-- knowledge of the realities of workplace discrimination showed how blinkered the contrary rule was. i thought how professors can harass their secretaries, even though they have no formal power to fire them. justice ginsburg illustrated through a series of cases just how often that kind of harassment can occur. and so how much workplace discrimination the majorities rule would allow. but in this decent too what is perhaps most notable is its closing. as in ledbetters justice ginsburg called on congress to intervene to correct the wayward interpretation of title seven, in which a court adopted

interpretations of it that congress later had to reject and correct. the passage seems a bit wearied as if to say haven't we been through all this before? but it also has the sound of a boxer jumping back into the ring for another round. others who fought so long and hard might have grown frustrated for disappointments a fight equality entails. but as anyone who knows her can tell you, as the trainer whom we share as justice ginsburg told you often tells me justice indefatigible. justice ginsburg would have been a giant of the law even if he would have never been a justice. the same is true of her although

she has brilliantly extended those contributions as a judge. more than any other individual ruth bader ginsburg is responsible for eliminating sex discrimination from american law. how has she done it? one of the constants of justice ginsburg style extending from the brief in 1971 to the advance decent in 2013 has been a keen attention to the realities of gender discrimination. partly no doubt this comes from personal experience, the doors that shut on her when she graduated, the paid discrimination as rutgers. it also must come from her many years from listening to and fighting for other women who suffered from even greater discrimination. as a it will gator she used this owledge to rebut every dated

rationalization to refute gender discrimination. and she relied on it to give the court a full understanding of the justices she was seeking to correct. as a justice too, she cons at that particular timely returns to the realities of discrimination to show how to correctly apply anti-discrimination principles. another equally important feature of justice ginsburg's approach has been her sensitivity to the role of courts in our democracy. now, that may seem paradoxical for a person who led a law reform movement. but it was and is a crucial part of her thinking. at her harvard conversation, she told me and i'm quoting her words, the courts are reactive institutions. they are not out in the vanguard of any social movement. ile they can put their imprimteter on the side of change they cannot lead it. her work as a justice has

reflected her understanding of this delegate balance. as lawyer, she urged and sometimes shamed the court to catch up with the events occurring outside its doors. but she also recognized that change could not come all at once. she chose her clients, her cases and her targets with exquisite care to avoid pushing the court too far, too fast. and much the same way as a justice, she has often been a tempermental conservative who prefers the gradual common law approach to the sweeping rule or understand necessary holding. she has been critical of certain wade ost notably roe v. for having voted to expansively and too quickly. but she also recognizes that when the time is right, courts can play an important role in ratifying society's progress and

a well placed decent can become an important spur to justice. and there's a third piece of the ginsburg style, one that has become especially impressive to me since i joined the court and that is simple mastery of legal craft. that appears in the appellant brief she wrote as a lawyer which are models of precision and power. and so too her opinions reflect this great apparently inborn gift. each opinion is crist lean, exact and elegant. every word is carefully chosen and perfectly apt. every sentence well considered. every argument organized coherent and to the point. you're never afraid that a stray word or thought may cause some unforeseen bad consequence down the road.

of all the justices, justice ginsburg drafts her opinions the most quickly. yet, when i read them i'm always struck how error-free and polished they are. we have a practice of inviting others to comment on our opinions and ask for changes. i almost never have anything to say about justice ginsburg. they are ready to be published the moment they are circulated. she's a judge's judge. and every time i read one of her opinions, i feel as though i learn how to do my job a little better. justice ginsburg has also taught me something more personal being a member of an institution like the supreme court isn't always easy. we disagree about a lot of things of great import, matters on which we all feel deeply. it's a commercial part of the job not to take those disagreements personally.

partly that's because there's always another case and if we're to remain open to persuasion and also able to persuade others. we need to stay on good terms. but partly it's because the court is an important institution, an institution that the country needs to work and it's just not going to function well if its members aren't able to cooperate. no one performs that difficulty better than justice ginsburg. she knows about what the law requires and what the law demands. but she's also a model of respect and collegiality with every member of the court. she mansion to be universally admired and beloved by me, by justice scalia, by everyone in between. [laughter] without sacrificing and iota of her principles or convictions.

she told me once that her secret comes in part from something her mother-in-law told her back when she and marty were young. what's the secret to a successful marriage she asked? sometimes her mother-in-law says, it pays to be a little deaf. sometimes it pays to be a little deaf around the court too. [laughter] and justice ginsburg knows just when to do that. i've seen justice ginsburg maintain those values of collegiality even when it's toughest. our tradition at the court and it's usually a lovely, lovely tradition. is to have lunch together after the conferences in which we discuss and vote on cases. the rule at those lunches is no more court talk just friendly conversation about sports and movies and music and things like that. now without giving any

specifics, i can tell you that i once left a difficult conference, maybe the most difficult since i joined the court. and i found it almost impossible to imagine going to lunch with my colleagues. [laughter] we had just had a very serious disagreement about a very tough issue. and i wasn't so inclined to immediately switch that off and chat about the movies. i told justice ginsburg that i didn't think i would go. she was understanding but quite firm. you have to go she said. you have to act as though nothing has just happened. her temperament, her maturity and judgment, her calmness and wisdom helped make the courts the institution it is. and of course, when the nore tores you r.b.g. tells you to go to lunch, you go.

-- nor tores you r.b.g. tells you to go to lunch, you go. and so i went. one last story. one this one coming from one of my clerks. a few months ago the court held a seminar of sorts for women in he law for the women law law clerks. they dealt with gender discrimination, issues that are still present but unimageably different than in justice insburg law of age when it was fanciful. justice ginsburg surprised everyone by walking into the room by asking questions. as soon as she entered, one of my law clerks told me, all of these young women stood up and applauded. it was like seeing a legend walk in the door, my law clerk said. i know that i'm her colleague and not one of her army of 20-something groupies.

[laughter] but every day i feel much the same way when i see justice ginsburg walk down the halls, think i'm seeing an era. she has done a lot in the last 40 years to make america an equal and just society. it's an honor to sit on the same bench with her knowing how much she's contributed to my life and much more importantly to the lives of women around the world. thank you, justice ginsburg. [applause]

>> thank you, everyone. that was wonderful. so i -- i think, i hope we have time for just a few questions. and i believe that it will be permissible to pose questions to either of the two justices if that's ok with them. the crowd in the room and the technology lnology in the room is such that if you do have a question, i'm going to ask you to raise your hand, to stand up and to ask your question as loudly and clearly as possible if -- if necessary i will rephrase or rearticulate the question. and again, we have limited time. it's getting late. i think it's still snowing but if anyone has a question, please raise your hand and we'll try to deal with it. right there. thank you.

