corruption. it is just as good for that to come out on hearings in capitol .ill as through publications and leakspublications of that form should be a fallback in our democratic system. the fact of the matter is the whistle lowers have been short-circuited. it doesn't work anymore. whistleblowers who would have gone to the senate committee or the house committee feel they are going to be observed the minute they go there. they will view them as traders. they will be spied upon. have something that rises to the level of a constitutional crisis that does seriously impact the way we work and gives unfair advantage to those in the intelligence community who want to stem the

flow of vital information. i agree with your point about whistleblower protections, but there are a range of different motives. there are spy, robert hanssen types. no sympathy for that. a lot of people leak because it makes them feel important. they are in the know, and it shows they are in the know. it makes them feel good to do that. i don't have much sympathy for that. i do have sympathy for an actual whistleblower. were are instances where h have seen for the right reason they have gone to the press and laid out what a disagree with. adon't know that we can have system that allows every person asideide, but if you put that systemic issue, i understand where whistleblowers are coming from, and it's

incumbent on the government to have a process that allows whistleblowers to raise his or her concerns, get them heard, protect them from retaliation, and be confident if there is a need for change there will be congressional a committees. you say it's broken now. i don't know if it ever became as effective as it needed to be. if the government is ever going to remedy the leaking situation, it's incumbent on the government to make sure there is a system therece where people feel is a user-friendly whistleblower system i can get my issues raised. if that happens, and there really is that avenue to get redress of what somebody sees as wrong, then there isn't a justification for a government press,e to go to the because then they are just doing that because they disagree with policy, and i don't think that's a reason why somebody should be allowed to violate their oath. >> we agree on that.

>> on that harmonious note, we are out of time. let's thank our panelists for their thoughts. keep your seats. are guessed from the new yorker and one more panel. from "the new yorker" and one more panel. >> during this month, c-span is pleased to present our winning entries in the student cam documentary competition. student cam is c-span's annual competition that encourages middle and high school students to think critically about issues. this year students were asked to create their video based on the question, what's the most important issue the u.s. congress should consider and what a 14? eight grade students connor angelo tydings-lynch

enter this video asking the government to fix the debt. >> it has never been a problem as cover and -- as countries have always been willing to buy u.s. debt. now that the u.s. is growing more and more debt other countries may not continue to buy u.s. treasury bonds. quest of it got too big, at some point -- >> if it got too big, at some point you can have a situation where lenders got nervous about our ability to repay, and they'd stop lending money, and that would create a cascading series of problems and put into a debt crisis like you have seen in some other countries like greece go through. >> in the current environment, my question is isn't and weak ?emand the greater concern spenders pulled back because of debt burdens, underwater mortgages from the financial

crisis, business is holding off on investment because of weak consumer demand. debt is ourress, country's greatest concern. >> how will the u.s. code with its own accumulating debt. -- how will the u.s. cope with its own accumulating debt? the u.s. debt began directly after the revolutionary war. america has borrowed money from france in the netherlands to pay for the cost of the war. over the next 10 years with the national debt at 43 million modern dollars, the u.s. created tax organization firms such as the department of finance and the u.s. treasury department. the u.s. treasury department was created with the ability to borrow money and was created to keep the debt at a manageable level. the department of finance was created to manage different cost

s and to make sure the costs were not so high as to raise the debt. the next issue came in the 1860 one civil war, which cost over $5 billion to fund. to help -- in the 1861 civil war, which cost over $5 billion to fund. bill that allowed them to print money and to sell treasury bonds. 20th-century america prepared for world war i by raising taxes and selling bonds. after the war the u.s. that was set at over 25 lien dollars. overe u.s. debt was set at $25 billion. by world war ii, the u.s. economy still had not come close to surpassing the gross domestic product of america. however, after the war the debt had more than quintupled from $50 billion to $256 billion. >> we had a big dead after world war ii, in excess of 100% of

gdp. >> a large month of debt the u.s. had accumulated almost caused an economic collapse. the debt situation has never been more dire. >> we are approaching a level which would be the worst we have ever had. >> we are worried they are not going to get a handle on this. >> one of the greatest stresses has been fear of the act of being unable to pay back national debt, which can lead to distrust of the nation as a whole. for the united states, default would be horrific, as the country would not be able to borrow massive amounts of money it needs to keep running. default could possibly mean the collapse of our economy. >> we came allegedly close to a point where the u.s. would have been unable to pay its bills -- we came close to a point where the u.s. would have been unable to pay its bills. unless the

ceiling is lifted periodically, the treasury department runs out of ways to finance the debt we have. so we came relatively close to that, and that has happened several times in the last five years. >> thankfully, the different parties are being urged to work together to combat national debt. >> the good news in this round that we hope our republican colleagues have learned the , how from the debacle we just went through didn't have to be that way, and we are hoping our colleagues will put on the clubs and recognize that this negotiation should be between two budgets and no one should try to gain advantage by threatening to shut down the government or default on our debt. if we can put on those clubs and have a serious conversation, .aybe we can advance

>> congress and the white house are working together to make the monstrous debt a thing of the past. >> the president has made it a priority of his, which is why he submitted a series of budget including cover misys -- compromises, which seek to reduce the debt as a share of our overall economy. >> as long as i am president, i will work with anyone in this chamber to build on this momentum. i intend to fight obstruction with action, and i will oppose any effort to return to the very same policies that front on this economic crisis in the first place. that brought on this economic crisis in the first place. howe get very serious about it can impact overall stability. >> the debt problem has been part of the united states for decades. due to efforts, america is

beginning to lower the gross -- isic out a ratio and beginning to create more jobs. >> we lost 4 million jobs, and we lost another 4 million before our policies were in full effect. those are the facts. so are these. in the last 22 months, businesses have created more than 3 million jobs. >> making those kinds of investments today should help us for the long haul. as we do that we will see reduction of debt. >> i think you have to be smart , and you have to do it in a balanced way. >> to watch all the winning videos and learn more about our

competition, go to www.c-span.org and click on student cam. tell us about what issues you think congress should consider. post your comments on the facebook page or tweet us. >> in a few moments, a forum on this weekend's election in afghanistan. and a little over an hour, the bipartisan policy center hosting a discussion on the future of long-term insurance. after that, an update on how many people have signed up for health insurance under the affordable care act. that we will re-air a conversation about a bill that would shield journalists from prosecution who are protecting their sources. will have a couple of live events tomorrow on the c-span networks. secretary of state john kerry will testify before the senate foreign relations committee on national security and foreign .olicies you can join that conversation on facebook and twitter. be coveringwe will

a defense department briefing on u.s. strategy and operations in africa, including peacekeeping and anti-terrorism efforts. recent forum on the elections in afghanistan, hosted by the alliance in support of the afghan people. this is is an hour. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] >> thank you all for coming. as you know, the elections took place on saturday, and our panel will discuss what we know so far and what the consequences and likelihood of those elections

are likely to be. ofm the executive director the partnership for secure america, and we are proud and happy to cosponsor this panel with the alliance in support of the afghan people, asap. the alliance itself is a group of individuals who are in a coalition dedicated to support the progress made by the afghan people over the last decade. secure partnership for america was an organization founded in 2005 dedicated to the idea that we ought to promote fact-based, bipartisan approach to foreign-policy and national security. over the years we have issued a statement on key policy issues, and we have a very exciting, model,teresting congressional program we have been doing since 2009. i want to get right onto the panel of discussion. let me introduce our moderator,

