classified information. second, it looks forward. the government gets to ask for your testimony only if it can prove there is specific harm to the national security that it will either prevent or mitigate. it is really looking forward at preventing harm. jim rison is writing a book about a leak that occurred in 2003 about a country -- iran is very different than it was then. is difficult to see how the government can prove there is national security harm that stems from that leak. >> what about by trying to prevent future leak? that seems to be a major deterrent. >> there is a specific provision

in the bill that says that cannot be used to demonstrate harm to national security. that, to me, is an indication we've got a pretty good shot and if we can get applied to jim's case, it would be efficient in keeping him out of jail. in terms of the national security piece, another thing to remember is, every confidential security case. there are at least as many and perhaps more journalist who have been put in jail in civil litigation for money damages arriving out of claims against the u.s. government. in the win ho lee case several years ago, there were six journalist held in contempt, including journalist from cbs, new york times, washington post, and ap. one was held in contempt and subject to $5,000 a day penalties that she was not allowed to ask usa today to pay for her. she had an offer from her students to hold a bake sale so she could help pay her contempt fines, which i thought was charming but ineffective. she almost certainly would have been held in contempt and gone

to prison in a similar case for money damages had that case not settle. the reporter for the detroit free press is still litigating a privacy act case where he was held in contempt. there was a point when david had to decide, or may have had to decide whether to go to prison in the same week he was winning a pulitzer prize for his reporting. there's something fundamentally wrong with that situation. in terms of civil suits, this bill would not just take a step for the problem, it would fix it. there'd be no further confidential source cases coming out of civil litigation for money damages that would be effective if it passes. there's a whole range of things i would be highly productive for journalism as a whole even outside the national security context.

>> just introduced a devil's advocate voice from the beyond, since you mentioned the win ho lee case. there are some very distinguished members of the journalistic love who are skeptical of the shield law. anthony lewis was one of them, a great journalist and columnist and self-taught scholar of the constitution. he thought specifically of the case of wen ho lee, scientist who was accused of possibly having leak secret technology. this was a case where, as he would have put it, inadequate journalism tarnished this man's reputation, ruined his life. why should the journalist be protected from helping him get some compensation for that? >> if you look at the balance of interest overall and whether you can actually get sources and

other types of investigations, my view has been that it's more important to protect the confidential source relationships in terms of future reporting than to say we're going to force the reporters to testify, because of the merits of a particular case. the problem with that is once you force reporters to test or they can be jailed, that sends a broader signal to sources and it really creates the kind of chilling effect that jonathan was talking about. >> do you want to respond to any of this? >> a couple of things. first, it is true that if you are a reporter, you are served with a subpoena, your testimony is demanded and you refuse in litigation, you could face contempt and that could end up putting you in jail if you refuse. that would happen to me if i didn't want to testify about my neighbor. it could happen to any american who refuses to provide information in a criminal or civil proceeding. the question is whether because of the first amendment, reporters deserve special protection.

you have to remember that everybody else doesn't have that protection. so it still goes back to the fundamental question about transparency versus security. do we want to have a system whereby someone can leak and really the person who is in the best position to tell the prosecutor who the leaker was is off-limits. i understand the rationale for it. i understand that there should be a check on it. my position is that there is a suitable check right now and it is a self-imposed check. >> what do you mean, a self-imposed check? >> if you look at the record of the justice department in terms of how often they subpoena reporters would write you mean the restraint of the justice department who regrets if there's a situation where subpoenas are coming out every day, where reporters are prosecuted, if it is a situation where contempt and jail terms were imposed on a regular basis, i would see a much stronger argument for a shield wall.

