c-span.org. we remind you that the house is coming in briefly for a pro fora session. we will cover that next. news that, we expect the conference to get underway at the white house. german chancellor angela merkel will be meeting with president obama. it was opposed to start 20 minutes ago. it has been delayed a bit. once the house comes in for the pro forma session, no legislative business expected. [captioning made possible by the national captioning institute, inc., in cooperation with the united states house of representatives. any use of the closed-captioned coverage of the house proceedings for political or commercial purposes is expressly prohibited by the u.s. house of representatives.] the speaker pro tempore: the house will be in order. the chair lays before the house a communication from the speaker. he clerk: the speaker's rooms, washington, d.c., may 2, 2014, i hereby appoint steve womack to

act as speaker pro tempore on this day, signed john a. boehner, speaker of the house of representatives. the speaker pro tempore: the prayer will be offered by the guest chaplain, christ church, washington, d.c. >> let us pray. god of all nations, you called all people to live lives of righteousness and justice. bless those who gather in this place, to those who lead here, grant the patience and cooperation. to those who debate here grant clarity of thought. to those who decide here, grant the courage for truth. keep ever before us the broken places of our lives together and find ways to speak hope into one another's lives, that our hearts be in rhythm with yours and all together with people of goodwill both in this place and beyond in order that your will may be done.

amen. the speaker pro tempore: the chair has examined the journal of the last day's proceedings and announces to the house. pursuant to clause 1s rule 1, the journal stands approved. the chair will lead the house in the pledge of allegiance. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation, under god, indivisible with liberty and justice for all. the speaker pro tempore: the chair lays before the house a communication. the clerk: the honorable, the speaker, house of representatives, sir, this is to notify you pursuant to rule 8 of the rules of the house of representatives that i have been served with a subpoena issued by the united states district court for the district of columbia for both documents and testimony in a civil case. after consultation with the office of general counsel, i will determine whether compliance with the subpoena is consistent with the privileges

and rights of the house. gned sincerely, sanford d. bishop. member of congress. the speaker pro tempore: the chair lays before the house a communication. the clerk: the honorable, the speaker, house of representatives, sir, this is to notify formally, pursuant to rule 8 of the rules of the house of representatives, that i have been served with a subpoena issued by the united states district court for the district of columbia for both documents and testimony in a civil case. after consultation with the office of general counsel, i will determine whether compliance with the subpoena is consistent with the privileges and rights of the house. signed sincerely, james e. clyburn, member of congress. the speaker pro tempore: without objection. , the house stands adjourned

angela merkel will be meeting, is to begin shortly. possible questions from reporters including the international effort against the russian intervention in ukraine, the sanctions. chuck todd tweets a short while ago that senator dan cook from indiana had dinner last night with angela merkel and she knows and sanctions are not working. after the news conference, we will open up our phone lines and hear what you have to think about that issue and other issues that may be brought up in the news conference today. it is also possible the president will get asked about benghazi, as reports today that the secretary of state john kerry has been subpoenaed by the

chairman of the house oversight committee. darrell issa to appear before the committee on the benghazi attack. that meeting set to happen on wednesday, may 21 and also one more note on that, politico says the republican congressman from south carolina trey gowdy is being strongly considered to have a special panel of the house looking into the benghazi attack. more on that as we are able to pass along with you. meanwhile, we wait for the president and german chancellor furthefor their joint news conference.

>> ladies and gentlemen, the program will begin in two minutes. >> you may have heard that two minutes to the new year's conference with angela merkel, german chancellor, and president obama. later this afternoon, the chancellor will be seeking at the u.s. chamber of commerce and she will be focusing her comments on u.s. trade relations with germany.

>> republic of germany. >> good morning, everybody. pleasure to a great welcome my friend, chancellor house. to the white germany is one of our strongest allies, and angela is one of my closest partners. and with her indulgence, i want to start by making two brief, comments. first, as president, my top priority is doing everything we can to create more jobs and opportunities for hard-working families for our economic strength as a source of strength in the world. this morning, we learned that our businesses created 273,000 new jobs last month. all told, our businesses have now created 9.2 million new jobs over 50 consecutive months of job growth. the grit and determination of

the american people are moving us forward, but we have to keep a relentless focus on job creation and creating more opportunities for working families. there is plenty more that congress should be doing, from raising the minimum wage to --ating good restriction good construction jobs rebuilding america. i want to work with them wherever i can, but i keep acting on my own wherever i must do to make sure that every american who works hard has a chance to get ahead. also want to say on behalf of the american people that our thoughts are with the people of afghanistan who have experienced an awful tragedy. we are seeing reports of a devastating landslide on top of recent floods. many people are reported missing, rescue efforts are underway. has as the united states stood with the people of afghanistan through a difficult decade, we stand ready to help our afghan partners as they respond to this disaster, for

even as our war there comes to an end this year, our commitment to afghanistan and its people will endure. now, angela, i am still grateful for the hospitality that you and the german people a extended to me, michelle, and our daughters last year in berlin. it was an honor to speak. you promised me a warm welcome and delivered an unbelievable 90 degree day in berlin. this morning, our work touched on a range of issues where the united states and germany are vital partners. we agreed to continue the close security cooperation, including law enforcement, ciber, and intelligence that keeps our citizens safe. we refer to our strong commitment to completing the transatlantic trade investment which boost to jobs in the united states and

europe, we discussed energy security, including the europe diversifying its energy resources will stop united states is already approved natural gas exports, which will increase global supply, and ptip will make it even easier to get exported gas to europe. at our working lunch, we will review negotiations with iran and our shared determination from preventing iran from developing a nuclear weapon. we will discuss in syria where we continue to support the moderate opposition and provide humanitarian support to the people. i look forward to a briefing on asia, a region where both of our countries can ensure that all countries in the asia-pacific and adhere to international law and international norms. of course most of our time was spent on the situation in ukraine. angela, i want to thank you for being such a strong partner on this issue. you have spoken out forcefully against russia oppose the illegal actions in ukraine and you have been a leader in the

european union as well as indispensable partner in the g7, and your presence here today is a reminder that our nation stand united. we are united in our determination to impose costs on russia for its actions, including through coordinated sanctions. we are united on our unwavering article five commitment to the security of our nato allies, including german aircraft joining nato patrols over the balkans. we are united in our support for ukraine, including be very important imf program approved this week to help ukraine stabilize and reform its economy. to as ukrainian forces moved restore order in eastern ukraine, it is obvious to the world that these russian-backed groups are not peaceful protesters. they are heavily armed militants who are receiving significant support from russia. the ukrainian government has the right and responsibility to uphold law and order within its territory, and russia needs to use its influence over these paramilitary groups so they

provoking stop violence. let me say that i we are also united over the appalling treatment over the observers who have been detained in russia. pro-russian militants are still people including seven germans as well as their escorts. they have been paraded in front of the media and forced to make a statement at the barrel of a gun. it is disgraceful and it is inexcusable. russia needs to work to secure ther immediate release, and international community is not going to be satisfied until colonel schneider and his fellow captives come home. angela and ioth have repeatedly said, we want to see a diplomatic resolution to the situation in ukraine. thate have also been clear if the russian leadership is not change course, it will face increasing costs as well as growing isolation. diplomatic and economic. already it has fallen to near

all-time lows. russian stocks have dropped sharply and russia has dipped into a recession. investmentn in russia will exit this year. russian companies are finding it hard to access the capital they need and russia's credit rating has been downgraded to just above junk status. in short, russia's actions in ukraine are making a weak economy even weaker. moreover, if russia continues on its current course, we have a range of tools at our disposal, including sanctions that would target certain sectors of the russian economy, and we have been consulting closely with our weopean and g7 partners, and are stepping up our planning. angela and i continued these consultations today. leadership must know that if it continues to andabilize eastern ukraine disrupt this month's presidential election, we will move quickly on additional steps , including further sanctions that will impose greater costs,

