operating in those areas. host: the u.n. has pledged $25 million relief effort, the united states about $20 million, britain $16 million and australia $9.4 million. what do you think about the u.s. contribution? >> i think that the pledge of $300 million really speaks to the tragedy and the need for the international community to respond. i think a lot of countries have been enormously generous so far. but the reality is that the devastation and destruction is

so great that the resources committed to date really are not going to be sufficient to meet the growing need. host: when you're on a scene like that, do you work under -- is it the government that's basically dictates how much efforts you and other organizations will have and how much impact you can have? guest: we do work very closely with the government. the fill pino government their country is a sovereign nation and the tragedy is just enormous. they have the presence on the ground, they have police, they have military. and their ministries are deeply involved in helping determine where the greatest needs are and how the relief effort will unfold. there are also other international players. the u.n. system has kicked in. the u.n. ocha is in the lead. but the goal as stated is to really support the fin pino's in their recovery. so my organization, we work in communities with the fill

pinos. we talk to them. we want to know what their needs are, how they want to rebuild the communities and their lives. ultimately we want to create the capacity for them to be on an upward trajectory and maintain their lives and move forward in a productive way. what we don't want to do is create a dependssy on assistance in the long run. we will stay as long as we're needed and we will continue to support fill pino efforts. host: does the government say you can work in these areas, not these areas? i'm trying to get a sense of how you work together. guest: i don't want to get bogged down in bureaucracy but there is what is called a cluster system where they take sectors in health, water, sanitation, food, and it's divided up. and the needs are identified and people work against those sectors. in the country. and then regionly people will be operating in particular areas of the country. so again, for the international

rescue committees, perspective, we're working in an area of the country that is enormously underserved by other international ngo's and in sectors that the fill pinos call for you is surely from texas. you are on with sharon waxman. good morning. caller: good morning to you. -- my concern is -- we are so concerned about being politically correct. these people are without food, water, electricity. we have waited all this time. i was looking at this woman on tv. it is 10 or 15 days later. these people are in dire need. tocannot lend a helping hand someone who supports the united states, but we can spend

billions for iran, syria, and libya. i do not get it. not with these -- our concern is not with these poor people that have a dire need. we cannot do anything about it because it is a natural disaster. what is going on and why can't we respond like human beings with honesty and integrity? guest: thank you for the question. i appreciate the sentiment of the caller. the needs are enormous. people's lives have been completely upended. the death toll continues to mount. the number of people who have been affected by this tragedy is up on most 12 million. there are almost a million people inside of the philippines who have been displaced. are have no homes and they living in tents and shelters. in terms of the response, individual people can

participate in the recovery. many, many private organizations like the international rescue committee that are on the ground, operating. individuals can make contributions to organizations like these. in terms of the international response, the u.n. systems have kicked in. the u.s. government is providing assistance. the british government is providing assistance. the japanese government is providing assistance. there are a lot of countries that are stepping up to the plate and stepping in because this is an enormous tragedy. i agree with you that the international community has enormous role to play. so does the individual citizen. host: mike is from dillon, montana. would like to ask a question about the geography of the country. the rescue committee my rented -- run into some problems. islamic rebels in the

country. will that be a problem? thet: thank you for question. security is always a concern for the international rescue committee, wherever we operate. our understanding is that there is a cease-fire. we do work in very challenging environments across the globe. a couple of weeks ago, we saw that in africa. we watched the staff operate in pretty tough environments. go into a is community and engage with the local population. we make sure that they understand who we are and why we are there. this helps to address the broader security concerns. you are absolutely right. security is no norm is challenge everywhere. a way to do this and operate and complicated environments very well. host: from 2009 to 2012, you're

the deputy to the state department. these, what is the state department role? guest: at times like these, the government kicks into action. itesponse very quickly -- responds very quickly. i have not talked to my former colleagues, but i do know that in a situation like this they will have a working group with white house representation and state department representation. the pentagon will be involved. it will be an all hands coordinated effort to bring the to thees and brain power problem. host: coming up next, gary in cleveland. republican line. caller: i am sure you are aware of the people in the path of the typhoon -- the ones that were

tip,er south, toward the they are without water. there has been a lot of migration to the smaller towns. it has caused disruptions. the military is out in force and is trying to keep things in hand. away fromese towns the path of the typhoon are affected and should probably the attended to in some course. that is all i have to say. guest: thank you for the observation. i think what they are underscoring is the widescale devotees -- devastation and destruction of the storm. almost 12 million people have been affected by the storm. that is only directly.