who is a senior fellow for the center for american progress. first, we are also welcoming c-span 3, who is going to be telecasting this program today. those of you who are interested and want to twitter, we are at #afghan elections panel. karen is a senior fellow at the center for progress. she has written and spoken extensively on issues of south asia and terrorism. she spent some time here in congress on the senate side, as i have and one of my previous incarnations. she has also worked as an elections observer in afghan parliamentary elections in september, 2010, and in

pakistan's parliamentary election in february, two thousand eight, so i will pass it on to caroline, who will give introductions, and then we will get started. >> thanks, sandy. hi, everyone. thanks for coming today. we have a great panel, and i am going to quickly add a little more about the alliance in support of the afghan people, of which i am a member. a completely is bipartisan coalition of afghan , and asican individuals andy said, it's organized around this idea that there has been progress made in afghanistan. maybe it's not to the extent we hope given the investment, but there is progress, and it deserves to be sustained. while the members of this coalition don't agree on every detail of policies moving forward, we do have a general sense there is a shared belief

that we should remain engaged in afghanistan that we should continue supporting the afghanistan people. we have a panel to discuss saturday's events in the app -- the implications of the elections. even though we don't know the results yet, i think it was an exciting day and exceeded many of our expectations. i think a lot of us were especially concerned about some , andof spectacular attack we saw, while there were incidents overall, it seemed to and the turnout was great, especially in the cities. i know many of us have received who were so afghans excited. it was really inspiring to see that unfold. i am going to quickly introduce the panel is here today. -- panelists here today. i'm not going to get to all the

details about their bios, but let me tell you a little bit about them. to my right is the ambassador who is the founder and president of the consulting company based in virginia. he was previously with the u.s.ip and before that was the afghan ambassador to canada and france. he is a prolific writer and is often commenting on politics in afghanistan and regional implications, so they queue for being here. for being here. then we have jed, the director of programs. he is responsible for overseeing the implementation of di's programs. he was the chief of staff for the election observation mission , on which i served, so i worked

closely with jed. he knows how these technical processes work for elections in and also around the world, and we are delighted to whereim here to explain we are and where the process could go. finally, we have lisa curtis, who is a senior research fellow at the heritage foundation. since 2006, there and prior to that, lisa was a member of the professional staff on the senate foreign relations committee, working for senator lugar, who was the chairman at the time. she has also worked for south and central asia office at the state department, for the foreign service, for the cia, and had a wealth of experience. inc. you, lisa. there going to start with ambassador. if you can give your assessment saturday andned on

what you think it means moving forward for afghans but also for the united states. >> thank you so much. and thank to be here, you to the partnership for as wellmerica and asap for putting this together. glad to be on this panel. saturday turned out to be a historic and groundbreaking day for afghanistan. expectedot many people this type of turnout on election day in afghanistan, and didn't afghan forces, security forces, to be able to control the situation as best as they did. the men and women

of the country to line up in a regimented manner and an organized manner, which is usually not the case in be verytan, and patient, patiently await their turn to cast a vote, and they didn't expect to run out of ballot forms and some of the polling stations. as an afghan i am very proud of what happened. it was a watershed moment that sent several messages. the first was from the afghan citizen to the nation as a whole saying, we all one. our destiny has one. -- we all won. our destiny has won. conflict,rmoil and

and now the last 13 years have laid the foundation for something better for the country. there was a lot of doubt as to whether a found -- and -- foundation has been laid in afghanistan. from a political perspective and from a nationbuilding and state building perspective, we see the constitutional order it in place in 2004-- put in place and resulted in a lot of work on different fronts trying to develop democracy in afghanistan is paying off. overlyt want to sound optimistic, because i think that orhave crossed one hurdle maybe several, but one major we haven saturday, and several more ahead of us. this electoral process it else is still unfolding. ago or so i hour

saw on twitter that there is breaking news saying one of the leading candidates, one of the top three, is thinking of his team doesuse not seem to be picking up some traction, and he may be dropping and is in discussion with at least one or two of the other main candidates, the front runners. can see afghanistan on an hour by hour, day by day basis is -- in my opinion, trying to find its way and doing so in a peaceful manner, as we are going to be experiencing the first peaceful, democratic transfer of power in the history of the country. those whoone was for

want to disrupt this process. we all saw what the taliban did or was capable of doing by planting ied's and targeting people,es and ordinary thaty soft targets, and did not happen. that was not realized. the one hand because afghan security forces did an amazing job. i think the intelligence services did an amazing job. the head of intelligence today read thousand 400 reports of incidents that were going to -- 3400 incidents that were going to occur across the country and almost all of them were neutralized. result, more than 50 or so militants would be sent as suicide bombers were killed, and were arrested, all

parts of different operations. loudly andt speaks clearly to the fact that afghan security forces have reached a certain level of capacity that was not observed in the 2009 elections. sent to themessage afghannic is that the people have chosen to support a democratic future -- sent to the the afghanthat people have chosen to support a democratic future, that this strategy of trying to intimidate is not going to dissuade afghans from a better

future. also sent a message that the policy needs to be reviewed, the now they are facing the afghan people and afghan forces. ways of trying to come to terms, and i hope that is heard loud and clear. then there was a message to the international community. message to especially those who have been on the side of the afghan people, and that includes the united states at the top of we are not as

backwards as some people pretended. as -- ast as limited primitive and that the democracy is not bad or wrong. we are going to embrace it. all your efforts, all the blood and treasure that has been spent been innistan, has not vain, so we look forward to continuing to work with the international community. clear thee message is afghans are not ready to take care of everything themselves. they don't have the resources to do so, but they are appreciative of what others have done. they recognize it is the who hasional community

paid. we can look forward to a reset in relationships with washington and with others. i think we can look forward to the signing of the bsa with new government in place soon. implications the new governor decided to have them sign it before transfer of power, but regardless, the dsa is seen by most afghans if not of, as the cornerstone future relations with the united states. nato is another partner in the future. then there is the donor community. good, but let me end. that thereby saying

are some major hurdles ahead. aheadare some challenges with the process, but the expectation is everyone's vote should count. everyone's vote should be respected, and in order to do so, the process has to deal with next step and the with elections, which is counting the votes and handling the boats and transferring them from one place to another and eventually tallying the votes and doing the part that has to do with complaints, the process of education and so forth, has to be handled in the same manner as elections were handled so forth. it has to be according to the rules. it has to be transparent. it has to be as fair and just as possible.

overcome these think we allhen i may be in a position to because i think that would be very good news, knowing that the electoral process has functioned as it should and the results would have to be accepted by whoever is a winner, and the results have to be accepted by whoever is a loser. >> thank you so much. jed, i want to turn it over to you. you know democracy international has a team of people who are there and have been following this, and i know you just returned from afghanistan. could you talk a little bit ofut the initial assessment what is happening and where things are going with the process. thank you. >> thank you, caroline.