facingt is a choice the russian leadership. our preference is a diplomatic resolution to this issue and the ukrainian government has already shown itself more than willing to work through some of the issues that would ensure that the rights of all ukrainians are respected, that you have a representative government, they have shown themselves willing to discuss amendments to the to aitution, to give power local level. they have gone through with their commitment to potentially provide amnesty for those who lay down arms and who are willing to abandon the building that they have occupied. the ukrainian government in kiev as follow through on the commitments that it made in geneva. we need russians to do the same. so angela, i want to thank you again for being here, and as always for your friendship and partnership. these are challenging times. russia's actions in ukraine pose a direct challenge to the goal that brought europe and the

united states together for decades, and that is a europe that is whole, free, and at peace, just as our predecessors are united to pursue their version, so will we. chancellor merkel. well, thank you very much for the gracious hospitality and the very warm welcome the you have accorded to me, and i am very glad to be able to be back in washington to have an opportunity to address all of these different issues with you. i think priority really is on the current issue of ukraine, and the agenda showed how important the partnership is also in today's time. i think it is a very good thing that all of the steps that we have taken so far we have taken together and today. in our talk, we yet again underline that we fully intend to go ahead as we did in the past. what happened on ukraine, what

happened on the crimean peninsula? well, the postwar border has been put into question on the acceptance of territorial integrity by all. and this is why it was so important for us to react in concorde. what is at stake here is that people in ukraine can act on the basis of self-determination and can determine themselves, which they wish to embark on any future. the 25th of may is a very crucial date, to ensure that, and we will see to it that elections can take place. will play a central role in all of this. we talked about this. and together with the osce, we will do everything we can in bring russia to do the necessary steps on the 25th of may, bringing about the stabilization of ukraine.

of may is not all that far away. tould that not be possible remedy the situation, further sanctions will be unavoi dable. this is something we do not want and we have made a diplomatic offer. he diplomatic solutions are very much up to the russians, which we will embarq on, but we are resolved to continue down that road. let me address issues that have a bearing on the intelligence services. let me underline the yet again for the german side. we have always enjoyed it very close corporation with our american partner. than aware looking at the challenges of the modern world today, and obviously in fighting terrorism, the work of the intelligence services is not only important, it is indeed indispensable. firmly

convinced that our corporation in this area is a friendly one, sort of balance to strike because of the intensity of civilians trying to protect the citizens against threats and on the other hand protecting individual courtesy and individual freedom and right to privacy. that will require further discussion between our two countries and over to overcome these differences of opinion. we had these discussions also on the european front. we have the safe harbor agreement about the privacy protection agreements, and i take back the message home about is u.s. is ready to do that, ready to discuss this, although we may have differences of opinion on certain issues. but i think particularly in the overall context of further intensifying our trade relations , of global growth but also in the context of diversification , this is a very

important issue. it will be very important for us to bring the negotiations very .uickly to a close we are firmly convinced that for the european union, for germany, and for the united states, this offers a lot of opportunities for the future, and it is so important for us to bring this agreement to a successful conclusion. discussions,er of i know people have doubts, but they can be overcome, and need to be overcome. just look at the many partners all over the world that have bilateral traitor permits. agreements. trade i mean it is simply necessary. looking at the closeness of our partnership, for us to have this agreement, the trade agreement, and we are fully at one on this one. so we have very intensive talks,

and we're going to build on this over lunch. thank you very much for giving me this opportunity and also thank you for your gracious hospitality. >> i think we are going to take to questions from the u.s. questionsand two from the german press. we will start with leslie card. -- lesley clark. >> thank you, mr. president. he violence in the ukraine coveys a said germany and the united states are united in the effort to de-escalate, but have you been able to reach any common ground on sanctions, particularly the russian energy sector? what is next if you are unable merkel,nt to chancellor reports in the u.s. have said that you believe president putin may not be in touch with reality. is that what you said? is that we believe? and you talked to him earlier this week. could you give us a little more insight into what he might be thinking? andy you believe he is a threat to europe? we areously every day watching the events in eastern

ukraine and southern ukraine with concern. and i think what you have seen over the course of the last several months in the midst of unityrisis is remarkable between the united states and the european union, and the response. offeredat the same time a diplomatic approach that could resolve this issue. we have been unified in supporting the ukrainian government in kiev, both economically, diplomatically, and politically, and we have said that we would apply cost and consequences to the russians if they continued with their actions. that is exactly what we have done. course saw just over the of the last week additional sanctions applied both by the europeans and the u.s. be aext step is going to

broader-based sectoral sanctions isime, and what we have said that we want to continue to keep open the possibility of resolving the issue diplomatically, but as angela merkel said, if in fact we see the disruptions and the sotabilization continuing severely that it impedes elections on may 25, we will not have a choice but to move forward with additional, more severe sanctions. the consultations have been taking place over the course of the last several weeks about what exactly those would look like and would apply to a range of sectors. the goal is not to punish russia. the goal is to give them an incentive to choose the better course, and that is to resolve

these issues diplomatically, and i think we are united on that front. eu,in europe, within the i'm sure there has to be extensive consultations. you have got 28 countries and some are more vulnerable than others to potential russian retaliation, and we have to take those into account. not every country is going to be in exactly the same place, but what has been remarkable is the degree to which all countries agreed that russia has violated international law, violated territorial integrity of a country in europe, and i think there is unanimity that there has to be consequences for that. how we structure these sectoral sanctions, the experts have been working on, and we anticipate that if we have to use them, we can. our preference would be not to have to use them. merkel'snk chancellor leadership on this front. she has been extraordinarily helpful not only in facilitating

haspean unionity, but she also been very important in helping to shape a possible diplomatic resolution and reaching out to the russians to encourage them to take that door while it is still open. keep in mind that when it comes to sectoral sanctions, we are looking at a whole range of issues. energy flows from russia to continuedand those even in the midst of the cold war, at the height of the cold war, so the idea that you're going to turn off the tap on all russian oil or natural gas exports, i think, is unrealistic, but there are a range of approaches that can be

taken not only in the energy sector but in the arms sector, the finance sector, in terms of lines of credit for trade, all that have a significant impact on russia. i don't think it is appropriate for us to delve into the details at this stage because our hope is that we do not have to deploy them, but what i can say is that the highestat level, not just bilaterally but multilaterally through the european commission and our diplomatic teams have been working through all the and we arees, confident that we will have a impact that will further .ussia's growth and economy but again our hope is that we should not have to use it. we are not interested in punishing the russian people. we do think that mr. putin and his leadership circle are taking

bad decisions and unnecessary decisions and he needs to be dissuaded from his current course. >> i think there is been a very difficult assessment on what happens in the ukraine. on the one hand that you have the united states and europe. we have always taken our decisions together. on the other hand, the russians situation, i hope that russia will live up better in the future to its responsibilities, but we need to see deeds matching their words. we do not have any release of the hostages, among them also four german hospices. -- hostages. this is a crucial step. we have not set any indication of the geneva agreement. on the russian side. ukrainian side has taken the

steps. and the osce is an organization to which we want to accord a greater role for they can pave the way and prepare for elections. one word on sanctions was up i agree with the american president. they are not ean end in and of itself, but combined with we want a diplomatic solution, it is a very necessary second component to show that we are serious, we are serious about our principles, and those abroad say a whole range of possibilities are being prepared for in the european union. in europe, we have taken is sufficient that if destabilization happens, we will move to the third stage of sanctions. i want to underline that this is not necessary to what we want, but we are prepared. my main aim will be first and foremost to improve stabilization and to see to it that the elections can happen. we will work on that in the next

few days, but we are also prepared to take further steps. what we are talking about here will be more measures in the context of industry, the american president, i can only agree, he has said what is necessary. strong ins is very europe. we can also look ahead in the median term, what we can do in order to promote an energy union and the european union, which we are doing. having our dependency in the next 10 to 15 years on russian gas supplies. there are 10 countries in the du that depend 100% on gas supplies. we need to improve evan flow, we need to create our grid of pipelines. all of the countries need to share supply, and those are measures that we are currently discussing in europe. we are talking about short-term but also medium-term and alsoterm measures, and