>> justice ginsburg, i was -- i was wondering if you could explain something about your opinion in virginia partly through the opinion you discussed the differences between men and women and you say that there's something to be celebrated? and i'm wondering if you could talk about why you use a word like "celebrate" especially when there was so little to be celebrating? >> i would ask to repeat the question -- >> the question was in the virginia case, justice ginsburg's language identified reasons to celebrate the differences, am i right, between men and women and the question is why use the word "celebrate" when there was so many things in the fact pattern at issue not be

celebrated. it's a tough one. justice ginsburg? >> well, don't you agree that it is something to celebrate that we have a world made up of both men and women? i celebrate that i have a daughter and a son. my life as my colleague mentioned was enormously enriched by picking the right life partner. so what i meant to say is that we are not alike. we don't look alike men and women. we look different. well, the world couldn't go on if there weren't both of us. [laughter] [applause] >> in the back? >> can you hear me? i can be really loud. [laughter] >> i'm a second year law student

atfordham. and i want to know if either of you have any advice? >> i don't think that needs to be repeated. >> i have enjoyed everything i have done in the law. but what has made me so satisfied with my career is what justice kagan spoke about. that i spend a lot of my time doing something outside myself, doing something that i hope makes life better for people who are not as fortunate. so you will have a skill that you can use to make a living but also to help make things a little better for other people, to repair tears in your

communities. we should ask the once great dean -- he must have been telling students all the time. [laughter] >> well, it turns out that justice ginsburg could have been a great dean too because that's what i would have said. [laughter] >> very funny. >> for justice ginsburg. how do you feel about the educational institutions that still only admit women on the there toy that those institutions are nurturing and otherwise protecting women. n example might be such as barner college is still women only even though columbia accepts women as well? >> in the v.m.i. case, one of the best friends of the fort

brees was filed by the seven sister colleges. there was nothing the state of virginia offered to its women that could compare with v.m.i. so a state can't make an opportunity available only to omen or only to men. my daughter went to an all-girl 12thl from kindergarten to grade. i think that the school she went to was the best school in the city of new york. so v.m.i. was not about single-sex schools. it was about a state providing an opportunity to to one sex only. by the way, there is one person in this room who knows about it.

and that is ranela, my swedish friend. [laughter] o you remember the book? it was called "dalabin" and so that was the closest i could come to the translation of that. >> well, that's good. now i know the origin. and again i agree with everything with justice ginsburg with one exception because i went to the best single-sex school in new york city. it was at that time single-sex. so sorry, jane. >> in the red? [inaudible]

-- way better. [laughter] >> we read your opinions and that's the way that you convey the messages that you've talked about. what can we do as individual attorneys, women attorneys to advance women in the law and in society generally. we've got to be able to do something to even the playing field. >> that's a good question. >> think the question is what can individual women do generally speaking not as supreme court justices but to even the playing field, even still in the community as it still needs to be done? correct? >> well, you find the place the audience that needs a little education, you give it to them.

nd that was -- i am a little worried that the gains that slowed and ade have backslide. ven be a i wonder why today's women aren't as fired up as the women in my generation were about ssuring that women have an equal chance to as pyre, to ollow their dream. >> although the women who have made you into a hip-hop icon. [laughter] no, i think -- yeah, sometimes maybe younger women don't -- don't appreciate how hard -- how hard the struggle has been,

right? and maybe don't always appreciate it as much because of the -- you know, i think it's a great question. i think different people find themselves in different positions and different roles and there's no one right answer for any -- for everybody. so it's great that you're asking the question. >> i'd like to ask you a question. you watch the super bowl -- [laughter] w did -- [applause] >> she did better than peyton manning. [laughter] [applause] freezing out en on that field.

>> it started in the 50's. [laughter] and what you have been trying to do is get the court reflect what the current sentiment of the country. i don't think the current sentiment of the country is journalism. so what do we do about that? >> you seize the opportunity to correct people who have the rong idea. i've done that in an opinion or two. [laughter] >> i think maybe two more questions. blue. >> thank you, justice, this is really, really fantastic. i wonder if either of you would

speak on the supreme court's sort of unwillingness to allow cameras in the courtroom during arguments. >> well, i don't know why elena's view is on that question. here's one aspect that perhaps the public doesn't notice as much. what we do in the main is not seen in the courtroom. before we come on the bench to hear a case, we have read the opinions that the other judges, the other judges who past on the same question. we read the party's briefs. briefs. the precedent in point. .f there's a good article

ecome bomb to the tee with the arlingtons. what you'll see are two people having a conversation with the justices. and may come away that the best debater would win that question. it would be a false impression to think that the oral argument is what is decisive in most cases. it's not like a trial where you see it's all happening there, witnesses testifying. the hard, hard work is done back in our chambers. >> i think it's a really hard issue. she's taken offsides in this position. obviously there are reasons to have cameras, tarns parent si is an important thing in government

institution. and for the most part i think the court would look pretty good. i think it's actually, you know, nine people who come prepared every single day, important cases, less important cases who are thoughtful and smart and really trying to get the questions right, all nine of us. and so i think -- when people come to the court, it's actually kind of -- kind of impressive actually. when i was solis itor general, i would come in the quourt the cases that i argued and whenever someone in -- would co anymore and watch how they worked. i remember thinking if every america would see this. because i think it would be good for "people" to see that. but i do agree request justice ginsburg there are opportunities for people to misunderstand the

nature of what we do. and to take snippets of conversation in an argument taken out of context to think that's what won or lost the case. and that would be a very unfortunate thing. i don't know -- it's a good example of what you see depending a little bit of where you sit when -- i think as i rved on the court, i've come to see more than i once did the reasons why maybe cameras would not be such a good idea. that they would actually -- in addition to what justice ginsburg said that it might actually change the proceedings themselves, i think people naturally ham a little bit when cameras are on them or speak in sound bites a little bit more than they otherwise might. so i think that something -- i think we're going to have to

become more transparent. but i'm not necessarily sure at putting a camera in for every argument is the way to do it right now. >> one more question. [laughter] >> thank you so much for being here. this is exciting. [inaudible] > at home tests for sufficient context -- corporations can spread their business around in a way to effectively inoculate them against -- can you speak a little bit about projected way or ffects one another corporate

accountability? >> i'm not going to try to epeat that question. the ere was a case about ad days of the dirty war where atrocities had been committed by the government and the charge brought by argentineans was that the affiliates in argentina collaborated with the government the ll or injure some of employees. do you think that that was the suit that belonged in the united states? argentina is where it all happened. -- of them were available

is it appropriate? do you think it would be appropriate for the united states to be the operator to be the forum in which that case is heard? [inaudible] >> in light of what it said. but doing business and the agency theory that was completed, that yes, that general jurisdiction could have stood. >> well, then it would be the court for the world because every life corporation could be sued in the united states in that theory. and that would make us look a rather arrogant to our nations, to other nations in the world community who has the kind of attitude towards jurisdiction and i'm -- i first began to think about these questions when i was studying civil procedure

of sweden. [laughter] where the notion was you don't bring a suit where you happen to grab the person who committed the wrong. but it depends on where it happened. where the events insuit occurred. it's a logical place for the constitute be brought. >> we were asked before about giving advice and my last piece of advice is don't mess around with justice ginsburg when it omes to personal jurisdiction. [applause] >> thank you all for coming. and at home, thank you. thank you.

[captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] >> i think it's more important that justice itself. i know that's a strange thing for one to say. it's believe that because very small comparatively. people ever come -- even enter into a courtroom much less have any an tagism with the law. >> friday, we continue our interviews with former supreme

court justice. tom clark at 4:00 eastern. in washington, d.c. on c-span.orling and nationwide on channel 120 on xm radio. >> the u.s. senate may have noted something unusual in wednesday's vote to end the debate on the debt ceiling bill in the senate. some of the tarn parent si issues that it has raised -- tran parent sis issues that it raised -- what happened on that vote? >> well, what happened on wednesday during the vote is that basically the decision was made and we're just now learning from a spokesman from majority leader harry reid that the decision was made at the request senate republicans to not have the clerk of usual

announcement of vote positions as the vote is ongoing. and so the microphones were essentially turned off. and so if you were anywhere other than inthe senate chamber itself either as a reporter or a senator or a stuffer, you were left to really guess as to what was going on in terms of the way the vote count was during that extended period of voting as regular viewers will know frequently what happens, it's customary that the clerk after going through the whole list of names of senators and calling the role the first time will announce which senators which senators voted in affirmative and which voted in the negative. yesterday t happened and this has raised all sorts of