i want to thank the partners for having us here today on this is truly well-timed discussion. electionmodest observation mission on the .round in kabul we have been observing the political process in afghanistan since we observed the provincial council. our initial assessments are very the openistent with source reporting you have seen. despite significant threats,

personal threats, amidst great personal risk, the fact so many afghans came out and voted in those elections on saturday is really inspiring, and we certainly observed that enthusiasm in the places are observers were able to get out and observe on election day. the turnout being reported at somewhere around 7 million votes cast. i think we will see that number refined a little bit as the results sheets come in from the polling stations. a few weeks ago we were sitting around talking about perhaps we distributed to many ballots around the country, and the fact that one of the issues we are talking about is their were ballots and because

voters are coming out is exactly the opposite of discussion. it is a very positive sign. as you mentioned, the incident of violence in the past and leading to the 2010 parliamentary elections were much higher. on election day specifically violence was much more widespread. that was not the case on saturday. the afghan national security forces performed their jobs andrably on election day, going forward, i think there are two tracks now, two things i want to talk about. ofction day is just one part the process. a lead up to election day where we saw a robust

campaign. there was great enthusiasm. election day we saw that. they said they were going to participate in the election. would be a there higher turnout. i don't think we expected it would be around 7 million. be the cases out to as to how many people went out to vote, that's a real statement and a statement to others who thato disrupt the process, democracy is the path to power in afghanistan. what happens over the next couple weeks is critically important to the process.

the hard task of determining who won the elections. the process has been depleted throughout the country. the result form should be coming to a council there were they will oversee the tallying of the votes cast on saturday through a double-blind entry process. point we will start to see preliminary results released from the commission. pastesults process in the has been one of the most contentious parts of the

process. onle we can all agree that election day what we see is very positive, there is a lot more work to do. it's very important that the commission conduct its work transparently, not just with the international community and local media, but with the candidate's campaigns, and it's going to be critical that the campaigns exercise some patience and respect the commissions process that they determine whoto won the election and to make sure the votes that were cast on exactly thelect votes cast on saturday. in addition to the results is aation process, quarantine process. fine some number of

triggers by which a polling station is suspicious and whether or not the polling station should be further investigated, so there will be some number of polling stations that will meet the criteria, and the commission will be responsible for going back to determine what will happen there or not. be a critical process. it will be important for the commission to be transparent, to to tell theation, local and international community exactly what they are doing and what the implications would be. in addition to the results tabulation process, the independent election complaints commission will manage the complaints process, which will happen concurrently with the results tabulation process. the complaints are still coming in, and i believe that process

will continue until april 27. the number of complaints is still unknown, although i think the estimate so far has been around 2000. the commission will be responsible for categorizing that into three categories. category a being the ones that the race.ct those will be the priority complaints the commission will look into. those will be the most important complaints lodged. it will be most important for the commission to communicate exactly what is the complaint, what's being done, and what the decisions are when they do come to decisions. those processes are extremely critical to the election outcome, and as has been the case in the past, they take some

time. it will require patience, particularly among the , to respect the process, to respect the independence of the election ofmission, the independence the commission. there are two scenarios were the processes could be even more important. that one candidate could potentially be close to 50%. case and thethe actions throughout the process and the decisions through the adjudication process could affect whether or not one candidate gets over the threshold to avoid a second round runoff, which is 50%. the secondcenario is and third candidates could be very close. resultsat scenario, the

of the polling stations or a specific complaint that has been lodged could affect whether or not one candidate or the other is participating in a runoff election should know candidate reach 50% plus one, so in those scenarios, the results tabulation process is critically important and complaints process is important, that in those scenarios, they will be absolutely critical to determine who will be hurt is abating in a runoff election and who will eventually be the next resident of afghanistan. >> can we pull the lens back a little bit and talk about implications for the u.s. and also the region? you could get a little bit into pakistan. i know you don't have much time, but i would love to hear your thoughts. thank you. then we will open it to questions. >> thanks, caroline.

thanks to the department and asap for hosting this event. i am happy this event is taking place today. originally we were thinking of holding it last week. today we have good news to report. the telegram -- taliban did try its best to disrupt the process. you have major attacks at the hotel in kabul, which looked like they were directly targeted. the attack on the independent election commission. there were attacks on election day, smaller level attacks, but clearly they tried to disrupt the electoral process, and they failed. the high voter turnout. most reports are seeing around 60%, which is almost twice as much as turnout in 2009, so what

does this say? wantsays afghans democracy. they don't want what the telamon -- taliban has to offer. in a way it is a blow for the taliban. dent in their narrative. i am not saying the telamon is going to disappear and peace will break out tomorrow, but this will put pressure on the taliban. it has been a blow to them. these elections should also restore a sense of optimism among americans, and it should remind us why the u.s. went to war in afghanistan in the first phase, and what's at stake for u.s. national security interests, and what could happen if we withdraw troops to quickly. unfortunately, american popular

support for the war has dipped considerably. some of the latest polling sew shows it is below 20%. i think this is because of the western media bias for reporting on violence and bad news coming out of the country, but i think it's also the result of president karzai and his continuous criticism of american despite there massive amount of assistance in blood and treasure the u.s. has re, but the white house has been reluctant to talk about the war and really spell whator the american people is at stake, so i think all of these combined have led to the dismal view about afghanistan. the point is with these elections we have an opportunity to reframe the debate, and we can focus on what is right about the u.s. mission in afghanistan and what has been accomplished.

i think this is a good time for the white house to be clear that leave at leasto 10,000 forces after 2014 in the country, assuming the new minister or perhaps a in the karzai administration signed the bsa. our u.s. commander in afghanistan general dunford has said at least 10,000 are necessary to advise and train afghan forces, and i think the white house has favored a smaller u.s. footprint, which may appeal to american domestic opinion, but it really carries a risk of failing to meet the minimum requirements of the afghan forces. it is vital the u.s. partner with the afghans to prevent the taliban resurgence for many reasons. election and

continued u.s. engagement with the country is particularly important for women and ethnic , unlike when the taliban ruled the country and prevented women from going to school, let alone participating in the economic and political life of the country. one of the election candidates had a woman on the ticket as a vice presidential candidate, and early results are showing 30% of voters were women, so this is a remarkable a compliment for women. second, preventing a taliban resurgence is fundamental to combating the global terrorist threat. of the seen the impact u.s. completely withdrawing forces from iraq, where al qaeda had made a comeback. i think this should serve as a warning to the u.s. on the risk of leaving afghanistan too soon. i would simply say if we can afford to have ready thousand u.s. troops stationed in korea 60 years after the war ended

there, surely we can afford to keep 10,000 troops in the country from which the 9/11 .ttacks originated third, we must consider the blowback effect of the taliban resurgence contact -- on pakistan, a nuclear armed state. i think ambassador samad is correct when he says this election is puts pressure on pakistan to reconsider some of its policies, and i think certainly there are people in thestan who realized increasing threat from the pakistani telamon, which coordinates with the afghan taliban, and more people are realizing the blowback impact of supporting the afghan taliban force of many years is certainly hurting

pakistan now, so hopefully, this election will help push the needle in pakistan more toward a on theof cracking down telegram -- taliban on its side of the border. itshe taliban reestablishes influence in afghanistan, not only does it offer the opportunity to provide al qaeda safe haven, but also the many other terrorist groups that operate from the region and ideology,same kind of and i am talking about the islamic movement of whose pakistan, which poses a threat. on attackingocus india. even china is growing increasingly concerned that afghanistan could become a safe .aven for uighur separatists