the reality is it that you don't see that right now. the fact that no reporter has ever been prosecuted in the history of this republic and never has to worry about being prosecuted, the attorney general has said he would never do that. i could never imagine it happening. the ones where there's something particularly egregious and has gone on, i think that is the best evidence that right now the calibration between transparency and security in the investigative prosecution realm is being struck pretty well. i agree with the point that one thing you might -- one result of this might be that this is now put on a judge. if the judge says ok, fine, that subpoena is ok because it meets the needs of this action. in some ways that does undermine the political accountability. if you are senior justice official, you are thinking about what the political accountability is for you and the administration. you know that the members of the press have a way of getting their side of the story out. look at the ap situation where a

subpoena was issued for 20 something lines for the ap reporter come there may be questions about whether that was overly broad, but in terms of what they did, how they investigated the case fully, they got the records and ended up getting a conviction out of the case. a lot of people would say that is the weather system on to work. given that ended up with the huge firestorm. the administration on their heels, and that i think is a good measure of the political accountability that does keep the justice department in check. i wonder if you start putting this in the lap of a judge, that

in some ways might undermine that political accountability. it has held the justice department in check for over two centuries. >> you are talking about formal cases, prosecution where subpoenas are issued. we know that at least until 2006, the fbi was going and collecting information, telephone information from journalists. the new york times got collected on, it only came out because the justice department inspector general went to the examination and examine that. as a result of that, the office of legal counsel decision basically said the fbi has the power to collect this kind of information without a formal court ruling, without any kind of subpoena. they just haven't used it yet. we are assured since 2006, when we learned about this, that they have never used that power, but i don't think there's ever been a case where they have actually

said we never going to use it in any form of restraint. the opinion actually says they can do this, they just haven't yet. >> on the point of numbers, and this is always difficult because i think in our view, the justice department always under reports the number of subpoenas. they didn't report for example a subpoena that put judy miller in jail and almost put matt cooper in jail because it said it was done by an independent prosecutor and not the department of justice. they also tend not to report subpoenas in the field. there's a study that instead of looking at self reporting went

the other way and ask journalism outlets how many did you receive in the same year. the department of justice said it was 19, and it came out to be 67. so there is the numbers game. >> keep in mind, the u.s. attorney for 15 years, they knew it was coming. they agreed they would receive it and satisfied. that was for outtakes from a newscast. that was not source related information. that might be the 67 -- >> 41 over the course of history. >> this is the thing that is surprising to me about that. the attorney general of the united states has to personally certify and approve that.

that's why mary skeptical that there are 41 ago subpoenas issued and the justice department is somehow not capturing that. x just as an aside, i know the justice department takes it seriously. we are a big fan of the internal rule that the justice department has and in terms of the political accountability point, the current draft of the shield you'll actually build a minute says the attorney general has to certify that the rules have been complied with for that political accountability point to try to maintain the discipline that has grown up over the years within the department on that point. >> is enhanced with the new guidelines it just recently came out. it does address a couple of the main things that have people riled up over the last year, the use of the carveout with the rosen situation and also the notice issue that was front and

center after the ap situation. it expressly addresses both of those concerns. >> it used to just apply to telephone records and now it is broader. i do find a director of national intelligence part to be troubling. the fact that they have now sort of gone to a definition of ordinary newsgathering for the applicability of the guidelines rather than just newsgathering is concerning to me. i hope there will be further improvements. what is ordinary newsgathering in an era where some people called journalists accomplices to their sources? >> this kind of gets to a little bit about -- for me, the biggest problem with something like a shield law is that we are getting to the point where we don't really need a subpoena. i am in a class of people who are fairly well surveilled, and it is hard for me to know whether or not i've already given up my sources. are the measures that one takes to guard against that -- i heard from an earlier panelist that may be using encryption does

possibly -- does it take you out of ordinary newsgathering if you're trying to protect her sources? are you more of a target? i don't think anyone can adequately answer that. i don't expect to ever see but i would love to see some legislation that recognizes that the techniques of surveillance are chilling to journalism and addresses that. >> you were saying before when we were talking that we are now in a realm where in order to protect your sources, you often don't know who they are. i think that is probably not the case in jonathan's reporting. >> people like anonymous and hackers. >> i reported extensively on anonymous. let me make something very clear. most of anonymous are not criminals and never break any

laws. they are engaged in speech acts and messing around. speech acts and pranks. when i work with a specific group, which at the time was infiltrated by the fbi, they were specifically trying to commit crimes. so in order to work with them in a way that was safe, knowing this upfront, believing this was newsworthy, which i believe are covered supported over time, these were very much politically motivated crimes and we were all really clear that they were crimes. i had to design coverage in which i could verify the back using outside experts, looking through data, and using timing and other techniques and building relationships with people without ever knowing who they are.