getting more prominent in this respect. >> madden 10 slur, you said that time is of the essence -- madam chancellor, you said time is of the essence. when would be the time you would say the first phase of sanctions is what you would promote and is a more energy intensive initiative by the eu for example on the government level? can you understand the fact that also mr. putin needs to play a ise in the solution, which the position of the european union, but also his items have to be weighed, and also the chancellor have a may go several phone calls with him, do you this?he will work on >> as for the question what about the next few days to come, i think the meeting of foreign is going to the eu

play a very important role on this respect. there are possibilities we will do everything we can and order to bring -- in order to bring a supported political situation to do what is necessary to move forward in ukraine. you have the monitors for the elections. you have changes of the constitution. you have decentralization. all of the different parts of the country have to be at the same level. we want to give them the necessary political backing. at a certain point in time, that is very difficult. for me, the elections on the 25th of may are crucial. destabilization,

this could be getting more and more difficult t. for now, i am working toward elections on that date. d that in other areas. we will demonstrate this resolve yet again. that thely convinced united states of america and the european union need to act in concert here and they have done so in the past and they will continue to do so. startave said from the that russia has legitimate interests in terms of what happens next door, in ukraine. there is a deep and complicated history between russia and the ukraine. putin's views

should be taken into account. what cannot be taken into andunt is his suggestion words and actions that he has the right to violate another country's sovereignty, territorial integrity, to dictate the economic policies or foreign policy of a sovereign country. that is not acceptable. our view from the start has been that the ukrainians should be able to make their own decisions. if they are allowed to make their own decisions, they will have a good relationship with russia and with europe. they will want to trade with russia and with europe. except,y cannot understandably, is the notion that they are simply an and that the kremlin

has veto power over decisions made by a duly elected government in kiev. goal is to allow ukrainians to make their own decisions, then he is free to offer up his opinions about what he would like the relationship to be between ukraine and russia and i suspect that there will be a whole lot of ukrainian leaders who will take those views into consideration. but they cannot be done at the barrel of a gun. they cannot be done by sending masked gunmen to occupy buildings or to intimidate journalists. one of the biggest concerns we have seen is the russian propaganda that has been blasted out nonstop, suggesting that the ukrainian government is

responsible for the problems in eastern ukraine. they have shown remarkable restraint through this process. that this is some spontaneous uprising in eastern ukraine is belied by all the evidence of well-organized, with a, armed militias capacity to shoot down helicopters. generally, local protesters don't possess the capacity of surface to air missiles or whatever weapons were used to shoot down helicopters, tragically. ce have seen the attempts of os monitors who were approved not just by europe or the united states, but also by russia, being detained. ansd somehow russia is suggesting that kiev is responsible for that. we have heard mr. putin say that

they have to do a better job of reaching out to eastern europe -- or eastern ukraine. you have seen attempts by kiev in a serious way to propose decentralization of power. to provide for local elections. and for them to offer amnesty for those who have are the taken over these buildings. none of them have been ignored by mr. putin or the various russian mouthpieces that are out there. you have seen suggestions or implications that americans are responsible for meddling inside ukraine. our only say that interest is for ukraine to be able to make its own decisions. is last thing we want disorder and chaos in the center of europe.

whofor the german audience, perhaps is tuning into russian stayi would just advise to focused on the facts and what has happened on the ground. a few weeks ago, mr. putin was denying that the russian military was even involved in crimea. , he aweeks later knowledge, yeah, that was our guys. there has not been honesty and credibility about the situation and a willingness to engage seriously in resolving these diplomatic issues. our hope is that mr. putin forgnizes there is a way good relations with kiev and good relations with the united

states. they cannot be done through intimidation and coercion that we are seeing right now in eastern europe. >> thank you, mr. president. earlier this week, critics humane manner of an execution. some countries have expressed concerns. what are your thoughts? does this raise more questions about u.s. justice? two chancellor merkel, after edward snowden's revelations of your own cell phone, are you satisfied by the steps taken on ?he u.s. -- by the u.s.

has just been rebuilt? thank you. >> what happened in oklahoma is deeply troubling. who was subject to the death penalty had committed heinous crimes, terrible crimes. i have said in the past that there are certain circumstances in which a crime is so terrible the application of the death penalty may be appropriate. mass killings. the killings of children. that in thelso said application of the death penalty in this country, we have seen

significant problems, racial application of the death penalty. which there were individuals on death row who later on were discovered to have been innocent because of exculpatory evidence. all of these do raise significant questions about how the death penalty is being applied. this situation in oklahoma highlights the significant problems. i will be discussing with eric to give me aners have beenf what steps taken in this area and brought

her. we have to ask ourselves difficult and profound questions as a society. i am also going to say something about nsa because i know it is of great interest in the german press, as well. is one of our closest allies and closest friends. that is true across the spectrum of issues. security, intelligence, economic, diplomatic. angela merkel is one of my closest friends on the world stage. she is somebody whose partnership i deeply value. it has pained me to see the degree to which the snowden disclosures have created strains in the relationship. more broadly, i have also been timenced for a very long

that it is important for our legal structures and policy structures to catch up with rapidly advancing technologies. , three seriesce ,f -- through a series of steps we are trying to reform what we do. we have taken these issues very seriously. tried tolly, we have provide additional assurances to the american people that the privacy is protected. when i have also done is taken the unprecedented step of ordering our intelligence communities to take the privacy interests of non-us persons into account in everything that they do. that is something that has not been done before and most of the countries in the world are not to. the privacy interests of non-us citizens are deeply relevant and

cap to be -- have to be taken into account under have to be policies and- procedures to protect them. we are in the process of implementing those steps. we have shared with the germans the things we are doing. i will repeat what i have said before. ordinary germans are not subject to continual surveillance, are not subject to a whole range of data gathering. i know that the perceptions among the public sometimes are that the united states has capacities similar to what you see on movies and in television. is principally and surerily on how do we make , those who want

to proliferate weapons, transnational criminals are not able to engage in the activities that they are engaging in. in that, we can only be successful when partnering with friends like germany. we will not succeed if we are doing that on our own. what i pledge to chancellor been in addition to the reforms we have taken, in addition to saying we are going to apply privacy standards to how we deal with non-us persons, as well as u.s. persons, in addition to the ways we are constraining the potential use committedta -- we are to a u.s.-german cyber dialogue to close further the gaps that may exist in terms of how we operate, how german intelligence operates. to make sure there is transparency and clarity about what we are doing and what our

goals and intentions are. these are goals that are complicated. we are not perfectly aligned yet . values and weame share the same concerns. this is something that is deeply important to me. i am absolutely committed by the time i leave this office, we're are going to have a stronger legal footing and in the national framework for how we are doing -- how we're doing business in the intelligence sphere. i do noty though that think there is an inevitable contradiction between our security and safety and our privacy. the one thing that i have tried to share with chancellor merkel is that -- you know, the united states historically has been concerned about privacy. it is embedded in our constitution. it is the world's oldest continuous --

constitutional democracy and i think we know it little bit about trying to protect people's privacy. we have technology that is moving rapidly and we have a challenging world that we have to deal with and we have to adjust our legal frameworks. she should not doubt on the german people should not doubt how seriously we take these issues. i believe we will be able to get them resolved to the satisfaction not just of our two countries, but of people around the world. under the conditions, we have possibilities were differences of opinion to overcome. in the medium term and the long term. is to enter into cyber dialogue because this is very important, a forum to have longer discussions as to where we stand individually and ramifications.