in early march terrorist attacks civilians at a railway station ,n the city of kunming in china leaving 20 dead and 149 injured. china blamed the attack on uighur extremists, and quickly followed up saying beijing will work with the international community to fight terror in afghanistan. with thewhat happens taliban in afghanistan has far-reaching consequences not only for the u.s. but for all the countries. that are several factors will determine whether afghanistan will indeed become a state or democracy in the coming years. the credibility of these elections was critical. i think we have some good news, but also the issue of how soon the u.s. withdraws its forces from the country plays a role in whether afghanistan will be successful. i would only say the afghans

have risk their lives to show they are committed to democracy in the country, and we should leaving aby substantial presence and continuing to fund and train the afghan security forces. now is not the time for the u.s. to give up on the afghan mission. instead, we should use this opportunity to reinvigorate our commitment to the country. thank you. thanks, lisa. i do want to open it up to questions from the audience. you have cards, and they need to be delivered to me. will ask the first question while those are being collected. then we will open it up for your questions. much for your comments. i am just going to throw a question out for a quick response, and then i want to open it up. what happens if this becomes a

very prolonged process and we have a second round and things are not decided for many months? what would be your advice to the white house, to members of shoulds about how they be talking about it, how they should be approaching it? what's the role, what's the of the u.s. during a sensitive time in afghanistan? ambassador, can i start with you for your quick thoughts about advice for u.s. policymakers? thank you. >> in case there is a prolonged process and no definitive it's incumbent on the international community as a whole and the u.s. in particular to be patient.

i do not foresee a very ,rolonged and arduous process but the possibility exists. reasonssay for all the the other panelists gave, whether electoral or strategic there is noiven, need to rush. there is no need to make decisions purely because of domestic pressures. afghanistan, as history has shown, especially the history of the post-soviet period has shown, when the soviets left afghanistan, the country was sort of left to its own devices and ended up becoming a failed state, and the failed states and

it up becoming a hub for terrorism. we all know the story. we have definitely given the conditions that exist in the region as a whole, we definitely cannot afford to rush to judgment and make a decision that is in haste. >> jed, lisa, do you have anything to add to that? want to start? >> it wasn't that long ago we dealt with that exact scenario in 2009 and in 2010. in 2010 the parliament was seated almost a year after election day. i think we all hope that won't be the case again. the message needs to be clear that ultimately it's for the afghan people to decide whether or not the electoral process beats their standards and whether or not they can respect the outcome of the process. it's really important that

provided to the independent election commission, and the independent election complaints commission to conduct their work independently and impartially, which as you know was art of the question, and there was great focus on the karzai administration in 2009 on alleged foreign interference. the worst thing we can do is fall into that trap again. whether that is reality or simply perception, we certainly want to avoid that. >> i want to add that the u.s. should be patient. there's a lot at stake, but the reality is there are some constraints when it comes to the bilateral security agreement and whether or not the u.s. needs any troops post 2014. i think the u.s. has shown as much flexibility as it can on the issue, and the real question is whether the nato countries can show the same amount of flexibility, because they are not going to commit any troops

until the u.s. signed the bsa with afghanistan, and they are under constraints in terms of meeting time for planning and logistics, so yes, we should be patient, but at the same time, if afghans want to see a true presence post 2014, i think there are some constraints in that regard, and if it goes much beyond the summer, i think we're in real trouble in terms of the and politically with the white house, the desire troops after 2014. >> thanks, lisa. i have a question from the audience. i think i'm going to turn this to you, ambassador. could you comment on the quality of the top presidential contenders. in terms ofsee their vision moving forward? >> we started out with a lesson

who went through the first round of electoral qualification testing. they had to meet certain criteria, and they did. , three of them decided to drop. we were left with eight. finally, the common understanding was that there were three contenders and the bank, of the former world professor of johns hopkins, the minister of finance, and also in charge of the transition that took place, the security transition that took place with the international community. then you have dr. abdullah, in the anti-soviet period and the anti-taliban movement, as a

civilian assistant and advisor, and then turned minister of foreign affairs in 2001 and then and government in 2006 became the opposition leader in 2000 nine and decided not to go into the runoff. then you have the foreign minister and national security the former came from kings cap in rome and was andciated with hamid karzai considered as the person probably closest to hamid karzai and probably someone who has his blessing. i think the preliminary assessments made over the past 48 hour show that they seem to

be heading the pack. mesul is trailing, that he may not be able to go into the second round. i am speculating, but this is based on preliminary we see. either there will be a runoff thathe way to the end, or in between there will be a political arrangement. a coalition would be built, a government of national unity would be formed, and they will agree on sharing power. the other question is with president karzai leaving office and seeming to want to exercise some level of influence in the and have a say about

afghan policy in the future, whether he will be given -- how much space will he be given, and in what area, and whether he will be satisfied or not, but regardless of whether karzai is satisfied or not, what is important is we had a first round. the afghan people had a chance to go to the polling stations and deliver their ballots, and there is no momentum to a second round. -- there isbility no momentum to a second round. the responsibility is on the shoulders of the commissions. as well as other related mechanisms that exist. they have to do their job as openly, as transparently as possible, in order to make sure the track the afghan people have shown and the risk they took on saturday has

some type of results that is acceptable. no one is looking for perfection here. no one is looking for a totally flawless election. we are looking at an election that would have enough credibility and enough acceptance with the afghans and international community. >> thank you. lisa, i am going to turn a couple of questions to you. two big questions, and let's see if you can have a go at it. the first question is foreign affairs recently published an article where someone made the asf was a great threat because of the risk of a clue. how likely do you think that scenario is? is on a totally unrelated matter. i want to get to a bunch of these, and that is on pakistan. the sharif government has said

they have taken a stance of noninterference. we saw some in the press, some reporting there was cooperation with order closures and other matters taken by the pakistanis. how concerned are you about pakistan continuing to influence in unconstructive ways throughout this process and beyond? let's leave it there, and if anyone wants to comment after lisa, but i do want to get more questions. thanks. of whetherthe issue there would be some kind of clue, i think unless worried about -- i am less worried about this now. i think the question six months ago was if you had a really divisive election, breaking down , a lot ofic lines bitterness and animosity, and the worry was that that would

reflect within the afghan security forces, and you can ofe a rupturing of the unity the afghan security forces, but we're are not seeing that happen. i would argue we are seeing the that cas enough has shown they can protect the afghan people. has protectedf the people. it was not as bad as we feared. there will be allegations of fraud, but it doesn't look inwhere on the level we saw 2009. it is a more orderly process. that i think that the concerns about any kind of coup coming from the left of

pakistan, again, i think that pakistan has sort of been waiting and watching. they have been focused on their own taliban threat. there was talk of the taliban theirry going after havens in north waziristan. airstrikes, but not the federal operation that some people expected. they were engaged in a dialogue. there has of course been some that they convinced the taliban and to go in for so that this operation would not happen and disrupt their ability to keep fighting in afghanistan. know, i wouldou not say i have seen a

fundamental shift among the pakistani military to crack down on the taliban, however i do think that this election will make them, you know, think twice and consider their policies moving forward. first, the blowback. they know that if they have a comeback it will have a blowback on the pakistani state. second, as we said, the afghan people have spoken, shown their support for the mock receipt. they don't want what the taliban has to offer. us will have to factor into their planning for the future. >> great, thank you so much. question on the economy. in at anyto jump moment. -- what are the prospects for sustained economic growth? we have turned a corner with the

election. or at least we are at the beginning. we talked about the unsustainability of the state and the need for continued funding. what are the prospects for the afghan economy to become more self-sufficient? thank you. >> it is a good question, actually. there has been so much focus on the past year or two on the security and political transitions that we are in the midst of. not enough attention has been paid to the economic transition that afghanistan is to undergo. i was in kabul a few weeks ago. you could clearly feel that people were anxious. that businesses, small businesses, not talking about the larger ones, but the smaller businesses are hurting as a result of it not being signed. that sense of uncertainty, that sense of not knowing what might happen, it has an impact on economic life of the country.