in fact, with many of my sources, we would have the kind of conversations when you're building trust with a source. if they started giving me too much identifying information, i would stop them. i had a rule where if i knew who you were, i wouldn't talk to them anymore. a lot of it was about not being able to respond to a subpoena. start using encryption when you are talking about something interesting is a terrible idea. i use encryption when i chat with my 11-year-old daughter. i can stand in front of a judge and say encryption is my norm. there's nothing extraordinary about any conversation that was encrypted. all this was designed and vetted by law years to keep me safe and to keep my sources say. as i have no particular interest in going to jail to protect my sources. >> in the wider world outside of

this auditorium and the world of people who practice journalism, i think people often have a hard time making a clear, moral distinction between leakers and journalists. a lot of people i know from the wikileaks experience revere julian assange, but they also revere bradley manning and think he is a hero. a lot of people not only admire what journalists who were here earlier do but think that edward snowden is a hero. i guess the question is -- and to those people, a group of journalists sitting around talking about how the law should protect journalists but not those other guys, it sounds self-serving. as journalist, do we have some obligation to advocate stronger protections for leakers/whistleblowers? >> first all, her name is chelsea manning. i think the first incumbent duty on us is to make sure that our sources are entering into relationship of informed

consent. with many of the encryption tools, i think it is more important that my sources know how to use it than that i do. to some degree i need to know how to use it so i can teach sources out to use it. in the daily gathering of news are working a story, i don't have a chance to push for legislation, but i do think if i explained that informed consent, if i explain the status of my sources, i give the public the opportunity to weigh in on that question in a useful way. with my sources, in some cases, i do think there are probably forms of leaking that should be better protected. in some cases it is clear that have set out to commit a crime. and i don't really feel like i

am welcome to weigh in to some degree to say whether or not they have made a determination. i have friends who face computer fraud abuse charges based on from a technical point of view what was fairly routine information gathering. that is separate from a lot of what we are talking about right now where the law is really out of control. but yes, when fairly routine technical things can be called felonies, i have advocated publicly for reform of that law because it is just not coherent at this point. working with someone who is specifically an anarchist, setting out to make a point about the government, i build that into my coverage. i don't want to just give them a blank passport, although i do think that there are many views

that are represented and it's part of news as well. more than anything, when i am turning to that source, i need to make sure they understand where their legal protections are and are not. it is really important for journalists to learn enough to be able to educate their sources so their sources can make that decision and not get surprised by what happens next. >> there is a huge problem right now. recent developments in the snowden case and a number of others really show that the whistleblower process doesn't work. it is broken completely. from a journalistic perspective, there is valuable information being provided about ineptitude, stupidity, criminality and corruption. it is just as good for that to come out on hearings in capitol hill as through publications. newspaper publications and leaks 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 with information in the past two would have gone to the senate or house committee now feel that going to be observed the instant they go there and attempt to communicate. it gives unfair advantage to those who want to stem the flow

of information. >> there are a range of reasons but lead someone to want to leak. a lot of people leak because in part it makes them feel important. they are in the know. and make them feel good to do it. i don't have much sympathy for that. i do have sympathy for the actual whistleblower. right reasons because they are concerned about they have laid out what they disagree with. aside the systemic issue, i do understand where whistleblowers are coming from. it's incumbent on the government

to have a process that allows the whistleblower to raise his or her concerns, get them heard, and be confident is -- if there is a need for change there will be change made by the intelligence committees. say it's broken. i am not sure it ever became as effective as it needed to be. it comes incumbent there is a system that 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 employee to go to the press, 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. next up our guest 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. >> we are not ruled by king's or emperors. there is no divine right of president. the president is sworn to preserve, defend the constitution of the united states. inherent in that oath is the responsibility to live within its walls with no higher or lower expectations than the just like ms.n, sims. when the president appeared at the deposition of ms. jones and

that a grand jury, he was sworn to a second note, to tell the truth, the whole truth, and nothing but the truth, so help you god. this according to witnesses, to the judiciary committee and the special counsel, he did not do. i will vote to impeach the president of the united states and to ask the case be considered by the united states body ofnd the other this great congress uphold their response ability to render on these serious charges, but to the president i would say, you have done great damage to this nation over this past year, and while your are contending further impeachment would only exacerbate the damage to this country, i say you have the power to terminate the damage