questions. >> yet, as you reported, you and a number of other reporters were questioning this and several other reporters andrew taylor of the "associated press" leading the charge on this and why the microphones were off. you're reporting that a spokesman for the democratic leader saying that the republicans requested that the microphones be kept off, correct? >> that's correct. receiving just now and that i received not long ago a this is a quote from reid's spokesman. the clerk did not call the names during the vote to make it easier for republican leaders to convince their members to switch their votes and the court. that's what was suspected by a lot of people who were monitoring this. there were a number of people

after the vote had dragged on for a while. it's clear that the people in the chamber that they were one or two votes short of this 60 votes that's needed to overcome a potential filibuster. and so it was clear that there was some sort of arm twisting going on to get a couple of extra votes to get us over that hurdle. and it wasn't clear that was going to happen until, in fact, senator john cornyn, the republican whip from texas and mitch mcconnell from kentucky both themselves voted in maver f the cloacher motion to cut off debate -- clowe cher motion to cut off debate. >> and let's talk about the politics that debt ceiling debate in the ceiling. what was at stake -- was bringing the debate of bringing the debt ceiling to the vote in

the senate. what's at stake? >> well, the bill which is the one that came out of the house essentially is a clean suspension of the debt ceiling for about 13 months. so what was being -- what they're basically voting on if you're a -- you know, if you're someone who's in a republican primary contest, there have already been arguments being made that these republicans essentially voted in favor of giving a blank check for government borrowing for a little more than the next year. and that's the kind of thing that really won't play well in republican primaries. and i think that this is something that the republicans generally didn't want to have to vote for. they ultimately voted against it on the final passage vote but observers of the senate know very well, this is not the kind

of thing where the final vote is the one that's really important. the vote that really matters is the one that has the 60-vote threshold which was in this case demanded by senator ted cruz, the relative newcomer from texas who really wanted that threshold. >> back to that vote and among the pieces you're writing and you're blowout, your world greatest deliberative body called on roll call. you said the democratic leadership that republicans requested the mic be turned off. in your covering the senate and from your colleagues there, have they ever seen something like this before? recollect. not ve been up there for several years on a regular basis and there have been people longer

than i could and now one recollect a similar situation when the microphones were turned off for an entire vote. and what i would think -- the other thing that i know is that a floor aid with who basically ran the floor for the democrat first more than a decade. he said it certainly hasn't happened frequently or recently. although with people who sort of deal with the floor regularly saying there's the announcement process, at least in their view is really designed for the information of other senators and their staff, people who are on the floor. although certainly it has become in to tell vised view that everyone who is watching on c-span who is sort of watching in the capital remotely from

other areas are going to be attention to. >> of course, our viewers can watch the senate. and niels is on roll call and on twitter as well. >> thank you. >> an official tally sheet of the vote was provided to c.y. roll call. it indicated that senators hatch, mccain and hewn switched their vote from no to yes and bring the debt ceiling measure to a final vote. roll call writes that it's possible that some of the markings on the page are due to a clerical error. you can read more on ollcall.com. >> the new c-span.org website gives you access to incredible events with more added each day through c-span's coverage of national politic, history, and

nonfiction books. final c-span's official coverage of washington or access more than 200,000 hours of archived c-span video, everything c-span has covered since 1987. it's all searchable and viewable on your desktop commuter, tablet or smartphone. just look for the search bar at the top of each page. the new c-span.org makes it easy to watch what's happening today and washington and find people and events from the past 25 years. it's the most come comprehensive video library in politics. >> two members of congress who are also for vision talked about health care and the health care system. tom price of georgia and fill moore of tennessee reported on the policy summit this week. it's just over an hour. >> we are really privileged today to hear from two leading

conservatives, two doctors no less who are on the forefront of thinking about what comes next after obamacare. representative tom price and representative phil roe have plans that would dismantle one size fits all approach to health care that has been imposed on our country by obamacare. instead it would focus on the delivery of health care by focusing on consumer demand and consumer choice. you all know, there's a tendency to focus on the movement on the details of different plans than and we sometimes will obsess over there. but the truth is that there is really a lot more in these different plans that are being presented here today and others that are percolating throughout congress and in the conservative think tank role. there's's lot more that join us on this issue than divides us. we ail agree that we should have

choices. we all agree that the market drivers down prices than do federal mandate. health care should be affordable. and freedom should be the center piece of any health care plan. relationships with our doctors should not be coerced both of these plans put us on the path of reform. please join me in welcoming john price to talk about the first one. [applause] >> thank you so much to all. great to be with you and greet be back at heritage. her tan does a -- heritage does a great job. patient center health care which is what the topic is and how do we get it. what does it mean? what it means to me that as a physician over 25 years taking

care of patient,patients and families and doctors making medical decisions, not washington, d.c. we're not insurance companies. --ients, families an doctors and doctors should make decisions whasm we've seen from the administration and washington is that we're moving way from not even on the right trajectory to patient center health care. interestingly i think that conservatives have actually won the debate on the president's health care law and tax. i think we've won that debate. by overwhelming numbers the american people say they don't like the patients health care law and the taxs that go along with it. but they want a new solution and that's what we're here to talk about today, positive solution. and they exist. hey exist all across the

republican perspective. there are over 150 pieces of health care legislation, in the house of representatives alone, 150. so when you hear the president aif anybody's got a better idea, you know, we'd like to sit down and talk about it? well the fact of the matter we've asked the president to sit down over and over and he has refused at every single term. i want to talk about the principles of health care and talk about h.r. 2300 a bill that i have introduced to the congress for the third year in a row. principles. if you think about them it's important that we follow those principles. you may think that you don't have health care principles but everybody does. everybody. most people have the top three. we need a system that's accessible. everybody needs to get into the system. we need a system that's affordable. everybody needs to be able to afford it. and we need a system of the highest quality.

accessibility, affordability and quality. i add three more to those, responsiveness. it doesn't do you no goo where nobody's behind the desk. that doesn't help anybody who is in need from the health care standpoint. innovation, if we don't incentivize innovation then we don't have the highest quality. people have to go elsewhere. the american people want choices and they should have a right, how they're going to be treated, when they're going to be treated. all those kinds of things. affordability, quality, responsiveness and innovation. those are the principles that we ought to make certain we adhere. to i suggest that if you look at the president's law that his law, the current law of the land violates every one of those principles. decreasing accessibility.

increasing cost which means decreasing affordability. quality, we talked to my medical colleagues. they're er because seeing a decrease in the quality. not because doctors have forgotten how to care for patients but because of the system is making quality that much harder to be able to provide. responsive innovation, government health care. you decide. i don't think they tend to go in the same system as government run often. and in this instance they certainly don't. fewer choices. we hear about this day after day after day with the president's law. .he choices are being limited so if those are the principles and step back and say those are what we agree upon, then let's look to solutions that actually support those principles, adhere

to those principles. h.r. 2300, is the bill i've introduced three times in a row. there are packets outside the room and you're so welcome to pick them up. they describe the bill in some significant detail. of. 2300 is the work product the republican committee two congresses ago. when the president was coming forth with his law, we got together about 20 or 25 people who had an interest in health care within the republican study committee. many vokes who had been working in health care for a long time and came up with an alternative. it's been refined and perfected over the last two congresses. but it does a number of things that we want to touch on because it does the kinds of things that the president's law does not do. first, you have to have folks covered and have that accessibility to care to

coverage and affordability of care of coverage. how do you do that without putting washington in charge? it's relatively simple. every single american ought to are the feasibility and incentive to purchase health coverage. you do that through the tax code, tax deductions, tax credits, refundable tax credits so that every single american regardless of their economic station whatsoever have the financial ability and have an incentive to purchase insurance. and it's something they want for themselves. no mandates. remember, you as an individual every single american knows best what kind of coverage they ought to have. there's no way the government can have a one-size fits all programs because it fits nobody. one size fits nobody. so you can get everybody covered. we've got the accept the insurance challenges. there are real insurance challenges that existed before

the president's law. but the two big one are affordability and preexisting. you ought not lose your insurance if you change your job or you lose your job if you work for a company -- and they provided heam coverage, usually worked for them for 20 or o 40 years you just kept your coverage. the statistics say they will work for between 12 and 15 different employers in their lifetime. there's no reason whatsoever that they ought to have 128 to 15 health care policies if they don't want. well we ought not have a system that forces them. we want every single american to own their coverage regardless of who is paying for it. so if you lose your job, you take it with you. u don't leave your pension plan to your previous employer? no. nobody in this country ought to be priced out of the market for

health coverage if they get a bad diagnosis. i may work for insurance companies. it doesn't work for patient. remember patient centered. if we think about the problem and diagnose the problem appropriately we recognize that there are about 18 million people who fall into that risk. those are the individuals and small group market. they don't have a big pool. they don't have large groups of individuals assists and purchases coverage together so they can't drive down the cost. how do you solve that? you make it so those 18 million people look for others for whom a preexisting system isn't a problem. you create pool mechanisms. not just high risk ones andy wonder why the price goes up.