now, if we have a successful political transition and we have new leadership in the country that stays calm, which is what , theneople now predict the business cycle is going to pick up again. again, you are going to see normal sort of development taking place in afghanistan, which has been positive overall. now, business in afghanistan, the economy overall in quiteistan has relied to an extent on foreign aid money. and a large amount of assistance that has come into the country over the last 13 years. that is going to shrink. we all know that. the afghans are ready to adjust. hopefully they will be able to come up with new ideas.

but they are looking forward to enough stability and security in the country to be able to implement all of these big projects that the country relies on so much. whether it is in the mining sector, which we all know is isy promising, whether it agriculture and business, whether it is turning afghanistan into a transit hub in that region of the world, building infrastructure, so on and so forth. the prospects can be bright. it all depends on political stability and security. >> thank you. another question from the audience here. what sort of bipartisan coalition is there in congress to support a unified front backing afghanistan? is anyone here aware of a congressional effort to support this? on the congressional side? takers?

is there anyone in the audience who knows? forthis may be a task someone there to start mobilizing people. i am going to turn and ask a question to judge. at this point, we have to be what is taking place in afghanistan over the weeks and months. how concerned are you about the sort of independent inanizations being used political ways? how much of a concern is this? >> i think it is a real concern. so far we have not seen indications that we will not act independently or be impartial. but if history is any indication, in 2009 that was one of the key concerns about the independent election commission. their impartiality.

particularly in the scenarios that i spoke about earlier. if one of those were to become true, you know, the independence is critical. the impartial work of those commissions would be critical. so, i think it is a real concern. at this point there have not been indications that the commission will not act independently. are, ther the results more pressure those commissions will be under. you asked what the message should be. .hat the u.s. can do it is one of the key things that can be done, to support those commissions, the independence and impartiality of those commissions. >> i am going to ask another question.

are there more questions from the audience? we only have a couple of more minutes, but we would welcome them. if there is a disputed outcome or a highly contentious second thed, do you see international community or the u.s. playing -- would you think that there would be a role for the u.s. or the international community in providing a kind of facilitating role among candidates? to help them reach a deal amongst each other? or do you see that kind of facilitation as dangerous to kind of the negotiations among afghans? >> i do not see that possibility in 2014. experience,the 2009 on all sides, has left everyone somewhat sensitive.

and worried about perceptions. that none of the afghan teams, candidates, and tickets, or political heavyweights, will come forth and ask for the u.s. or any other country. what i do see is maybe, maybe, , ifr strict conditions things are about to get out of hand, there may be a role for the u.s. to play. as an arbiter. that would probably be the last resort of engagement in the process. have run outink we of time. i want to thank the partnership for a secure america and the alliance in support of the afghan people. thank you so much to our panelists.

thank you very much. thanks to everyone for coming. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] nation is not founded on the whim of man. we are not ruled by kings or emperors. president is an ordinary citizen, vested with the power to govern, swore -- sworn to people and preserve the of the united states. inherent in the oath is the responsibility to live within its laws, with no higher or lower expectations than the average citizen. atn the president appeared the deposition of ms. jones before the federal grand jury, he was sworn to a second oath, to tell the truth, the whole truth, and nothing but the truth. according to witnesses, to the

judiciary committee, before the special counsel, he did not do. vote to impeach the president of the united states and asked that his case be considered by the united states senate and that other body of this great congress uphold their responsibility to render justice on these most serious charges. but to the president, i would sir, you have done great damage to this nation over this past year. while your defenders are contending that further impeachment proceedings would only protract and exacerbate the damage to this country, i say that you have the power to terminate that damage and heal the wounds you have created. you, sir, may resign your post.

[yells and catcalls from audience] >> the house will be in order. and -- and -- >> the house will be in order. [continued yelling from the floor] that i amnly tell you willing to heed my own words. to my colleagues, friends, and especially my wife and family, i have hurt you all deeply and beg your forgiveness. i was prepared to lead the narrow majority as speaker. i believe that i had it in me to do a fine job. , or beannot do that job the kind of leader i would like to be under current circumstances. that must set the example

i hope president clinton will follow. stand for speaker of the house on january 6. rather, i shall remain as a backbencher in this congress that i so dearly love were approximately six months, whereupon i shall vacate my seat and asked the governor to call a special election to take my place. i thank my constituents for the opportunity to serve them. i hope they will not think badly of me for leaving. my chief of martin, staff, and all of my staff for their tireless work on my behalf. and i thank my wife especially for standing by me. i love her very much. god bless america. [applause] >> find more highlights of house floor coverage on our facebook age. c-span, created by the american cable companies 35 years ago,

brought to you today as a public service from your local cable or satellite provider. >> coming up in a few moments, the bipartisan policy center, hosting a discussion on long-term care insurance. in more than an hour, an update on how many people signed up for theth insurance under affordable care act. after that, a look at a bill who would -- that would shield journalists who are protecting their sources. foreignat, more on the from the recent elections in afghanistan. >> on the next "washington discusses theryan federal budget on capitol hill. followed by the senate chairman on energy and health-care issues. later, a los angeles times correspondent will talk about white house deportation policy under president obama. washington journal, live every morning, with your calls,

tweets, and facebook comments, 7 a.m. eastern, on c-span. >> next, look at the role the federal government may have in the long term care insurance market as the baby boom generation ages. bill frist andde tom daschle. this is from the bipartisan policy center and is a little more than our. >> well, good afternoon, everybody. welcome to the bipartisan policy center. it is a real pleasure to invite you to the launch of a new initiative on long-term health care. based on the crowd on this rainy day, i would say that long-term health care is an issue whose time has come, if not long overdue. we really appreciate your joining us. this will be a shared effort over the next eight months to 12

months. led by tremendous public servants, like tom daschle, bill frist, and our newest senior fellow -- we emphasize the fellow, not the senior, governor tommy thompson. it is hard in the long-term care initiative not to stumble into those experience jokes. ourill try to avoid that. goal over the next seven to eight months is to put together politically pragmatic recommendations that we will be able to release late in 2014. as i think some of you know, the bipartisan policy center, -- prides itself on aggressive advocacy and analysis. we do not hit print and predict that through our genius and insight the world is going to embrace all of our ideas. washington, d.c., does not lack for ideas.

it may lack for the trust of people to contemplate them. today we are releasing a white paper, which just lays out what we think is the framework to organize our thinking on the discussion. this framework builds on a broader framework that we were able to articulate last year. last year the leaders of the health policy project and economic budget project were able to come together around a constructive collision of interests to determine how we can, in fact, build a value based health care system that provides access, quality, and reduce -- reduces costs. notprogram that we released only bridge the partisan divide, but actually a much broader and faster divide, the cultural divide between the communities. ofhired a number interpreters to enable that conversation to take place.

you think i am joking. we actually had to bring a kind of noah's ark of consultants together to make that conversation possible. having done that, we think we have overcome a real barrier and we are seeing a synthesis to this work. as of the release of that report, leaders have knowledge that one of the key drivers we did not have a chance to deal with was thinking about long-term service and support. the elderly, but for people with long-term care because of significant disabilities. today's object will try to fill the space. there is tremendous expertise in this room. incredible expertise across the country. we will be seeking to engage all of your support over the next eight months. to thank thent scan foundation for their generous support in this initiative and introduce dr. bruce chernoff, our first speaker today.