and heal the wounds you have created. you may resign your post. >> no! >> the house will be in order. the house will be in order. challenge you in such fashion if i am willing to heed my own words. colleagues, my friends, and most especially my wife and family, i have hurt you deeply, and i beg your forgiveness. i was prepared to lead our narrow majority as speaker, and i believed i had it in me to do a fine job, but i cannot do that

job nor be the kind of leader i would like to be under current circumstances. so i must set the presidentat i hope clinton will follow. i will not stand for speaker of the house on january 6, but rather, i shall remain in this congress for approximately six months until the 106th congress, whereupon i will make my governor declare a special election to take my place. i think my constituents for the opportunity to serve them. i hope it will not think badly of me for leaving. i think alan martin, my chief of staff, and all mice -- for their tireless work on my behalf, and i think my wife for standing beside me. i love her very much.

god bless america. >> find more highlights from 35 years of house coverage on our page. c-span, created by cable companies 35 years ago and brought to you by your local cable or satellite divider. >> on the next washington journal the ohio congressman tim ryan discusses a debate on capitol hill followed by john barrasso on energy and health care issues. later brian bennett will talk about white house deportation policy under president obama. washington journal is live every morning with your calls, tweets, and facebook comments. >> next, a forum on the recent elections in afghanistan, hosted by the alliance in support of the afghan people. this is an hour.

>> thank you for coming. we have a panel called the afghan elections in the future of afghan relations. the elections took place on saturday in afghanistan, and our panel will discuss what we know the consequences unlikelihood of those elections are likely to be. ofm the executive director the partnership for a secure america, and we are happy to cosponsor with the alliance and support of 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. the psa in partnership with secure america is an organization founded in 2005 and dedicated to the idea that they fact-based policy. we have issued a statement on key policy issues, and we have a very exciting, very interesting model in the program we have been doing since 2009. i want to get right to the panel discussion. moderator,oduce our who is a senior for the center for american progress. we also welcome c-span 3.

we are at #afghan elections panel. fellow forsenior american progress. 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 2008, 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. this alliance is a completely bipartisan coalition of afghan and american individuals, and as 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 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 kind of spectacular attack, and

we saw, while there were incidents overall, it seemed to go off well, and the turnout was great, especially in the cities. i know many of us have received e-mails from afghans who were so excited. it was really inspiring to see that unfold. i am going to quickly introduce the 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.i.p. 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 thank you 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 afghanistan and also around the world, and we are delighted to have him here to explain where we are and where the process could go. finally, we have lisa curtis, who is a senior research fellow at the heritage foundation.

she has been there since 2006, 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. thank you, lisa. we are going to start with the ambassador. if you can give your assessment of what happened on saturday and what you think it means moving forward for afghans but also for the united states. >> thank you so much. i am happy to be here, and

thank you to the partnership for secure america and asap as well for putting this together. glad to be on this panel. saturday turned out to be a historic and groundbreaking day for afghanistan. i think not many people expected this type of turnout on election day in afghanistan, and didn't expect afghan forces, security forces, to be able to control the situation as best as they did. didn't expect 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 afghanistan, and be very 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 won. our destiny has won. we have turmoil and conflict, 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 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 in 2004 and resulted in a lot of work on

different fronts trying to develop democracy in afghanistan is paying off. i do not want to sound overly optimistic, because i think that we have crossed one hurdle or maybe several, but one major hurdle on saturday, and we have several more ahead of us. this electoral process itself is still unfolding. just half an hour ago or so, i saw on twitter that there is breaking news saying one of the leading candidates, one of the top three, is thinking of dropping, because his team does 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. you 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. the other message was for those who want to disrupt this process. we all saw what the taliban did or was capable of doing by sending suicide bombers and planting ied's and targeting candidates and ordinary people, mostly soft targets, and that did not happen. that was not realized. on 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 said they had 3400 incidents that were going to occur across the country and almost all of them were neutralized. as a result, more than 50 or so militants would be sent as suicide bombers and so on were killed, and more than 90 were arrested, all parts of different operations. i think that speaks loudly and clearly to the fact that afghan security forces have reached a certain level of capacity that was not observed in the 2009 elections. i think the message sent to the taliban is that the afghan