so that anybody who wants to pool with anybody else we call them individual membership association. you can join with others across state line to be able to get that purchasing power of millions. so that one individual's adverse doesn't drive up the cost for that person or anybody else. and finally we waste huge ams of money in hale care. the biggest way we do that is through the practice of defensive medicine. as i mentioned i was an orthopedic surgeon. i spent 25 years taking care of patients. it's what i did. it's what every doctor does if he or she is honest with you. and they don't -- it's the extra tests that are ordered and examinations that are ordered. they're not done to harm you at all. but if that doctor ever finds himself or herself in a court of law that they can honestly look at the judge and the jury in the eye and say, i don't know what you wanted me to do because doggone it, i did everything. when in fact everything was

rarely necessary to diagnose or treat the patient. now, the standard line on the nservative side of how you ake care of lawsuit abuse. how much does defensive medicine cost? there are a cup of studying out there. jackson health care has a reputable study. estimates 1-3 billion dollars. that's not over a 10-year period of time, ladies and gentlemen. that's one year. that's every year. you add that up and see the amount of dollars that we are weaing in area of health care. so what do we do if we make the right diagnosis. you to make it. so the doctors if they do the right thing, if they order the right tests and do the right thing as it relates to a patient, not because of what the secretary of health and human

services says but it's because what that society says based on appropriate guideline. they ought to be able to dwhruse as an affirmative defense and say i did exactly as i should have done as it relates to the problem that this patient presented to me. >> to use that an as affirmative defense and you raise the bar. you raise it too clear and convincing evidence. then what you do is begin to chip away at that culture of the practice of defensive medicine. remember wasting $8 billion a year. so wlook we've done. h.r. 2300. gets everybody covered. not that the government forces them to buy. without putting washington in charge. and saves hundreds of billions of dollars all without putting washington in charge by one penny. and the solution that are in h.r. 2300 are included in a number of other pieces of

legislation. there's a lot more that we have in common, than not. what we do have a problem is that we stick to principles. we stick to princeable, innovation and quality. if we do that i have great faith that we should end up as a ystem that's truly patient -centered. what we want to make sure is that we make the decision not washington, d.c. thank you so much [applause] >> thank you, dr. price. and now please join me in welcoming dr. rhodes to the stan. [applause] >> well, tom didn't leave a lot for me to say after that i agree with everything. i'm the co-sponsor of this bill. those of you who don't know who i am, this is starting my six years in congress.

i spent 31 years practicing medicine and we started with a group of four doctors. we know because of managed care and other issues that came up in our practice to 100 positions an d to that. i one day come to my wife who is a nurse. and i said pam i'm either going to quit complaining or go to washington. phil said why in the world did you decide to run for congress. you had a great medical practice. i'm going the del -- teleyou the truth, i will say my medical license is still good and i'll write them a prescription if they need it. i got here in 2009 just as the health care debate opened up. i still find this the most astonishing of off.

we have nine positions. because we have 15 now. not one of us was asked one thing about the health care bill. what we thought about it. and i guess nyevly so i guess having gone through health care reform with king care, i thought i had slingts something to happen with the debate. unfortunately nobody cared. basically this affordable care about that we're dealing with now is on steroids. you can not have written something inner complicated because the simplest transaction in the world is where a patient call misoffice, comes in and sees me and leaves and pays the bill. no more complicated than finding a loaf of bread. and now you have to tie everybody into a pretzel to try to get health care. let me tell you. anaheim a town of 65,000 people.

e are a medical referral area. we've had almost 100 layoffs in our local towns. let me tell you those are the best jobs myself. vanderbilt university has laid off a thousands pime. d and cut their program by 10%. does anybody in the world believe that the quality of care goes up when you cut the size of your medical. and it's unbelievable. and you can repeat this story all over the country. and when they tell you it's creating jobs that is absolute nonsense. this sbill creating chaos. i can tell you right now among the medical community. >> well, last year, this last year, steve who is the chairman r.o.c.

i want you to write a republican subject committee. he said i want this bill to have no mandates. preexisting er a condition. malpractice reform. is that all you want me to do. we got to it last year. and this committee i want to go over in just a people, they did a great job. elmers. dr. fleming. dr. todd price to georgia. committee that we have all agreed on. it is a patient-centered and the prements of the affordable care act is absolutely spot-on right. you want it to increase access

and decrease cost. until it occurs between doctors and patients. and going to use myself about how this actually works. they're just six titles to this bill. i brought a couple of things onboard. some of you i've looked around the room. some of you do not. i can tell by looking at you. i know you're holding it. the affordable care act is about two years. remember they were about this thick. this is the s.g.i. reform. how we pay doctors. that's it. and this is 180 page american health care reform bill. 181 pages long that anybody can read it. it first thing it does is repeals. we have to get rid of this

monstrocity and not repeat it. i have spent hours trying to think -- when they said dock, can you just tweak it? eah with a nuclear bomb it's impossible to do because you'll mention one thing and i will tell you four things that's going to change what you just tweaked. so that's number one. and number two, a bought did lot of my baptist friends think the original sin occurred in the garden of eden. e think it's after world war ii when they tweaked tax treatment. en i worked for ob-gyn, my group, i could provide myself for my group at pretax dollars.

i retired and the next day it did, i had to pay first dollar. it cost me more money next day. so what we do with this bill is say ok, each family can take a $20,000 deduction for health care. if your health insurance premium -- and that makes it portable as dr. price talked good -- about -- if your insurance is say $15,000, the $5,000 is money you get back from payroll taxed and income axes the so we massively increase health savings accounts the now almost everybody in our practice, 450 people we provide insurance for selects a health savings account. why? because it puts the doctor and the patient -- i use a health

savings accounts. i have a debit card. i didn't call the insurance company to find out if i needed something. i let my doctor decide it. it is scary when you let one of your medical school classmates operate on you. i did that. i knew i needed it done. i went down there and said i want the cheapest price you've got. and in a second they had their money. didn't fool with the insurance companies or anything the something about the affordable care act that is unknown and after this year the erisa based people, 70 million, lose their tax status. i -- 40ex -- checked, i checked with vanderbilt and my own large center, 40% of the uncollectable debt hospitals have in our area are people is -- with insurance because the out of pockets are so high now,

they don't have enough. what this bill will allow you to do is fund up to what it is up to 12,000 a year. we increased it for people on medicare, who are disabled, for veterans who don't have that option. as dr. price mentioned, we have no mandates for a 26-year-old. well, a 26-year-old, i had to buy all my kids an individual policy before they actually got jobs with health insurance. but let me tell you what you can do if you can buy it across state lines. 26 states already do that. right now the federal government tells you what you have to buy. i'm going to be a little graphic here. let me tell you why that's important and has drinken costs up to the ceiling. i have been fixed. my wife has been fixed.