>> well, thank you for that warm introduction. i just want to pick up where the first speaker left off. it is great to see a room so full of people who care about this issue. to see this place at standing room only says something about long-term services, support, and the need for us to address these issues now. i really want to begin by thanking the leadership of the bipartisan policy center who are up here with me. without your energy, passion, and determination to take on this issue, and the understanding of the links between long-term service health and the broader of the country, that is just critical. today we begin a discussion that will involve all of you. people, many thoughtful many of whom have worked for years on this issue. it is now time to put that

energy and knowledge to work in a pragmatic, thoughtful, and comprehensive way. with that, i welcome you all. thank you. >> good afternoon. my name is catherine hayes, the health policy director here. i will be overseeing the staff level of all his initiatives. before i turn things over to the senator, i would like to take this opportunity to thank the scan foundation for their generous support. i would also like to introduce our senior vice president here, who will be working with us as well. as well as a number of our senior policy advisers. they are here today. chris jennings, they will both be helping us and participating in the project. stuart butler will be coming on for the next phase. i would also like to recognize steve. i saw him here somewhere. steve lieberman will be doing

the analytics. i am sorry -- [laughter] apologize, i wanted to say welcome to senator domenici, who is with us here today, for all the hard work you did on our initiative. >> i would also welcome pete and congressman glickman, who is one of our senior fellows and a very important part of the bcc. let me join bruce, catherine, and jason on welcoming each of you. this is a remarkable turnout, as bruce has noted, and real indication of the extraordinary interest and passion around this issue and how important this matter is from a public all see perspective. i am just thrilled to have the opportunity to again work with friends and colleagues, bill frist, tommy thompson, we have had experiences working together before. had especially a

the opportunity to work with many prospective colleagues, but none more so than tommy and alice. the financing and delivery of long-term care has been a challenge for many, many years. as we all recognize. both personal, as well as financial. families,duals, for friends, states, and the federal government. both on theoard -- delivery and financial side of health care, it has reached new levels of concern as we consider the long-term care challenges today. care is highly fragmented. a result, available services and support are not coordinated across providers or caregivers, making the effectiveness system inefficient and extremely expensive.

next eight months, the bipartisan policy center is going to embark on an effort to develop a bipartisan, realistic, and viable way to improve the financing and delivery of these services. the issue has a complex history, as we all know. has challenged policymakers, literally, for decades. in seeking solutions we are going to be drawing upon the excellent work of the commission. the practical application of that policy is for the administering of those programs today. today we are releasing a white paper discover -- discussing the state of long-term care and sicktant services with a policy questions that we hope we can address over the course of the next eight months. in addition to that, we will be

offering a framework to guide the deliberation forward. we recognize that policy solutions will not be easy. they are certainly going to involve a variety of what is most likely legislative and regulatory change. but we start the day with optimism and the hope that by coming together, by recognizing the importance of this challenge, by recognizing the need to address this challenge, we can make some real progress in moving this country forward on this important issue. we welcome your feedback, look forward to working with many of you, and i am very pleased to have the opportunity, now, to pass the podium along to my friend and colleague. >> can you hear from this microphone? i was going to try to keep it

informal. you know, one might ask why we are taking on this issue of financing and delivery of long-term care in a climate that is difficult and challenging, to say the least, politically and fiscally. my response is always simple. you can just look at the numbers, the metrics, the measurements to understand why now is the opportune time, coming as it is coming, something we address in a systematic way where we can effectively alter the course of that way. the number of americans estimated to need long-term service support will double over the next four years. from about 12 million to 27 million in 2050. secondly, this projected growth is not just due to demographic, but primary demographics

determined long ago. baby boomers are considered relatively healthy, but in 20 years many will have significant health problems, problems with daily activities like bathing, dressing, and eating. third, this tidal wave has compounded at the same time with fewer and fewer family by insufficient savings for retirement and by on thewing demands budget that we talk about every day. be, as we act will all know, devastating to states and the federal government, which are jointly responsible for the medicaid program. more importantly, to the individuals, families, and communities across the country who will be forced to spin the word that we all adopt and use, but to spin down has devastating consequences of families. valiant andmade a

in many cases a bold effort to develop innovative solutions to better integrate and assimilate these costs, but as many governors have said to us alone willnnovation absolutely not solve the problem. the long-term care insurance options, as we all know, they are very limited. we see it as we think about ourselves, our parents, our loved ones. the market has especially .truggled in recent years it only plays a moderate role today. in its current structure, the private insurance market, as structured today, simply cannot offer affordable options for those without the resources available to obtain coverage. , recognizing that developing policy options will not be easy here -- everyone in this room,

many, most everyone in this room has participated in policy options. sometimes the scattered way, by working together. partisan gridlock combined with the overall federal budget will makeve made and our task a particularly challenging one. fundamentally believe, however, that finding solutions to these challenges is not only achievable -- yes, cheap -- but also imperative. achievable -- but also imperative. before the baby boomers need this assistance. would tommy thompson please come up? >> thank you, bill. tom, alice, it is an absolute honor for me to be working with such a distinguished group of individuals. jason, bruce, thank you.

pete, dan. as a former governor and secretary of health and human services, i have had the opportunity to look at this problem in different ways. they are all very complex, as you have heard, and it is difficult to come up with the answers. people do not realize that the states of the individuals who will be held holding the financial problem and try to come up with a solution. because medicaid, which is really more the responsibility of states, though it is funded by the federal government, is responsible for almost two of long-term cost care. one third of the medicaid budget, $400 billion. increaseis going to out of what is required in the budget to take care of the long-term care problem.