that does not speak to people who have relatives who do not know what their status is. drinking water is contaminated. health clinics are down. roads are covered with debris. you are absolutely right. -- and all to hold hands on deck effort. the needs are enormous. the opportunity to make a for thece really exist international community and also for individual donors to chime in and send assistance to the victims of the hurricane. host: a photo in the washington post this morning talks about relief goods being dropped. talk about the logistics involved in bringing relief supplies to the country. the logistics are extremely complicated. for a while, they are ports were closed. fuel was short and trucks could not move on the roads. it is an island. that brings a whole new set of challenges.

crisis -- as we get further from the crisis, the roads are beginning to clear. the airports are beginning to open up again. we are beginning to see a greater ability and an enhanced capacity to deliver services. you are absolutely right. it is incredibly challenging. there are a lot of countries that are sending helicopter support to targeted areas. it is an enormous challenge. host: are the supplies brought from the united states or are they purchased closer to the country? guest: it depends. it is always preferable to purchase in country because it is faster and cleaner and good to support the local economy. you do not want to have a disruptive effect. we will be working first in the water sector with water filtration systems to help people to have safe, clean water. if you do not have water, you do not have life.

from alice joins us pittsburgh, pennsylvania. democrats line. caller: as a follow-up to one of the last collars -- it would seem that these people should be migrated off of this devastated area. a big effort made to clean it up and restructure the basic needs of life. people should have an emergency evacuations. isthink that that area geographically large enough that those areas that have not been affected should be supported and be able to consume a lot of those families and keep them together, but also give them safety. guest: thank you for the question. ise in the immediate effort to provide life-saving health care services to people.

harmedve been physically in the hurricane. the u.n.nt policy with and the government of the philippines is what they call shelter in place. it gives people a place to stay near their home. ultimately, we always try to work with those filipinos and citizens in countries where disasters have stricken to meet the needs of the multiple marvel. often, in a situation like this, you will see women, children and the elderly at a greater former ability than the rest of the population. we are always sensitive to meeting the needs of the vulnerable first. houston, texas on the independent line. good morning. caller: good morning. host: go ahead please. caller: hello. my question is about these

people. under ordinary circumstances, what do these people generally do for a livelihood? guest: i think it probably depends on the area. there is a lot of agriculture in the area. the relief effort will be aimed at kickstarting livelihoods to help people get back to their jobs and their lives and rebuild their future. host: a picture this morning from the new york times. hospital thereal after the devastation. medical supplies -- is that part of your organization's work? be -- we are going to there are organizations that will be working to deliver medical supplies. the international rescue committee will be working to revitalize health clinics and

hospitals. that is part of a continuum. how does this occur after the initial shock happens? to help out an country with assistance? of the areass one that the international rescue committee is very committed to. we come in, obviously, when there is a crisis and we are asked to help. we also stay for the duration and beyond if needed. one thing that our staff do on the ground is really talk to the people in crisis affected areas and talk to them about what their needs are. we develop lands and programs with them that address their needs and whether they can rebuild their lives and move forward on an upward trajectory. eventually, we can leave and they are not dependent. the program can develop now to be sustainable and increase their capacity. host: your experience with

international partners will also play a role? we have seen this on the dollars that are given. guest: it depends on the organization and the philosophy. i can speak for the international rescue committee. we're there to help people from harm to home. host: i'm speaking for the other countries involved in the effort. guest: i think everyone schools to help people recover. yes. paris --next is birmingham, alabama. caller: i just wanted to say that everyone -- the morning. -- good morning. everyone that is making an effort to help these people should be commended. disastern we had the of hurricane katrina, i think that we as a country need to be able to respond better than we did before. everyone that is making any type of effort, whatever money