ok? we've got three kids and both of us determined if we had to raise another kid now we would jump off the capitol into the parking lot face first. but we have to buy pediatriciatric coverage, o.b. covering, all that that i don't need. with health care reform, with malpractice reform, we also include that in our birbling the other reason that's important, i'm going to pass along our tense -- tennessee experience. 1975 when i got out of the army and came back to memphis to finish my training, all the malpractice carriers left the state. every single one. we set up a mutual company, the doctors did. over half the money paid out of that went to lawyers, not to the injured party.

that's terrible. we need a way to ensure we can help people who have been injured by the system. our state set a cap of $750,000 in 2011. the first full year after that implementation the physicians this that states and ultimately the patients who pay those bills, we're not a big state, our premiums went down $100 million in one year. the practice is going to take longer. no ge -- question about that. but being able to buy plans across state lines. that's very important. this bill requires that the hhs secretary tells us what they pay for something so if i go in with my debit card i know what is being paid there. you don't buy a suit of clothes and then they tell you what it costs later. that's how health care is done and it's ridiculous.

the other thing in this bill that is very important is cobra. had a ow, if you have -- to exhaust t have cobra. there are just people out there that have conditions that are incredibly expensive to treat. as a society we have to realize we're going 0 treat it. we're either going to shift look, the or say costs -- costs are there. we are going to shift that with the -- to dreat that high-risk pool. it's an easy bill to read. 181 pages. it will increase access and i can tell you right now it will decrease cost and put some certainty back. this is the most, i've been a doctor for 44 years and this is the most uncertain i have seen

our profession since i have been there. expert senior physicians are looking for exit signs and that's not what they should be doing. they should be looking for the next patient. that man sitting over there has not given up the fight and i have not given up the fight. the american health care system is the best in the world. no question about it. the miracles i could tell you. i will pass one on and then sit down because i want to hear your questions. when i was a medical student in memphis in 1969 and 1970, i went to st. jude's children's hoose. -- hospital. hat was my first pedestrian -- pediatriciatric rotation. 90% of those children died. today, 90% of those children lived. when the lord walks on the earth again, that will be the first step he takes is at st.

jude's children's hospital. every child is treated for free. the question is, are we going to shut off that innovation that is creating these cures that is treating these babies. i forgot to tell you i delivered most of my own voters so that worked out very well! [laughter] with that i will silt down the thank you all. >> thank you dr. and for your commitment to leading the reform efforts we really so badly need to talk about. i'd like to invite the rest of our you panel up now. two of the leading experts on this issue in this town, they really are all over the place and testify before congress and published in various places and they're in demand on the hill with a lot of members who want to know how to push their reforms forward. i will kick it off with a

question. i will address is -- it to nina and grace marie to begin with. there are technical differences between these bills. how do we, the conservative movement interested in pushing reform, how do we deal with the technical differences between the bills and principles and how do we push forward on this? >> you know, there is a lot of call for republicans to get behind one bill. why can't you agree on one bill and pass that? well, i will tell you that republicans do not have a better idea of how to write 2 ks 800 -- 2,800 pages of legislation that raises a trillion in new taxes and still leaves 20 million people uninsured -- uninsured. what they need to do is help the american people understand the vision of course what dr. price and rowe do. not just the specifics of the

bill. you can get very bogged down. there are some minor differences between did dr. roye and dr. price's bill and some of the others that are out there. if you focus on that, and that's what you do when you start legislation, then you wind up having people never understand what the core idea is that unites all of them. i think they both describe very clearly it's about putting patients in charge, real choice, true competition, all the things that obama care promised but none of which they are really delivering. >> i would just add that if you look at the process for delivering what we have today, it was all done behind closed doors and just appeared for a vote on the floor. i think we've forgotten what it's like to go through a normal legislative process. let it go through a markup. that's the process. move that to the floor and move from there. i think that creates the momentum you also need to

really get something past that not only do the members agree on but will have the confidence of their voters when they're voting on it. >> one more question from me. obama care took a lot of our labels. stole them from us. you know, choice, freedom, that kind of stuff. what are the -- one of the lablings that obama care stole from us that are most important to get back and how do we do it? >> the entire dictionary of health care policy. they've taken our game plan and talking points to conceal their liberal policies to enak this health care law. whether it's choice, portability, you can go through all the things. the question is what are -- are the real defining meaning of these words? that's where we're different. many times we've said -- no one thought before the heal care law that the system was perfect. we all agreed there is a

problem but it's where our solutions are that create such vast differences between what the the health care law was and what these congressmen and others are putting forth the >> i think that dr. price said that we've won the debate because the american people see the flaws and problems with obama care but i think we have won the debate in a different way because the other side really had to use affordable choices, security, going to make sure you can keep the plan, keep your doctor. all the promises they made were really things that we've been talking about for the last at least 15, maybe 20 years. but they put this mountain of rules and regulations underneath it that takes it in a completely different direction. so, getting back to those principles, telling the american people that this is what we really would do to get to affordable choices by having genuine competition, not fake competition, genuine choice,

genuine portability, having you decide what kind of health plaun want, not having it dictated by the federal go. i think that's what we do is get back to some real principles that work in the rest of the economy, and not just these fake labels that really have dereceived the american people. >> do you want to -- >> we can open it up -- >> sorry. let me just comment if i way -- may on the ideas of how you get this done. they touched on it. to h.r. 1500 isn't going be the first piece of but what it ought to be is allowing every single legislator and senator who has an interest and a passion for assisting and solving this to work together in the normal process, the due process of legislation.

we don't want this to be a partisan piece be slegs. we want it to be a bipart isan piece of legislation. we want every single member who has an interest to come together and put their two cents in and work it in the committees and on the floor. that's the way you get to a solution that can be embraced. we've seen where partisanship gets you. we're in a position now that shows that. that's not where we want to go. >> the fact that health care is a republican or democrat issue blows my mind. i have neefer -- never seen a republican or democratic heart attack. i have delivered a lot of republican babies, i will tell you that, where i live. but i almost had a joe wilson moment temperature last state of the union where the president at the -- for the umpteenth time had the audacity to stand up and say the republicans have no ideas when

that's all we've worked on for years now. we were at the recreate -- retreat now we attended in maryland and the principles laid out are in my bill and tom's bill too. health savings accounts, liability reform, buying cross state lines, all those with some variation. as grace said, if you look and nitpick these things, you will never get anything through. what we are for is debate it robustly in the light of day, bring it to the house floor, debate re -- robustly in the light of day. thep give it up or down. look, the bill i wrote, it should be amended. i don't even agree with everything in here. amendments the republicans brought to the committee, not one was brought to the house floor. that's not the way you get the

system for all. it's not a democratic or republican issue. it's an american issue. >> ok. let's open up for questions. >> observeaca care has regulations. tell me, if you repeal it and then move to something else what happens those -- to those six feet of regulationed? take me through the mechanics of going from observe ack -- obama care to something else. >> when we are -- repeal the law and replace it with something that works for patients and families, then there will be new law that will have to have the regulations and rules stipulated for it. however, what they would do is be much more memory -- flexible, perm isive for

individuals. it's a culture in washington right now and many areas that says washington knows best. the hhs believes that washington goes -- knows best and it can make the best decisions for patients. we simply don't believe that. i know it's not true. if we were to have our druthers, when that happens, then there will be a culture within that system that will say patients and families and doctors ought to be the ones in charge, not washington. >> the question was what happens to those six feet in do they go away? >> they would be in conflict with current law. then-current law. >> i suggest we all join for a massive weenie roast if that happens, burn it and get rid of it. we are in a process now of the most disruptive time in my lifetime in health care.