secondly, there are two strains of negotiations. on the one hand, the safe harbor agreement. and the privacy and protection. of this, it will come out very clearly what differences of opinion there are. i think it is of primary importance for us to bring these forward and to bring the process to a conclusion. if something else comes into play, i heard this morning thatg a breakfast meeting our parliaments should be in contact on this. it is very important. it is important for the broader public to be involved. we can understand each other's motivations and arguments. president, could you

explain why it is not possible to agree on a no spy agreement which was proposed by the u.s. government. what kind of assurances could you give chancellor merkel with regard to ordinary german citizens, but also with regard to government that they are not under u.s. surveillance anymore? the question addressed to you trust as regards to the nsa discussion has been rebuilt, can you say the same thing? not quite accurate to say that the u.s. government offered a no spy agreement and then withdrew it. i think what is accurate to say is that we do not have a blanket

no spy agreement with any country, with any of our closest allies. we do have are a series of partnerships and procedures and processes that are built up between the various intelligence agencies. what we're doing with the germans, as we are doing with the french, as we do with the british, the canadians, or anybody is to work through what governinge rules are the relationship between each country. and make sure that there are no misunderstandings. i think that we have gone a long way in closing some of the gaps. as chancellor merkel said, there are still some gaps that need to be closed. i think what we can be confident about is that the basic approach that we take with

germany is close to the approach we take with all of our allies and our friends. during the course of the last several years as technology advanced, i think it was a danger in which traditional expectations tipped over because of new technologies. is makehave tried to do sure our policies reflect increased capabilities and increased dangers of intrusions and privacy. -- in privacy. let me put it this way. our interest in working effectively with the germans and to making sure that german government as well as the german people feel confident about what we do is as important to us as any other country. germany is at the top of our list, in terms of friends and allies and colleagues. frome not holding back

doing something with germany that we somehow do with somebody else. i think the situation is such that we have a few difficulties yet to sort out. there was going to be a dialogue between our two countries. this is also why there needs to be and will have to be more than just business as usual, looking in the german parliament, but members in the german government and the german public. we need to do that. we are looking at what is still dividing us. issues will be addressed, we will work on them, and it will be on the agenda for the next few weeks to come. >> thank you very much, everybody.

>> president barack obama and german chancellor angela merkel speaking with reporters at the white house. she will be at the chamber of commerce this afternoon talking specifically about u.s.-germany trade relations. you're going to open up our phone lines to hear what you think about some of the issues they have talked about. particularly on the sanctions on russia for the intervention in ukraine. the numbers are on the screen. democrats, (202) 585-3885. republicans, (202) 585-3886.

others,ents and all (202) 585-3887. this was "the wall street journal" reporting on where sanctions are at. the headline says that german businesses urge halt on sanctions. there is military action in ukraine today. this is from the bbc. many dead in ukraine offensive. many pro-russian rebels have been killed, injured, and arrested in a ukrainian government offensive. the acting president has said this. the operation is not going as quickly as hoped. it was reported earlier today that two ukrainian helicopters had been shot down by pro-russian rebels. let's go to your phone calls. fromll from -- noel

illinois. caller: hello. i think the sanctions will have little to no effect on what is really going on in russia and the situation in ukraine. i think it actually does more harm toward u.s. interests tahn anything else -- than anything else. if you think this will help boom the natural gas industry in the u.s., that may be true, but it will only raise natural gas prices here in the u.s. a lot of the european partners do not want sanctions. it will hurt their interests, especially in western europe. i'm not sure why we are allowing the european union and lobbies and bureaucrats to dictate what is going on. the president has been abysmal his entire tenure.

we have seen what this has done in spain and italy. think this is going to work for in ukraine? thank you c-span for everything you do. you are fantastic. host: let's go to greg. obama's policy has been week i'm at timid, and feckless. this has been an abysmal failure. what has he done/ ? russia has been laughing at us and rightly so. obama's policy all across the globe are decidedly weak. president obama is not a good president. he has a lot of jimmy carter and him. nobody respects him and nobody should respect him. he has no right to be respected. putin has been walking all over him.

really, when you look at it, i think putin has been making out really well. he has iran, syria. what has obama got? he has been nothing but make fun of our allies, dismiss our allies, and show weakness. number ofe were a issues brought up at this news conference. here is a tweet. a report on that mudslide. at least 350 people are dead in the landslide in northeastern afghanistan. pete is on the independents line. he is in arlington heights. caller: thank you. i want to comment on the sanctions. they are not working. i agree with senator john mccain. we should provide some help for those poor ukrainian people. the armed forces need help

desperately. the pro-russian separatists are a bunch of cowards hiding behind people. why don't they come out there and fight? why are they pushing the ukrainian people in front of them so they can hide behind them? it is disgraceful. it is time for us not to get involved with boots on the ground, but at least provides a military aid to help the ukrainian people. host: a couple callers have mentioned senator mccain. here is a tweet from him. we are covering the state department briefing this afternoon and lots of questions about that. in's hear from bonnie lancaster, pennsylvania. go ahead. republican line. caller: i agree wholeheartedly that the sanctions are not working. i don't know exactly what the solution is. of help is needed by

the ukrainian people. i would suggest that perhaps we should give them arms so that they can defend their own freedom. host: the latest batch of aid to ukraine passed by congress, announced by the administration last week -- there was some nonoffensive military weapons as part of that package. gary is in lakeville, minnesota. caller: thank you. i wanted to concur with what others are saying. i don't believe the sanctions will work. look at how long it took for iran to feel some pain. i think this is flawed. ovitz -- that yannick viktor yanukovych was the duly elected president in ukraine. we disagreed with him. ukrainians do.

let's get back to where the people in the ukraine can decide what is best for them. the european union is not willing to do sanctions. that is where the rubber hits the road. host: on your point, you would say that these elections coming up in ukraine would be critical? should we wait for further action until then? caller: i really think we should. those elections were not scheduled until the riots happened in kiev and picked her yannick over'twas run out of town. he was a bad guy. nobody disagrees with that. when we talk about libya, north africa, the arab spring, the popular rueful, the people wanted the dictator out -- however much we disagreed with them, he was duly elected. let ukrainian sandal that. syntel because he turned back to russia and away from the european union, we have to get

back to what what makes our country strong. it just does not fly when we say that we really need to punish russia for doing something that we would probably do if it happened to us. host: those are presidential elections set for the ukraine on the 25th of may. there is the territorial phot on the 11th of may. on the 11th of may. alberta is in jacksonville, florida. make sure you mute your television or radio and go ahead. put you on hold and we will come back to you. also in jacksonville, philip. philip in jacksonville. we lost you. let's go back to alberta. i think you're getting a little confused. we will move onto to nancy in lagrange, georgia. caller: i hope i am still a

democrat. i don't think the sanctions are effective. i heard on msnbc that mr. putin signed a contract with exxon mobil. and the number one stockholder elizabethum is switzer. host: who did you say the number one stockholder was? caller: elizabeth wisner. they sponsor the stand-alone bill that will strip the epa of righty over the keystone, iscitizens, and mr. putin looking after his breadbasket, which is where mr. gore -- gore

-- gorbachev was from. host: another issue that came up during the news conference with chancellor merkel and president obama was the issue with edward snowden, and the reported nsa spying on the cell phone on angela merkel. here is a delete from -- a tweet "it has pained- me to see this noted disclosures strained u.s.-german relationship." granada hills. go ahead. caller: thank you for taking my call. most of the american people, most of us, are overwhelmingly opposed to war in the ukraine, syria, iran, elsewhere. you not have to be in the media to give you information to be intelligent. critical thinking goes along way. it seems a lot of the mainstream

media has forgotten that. americans, in large numbers, want the u.s. to reduce its role in world affairs. they are so preoccupied in washington, why don't we talk about the islamic jihad, and the murdering of christians going on today? you can look at the poll numbers, go on the internet, overwhelmingly americans have said that the u.s. does not have any responsibility to get involved in the ukraine, and only 18% of the u.s. has any responsibility to protect the ukraine if russia were to invade. most the people like myself and the people i know say the united states does not have any responsibility to get involved in ukraine under extreme circumstances. we have an epidemic overwhelming us in afghanistan. poppies are growing more than ever.