donation,, -- or should be commended. guest: think you. i agree that we need to be able to, as an international community, be prepared to respond when these disasters hit. with climate change and changing conditions across the globe, we will see more of these natural disasters. we saw it in haiti and we saw it in indonesia. we're seeing it now in the philippines. these needs are great. some of the planning should come in before the disaster hits with building resilient structures and preparing for disasters. the government of the philippines did that in this case. but the color is right. there will be more disasters and we need to be prepared to respond. host: how many representatives you have in the philippines currently? guest: we have a team of 11

people on the ground. we will be ramping up our programs to be operational. we have a core of emergency responders -- about 50 of them. they are on our staff and their job is to be prepared to respond to emergencies, wherever and whenever they occur. they have 72 hour notice. when a disaster hits, they get the call. within 72 hours, they are on the ground to figure out where the needs are the greatest in which populations are underserved. they are experts in all areas. in health care, and water, and protection of women and children . it is a very targeted approach. it is quick and agile. host: where do you get your funding? guest: we get a mix of funding. we get funding from private donors.

the unitedt from states government, from european governments, from the u.n. systems. we are part of the international rescue committee. one is our funding stream. the other is our presence. we are in 40 countries around the world. our staff is international. we have a lot of local hires and we operate globally. joining us ist sharon waxman, she is with the international rescue committee. she is their vice president. ue.org is their website. the wall street journal this morning has a photo. helicopter crewmembers are delivering supplies as part of relief efforts in the philippines. joining us on the phone, talk about the military role -- it is

jim michaels with usa today. he is their military reporter. thank you for joining us. could you sketch out the u.s. government role when it comes to the military relief efforts in the philippines? caller: it is a fairly robust military response. it is meant -- more than doubled in size. the carrier uss washington and a couple of its escort ships are on station there. helicopters and the ability to make freshwater. in about five days or so, additional marines will come in as part of the 51st marine unit. that will include amphibious ships and a lot of engineering assets aboard the ships. they are in route. it is a fairly significant effort. host: when they get to their

destination, what kind of jobs of and often? caller: a lot of different things. they have already moved 100,000 pounds of relief supplies into the country. we have flown in 480 flight hours. we have over 1000 relief effort cash workers. peopleternally displaced have been moved to safer parts of the country. we do a lot of stuff. the engineers that we bring and will clear roads and increase access into remote areas. too -- an early part of a catastrophe like this is mobility. -- they bringelp in the ability to move stuff and people quickly. it is really key. host: tell us a little bit about

how the u.s. government coordinates with the filipino government to make sure what they're doing is affected. especially in the early days -- it is never perfectly smooth. i have covered a number of these things. no matter how much planning you do, the u.s. military does a lot of planning, you are dealing and sovereignty issues national sensitivities and so forth. it is always difficult. there is nothing that the u.s. military does that is without or independent of the filipino government. they have a request where they have to coordinate through them. that does take time. to answer your question, everything goes through the philippine government. they have to request it and approve it. host: how do they work alongside

international partners as well? who makes sure that things are done as efficiently as possible? caller: they have set up task forces. the military often trains for this kind of stuff all the time. they are always working with civilian partners. groups and soal forth. they have already set up a ,ommand center to oversee this headed by a three-star general. they will be working in coordination with ngos, host department,state international partners -- again, it is a very complex symphony and does not always run absolutely smoothly. host: is there an estimation of how long forces will stay? caller: not really.

this contingent of marines is en route. they will not get there for another four or five days. cost estimates coming out of the pentagon alone are looking like $20 million at this point. it is hard to say. it is very early. we are assessing the needs. there is certainly no estimate that the pentagon has placed on this. it is too early to say how long it will be. host: is there anything else you want to add for our viewers about the situation? well, one of the things that i find interesting is that there is no permanent basis. we have a huge presence there since the early 1990s. the philippines has asked the united states to leave. they have withdrawn. only recently, we have been in talks with the filipino government to increase our