state level. the >> moving to individuals who do not want to stay in their home. opportunity for health services to take care of those individuals. that is what we have to do. for skilledill need nursing services and we still have to look at the financial implications. that is why all of you in this room are so important. to see sotwarming many individuals from all over this country coming for it and saying we have a problem and i want to be part of the solution. if we can only do that in congress, we could get those individuals to look at the situation in a bipartisan way, i think we would move a long ways towards finding a solution. i'm here to tell you that we

have immediate problems and those problems are going to increase in the future. it is people like you and the leadership up here that is going to have to come together over the next eight months and come up with solutions. the budget, financial ones, how we are going to do with individual staying in their homes. and how we are going to integrate the states and being able to solve the states budgets. we are going to be looking at serious problems unless we come up with solutions. ladies and gentlemen, i don't have the answers today. i want to work on those answers with all of you and i'm here to tell you with the people of this room and the people here at the bipartisan coalition, i am confident that we can come up with some very good solutions. we are going to have to figure out a way how we can take this bipartisanship attitude across the street over on capitol hill and get some solutions worked out as well. congratulations to all of you and now it is my honor to have

the individual with the most brainpower up here to come up here and actually fill in and be able to come up with the solutions. alice. doctor? only one of the distinguished group that nobody of voters has ever elected -- [laughter] the public office. i have been working on this problem often on for very long time. i wrote a book about long-term care in 1988. we haven't come much closer to solving it. reasons why we haven't and some of them have been alluded to year -- here. because this question of how to we provide long-term support for people who need it is at the intersection of family and private responsibility and

public responsibility. that is a difficult intersection for ideological parties to come to grips with. stereo typical democrats -- we are not stereotypical here -- stereotypical democrats say it is a public responsibility. stereotypical republican say it is primarily a private responsibility. it is both. the reason i think the bipartisan policy center is the right place to try to work out some combination of public and private changes that will help this deal as a nation with his big problem is that it isn't a stereotypical place. it is a place where people are probably republicans or democrats, but they come together to solve problems. that is what we hope we will do

here. have't think any of us exact answers, but there are some things that we know -- governor thompson just alluded to keeping people in their homes. what has become more and more obvious -- maybe it has become more and more obvious to me because i am aging is that most people do not want to be in an institution, in a nursing home, or whatever. the big challenge, where we need skilled nursing facilities and other kinds of institutions, the big challenge is how do we reconfigure communities and keepies so that they can older and disabled people in their homes as long as possible

without bankrupting the country. tot is what we are trying grapple with here. thank you. [applause] >> before we have the next panel, we have time for a few lessons for leaders -- for a few questions for our leaders. >> question right here. >> my name is barbara. of my nurse, -- caretaker dad and i am a patient advocate. we are frightened and we need your help to support our access to care. i can remember hearing the president answering a report andt elder care programs economic rationing of procedures by raising the issue of justification of providing dollars and care for those with limited capabilities or life expectancy.

your outlook on economic rationing, assisted suicide, and the compassionate choices movement strategies? >> i don't know. do we have -- why don't we use that microphone. be hard for it will us to go through because really have two minutes. those are the sort of issues and i think one of the advantages we have is that we -- many of us are new in the sense of a real focus on a lot of the issues that you bring up which are issues of equity, morality, distributed just this -- justice. i think the most exciting thing for us as we point out in the white paper itself in the foundation upon which we can

address those issues. becausexcited about it we can engage all of you, including you and those sorts of issues themselves. we're not going to be able to go through each of those, but i can ensure you buy the representation here we are going to be addressing those sorts of issues. >> i think there are two categories that help us frame the effort to address your issues. the financing on one side and the delivery on the other. we cannot ignore either side of this. we need to look at innovative ways to create new opportunities for financing and ways to find better means for coordinating and bring about a far more effective delivery of care that we have today. we are going to be looking at those options. if you consider the problem that we are addressing, cost and quality of care. theink of colin powell --

government at all levels and institutions that to be part of this. in terms of numbers, people, families, seems to be an enormous potential to do something very difficult. which iage movement think is -- >> i think you are correct. all of us really want to be able to allow individuals to have to make those decisions to be able to have the right decisions and be able to stay at their home. community health services wherever they have to be to get the services. we are trying to find the right answers and i think the white paper really set the framework for that.

it is going to direct us and i think that is what we intend to do as a committee. >> [indiscernible] >> it has to be a federal and state partnership. the states cannot do it alone. governor a lot longer than i was secretary and for 15 years, every state is really laboring under the cost of medicaid right now. we got to find a way to handle that situation but it has to be a partnership of the federal government and we cannot just say the states are going to be able to do it. it has to be incorporated one with the federal and the state and the local communities. >> i am glad you mentioned the village movement. i am in one. i think it is a very interesting coming together of neighbors and communities to support each other and to help people stay in their homes. when theh easier

people in the village are fairly affluent. howink the real question is can one take this community concept and spread it to places where there was much greater need. >> time for one more. >> i am dr. darrell roberts. in one area i would really like to see addressed is around the nursing and medical education. i taught at the university of maryland school of nursing. very rarely what i bump into a student who would say, yeah, i want to be a geriatric nurse. they want to go into pediatrics, labor and delivery. some even want to go into oncology. we need to change the culture around what physicians and nurses want to do when they get out of school. i really don't know the answer

to how to do that but it seems like a pretty good group up rock that make able to -- that might be able to help us find that. >> the bbc is releasing reports on human capital. i teach on a medical school and a nursing school and you are right. i think you hit on the word itself. it is a changing culture. that is where this last statement of empowering 20 million people out there that haven't been reached out directly to participate in the process. what i have found in the institutions themselves, the nursing and middle school schools, rmedical five to 10 years behind where the reality is. this new initiative that we have an coming together with a fresh the which is one of exciting aspects of building the infrastructure to meet the demand of the 20 million people that we have failed so many -- so miserably in the past.

>> i would like to thank our leaders for being with us today. we appreciate your time a look forward to working with you. [applause] we will have the next panel. thank you, governor. >> thank you, everyone. we will turn out to our second panel. i am sam baker. i'm going to do some quick introductions and then we can move on to the actual experts here. anne,l hear first from

founded a solutions group which delivers intelligent solutions and continuous research programs to health systems and health care providers. she previously held their long-term care practice and before, she got her start as a health care aide to congressman john lewis. cohenl hear from mark who is the chief officer at life plans inc.. he has conducted extensive research and analysis on a variety of public policy issues that affect the financing and delivery of long-term care services and the growth of long-term care insurance market. he has published several articles in the delivery and financing of health care services and has testified

before congress on a range of these issues. is the president and ceo and previous he served as a senior advisor to the bottom and -- bachmann consulting group. prior to that, tom spent 30 years working with ing and and that -- and aetna. he has been active on the financial services roundtable. last, diane is the executive and chairce president of the medicaid and chip payment access commission. she is a nationally recognized health policy expert. 'tis of the thing with career in public policy focusing on health insurance, coverage, access to care.

we are going to be hearing from and i will turn the podium to them. >> thank you very much. thank you for having me here. it is a pleasure to be here and to be talking about this. manyact that have been so forums and to opportunities have this conversation is very encouraging. i declared myself done with this issue year ago having worked on it for 20 years. just to give you a little tour of the long-term care population and building on what the remarks that other made today. there are 11 million people of any long-term care. it is important to figure out what is long-term care. what does that mean? it is easy to get that confused with health care. it is not the same thing at all. thatg long-term care means you need help on a regular and ongoing basis with the activities -- performing the

activities that are essential to your basic existence. bathing, eating, dressing. what happens to your health, sometimes bad things could happen to your health or development. it impairs her body in a way that you can't perform these activities. part of what makes this topic so hard is that this is a very diverse group. somebody could have a long-term care need could be a child with cerebral palsy or young woman with multiple sclerosis. a slightly older woman who has early onset alzheimer's disease or a very old person who is just aging. if you hear long-term care and you think yourself, little old lady in a nursing home. you have to expand your view of really aboutcause only 1.5 million people with long-term care live in a nursing home and 44% of them are actually under the age of 65.