the most uncertainty. all patients want is they want to go to their doctor and get their problems taken care of. i've done it for 30 years. the other maddening thing about me for this afford eable care act is the billions we have spent on infrastructure and web we that don't work and have literally spent billions of dollars and have nothing to show for it except failure. >> ok. here? >> thanks. so you're going to have to have obama care repeal. how is it going to get repealed unless the senate goes republican and we get a new president? because -- are you going to require that it's just going to get so bad, so 0 pressive before 2016 that it's just

going to collapse? >> our reference is to repeal the law, we understand that. with you -- but we understand that with harry reid in charge of the senate he's not going to sign a bill that says repeam the signature legislation. the problem we have right now is that real people are getting hurt because of this law. real people's lives are being destroyed because of the law. not just from health care standpoint but because of economic issues. the law doesn't work for employees, employers, doctors shall patients, doesn't work for the federal government from a financing standpoint. there will be a clamor to repeal and replace. whether that happens before the next presidential election or after because the law fails to be implemented, there are so many delays and changes and

postponements in the law now, we haven't -- >> because now they're talking about the individual mandate being extended past 2016. so they just keep changing the law. >> but i hear your question that you are thinking that repealing it, republicans would therefore be responsible for the law failing. the law is failing on its own the we have a paper on our web site of all the changes already made to the law, 17 of them by the white house. that's an acknowledgement that ts -- it's not working and almost every day we hear some new rumor about more changes being played. it's not working. it doesn't work. the -- we have got to start over and the american people now know what they want but they know that obama care is not delivering it. that's why we have to start over. >> a question. actually two questions. one, the portability aspect of

new slegs -- legislation, how much does it conflict with state level health insurance and state level mandates that differ, of course, widely? how do you reconcile -- > the provision that we have health coverage, all of it has a 10th amendment contest really. we stipulate that anybody that has a nexus for their health coverage with the federal government, then that's where it applies. so for example if our individual membership associations which would have a nexus with the federal government because it allows paur cross state lines, they would be able to own that. individuals who are in any erisa plan, they would be able to own that. so it gets to that by making certain that everybody has a nexus with the federal overnment.

>> one more quick question. i think we've seen how much patients and prospective patients are resistant to the law. looking at the damages, pharmaceuticals, hospitals, clinics, how much pushback is congress hearing from these organizations from -- in terms of the damages or are some of them still supporting obama care as they did at the outset? >> i can speak to that. a private conversation i had with somebody -- someone friday who is extremely knowledgeable in the hospital realm, he believes that several hundred hospitals across the country are going to go out of business. i think certainly when they change critical abscess where only one hospital is funded differently within a 10-mile radius or whatever it ends up being, those other hospitals will go away. we've already lost one in lee county that's closed.

when you look at partnering getting bigger and bigger, there is going to be massive consolidation and bankruptcy -- bankruptcies in the hospital business. no doubt about it. >> and look at the insurance company contributions to the exchanges. many of them have sat on the sidelines. i think we may not know everything today but as these years moving forward we're going to get a good sense of where the marketplace falls at that point >> i want you -- to applaud you on your long gain strategy. you actually have to seed the grass in order for it to grow and you have to change people's minds about things. but that say longer game because you have three or more years before you get to the finish line. what do you do between now and then? there is something called a

regulatory accountability act that allows congress to review laws adopted to see whether they are beyond the authority congress has delegated and then you can basically point out whether they are working or not or how they are not the you haven't won the battle yet of set -- selling your ideas going forward. by further going into the regulations and making them account to congress because they have to, have they met your delegation? i would tell you that you would probably find they have not and you could have all types of investigations and reviews of how badly these ideas in regulatory form are being implemented. >> well, first of all there are a lot of court challenges to the kay that the regs have been written and contradicts -- contradictions to the actual stull statutory language. but i think you may tell --

actually see, the problem now is it has to get through the senate. >> that's not a regulatory solution though -- >> and congress is holding countless hearings on regulatory overtight -- oversight. they are passing slegs in the house most often with significant democratic support to try to move forward and try to put into statutory language what the president is trying to write and rewrite the status -- statute to stay such as the delay of the mandates, but i think that the regulatory review act, is that what it's called? >> yes >> actually is an important tool but it still requires getting that legislation through the senate. >> yeah, but you have sound bites with that. >> you could have sound bites for the news about regulations that have been either well or poorly implemented.

>> i think you are spot on. a lot of what we do doesn't get covered. folks don't know that we're doing it. this is so onerous and 0 pressive to the american public and harming real people that there ought not to be any limit to what we are doing in the regulatory overnight -- oversight standpoint. and secondly, we do have a piece of legislation and phil has the venn diagram of where everybody has a common theme, purchase across state lines, medicine mal reform, those kinds of things so the american people can see that we're not just fighting to make them see owe awful the current law is, we have positive solutions they can point to and say that's the kind of thing we need. >> this issue of regulation is not in isolation to health care

and i think it can create a great message to the american people. i think pete are skeptical. how is it that all these rules are being changed? very few are getting to the final, final stage, so all that ambiguity is creating greater and greater insecurity. i think it's not just health care but all the regular layings that this administration is using the could be a good opportunity to use -- move it outside the silo of health care. >> are you familiar with the rains act? i think as jeff davis in the previous congressional, you talk about a game changer. because i didn't know it was four branches of government but that's the regulatory branch. all these bureaucrats i didn't know what they did up in all these buildings, now i find out they manage every phase of your

life and everybody has a story about how these regulations add to costs and create incredible costs to business not just in health care, i could tell you stories of builders. i have friends in the construction business and 9 raines act says if you have a rule-making that affects the u.s. economy by more than $100 million, which many of them would, it has to come back to congress for reapproval. that would stop that stuff in its track. could you speak into the microphone? >> you also have the problem if you rely too heavily on courts, called the chevron dock trin, where they defer to the courts. that's gone way overboard where nobody even questions things. deference is too great to make any time of change. that's why congress has a role in addition to the courts the >> right here?

>> i'm a believer in repeal and replace but also realistic that the only time obama care gets repealed and replaced is by replacing harry ride and then obama himself. so over the next three years -- first we've got to do something in 2014 but over the next three years people will continue to feel the greater pain. when the president says i can keep my two sons who are under 26 on my health insurance and then i get my health insurance and it's literally $10,200 for the year for both of them, others are facing the same thing, 300% increases in premiums and so forth. that pain is going to keep going up. is there a conscientious effort in the house about joining with six enate to get any net first -- so we can control the

senate? 2014? and then is there a longer plan, a three-year plan? do your plans work in three years? will your plans work now or three years -- >> the free market's been working for centuries and yes, it will absolutely work. people talk about i went to a -- tom and i went to this thimping tank in fort lauderdale and the guy was talking about the free market. are you kidding me? everything is waced -- based on what medicare pays and the insurance companies are keeg off that. so it's totally regulated. let me tell you what i think is going to happen in the real world and you're beginning to see it now. look, some of the most fun and best patients i ever took care of never paid me a nickel.