presence. it has been a bit of the difficulty, since there are no permanent aces there. there.s but the u.s. has kept strong ties with the filipino military. the government relationship has been up and down over the years. it has always been very strong between the two militaries. i think that has really helped out in this case. you can go in, they know each other and have worked with each other, they respect each other. that helps to smooth things out very much in these early days. jim michaels, military reporter and former marine himself. thank you for your time. ms. waxman, any takeaway? guest: i just wanted to build on that conversation and point out that within the civilian side of the response, there is a piece

of civilian and military coronation. forugh the agency international development, there is staff working directly with the military. they are addressing the issue that you .2, which is coronation. yesterday on a call with the agency for international development. on theeagues nongovernmental side have talked about the coordination between the ngos and the military. those conversations are happening all the time. everyone shares the objective of making sure that the effort is toward mated and that the assistance is meeting the people with the greatest needs. host: next call, new york. republican mine. -- line. caller: good morning. i am very satisfied hearing the response from mr. michaels. the sinking of

ships off the shore could take some of these people who have been devastated. take them away for a short amount of time so they can clear the land. illnesseck them out for and give them proper hydration and food. that has all been taken care of. i wondered how that would be extended to that area. -- our own people? guest: i cannot speak for the military, but i do know that they are sending in doctors to help provide some relief to the people on the ground. for our part at the international rescue committee, we are sensitive and focused on addressing health care issues. we will be working in the western part of the country on

health care systems and getting clinics back up and operating. we're getting hospitals operational, specifically for the reasons you said. people are hurting and they need help. i agree with you. host: you mentioned haiti before. were lessonsthere learned from the haiti disaster? guest: there are a lot of lessons learned. we are a lot smarter and more efficient. one area we learned from is that we need to be better coordinated. present a range of complex issues, from security to debris cluttering the road. the international community has a greater appreciation. the international rescue committee has an appreciation for the need to work quickly, but not fully, with the local partners -- but thoughtfully with the local partners.

maybe it takes us a half a day or longer, but we do the proper assessment and have the proper conversations so that our in water, health, or livelihoods will kickstart the economy -- so that those interventions are thoughtful and make sense for the people of the philippines based on what the people are telling us they need. host: here is evelyn from maryland. republicans line. one thing i greatly appreciate is the effort with international stuff. i am responding to the previous caller from texas, in reference population before the catastrophe happened. for one thing, the philippines

is actually divided into three major geographical areas. where the catastrophe happened, it is in one region -- you can see that it is in the root strategic central region of the country. before this happened, it was very much into fishing, shipping textile -- all of those things. it was centrally located. collaboration.of people weree why actually active in the economy and all of these things. most of them generally worked and were able to provide for themselves. host: we're almost out of time.

you have a question? caller: my question is, i am hoping that there will be accountability between the government and the relief effort and all these things. just like in any other government, there may be some corruption underlying these efforts too. you for the clarification and helpful explanation of the economy of the area. to answer your question, we're working with the filipino people. we are in contact with government ministries and our accountability as to the people that we are trying to serve. you mentioned a lot of jobs and livelihoods that were destroyed. part of the international rescue committee's effort in the longer term will be to help people rebuild their lives. ofwant to give some sort cash for work programs so people can get back to work and we can

jumpstart the economy. we have hopes that those areas that you eloquently identified will be rebuilt in the long run. host: our guest is sharon waxman. . thanksite is rescue.org you for your time. for tomorrow's program, we will have a did eight with two people who write on political things for blogs. and michael warren will talk about president obama's announcement that he will encourage companies to offer their companies health care plans. we will have policy talks about iran and the international community and the nuclear program at 8:45. and the john f. kennedy library foundation will talk about the life and legacy of jfk.

all of that, the papers, and your phone calls, starting at 7:00. we will see you then. [captioning performed by the national captioning institute] [captions copyright national cable satellite corp. 2013] span, theon c- congressional budget office will testify on the 2014 federal budget. this will be followed by the confirmation hearing for jeh johnson. president obama's head of homeland security. bill thatearing on a would require full disclosure and the surveillance program. >> now, part -- congressional budget office testifies on the budget. he appears before the house and

budgets committee office. it is part of the agreement that ended last month shut down. this is just under two hours.