us toda -- obama wants support al qaeda by going to war with syria. a tweet fromo to libby casey from al jazeera america. one more thought on sanctions from eric in babylon, new york. independent line. caller: i heard a lot of your other listeners comments, and, you know, i just wanted to start with one thing. you get the kind of government that you deserve, and you deserve the kind of government that you get. so, we, us, here in our country, yes, we are not involved with foreign policy. we do not understand it. we do not care it -- care to. it is not important to us. it seems we have elected leaders that want to bring us back

between the two oceans now. we wanted to hide from the rest of the world. we are tired of war. the situation in the ukraine will not be resolved with any kind of pressure on russia other than military pressure. i hate to say it, but putin does not care. rating, his popularity has tremendously increased in russia. every russian loves him now. there is very little dissent for putin. of military issue pressure, is there any support in the united states or european allies for any sort of joint -- whether it is nato, or military action against russia? not know if there is support or not, but nato should be conducting exercises just like russia is conducting borders on -- and do exercises

on the border of the ukraine, nato should be conducting exercises on the baltics. host: secretary hagel spoke about that. we covered that. to assure the news conference with president obama and chancellor merkel at 8:00 p.m. eastern. coming up come in just under an hour, we will take you live to the chamber of commerce across the street from the white house. the chancellor will be speaking about u.s.-germany trade relations. we will have that live at 2:00 p.m. eastern. tomorrow night, the white house correspondents dinner, beginning with red carpet coverage from the washington hilton. president obama will speak. joel mchale will headline the event. we will have coverage for you coming up at 6:00 p.m. eastern. lots of coverage online with your ability to tweak your

experience t --weet yorick. -- tweet your experience. with ticket to an event yesterday. former members of commerce were part of a special panel looking at health care law and the future of health care in the united states. one of those speaking was mike burgess, congressman from texas, and also a doctor. this is about one hour. [captions copyright national cable satellite corp. 2014] [captioning performed by national captioning institute]

>> ok. consensus -- we have the perfect panel to discuss this. we have mike burgess from texas, jim cooper from tennessee, bob walker, a former member of congress from pennsylvania, ron klein from florida. two democrats, two republicans. if there is an emerging consensus, we should see it right here, right now. congressman? >> thank you. ui for letting me be here. thank you for not wandering off while we found our seats. i listened to the last panel. it was enlightening. almost every topic that came up was one that we dealt with in our committee. i was happy to hear the discussion about the sustainable growth rate formula appeal. you talk about bipartisanship, it was a repeal of a problem, that, as the lady said, is what

bedeviled this town for over 15 years, and it passed the energy and commerce committee 15 1-0. henry waxman was my sponsor. you did not read about it, because who wants to write about it when things work? by february 6, we actually had to sign off, all three committees, house and senate, republicans and democrats, the big guys on each committee, chairman and ranking members, we hit a wall with the senate on february 6, and as a consequence, we ended up passing something on the house side that was not likely to pass in the senate, but here's the good news. everyone has agreed on the policy. every republican in the house of representatives has voted for that policy.

now, whether it is in a lame-duck or just before the election because people are mad at us, or after the election because there is a new senate, neuhaus, majority leader, every republican has voted for that measure. 15, 16 democrats have voted for that policy in the house of representatives. this is a big deal. we have never gotten this far before. i am optimistic that that sense of bipartisanship will carry forward. right after the near meltdown over the debt limit, everyone that wrote about stuff said the fta bill is coming up. the user fee agree is dissolved. what are we going to do? the energy and commerce may got to work in cobbled out those committees. they were tough. wenty of times people said would never talk again, but they can back, and they did. on may 10, 20 12.

i missed the vote, so i was grateful it was on a voice vote. it passed the floor of the house. in aresident signed it broom closet. you did not read about it because who wants to write about it when things work? this is new dissipation from the companies out there innovating. line, -- >> bottom so, bottom line, congress is not dysfunctional? >> things do work. on the pessimistic side, the the nexte care act -- three generations of americans are going to be adversely affected by. on the positive side, everybody has a smartphone, and there is an app for that. we had a hearing this morning. these are changing so much faster than anyone would have predicted seven years ago when nobody had a smartphone. this is the future of medicine. >> jim, you're not on the committee of jurisdiction now,

but you have been in the past. you have banged your head on this issue for a couple of decades. what do you think are you optimistic? progressas described in health care reform outside of obamacare, but the political process has made obamacare so toxic that it is difficult to the document and that mike waved around, we voted 57 times in the house of representatives to appeal it -- repeal it, and we are hoping that it freezes voters. we should, and ced, because you are about the only business group in america that had a reform plan prior to obamacare. everyone likes to be a backseat driver, an armchair general, but you all had a plan. widen-bennett, a much more market-oriented plan that obamacare, but hardly any

business group in america was willing to get behind it because it is so much easier to criticize than perform. i represent nashville, and sometimes musicians screw up, but how many of you all can play nation better than they can? it is easy to be a critic. every health economist in america, left, right, center, and knew that we had to change the old system because it was unsustainable, and you all had about the only alternative. let me give you a reform to obamacare that has been available to republicans last five years, and by the way, many priebus -- previous panelists said in their journal last fall wouldn't it be nice if the republicans had an alternative to obamacare. that is a great article, at least five years late. you cannot beat something with nothing. so, the available opportunity and has been hanging out there for five years has been

malpractice reform. which republican is going to step forward with a sensible malpractice reform package that is waiting to be added to obamacare because it omitted that area hoping for republican joinder, and it never happened happenedve made the -- because we have made the atmosphere so toxic you would lose your credibility at the country club if you said anything positive about obamacare. people would question your sanity, when, a lot of it, and believe it or not, i am a plan,rt with the oldced -- with the old ced plan, going back to clinton care, there is a lot of good stuff in the bill. let's build on that and a lot of bad stuff has been taken out, like the class act, more good news you never heard about. it has already been removed by the administration.

sot people enjoy hating much. so, give credit where credit is due, and let's add a malpractice case to this bill. republicans are afraid to do that even though we could save tens of billions of dollars because they do not want the stigma of being associated with this bill. >> congressman? >> i could not disagree more. liability reform is something the republican house has been after for years. the missing link in the affordable care act was fixing tr, the liability system, and letting doctors talk to each other. >> where is the burgess bill on malpractice reform? >> i am glad you asked. >> that is not a bill, that is a book. >> you know this because you are a doctor, but here is the you heardl question, from the last panel repeal is not a viable alternative.

millions of people have written contracts based on an existing bill, and most of the people on the last panel thought we would only get to a reasonable place if we have bipartisan agreement. why not sit down and figure out if there is a bipartisan way forward on this? >> i might've agreed in june, 2013, but when the president unilaterally change the contracts and you had to rewrite them, it certainly showed me that if the industry is called upon to do something quickly, sometimes it can perform. here is the deal. if ted cruz, who is my senator, comes to my town and says we will repeal every syllable of obamacare, i will stand on my chair and cheer like everyone else around me. tomorrow, i zoo would say for those people that have been forced to buy in the bronze plan and have a $6,000 deductible, you know what, you have a health savings account,

and the new limit on your personal contributions is $6,000 because that is what my deductible is under the affordable care act clan, under the texas federal fallback -- whatever it is i had to buy in that they canceled my plan. outfact is there are people there now who have to struggle and work their lives around this new reality. you know what? i am like everyone else in the individual market. i pay $600 a month for my health care. dollarhe most expensive i have spent because it is after-tax dollars. we can fix the discrimination. i would be happy to have discussion about tax credits and where that should go. i was john mccain's main guy on that in 2008, but right now we could fix a problem tends of millions of americans are having across the country, and the president has required that everyone in my district office in the state of texas by in the

d.c. exchange. >> no solution until you have a new president? >> no, we can do this before the month is over, before the memorial day resource -- recess. >> we have heard from current members. let me hear from some former members. you both escaped the zoo but you are now in the lobbying business. first, if you have clients in this game. clients in the health care care realm, largely doing statistical work. >> this is the go work, but you do not have -- statistical work, but not lobbying clients that pushed for changes in the afford the care act? >> no. >> ok. so, what do you make of this? >> look, whenever the good intentions behind the affordable care act work, it was passed in the worst possible way, which led to the toxicity of it, and