who takes care of these people and where do they live? other22 to 24 million americans, other than the 11 to 12 i mentioned, are working about 20 hours a week on average, providing a emotionally and physically challenging work. they are doing it without pay and they are doing it while they're getting paid doing something else. o this becomes an economically and emotionally challenging situation. while theye that -- are doing all of that, they're contributing financially to the care of their family members. we know about one third of all the payments for assisted-living are actually made by adult children. that is pretty phenomenal when you think about it. areddition, adult children not buying jeer at chick -- geriatric services, they are buying private duty nursing, home care aides.

all of the spending they are doing, all the care they are providing, none of the shows up on the national health spending account in the way we think of when those of us was been in the area for a long time in budget think is count will be long-term care and we collect $200 billion or something like that -- none of this is in the number. this brings me to my main point. i will say this as respectfully as i can. while this is a medicaid issue, this is much more of an issue for families and for individuals who are in the situation. do we have lots of aging baby boomers? we do. i was in charge of the medicaid budget so why worry about medicaid. what are really worry about other people today he was struggling and facing enormous economics insecurities as a result of these issues. noting, iit is worth

think this is really important as you think through the spending, is actually less of its budget on long-term care now that it has -- less than it has in two decades. we are spending less on long-term care than we have in the past, not more. i think governors are inundating significantly older to try the get a grasp on the amount of when you see ae lot of people coming, that is how much you are spending on a per person basis. relative the number of people that need it, there will be fewer job -- fewer dollars to go around. that is important because it really helps us focus on what the real problem is and what the -- in order to, but the real solution. this is an issue of economic insecurity for families. creating the right mechanism that the paper all of this is the solution.

almost any american can be devastated by this need. we all share risk for this type of event. here is what you were up against when you're looking for solutions -- you have to use government policy to create nearly from scratch a market for public or private insurance that has value for most americans. you have to persuade them to buy it. you have to persuade your actuaries that you're going to persuade them to buy it. that is necessary if you're going to do this on the context of voluntary insurance. the work that we have done for the past seven years suggested is very hard to get around this problem but i remain hopeful. i don't want to be a downer. i don't think this means that creating significant reform will help a lot of people because i think it will. there is output from a modeling that suggest you can provide more security to a lot of people under low-cost voluntary options.

shows, i our research -- ofbe wrong, is that the people that would be helped by that are not the people that need medicaid. if you want dramatic change in the way we finance care, a shift from the safetynet system to insurance system -- i haven't found a way to do that in a voluntary approach. i look forward to working with much smarter people that are undertaking this with the great hope there are solutions. i want to thank you all for taking up this issue. i am more hopeful today than i have been in a while. thank you. [applause] >> thank you very much. first, i was like to thank the bipartisan policy center for inviting me to participate in this this thing with panel -- this distinguished panel. i want to make a few general observations the frame the

discussion. first, americans are ill-prepared for the financials -- consequences of aging and the risk of disability in needing long-term services and support. the growing liabilities associated with long-term services and support make crowd out other initiatives. second, the lack of financial futuretion for possible impairment could force people to compromise of their lifestyle if they become disabled. expected cost of long-term services, just to put it into context, what account to about 31% of the net worth of households aged 65 to 74. most americans cannot be expected to maintain consumption and save for these expected costs. the private market for long-term care insurance has an important role to play in helping americans absorb the risk of needing long-term care. isever, the data suggest playing tomorrow -- too small of a role. it has underachieved.

currently, there are about seven to 8 million americans with hybrid -- with private insurance. a yearer million people are buying policies with a growing number buying, nation products -- buying, nation products -- combination products. there was a stricken percentage of the middle class that is buying policies. in six people over age 65 with incomes greater than $20,000 have purchased a policy. and demandth supply factors that result in under reliance on health care insurance. i'm going to discuss those in a minute, but before i want to create something -- reiterate something anne talked about. it essential to addressing the cap -- the challenge. long-term care is insurable risk. insurance is a reasonable way to protect against risk. to protect against

insurance premiums with the private. sensible.s very saving to pay expenses less so. it makes as much sense to say for long-term care expenses as a potential car accident or a fire in your home. we would never do that. we would always rely on insurance. to ask middle-class americans to save the long-term care expenses is not practical and it is not a serious policy option. challenges number of associated with expanding the private long-term care market which have resulted in too little insurance. we can talk about ways to address these. on the demand side first, consumers tend to misperceive their own risk of needing care. they underestimate the cost of services. they don't understand the degree to which existing programs do or do not offer coverage. some may prefer to rely on

medicaid financed care. day,tly, at the end of the if you don't perceive there is a problem, why would you do anything to try to solve it? decision-making around private long-term care insurance can become located. people have -- can be complicated. have issues of choices especially if they are uncertain and unpleasant. when considering current products, consumers need to make multiple decisions about policy configuration parameters. confusion as well as the cost of products have contributed to relatively low numbers of insured individuals. often mistrustful of insurers and where he purchase decisions that are very costly to reverse. on the supply side, there are issue. s. the understanding makes selling costs high which still accounts

for more than 60% of sales. second, insurers face unpredictable and uncontrollable risk that affect the pricing of policies like cost increases in services, interest rates, disability. these risks are hard to spread because they are common across the hope operation -- the whole population. they de-risk the product and having to charge higher risk premiums. also, a difficult and cumbersome regulatory environment has made the product more costly than it needs to be. carriers don't know whether they will be able to retain relief if pricing assumptions and on that. -- are not met. who drives out companies cannot earn adequate returns on their investment. thus, we've seen in next to this of companies from the market even as the growing number of people are at -- are benefiting from the policies. cliaims incurred are now over

$8 million in the vast majority get insurance payments. the key question we need to answer over the next eight months is what would it take to significantly move the needle so that the majority of americans would consider or be insured for long-term care? current strategies have not worked well. my own sense is that without expanded public-sector support designed to spur demand and supply would not be able to protect the majority of middle-class americans. i hope we will think through this over the next eight months new models of mechanisms to maximize the number of insured americans. this things they can be on current partnership products and exploring more expansive views of public and private shared insurance models. thanks. [applause] >> good afternoon.

it is a pleasure to be here. i guess i represent the insurance side of the argument. i want to start off by saying i have spent a lot of time in washington working with both sides of the aisle. i cannot think of a better group than senator daschle and senator frisk who can bridge that bipartisan gap. i think ultimately there i sno s no way the private insurance sector could cover everybody. only 7.5 million people today have coverage so there is a huge gap. how to get all of that financed and how do you improve the delivery of care. programs,ntitlement medicaid and medicare, have

significant issues today and that is before -- the oldest baby boomer is 68. that is before they get to the age with a significant spike in needs for this coverage. a very large database. we are the number-one insurer in the market. we insure 1.8 million people people. we have helped 200,000 families. insurance industry -- you may hell have your own interference is. -- experiences. what is interesting about people who have long-term care policies, hhs was involved. 97% of the people who have long-term care insurance and have made a claim have been satisfied. in any event, as others have said, there is not the ability of most people to afford coverage, although i think there is an opportunity for this group as well is the private and

public sectors working together to come up with lower costs, more innovative solutions. it doesn't have to be a policy that covers 500,000. i think there is a lot of innovation that we can bring. there have been some comments just just to give you some statistics about the care. 1974, thearted in first year we issued a policy. all the policies were nursing home only. today, 70% of care was provided in-home. we just published our 11th study on cost of care. we actually can tell you how much it cost for in-home care. about $20 an hour. assisted-living, $42,000. nursing homes,