i live in rural appalachia and i took care of anybody that walked in the door. that's what i thought doctors are supposed to do. but they're starting now to have a concierge type practice, move their practice out, you are going to pay them cash or a certain amount of money. i do that right here in washington, d.c., right now so i can see a doctor here if i need to and you file your insurance. whatever you have, that's a contract between you and the government not between you and me. i will see you, take care of you, not -- be glad to. unfortunately, people without means are going to be left standing, have to go to the get care like to they always have. now, the six, i would suggest them a role of course tape to put over their

mouths so they don't say stupid things. we can win six. i don't think there is any question about it. we have great candidates out there. some ma -- that i know, tom cotton. three in georgia, great candidates running for senate. we've got really good candidates. it starts with that and then we've got to go out and get behind our candidates and not pick every little thing, they didn't vote for the farm bill or this or this -- let's get them on our team. get behind our guys. >> your question of strategy, jack kemp had four or five votes and they were losing votes until this passed. what we and others in the congress are doing is putting our ideas out this so we can actually pass them in the house. john boehner should put these

bills on the floor the mib it gets killed this year but we're trying to gain the trust of the american people here. it's a campaign to regain that and we do it over and over again same way jack kemp did. >> the president keeps saying the republicans have tried to repeal obama care 40 times. well, many of those bills have not only become law, and because they're targeted at specific things like the repeal of the 1099 rule, a lot of those bills have had huge democratic support. 30 to 40 democrats have signed on. i think the closer you git to -- get to the 2014 election and the more scared the democrats get i think there is going to be more and more of a call to make fundamental changes. i don't think the president is ever, for the next three years he's not going to sign a repeal law for obama care but there are strategic things that can

be done that really would significantly delay this law. like a delay of the individual mandate, like a delay of the employer mandate. like not requiring people to have health insurance that has so many mandates and benefit requirements that nobody can afford it. i think you are going to start to see democrats having, making some demands for legislation and trying to get that through harry reid. maybe that's again my optimism but i think it's also some political reality. >> yes, back here? >> i wanted to ask you about the medicare s.g.r. reform. that came out last week and it gets to the provider issue but really doesn't do the hard part, dealing with the offsets, making those necessary reforms that have actual permanent solutions and savings. rather than go through price controls or manipulating parts of the program, do you think conservative lawmakers are ready to embrace some structural reforms in medicare?

you have a history of -- -- bipartisan support? >> i do. whether it's increasing age of eligibility, increaseb -- increasing premiums, things that make it so the system can actually work. many of these reforms are necessary because the program is going broke. that's not tom price or phil rowe saying it, that's the medicare actuaries. in the next decade medicare is broke. it doesn't mean they go broke, it means they could no longer provide the services they have promised to seniors. again, harming people. saving, reforming the system, that's what republicans are trying to do but we haven't had a willing partner on the other size -- side. so in order for the kind of things that have had bipse --

bipartisan support, some brought up in the president's budget, but then when we bring them up as possible opportunities to move slegs -- legislation across, the administration says oh did, oh, no, it was, we only meant it in context. or hairy doctor -- harry reid says no, we have to do it in targeted fashion the that's where the whole issue of the politics of it, we're not going to change this from washington, d.c. this has to be changed from across the country, from the american people standing up staying we want our representatives to represent us, not the party. us, not the administration. and as long as the american people do their, fulfill their citizenship responsibility and elect to washington folks who are interested in solving problems, not gft -- just getting to the way, that's the solution the >> here's where dr. price is right, as long as my mother who

is 91 can still go to her doctor and get everything done she needs it's not a problem for her. we see these numbers and realize that for every dollar you pay in as a premium you get three out in benefits. you can't continue to do that. along the line we're going to have to do one of those things that dr. price mentioned. i don't know but, but i would put off studying calculus to the very end. i hated it and i wasn't very good at it so he put that off to last. reforming medicare is going to be hard and painful. the reason we didn't put it in our health care bill, we left medicare and medicaid specifically out of that bill because that's a whole other area and we don't wnt it -- didn't want to get bogged down in that. but you're right. the real tough part is who pays

for it. i'm on medicare. i turned 65 one day. nothing happened to me, i just got to be 65. i had a kealt -- health policy the day before. now i got alphabet soup, a, b, c, d, trying to figure out how these worked together. with the ryan plan, even before boles th the simpson plan, you can just have people buy a plan. i would have kept the one i had the day before -- day and been perfectly happy with that but you can't do that with the way the rules are set up. and we have to do this in a bipartisan way. >> we have time for a few more questions. our next speaker is running a little bit late. down here in >> congressman price, well, ate your bill as

but you mentioned you don't want to be bogged down in questions of medicare and medicare. prior to obama care we were already very close to where 50% of the people rely on the government for health care. i think that's very important to discuss, this elephant in the room, and perhaps even sooner, getting to the point where we can reform obama care. you are giving the medicaid and s-chip beneficiaries a voucher for a private plan, which i think is an excellent idea, and many ys -- others agree with me, the question is why are you putting it in the middle of another -- is there a strategy behind it being here and not out of the organism so we can having something to go to media with and to have eye national discussion during these three's

years of waiting to get to obama care. is there anyone else of your colleagues because someone mentioned that there are 150 bills out there. any of them specific willing -- specifically looking at this area? >> great question and we've peeled off a number of different pieces in, 2,300 separate bills. the ones you talked about provided for individuals to utilize and, or to have the flexibility to buy something that they would want as opposed to to being stuck in the medicaid system they currently are now. right now it's against the law. exactly right. exactly right. it's a good point. i don't know that anybody has that specific piece of legislation that we included in ours as regards to medicaid but we'll revisit that question of

whether it is something to peel off the >> let me give you a real-world example. just left the emergency room at the local medical center. we had six urologists in johnson city and a quarter of them said i'm out of here, i'm retiring. they all took medicaid in town. every single one. they shared the load among audible them. what happened was when those elingses -- urologies -- urologists quit, the other ones had so many patients lined up, they stopped taking medicaid. now what happened is you have to go to the emergency room and be admitted to the hospital. we have to see anybody that comes in. so stuff that wouldn't be now gets much more expensive because they have to be

admitted -- knitted to the hospital or they have to go 100 miles to knoxville to be seen have a have -- should health incidence plan like i have. i absolutely agree with what he's doing, we just didn't include it in our bill. >> but it's a great wedge issue because we know that medicaid is draining state budgets. it's a great wage issues -- issue to make the case to the people that government didn't just show up in obamacare, it's been moving toward a one-payer system for a long time. >> in my state they're estimating we will take $192 million new dollars in. our governor elected not to expand medicaid. this next fiscal year we expect just miss kal -- med -- medicate to take up $100 million more.

$17 million in a $30 billion budget. the medicaid is currently taking up all the new dollars. so we have to reform it. >> i would just underscore too that it's really a quality issue. this administration is a wonderful opportunity to contrast -- contrast the different issues. this administration just says well, we'll give everyone coverage and you can just enroll on medicaid. well, dr. rowe said it beautifully. we want low income people to have the same access everybody has. why should they be cast aside to a lower quality program? you have -- you can have medicaid but as many of the beneficiaries say on their own, it's a card with no access behind it. >> that's really one of the reasons so many states are resisting expanding medicaid because they know that without increasing the supply of physicians and hospitals you are going to wind up simply putting more people on it and waiting longer.

the government wants to reform medicaid so that people on this program have the dignity of being able to see private physicians and not being forced to wait in long lines, five or six hours at an emergency room just to see a physician. >> a blind man put it really well. he said i just want to be treated like everybody else 78 my question addressed -- addresses enforcement for the bills. are there provisions for them to routinely read their files to make sure they're correct? are you going to go after the drug companies like sanofi or the drrs -- doctors that participate in take the drugs for free? and a target i.d. stolen is worth 59 cents but medical i.d. that's stolen is worth like

$77. >> the transparency we have stipulates that individuals own their own health records and that they control them so they would have complete access to them. that's more a rule-making specific regulation that would need to be put in place. but we're decades away from when patients actually knew that they had the opportunity and privilege and right to control their own records. we've gone a long way down the wrong road and it's going to take time to get that back. but you're spot on. >> i actually write for myself now and say what i want to say. stop quoting "the new york times" from the committee hearing rooms and whatever you say gets the exact same place the new york times gets to. anything you put out travels the world at the exact same speed. so talk about your own stuff. >> thank you. >> time for one more right

ere. >> asking you to extrapolate into the future. i have a son who is currently in medical school. how do you see this additional government intrusion into medicine. how is that going to affect his life? >> know, two weeks ago, we have a medical school in johnson city and was privileged to be on the clinical faculty before i came to congress for almost 30 years. if i were a young man back deciding am i going to be a congressman or go back to the operating room, that's easy. i would go back to the operating room. taking care of patients is still a fun, fulfilling thing to do. i'm the son of a factory worker b.f. dad worked at a goodrich plant in tennessee.

i went to college and medical school in seven years with no debt. and i didn't live large. i ate a lot of chicken and stuff. >> you were eating good! >> didn't realize i was eating good then. that's all i could afford! young doctors are facing a different climate than i did. you're not going to be able to go like i did, hang your shingle out and build a practice and take care of some of the same patients for 20 years. insurance companies moving them around. you lose that loyalty the but some of the things i will to do, cancer surgery and such, it requires enduring trust to be able to do that. i would tell your son, let dr. tom price worry about that and let him worry about being the best doctor he can be.