people have chosen to support a democratic future, that this strategy of trying to intimidate and so forth is not going to dissuade afghans from a better future. it also sent a message that the policy needs to be reviewed, the -- that now they are facing the afghan people and afghan forces. there are other 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. a message to especially those who have been on the side of the afghan people, and that includes the united states at the top of the list. we are not as backwards as some people pretended. we are not as primitive in that this democracy is not bad or wrong. we are going to embrace it. all your efforts, all the blood and treasure that has been spent in afghanistan, has not been in

vain, so we look forward to continuing to work with the international community. i think the message is clear the are not yet ready to take care of everything themselves. they don't have the resources to do so, but they are appreciative of the united states and what others have done. they recognize it is the international community who has 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. mr. karzaiumors that

ministersne of his transfer ofore the power. but regardless, the dsa is seen by most afghans if not all, as the cornerstone of future relations with the united states. nato is another partner in the future. then there is the donor community. all of this is good, but let me end. let me end by saying that there are some major hurdles ahead. there are some challenges ahead 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 elections, and the next step with elections, which is

counting the votes and handling the votes 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. if we can overcome these challenges, then i think we all may be in a position to celebrate, 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 about the initial assessment of 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. we had a modest election observation mission on the ground in kabul. we have been observing the

political process in afghanistan since we observed the provincial council. our initial assessments are very much consistent with the open 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 that our observers were able to get out and observe on election day.

the turnout being reported at this point is 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 too many ballots around the country, and the fact that one of the issues we are talking about is their were shortages of 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

the incidents of violence were much more widespread. that was not the case on saturday. the afghan national security forces performed their jobs admirably on election day, and going forward, i think there are two tracks now, two things i want to talk about. election day is just one part of the process. there was a lead up to election day where we saw a robust campaign. there was great enthusiasm. election day, we saw that.

public opinion polls leading up, 70%, they said they were going to participate in the election. we expected there would be a higher turnout. i don't think we expected it would be around 7 million. if that turns out to be the case as to how many people went out to vote, that's a real statement and a statement to others who try to disrupt the process, that 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. at some point, we will start to see preliminary results released from the commission. the results process in the past has been one of the most contentious parts of the process. while we can all agree that on 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 diligently, 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 have in place to determine who won the election and to make sure the votes that were cast on saturday reflect exactly the votes cast on saturday. in addition to the results tabulation process, is a quarantine process. they will do 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. that will be a critical process. it will be important for the

commission to be transparent, to share information, to tell the 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 could affect the race. 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 candidates, to respect the process, to respect the independence of the election commission, the independence of the commission. there are two scenarios were the processes could be even more important. one is that one candidate could

potentially be close to 50%. if that were the case and the 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 other scenario is the second and third candidates could be very close. under that scenario, the results 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, but 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 -- president of afghanistan. >> can we pull the lens back a little bit and talk about implications for the u.s. and also the region? if 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 taliban did try its best to

disrupt the process. you had the 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. we saw this in 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? this says afghans want democracy. they don't want what the taliban has to offer. in a way it is a blow for the taliban. it puts a dent in their narrative. i am not saying the taliban 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 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 policies there despite the

massive amount of assistance in blood and treasure the u.s. has spent there, but the white house has been reluctant to talk about the war and really spell out for the american people what 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 it is willing to leave at least 10,000 forces after 2014 in the country, assuming the new president or perhaps a minister in the karzai administration signs the bsa. our u.s. commander in afghanistan general dunford has

said at least 10,000 forces 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 that the u.s. partner with the afghans to prevent the taliban resurgence for many reasons. first, this election and continued u.s. engagement with the country is particularly important for women and ethnic minorities, 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. we have seen the impact of the 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 -- 30,000 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 attacks originated. third, we must consider the blowback effect of the taliban resurgence 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 pakistan who realized the 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 policy of cracking down on the taliban on its side of the border. if the taliban reestablishes its 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 share the same kind of ideology, and i am talking about the islamic movement of whose pakistan, which poses a threat. groups that focus on attacking india. even china is growing increasingly concerned that afghanistan could become a safe haven for uighur separatists. in early march, terrorist attacks civilians at a railway station in 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. clearly, what happens with the taliban in afghanistan has far-reaching consequences not only for the u.s. but for all