intimate than in the worst possible way, which led to the toxicity. >> how do you fix that? >> part of the issue is to find elements where there is a lot of agreement. there are elements were people do agree. pre-existing conditions, for example. some of those things would be included in any republican bill that would be offered. >> so, you repeal it and you do it again question mark >> will -- again? >> well, my guess is because you have implementation taking place, what you're likely to get is a significant rewrite of the bill that would move it far more toward a market solution, and that it would not involve a total repeal because of the disruptive elements of that, but, certainly, a bill that was passed in the manner that it was --a totally partisan bill that literally ended up with a process at the end that cold

pieces together that were incompatible, needs some revision. the people trying to implement the bill in the agencies cannot implement it properly because the bill is such a mess, so at some point that mess has to be dealt with. the president is acknowledging that by continuing to revise the bill without any legal standing to do so. lending to the toxic atmosphere as well. so, i think we have to get to the point where common sense begins to prevail, and where we get some bipartisan teams that get together and figure out what we have to do to eliminate the mess and get to a workable solution. clients inyou have this area? >> the firm does have clients, but i do not do work in this area. i have a couple of observations. number one, i guess i am coming at it from the point of view of

where the previous panel was saying let's be positive, let's figure this out -- we are moving. the country is moving. the cleveland clinic is moving. organizations are moving. electronic records are moving. collaborative medicine is moving. i was speaking to one of my sons best friend at the yield school of medicine, all they teach is collaborative medicine. do with quality of care. it is the way the system is set up. the more you code the more you make, that does not make sense. anything that does not make sense that was touched on, but i want to emphasize this because i voted for the bill, i supported, and i think we'll take a number of years to filter out. it needs improvements and both sides to move forward. what was missing was a lot more responsibility on the individual in having some stake in their health care, both financial incentives and disincentives. by the way, a lot of the

conversations that took place in the previous group was talking about insurance plans, big business, and everything else. guess who provides a huge amount of the cost of the health care system? it is poor people who do not take care of themselves, many who have not been getting health care, and the diabetes issues in minority populations and a lot of other things aren't serious cost factors built into the system. now, if we are going to look at this as a country and say this is a huge cost to our country, then we need to look at it across the board. health savings accounts are great if you have enough money to put money aside. if you're not earning enough to pay taxes, the health savings account is not incentive that will change your behavior. we do need to incorporate a lot more responsibility into individual decision-making across the board, including people that have not traditionally done this before. it goes to the points of literacy, information, our health care system, both the private and public needs to

focus more attention on that. that is a big cost piece of this thing that needs to be part of the rebuild of the system. , --ommerce and burgess congressman burgess -- >> cannot comment on that? >> go ahead. , the agreement, i would never understand why we hre having the debates, with 3200, i never understood why we did not get mitch daniels in the him how he wassk doing it in in vienna? how -- indiana? how is his health savings program costing less and less when everything else is going up 6%? he funded into everyone's account who voluntarily decided to do this -- he would buy them a catastrophic plan, and then he would fund up to the amount of the deductible for that family. and what governor daniels found is something magic happens when

people spend their own money for health care, even when it was not their own money in the first place. the commonwealth on this last year when they published a paper, "deactivated patient." it is someone that is more -- "the activated patient echo -- patient." it is your money. i would rather see a system built on that rather than waiting lines and rationing, which is where we will end up with a yellow book. >> mike, i love you, but we have to get away from the talking points. , theave seen, this quarter greatest moderation in medicare price growth in 50 years. it is not enough, and we're not know if it is sustainable, i thought helen was a little pessimistic on that. something is happening. it could be tom rices of the world, and even though those are voluntary, they are miracles making of the physician groups

at least curious, if not jealous, and that is a powerful of -- phenomenon because physicians are extraordinarily able people, and it does cause self reflection. the study you cited of 800 billion shifted from employers to employees, i think most would tell you employees have been paying for the health benefits already in foregone cash pay raises. now, this is tricky because they do not know this and the employer likes to act like santa claus, but they are a sponsor of health benefits, not really a pair in any real economic sense. so, that shift is $800 billion in the direction of economic transparency. that is a good thing. for the first time in history, on the w-2, the worker can see the amount of the employer-sponsored contribution. that is never happened before. that is a little bit of a bureaucratic miracle right there just so people know what it cost because the previous system was you only found out when you lost

your job, you are on cobra, and while we ever named a law after a poisonous snake, i do not know. [laughter] turned downeople cobra because it was too expensive, and that was just the price they were paying their whole working life. this move to transparency was incredibly painful. $2.9undamental move, the trillion, or whatever we pay, exactly equals $2.9 trillion in incomes, and not a single person wants to give up a penny of the income because they will not admit the $750 billion in waste that iom has documented. the survey on medicare rangers -- reimbursement, even the guy that may 20 $2 million a year -- even the guy that made $22 million a year, is he going to admit that he made even a little bit of a mistake? for companies that want

quarterly earnings to go out, they cannot have it down quarter. they have to grow revenue and cut costs. the process is happening, and as business people, we have to help it happen. endorsingu seem to be the last panel said in writing off the debate in washington. >> it is so fashionable to diss washington. recent, people on the platform will have never visited washington. that way they want not be tainted. what you need is laws that establish the public sector will flourish, it is like a lattice where the line can grow. it is a we should do, set up rules so that companies can succeed. i know the health industry well. a lot of it is headquartered in nashville. there is loophole-chasing in games played, and despite all of the billions made in nashville, missionnumber said no

-- no admission, she was at the national hospital. people want results. i almost wish this conference could last two days and everybody would be locked in a room because we can figure this out. >> there cannot be anything there you disagree with. >> 20 years ago today i was sitting in a room in the national managed health care conference in this town listening to jim cooper say the same thing. my question is why have you not fix the problem yet? >> the question is why if the two of you agree are we at the state of affairs that we are at? that is all -- the question a lot of us on the outside have. there are commonsense things that are not really partisan at their core. >> i do not know why it has taken jim so long. [laughter] there was a question asked from the audience about preventive care, the cost savings for

preventive care. jim reference the fact that medicare costs are down. to get thed i hope cbo to study this, i think part of that is because medicare part 10 years old,be everyone said if you pay for the lipitor, you will have fewer episodes of congestive heart failure. those resultsif are accurate, but i would rather suspect it is that program that has been around for a .5 years that have had a more positive role on costs in the medicare system, and something that has been around 18 months and only fully implemented for the last four. the other aspect of that that i -- onis worth discussing the congressional budget office cost.everything is a

i would like to make immunosuppressive drugs available indefinitely to those that have had a transplant here at rent -- transplant. right now, we do it on your own. you might be ok, but you might be back with another renal transplant at a considerable cost. the only way the congressional budget office can look at that bylaw is by providing the indefinite suppressive drug. that is a dramatic example, but there are other things that fall into that category. donna christiansen, who is a member of jim's party, and i have worked to try to allow extended time interval for that look back on the congressional budget office. they do it on a 10-year interval. there are some things i do not show up, or the savings result will be marginal. we need a longer window to look back, and that is one of the

things we have been trying to do. people in your party were astounded when doug elmendorf came into your midi and said we want to do everything in the affordable care act, and pay for it with the savings, and they said the savings do not score. a were aghast that the savings do not score. that is something we have got to work on. to put you int the position of being the old curmudgeon on the panel. god knows there was plenty of -- >> i was responsible for some of it. >> that is the way i remember it, too, but it was not like this. you don't think the ability to deal with, you know, it is pretty clear even though it sounds like these two commerce men are arguing with each other, that there is a lot they can agree on. duringmber, i was there hillary care, and hillary care did not go anywhere because of the kind of atmosphere that there was in the congress on