>> and i encourage anybody who has any interest in going into medicine to go into medicine. there is nothing more noble than caring for one's fellow man. there is nothing more gratifying, more incredibly fulfilling as phil said than taking cache people. so your son i'm sure is going nto medicine for all the right reasons and i will be fulfilled because of that. remember, this is a dynamic process. it isn't a static process. he will practice 30, 40 years, god willing and the creek don't rise. suspect in three to five years, let alone 10, 20, the technological abilities for curing disease and helping people, we're on the edge of incredible, incredible innovation in curing disease. he's going to have the

opportunity to be involved in that process, so i would encourage him to stay the course and then another positive note, i talk to medical students all across this country. medical students, as you might imagine, cover the ideological spectrum. many of them at their age start over on the left. they'll get to the right place as soon as they get out and realize that it ought to be patients and doctors and families making medical decisions the regardless of you ask logy, when them who would be able to make the decision about how to care for your patient, you or the government, they all answer correctly, no matter where they are political lilt once they realize that, the ability to care for patients will be in the right spot. >> i think also the fact that there are about 20 physicians in congress now that are making policy, they can't say this but

their colleagues really do look to them for leadership and what should be done. it's very important. i could -- would tell your son to hang on because things are going to change. the american people now get it. they want to be in charge. they want their doctors to be making decisions. i think the future can potentially be hugely bright but thank you all for coming because your voices are really important in helping people understand the changes that can -- have to be made. >> one anecdote for your son. in the 30-some years i practiced i took care of some of the sickest people you can ever adge and never took a tums or maalox. six months after coming to this place i'm on prilosec every day! [applause] [captioning performed by national captioning institute] [captions copyright national

able satellite corp. 2014] >> next week a debate on evolution versus creationism between bill nye the science guy and ken ham, the founder of the creation museum. that's next wednesday here on -span. >> cotton avenue serves as a metaphor for macon's history. when macon was first laid out in 1823 they laid it out in nice, square blocks with alternating large, wide bfrleds, wider than lenfant, washington, d.c. boulevards. but anyway as they were laying it out a farmer with a lot -- load of cotton on his wagon

headed toward the river to market it downstream rode right through the stakes that the engineers had laid out ond the engineers simply wove the angled road into the the -- into the lieout be macon, georgia. >> this weekend, book tv and american history tv look behind the history and literary life of macon, georgia. [captioning performed by national captioning institute] [captions copyright national able satellite corp. 2014] >> three-time pulitzer prize winner thomas friedman was interviewed by marvin kalb. this is part of the series co-hosted by george washington university and harvard university. >> the kalb report is funded by a grant from the ethics and

excellence in journalism oundation. >> from the national press club in washington, d.c., this is the kalb report with marvin kalb. [applause] >> hello and welcome to the national press club and to another edition of the kalb report. i'm marvin kalb and tonight a conversation with "new york times" columnist thomas riedman about freedom. over the past 20 years i've had the pleasure, indeed the privilege, of speaking with some of the best journalists in the country. some have even won a pulitzer

prize, which is the highest compliment in the newspaper world. none except our guest tonight has ever won three pulitzer prizes, two for his reporting from the middle east and one for his commentary the tom friedman joined the "times" in 1981, was bureau chief in beirut and then jerusalem. diplomatic ef cronet and in 1983 he became the foreign affairs columnist for the paper. he does that twice a week and somehow still finds time to write six best-selling books, to host six television documentaries, numerous seminars and conferences and to be with us here tonight. so, tom, thank you. thank you very much. thank you. [applause] our subject tonight is freedom.

big word. and i'd like to start, tom, by asking what is your definition of freedom. >> well, first of all, marvin, it's great to be with you. you and your brother bernie were always great path breakers for me and people i admired as a young journalist. so it's a treat to be here with you today. tell bernie i said hi. i'm not a philosophier, i'm a journalist, so let me answer your question in the context of journalism. and if you started this evening by asking me who was -- what was the greatest story you ever covered? been doing this here, i just turned 60, been at the "times" now for 33 years, what was the the hat really you say was most amazing? and i would tell you it was tahrir square.

being in tahrir square for the original revolution that overthrew president mubarak. and when i came home and people asked me about it and i would say that this was the most amazing story i ever covered they'd say why? and i said, because it was the most apolitical political event i ever covered. >> meaning? >> and that's what they said. meaning? at some level it was about this very deep human level emotion of i am somebody. and if you asked me, what is freedom? freedom is the ability to -- the desire, the aspiration to live in a context where i can realize my full potential as a human being, a man or a woman.

and i believe what tahrir square was about at its very root was that very, in some ways, apolitical aspiration, young people living in a world where they could see how everybody else was living, to also want to live in a context where they could realize their full potential. yes, it had to do with mubarak and corruption and a context that had been built where they couldn't realize their full potential, where they lived in a rigged game. but i've always thought freedom, it isn't just about the freedom to write anything, to say anything, to travel anywhere. it's all those things, to be sure, but there is something deeply personal about it. it's to live in a situation where i can be the fullest person i wouldn't -- want to be. >> do you feel, tom, that people all over the world share the same sentiment? >> well, it's a very interesting question and i've thought a lot about it since the arab spring. one of my teachers, a business

philosophier, doug seidman, liked to use the form la, freedom from and free to, based on the formula. what so much of the arab spring was about initially was freedom from. people wanted their freedom from various autocratic regimes. but what often stalled him in the next stage was freedom from is great but there's also freedom to. what do you want to be free to do? and for that you have to build a context. you have to enable people to be free to. it turned out people, some people wanted to be free to be more islamist. some wanted to be free to be more sectarian. and some wanted to be free in the democratic sense to be equal citizens with equal rights and responsibilities. >> but, tom, that's more like choice.

if you are free to have a choice and you can go one way or the other but what i'm asking you is something bigger than that. i'm asking you whether there is a concept that we call freedom at is due us as human beings or is this something that we simply acquire because we live in a united states where that idea of freedom is built into us from public school on? i'm trying to get from you a sense of how you get from the imagine -- majesty of freedom, not a choice. >> well, i do believe, because i believe everyone wants to live in a context that enables, empowers, inspires them to realize their full potential, i do believe the aspiration for freedom, to live in a context where i can do all those things, is universal. >> and yet as you were saying before, some people in the middle east even today would

have a areael about that in the the united states we grow up believing it is due s. >> yes. >> the people in >> the people in egypt and yemen do not. into then also fall opposite trap, to think that somehow we have got a and it is , and it is not an aspiration that other people necessarily want. i am only speaking from my own expense. -- experience. once we lifted the lid in that part of the world, it turned out wanted to be free. maybe it was tli