the countries. there are several factors that 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 risked their lives to show they are committed to democracy in the country, and we should back them by leaving a 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. i think that you have cards, and they need to be delivered to me. maybe i will ask the first question while those are being collected. then we will open it up for your questions. thank you so 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 congress about how they should be talking about it, how they should be approaching it? what's the role, what's the message 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 results, 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 prolonged and arduous process, but the possibility exists. i would say for all the reasons the other panelists gave, whether electoral or strategic or policy driven, there is no 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 ended 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? jed, do you 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 meets their standards and whether or not they can respect the outcome of the process. it's really important that space be 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 u.s. ability and politically with the white house, the desire to lead 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? what do you foresee in terms of their vision moving forward? >> we started out with 11 who went through the first round of electoral qualification testing. they had to meet certain criteria, and they did. over time, three of them decided to drop. we were left with eight. finally, the common understanding was that there

were three contenders and the person of the former world bank, 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 left government in 2006 and became the opposition leader in 2009 and decided not to go into the runoff. then you have the foreign minister and national security

advisor who came from the former kings camp in rome and was associated with hamid karzai and 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 hours show that they seem to be heading the pack. that 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 all the way to the end, or that

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 future 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. 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 with the 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 case that the asf was a great threat because of the risk of a coup. how likely do you think that scenario is? the second 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 border 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. >> i think the issue of whether there would be some kind of coup, i am less worried about this now. i think the question six months ago was if you had a really divisive election, breaking down along ethnic lines, a lot of bitterness and animosity, and the worry was that that would reflect within the afghan security forces, and you can have a rupturing of the unity of the afghan security forces, but we're not seeing that happen. i would argue we are seeing the opposite, that cas enough has shown that the asf has protected the people. it was not as bad as we feared.

there will be allegations of fraud, but it doesn't look anywhere on the level we saw in 2009. it is a more orderly process. that lessens the concern 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 military going after their havens in north waziristan. there were some airstrikes, but

not the federal operation that some people expected. they were engaged in a dialogue. there has of course been some reporting that they convinced the pakistani taliban to go in for negotiations so that this operation would not happen and disrupt their ability to keep fighting in afghanistan. so, clearly, you know, i would 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. -- for democracy. they don't want what the taliban has to offer. will have to factor into their planning for the future. >> great, thank you so much. question on the economy. jed feel free to jump in at any moment. the question is -- 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 nsf 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 most people now predict, then 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 afghanistan has relied to quite 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 very promising, whether it is 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? oh, this may be a task for someone there to start mobilizing people. i am going to turn and ask a question to jed. at this point, we have to be patient with what is taking place in afghanistan over the weeks and months. how concerned are you about the

sort of independent organizations being used in 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.

the closer the results are, the more pressure those commissions will be under. before you asked what the message should be. what 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 round, do you see the 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. i feel that the 2009 experience, on all sides, has left everyone somewhat sensitive. and worried about perceptions. so, i believe 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, under strict conditions, if

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. >> well, i think we have run out 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] >> c-span, 435 years bring public affair events to you, put and into the room at

congressional hearings. and offer complete gavel-to-gavel coverage of the u.s. house all as a public service of private industry. we are c-span crated by the cable tv industry and brought as a public service by your provider. watch is in hd and like us on facebook and follow us on twitter. >> will have a couple of live in c-span.omorrow secretary of state john kerry will testify before the senate foreign relations committee on foreign policy. you can join the conversation on facebook and twitter and watch on c-span 3. on c-span 2 at 1:30 p.m. eastern, we will cover a defense department briefing on africa strategy and operations including anti-terrorism efforts.