health care. i mean, i do think that the divided congress at the present time does have problems getting things done. the house is passing bill after bill after bill. it is sitting in the senate. the senate is frustrated because some of the things they set -- they sent to the house sit in the house. thee are problems because legislative process does not work anymore. actionot see the kind of that begins in subcommittee, works its way through committee, where there tend to be bipartisan discussions and then we bring it to the floor, often with bipartisan backing by the time he gets through the committee process. that does not happen anymore. the health care bill being an example -- it was basically written in leadership offices. the members who voted for it had no idea what was in it. the speaker did not know what was in it. there was a combination of bills

that before did not even make sense. -- that hasis become a problem. there is a need for some getting back to the legislative process that works, that allows bills to build over a period of time and get some bipartisan backing as they do. i am regretful that does not happen, and i think there was more of that when i was in the congress. do as some people are saying, those were the good old days when everybody threw their arms around each other and -- >> it was not quite like that. >> love in every room, that just was not the case. >> what do we do to make progress on this? >> first of all, it takes two members who are no longer there

to agree, so that is a good thing. i am a little more recent vintage, just three years ago. but i think there are a lot of talking points that become the predominant way that we think about these things. some things are just repeated over and over again and people just repeat them and believe them. this is an educated group in this room. all of us are much better read than most americans, so americans get a lot of their information today, if they read at all, in terms of daily media. they pick and choose other source of information comes from, and that reinforces a lot of the silliness that goes on in terms of bad information. electedng said, officials have to still take responsibility. there is a role for people in this room, a big role, because if you heard from the professionals from the previous panel, they were all saying we are in the middle of this. we still have friends or investments in the middle of this, and it is very difficult

for us to make decisions if things are in flux. on the democrats' side, it passed, is not going anywhere for couple of years. taking longer, doesn't matter. that is just the facts. thisgoing to invest in piece of equipment, make this acquisition? impacted big decisions by the decisions taking place in this city. but there is a role for the business community. because it is so important and this issue has more connection than any other issue because there are so many stakeholders -- personal stakeholders where there is medicare, but everybody is involved. nobody wants their piece touched. they don't want less care, they don't want reimbursement -- they will -- they don't want to lose reimbursement. this is the perfect issue for ced and those of us in this room and the friends we have out

there. if there is a recommendation for what is going to happen in the next two years, what are the limited things in terms of specific toys that we can bring forward to congress and say at least less do this? business community does not agree it has a responsibility, it does, and it is affecting everybody possible out of line, it is affecting the care of our country, and i want to challenge the business community to comment democrats and republicans and the administration to say we have to have this. a few questions i want to ask all of you. this is at the risk of oversimplifying what is clearly a very obligated problem, but if you could change one thing in the affordable care act, what would it be? mandate.dividual >> congressman cooper? you are rebelling up the question, i can tell. >> it is not enough to have a dual eligible program that

combines isco unworkable bureaucracies. foreed a whole separate ram the most sensitive patients in america. the would agree to repeal individual mandate. >> ron? >> if you repeal the individual mandate, the entire interest and goes down. it thatadd pieces to incentivize patient involvement and incentive economic incentives. i gave a short answer and i did, and now i feel badly about it. [laughter] there has never been any legislation like this that has been as coercive as this is from the top down. medicare in 1965, there is not a lot of option over the medicare tax, but there are still plenty of options going into medicare. this is different. this has fundamentally changed the nature of the governed and those that govern, and that is why you have so much resentment

to this day. it has been over four years since the law was passed. the resentment endures because from the get-go this was something that violated one of the fundamental tenets -- government with the consent of the governed. >> that is revisionist history, with all due respect. --is a conservative idea individual responsibility. what is more basic than that? >> that is a talking point and i will disagree with that. >> when you leave this building, do you want to be hit by an uninsured motorist? states have the power to mandate things. but somehow our federal government does not? aren't we one nation? we are competing against other nations like china and others, which, by the way, according to yesterday,ial times" will soon supersede us as the largest economy in the world -- earlier because this congress shut government down for 16 days and refused to pay our bills.

this congress lowered americans credit rating -- america's credit rating for no good reason. this is not a partisan fight. we should approach this as americans. i have offered malpractice reform as a sensible solution. why isn't it being offered? because people no longer want to be constructive. they want to be angry because somehow anger is therapeutic. so much of health reform needs to take place outside obamacare. what if we no longer subsidize the sack food -- the snack food industry in america so that people did not become obese? one of week limited food stamps to healthy foods? coca-cola and pepsi and other companies are against that. >> i do not recall you voting for the amendment last summer that would have done that. >> let's check the record. i might not be as bad as you might think. often we barely know each other's names anymore -- in the

newt era. a lot of times we could get along and we knew the facts. committees are a joke today, and bob alluded to that. the decisions really come from so-called leadership, which is supported every time. i did not vote for a cut -- --that is not why you are that is why you are not on the jurisdiction in this case. was not passed in some environment where everybody thought it was a great thing. it was the first time in our history that we were basically the country saying we were going to require you pay taxes, you pay medicare taxes, and all of a sudden people who were senior citizens remain covered. idea, passeddical after many years of introduction, and it took a number of years for it to work out the kinks as well. so i am not saying it is right and wrong, but this is not the

first time we have dealt with something with health care. it was pretty radical at the time. >> the cooperation that we was ones think about party control of both houses over a long into of time, where republicans did not have much to say in the governance. we do the fact is that need to get back to a process that allows a lot of more input, to input that is being given legislation at the present time is pretty limited. now to use capacity a lot more information as a result of all the technologies that we have, including smartphones, and we are not using it very well because we do

not allow all the voices that are capable of dealing in the legislation to have a say, and i think we are getting some very bad product as a result. >> same question i asked the last panel. do you think there will be major changes in the affordable care act by congress in the next two years? a show of hands. >> i do. >> i do. have a major election coming up in six months, and i think you offer the story in order for congress to see the light, they have to feel the heat. i think there will be some heat that is felt. i think there will be some changes. i have reached out -- >> you think democrats will take a different position? >> i don't know the answer to that. people asked my greatest fear

going into the 2012 election, and it was that the same three people would be in charge. same speaker, same president. we got what we got. ibo are anxious for something to be different, but what that is thomas i don't know what part of that. obviously you're not changing the president in this election, but the house and the senate will look very different than going into the election because fact of people paying attention to this stuff. i need to stress major pieces of bipartisan legislation have happened. you had the fta bill last year, and major track and trade bill to ensure the pedigree of the pharmaceutical agents, that every pharmacist and doctor wanted, that we were able to put our differences aside and get it done. ofse are major pieces legislation passed out of committee. people do not pay attention to it because that is not the headline. >> hutchins and comments? -- questions and comments?

>> as i understand the exchange -- >> i'm sorry, these identify yourself to the panel. >> i am a trustee. nobody mentioned that a solution that might help would be a national exchange so that it could start out considerably smaller and yet presumably then still preserve the actuarial basis for the exchange structure. is that incorrect, and assuming is there any possibility that national enablement of the exchange is part of the solution? >> anyone? >> i don't see that happening, but ron had a good point that i wrote down about in limiting

exchanges at the point at which purchase occurs. i thought that was a pretty powerful mentioned is -- a pretty powerful message. i don't see a national exchange as replacing -- there are state exchanges that some states feel are working. my home state of texas did not do in exchange. 32 states said we want no part of it. i don't see that in the near future as changing. >> are you talking about risksharing? you know, if you think about it, the big argument between having interstate exchanges was that some states historically have coverage thanless states. that is why some people who like more coverage were pushing that. but the notion of having state lines or county lines property and casualty insurance, those are artificial lines in many ways. you could argue that once you

establish what the minimum coverage is, whatever that may be, and that let -- and then let other companies come in -- you could do that on a national level and maybe get better competitive rates that way. >> i did not understand your observation. the point i was making early on is that the president now requires any member of congress or staff to buy in the d.c. exchange. president is requiring them to buy across state lines. i think we ought to permit that to happen more generally and allow people to share cost savings. -- 15 minutes% could save you more on car insurance. we all know that. >> others? right here. >> just a comment that did not come out so clearly in the panel discussion. thank you, congressman cooper, for recognizing cde's