>> a look at the role of federal government may have in the health care as the baby boom generation ages. panelists include bill frist and tom daschle. this is from the bipartisan policy center and is a little more than hour. >> 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. hard effort is 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. we will try to avoid that. our goal over the next seven to eight months is to put together the 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. the program that we released not only bridge the partisan divide, but actually a much broader and faster divide, the cultural divide between the communities. we hired a number of 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 and we will bring the same kind

of synthesis to this work. that oners acknowledge of the key drivers that we did not have a chance to deal with was thinking about a comprehensive system for the finance and delivery of a long-term system of support not just for the elderly, but for people with significant disabilities. the project that we are announcing today will try to fill this space. there is tremendous expertise in this room and across the country. we are going to seek to engage all of your support as we move forward over the next eight months. thisly, i want to thank foundation for their support. >> thank you for that warm

introduction. i want to pick up with where the speaker left off. it is great to see a room so full of people that care about this issue. to see this place standing room only says something about long-term services and supports and the need for us to address these issues now. thanking thein by leadership who are up here with me. without your energy and passion and determination to take on this issue and understanding the links of service and -- services and supports has helped. it is just critical. today, we begin a discussion that will involve all of you. i look across this room and see so many thoughtful people, many of whom have worked 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. sheila burke, 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] i will 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. bill and i have a had especially 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. for individuals, for families, friends, states, and the federal government. across the board -- both on the 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. as a result, available services and support are not coordinated across providers or caregivers, making the effectiveness system inefficient and extremely expensive. so, over the 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. it 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 important services with a sick 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. -- 40 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 caregivers by insufficient savings for retirement and by the growing demands on the budget that we talk about every day. failure to act will be, as we 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. states have made a valiant and 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

directly, innovation alone will absolutely not solve the problem. part of 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 struggled 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. we, 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

deficit have made and will make our task a particularly challenging one. we fundamentally believe, however, that finding solutions to these challenges is not only achievable -- yes, 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 thirds of the cost of long-term care. one third of the medicaid budget, $400 billion. and that is going to increase out of what is required in the budget to take care of the long-term care problem. especially at the state level. moving to individuals who do not want to stay in their home. more and more individuals who

reach this age do want to stay at home. we are seeing a new opportunity for health services to take care of those individuals and keep them at their home. that is what we have to do. there are still need for skilled nursing services and we still have to look at the financial implications. that is why all of you in this room are so important. it is heartwarming to see so 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?

>> i am the only one of the distinguished group that no body of voters has ever elected to public office. [laughter] 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. i think the reasons why we haven't and some of them have been alluded to 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.

stereotypical 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. i don't think any of us have 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 families so that they can keep older and disabled people in their homes as long as possible without bankrupting the country. that is what we are trying to grapple with here. thank you.

[applause] >> before we have the next panel, we have time for a few questions for our leaders. >> question right here. >> my name is barbara. i am a nurse, caretaker of my 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 about elder care programs and economic rationing of procedures by raising the issue of justification of providing dollars and care for those with limited capabilities or life expectancy. can you tell me 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. i think that it will be hard for 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. we are excited about it because 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. i think of colin powell -- the 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. the village movement which i 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. i was the 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. it is much easier when the people in the village are fairly affluent. i think the real question is how 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 that might be able to help us find that. >> the bpc 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 medical schools, are five to 10 years behind where the reality is. this new initiative that we have an coming together with a fresh look which is one of the exciting aspects of building the infrastructure to meet the demand of the 20 million people that we have failed 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 now 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. we will hear first from anne, who 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. we will hear from mark cohen 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. tom previously served as a

senior advisor to the bachmann consulting group. -- boston consulting group. prior to that, tom spent 30 years working with ing and aetna. he has been active on the financial services roundtable. last, diane is the chair of the medicaid and chip payment access commission. she is a nationally recognized health policy expert. distinguished career in public policy focusing on health insurance, coverage, access to care. that is who 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. the fact that have been so many 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. having long-term care means that you need help on a regular and ongoing basis 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 a 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, a little old lady in a nursing home. you have to expand your view of little bit because really about 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? about 22 to 24 million other 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. so this becomes an economically and emotionally challenging situation. i might have that -- while they 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. in addition, adult children are not buying 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

roles, we count will be think is 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, none of this is in that number, none of it. to my mainngs me point. more of an issue for families in this situation. babyve lots of aging boomers. i was in charge of the medicaid budget, so i worry about medicaid. but i worry about the people facing economic insecurity as a result of this issue.