contribution in 2007, and also in terms of your challenge. we are engaged as a subcommittee , that ron and i are cochairing along with other members of our panel who are on that -- where do we go from here to opposite kind of goals for policy framework that we've heard pieces of throughout panel discussion? we are very much engaged, and our goal is to lay something out that can help build that consensus in terms of basically pulling together different ideas . my source of optimism is that we will accomplish that, and based , there isr experience a consensus among members that may be hidden at this point. hidden.e the sort of that was an understatement, i think. >> you cannot the something with

nothing. and i think we have something and can make a major contribution. >> other questions, comments? joe? minarik, a member of the ced staff. in the course of the question i will probably be asked to betray my inclusion. two different divisions incorporate health care -- one account,alth savings so you have a substantial deductible which requires individuals to make medical decisions about the care they pursue and the care they don't. sometimes they might, because it is their own money, choose not to pursue an episode of care that they really need. once their expenses exceed the deductible under the health savings account, all of the incentives to economize on expenditures are gone, which

means that what you are really economizing on our the low at theexpenditures, expensive care, which is where we have the problem. nott fact -- is it in fact restrained by that problem? second, the individuals are responsible for the incremental cost above some base for the insurance plan that they buy. the insurance plan might not involve particularly high co-pays, but you can have an inexpensive plan because it is efficient and care is delivered in a cost-effective way, or a more expensive plan because it offers choices among uncoordinated positions, with care delivered in inefficient way. given the choice between the two, i would say the second model seems a lot more promising

than the first. i am wondering if the panel has any reaction. >> i love it when economists ask questions. joe was one of my favorites. the idea of tier pricing is very powerful. you want freedom for unlimited choices? it might cost you a little bit more. there is so much meat in what you were talking about. that is really the core of the issue. i hope we can get sensible business people to focus on this. remember the business here. managed care did not manage care, it managed cost, and employees hated it. "he movie "as good as it gets with jack nicholson and helen hunt, theaters all over america erected with hatred of hmo -- people allover america you with hatred erupted of hmo's.

the core is the economic thing. what gets people to choose wisely? health insurance is an insurance. there is a wonderful book on this by giving gold hill called "catastrophic care." you may have seen this -- "how health care killed my father." today have no idea how much they are spending on "health insurance," when prepaid medical care -- the third. -- the third-party payer system is eating us alive, not only in college care but tuition. i love how mike mentioned that mitch daniels gave everybody a deduction in indiana. that makes you a tough -- a touch more careful, but we have to get away from other people's money. spending four or five

times more than it would cost to lift every american out of poverty. where is the money going? we could double everybody out of poverty and still save 60%, but we insist giving poor people benefit in kind. companies do not want to give people money, they want to give them health care at their prices, and the housing sector wants to give them housing at their prices. there is a lot of waste in there that we do not want to talk about or admit. ofis scary the idea empowering poor people. it is crazy, like george mcgovern talked about years ago -- but charles murray, a noted conservative offer -- noted conservative offer, is advocating this. things areisruptive really uncomfortable. there is a type of health insurance sold today in tennessee that nobody wants to talk about because it does not require an agent to be sold.

it is so good and affordable, it sells itself. the farm bureau is the parent organization, but you go to a farm bureau office and the secretary will give you a piece of paper and it is still an unwritten -- an underwritten product. it is magic, and it works. why doesn't it spread? because it is this active -- because it is disruptive. and incumbent industries hated. come to of economists our committee, and my fondest wish is that someday we will come to committee and there will be five m.d.'s on the panel and we will decide how much economists should be paid. i have had a health savings account since 1996 or 1997. one of those years, unfortunately, we exceeded our deductible. i do not look on that as a positive experience. withhappy to make the bet

the seller of catastrophic i am always happy to win that bet at the end of the year. but for the stuff, the more mundane health-care expenses, the kinds of things that used to be financed out of cash flow, it is great to have a debit card that goes to my health savings account to be able to purchase those things. ability tor time the accumulate dollars in those accounts, particularly the person who was 30 years old and starting out, i recommended to my children that they consider doing that. the early days of health savings accounts were not as great. we only had two carriers in texas who provided, and you got your best results that way. when ron got into the business, it change my life with the health savings account. it was great to have it. it was a sad day to make when -- to meet when obamacare took it

away from me and said you have to do something else. that was a powerful way for me to manage my own expenses but to carecipate in the health that i and my family consumed, and to do so in a way that was rational, and there were times i did not do what was right for myself and my family because i was just too cheap, what i did look for value and that is what we were talking about in the previous panel. how do you get value in a system that has not really put a lot of value on value? i think the health savings account model -- consumer that was coming in to health care when the affordable care act knocked everything off its stride, i think that was a good thing and that was a way to allow people to participate. jim references the "atlantic" article. talk about health care expenditures in three realms.

you would never go to your health insurance company for reimbursement on a mandate. but if you have your knee scoped, you're having a baby, that is a good place to have that coverage. a major militancy, you want to catastrophic policy to back you up. >> this goes back to the consumer choice issue, and the understanding. transparency notion -- if i go to buy a suit and i go down the street to macy's, i will buy it based on the quality and reputation of the brand, the service, the cost, all the normal things you used to buy any product. i am on a plan, my choice is limited to the people on the plan. that is not total free enterprise to start with. i would love to be able to pay possibly the best doctor i could find. if you want to go extreme, the best doctor with the best record, the best training. that is not usually the deal for a lot of people. medicare may be is different,

but for private insurance is not that way. second, if you need a procedure, do you typically choose your hospital? who chooses your hospital? your doctor. at twoctor is on staff or three hospitals -- and i am not saying they are making a bad choice -- but there is no cost factor involved. it goes on and on where our habits are such that we are locked into the notion that other people are making choices for us. >> one last question, comment. >> i don't know if you can get to joe. go ahead. >> it is great. jim has left, so i will take his time, too. >> clarify this point for me. federal elected officials, members of congress, artistic. in the federal employees of benefits plan, which was a good

employer plan that involves choices among alternatives -- >> as i recall, that was a reform that was created somewhere along the line, that we would have nothing any better or any worse than for federal employees. up until last year, that is correct. >> whose initiative were members of congress pulled off in the affordablens of the care act? >> i don't know. it is probably referred to as the grassley amendment. the concept was a valid one. didd not like the law, i not vote for it. but if congress was going to pass something that is visited upon your heads, we should have to live under the laws that we pass. there was some fancy footwork that happened last august, and the office of personnel management said you get a special deal for members of congress, even though there are no motor subsidized at the -- we

will give them money in the d.c. exchange. i said, no thank you, i do not want to be in the d.c. exchange. my doctors are in texas, not in d.c., and i voluntarily took myself out of that system, and i plan fora bronze healthcare.gov. it is the most expensive insurance i have ever had, took me forever to sign up. i started at 3:00 in the morning on october 1. i remember that shutting the government down. you may have all heard about that. jim mentioned it a couple times. the check cleared january 6. it took that length of time to sign up. facing.what people were it was good for me as a member of congress to have to go through that so that everyone buying in the individual market back home was forced into this system, got kicked off their health plan, and now they have to buy a compliance plan. that is what they had to go through.

the employer part does not kick in until after election day. i would not be cynical about why that decision was made. if the experience was like anything that happened to people in the individual market, i can see why they made that decision. i received no subsidy for health insurance. able to buy a policy that was hsa compliant, but it took a lot of digging to find that. it was a $6,000 deductible. my ability to replenish my existing accounts is capped at $3400 per year, so theoretically i could exhaust those accounts within a couple of bad years. >> congressman, congressman, thank you very much. i am not sure we solve the problem, but i think we should some light on it and i think they deserve a round of applause. [applause] alan.l, thank you,

to our panelists, this is as been a great couple of panels , iether, and complementing think it has been great. i want to thank our sponsors. ct,itte, state farm, a insignia and, rosetta stone, a gun sender, stephen palko, and todd pencil. i are a hundred as all are