unacceptable. improved bureaucracy fails that test. secondly, the lessons we learned in thinking through a 21st-century veterans health astem will teach us a lot bout the characteristics of our future health system for all. the same technologies that will improve veterans health will help improve everyone's health. third, replacing this obsolete bureaucracy with a new 21st-century system will teach us a lot about how to replace every other bureaucracy. the v.a. could be deferral runner to a generation of profound transformation in government. the changes we have seen in information technology are so indoor mist that the next few decades will be the most creative in rethinking government since the founding

fathers. virtually every field. pioneers of the future are developing new technologies am a new science: new solutions, new products, new ideas. currenteakthroughs are in the private sector, nonprofit sector, and in government. they are going to continue and accelerate. just as the founding fathers had to think through the relationship between organized citizens, so we have to think through the relationship between organized public effort and the technologies which are revolutionizing our lives. my recent book outlines the scale of change has occurred around us and begins to imagine a new 21st-century model of government that takes advantage of this emerging world. our current federal bureaucracy is trapped in the late 19th century. bureaucracy is largely an

intellectual pattern developed at the same time as the manual typewriter. they were the clerical requirements of carbon paper which led to a pentagon of enormous scale. 17 miles of hallways, 6.6 million square feet, and extraordinary symbol of american power when they were completed 71 years ago. yet to fulfill clerical and administrative purposes dating back to the 1940's, 31,000 people still work at the pentagon. technologyrmation should enable us to turn the pentagon into a triangle. we should be able to replace at least 40% of the clerical effort with modern information technology. this potential for rethinking

exists throughout the government. speed,ear the convenience, accuracy, quality and affordability we see in most private sector roddick's and services keeps growing. as results, with each passing year the gap between the obsolete typewriter bureaucracy we have and the modern decentralized citizens government we could have continues to grow. the smartphone and ipad are symbols of this gap between failing bureaucratic systems and the speed, accuracy, and convenience we are experiencing in our private lives. atms.er the you can go virtually anywhere in the world, find an anonymous machine, insert a plastic card, punch in a code, and get local currency in 11 seconds. how many have have this

experience outside of the u.s.? takes 175 days for medical records to move through the department of defense to the veterans administration. has a problem with the accuracy of their credit card statements or atm transactions. $4 billion inut bad refunds last year. including 340 three checks to one house in shanghai. medicare and medicaid have $70 billion in fraud every year. almost every government redistribution program has substantial fraud. the fact is that a manual typewriter bureaucracy that goes home at 5:00 cannot keep up with crooks using ipads.

the on efficiency and honesty, there is a more powerful reason to rethink modern bureaucracy. inevitablytypewriter is focused on the bureaucrat. it is devoted to rules that make the citizens subservient. will be century digital, mobile, virtual, and personal. digital,nment used mobile, and virtual capability to empower citizens to leave -- leave their lives focused on their concerns and would be different from the current federal bureaucracy which increasingly uses its power as a tool for social control. californiaovernor of and former mayor of san francisco has intriguingly outlined the potential for a

citizen centered smartphone enabled 21st-century model of government in his book. he writes, technologies like smartphones in the cloud enable an enterprise to organize itself in a distributed fashion without central power to collaborate in ways you couldn't before. it gives power to the people. it is the first crucial step in moving away from top-down chokingatic government our democracy. understanding this concept is central to understanding how the government must change and what it must become. appliesroach everywhere. the veterans administration is a particularly good starting point. the scandals, corruption, dishonesty, and failures and serving our veterans are so deep at the v.a. it is especially ripe for a fundamental

rethinking that shifts from the manual typewriters of smartphones and from a system centered on bureaucrats to a system centered on veterans. this process of thinking requires adopting the three principles. the problems are a systemic and non-episodic, and models are central to refocusing our thinking and analysis. second, modern information technology and its ability to empower the citizen and to dramatically improve how we organize public activities is at the heart of how we will rethink government. systems thinking in modern information technology can only work if the bureaucratic model of the 1870's is replaced with a agileexible adaptive system of continuous improvement , measurement of metrics,

learning, and continuous willingness to reward achievement and take steps to eliminate failure. requireree key steps congress to shift from traditional oversight based on reviewing failure in playing got and to focusing on breakthroughs in the world that empower and best practices throughout the world, not merely the best bureaucracy. you can see a paper on congressional committees and the concept at gingrich reductions. productions. it goes far beyond the recent reform bill. that bill represents a fascinating balance between the reformers push for new solutions and the prison guard of the past protecting their bureaucratic turf no matter how bad. the v.a. scandal has been big

enough that the reformers want a notory of allowing veterans wait 30 days for a department have the choice of any dr. who accepts medicaid. -- this wasobably probably worth the entire bill. and one of the most remarkable steps to prevent the secretary to expedite firing of senior officials. the reformers had to agree to open 27 clinics and provide $5 billion to hiring more people for the be a your accuracy even though the current productivity is so low that modest improvements would have improved veterans health without a larger yurok received. the extra $5 billion was the price of having a socialist who believes in bureaucracy chair the veterans affairs committee. the bill that obama signed into law thursday is only a start.

there is some bipartisan agreement that the reform effort needs to go further. said this will not and cannot be the end of our efforts. daniel dillinger said in a statement that the v.a. reform inkage is an important step the process to begin repairing systemic problems, but only one step, and only a beginning. on theking republican veteran affairs committee agreed that the bill was only the beginning of what it will take to repair it or rent this -- her friend is a blemish -- horrendous blemish. it starts a conversation for the future. a bill signed into law was only the first step. now, the real work begins. "thisor john mccain said,

bill is the beginning, not an end." house majority leader kevin "a modern v.a. must except the modern world and give veterans the ability to access private care, streamline its system, and remove bad employees." real reform is possible. only if we unshackle ourselves from the old idea that more bureaucracy, more government, more money will solve today's problems. it is time to try something new and build a 21st-century v.a. the skill of reforms needed is suggested by this interactive , which you can find it in

gingrichproduction .com. people kept saying it is isolated, it is isolated. there are 62 sites up there. you to goem allows and look at the data on each site. we didn't make the case this can't possibly be random episodes. system in collapse. i am proud of the work they did. this is what is amazing about where we are. , there all the evidence are still supporters of bureaucratic big government who continue to believe in the current bureaucracy. in 2007 him as recline stated the v.a. lead in care quality isn't disputed.

krugman called it a model to be immolated for the rest of our health care system. even after the recent revelations, the true believers stayed firm. "it is stille that, true it invites excellent care at low cost." just member that one quote. everything he says is out of touch with reality. " i'm sanders maintained, chairman of the veterans commit need -- committee. it provides high-quality health care." before i outline and propose a bold 21st-century veteran services bill, i want to examine these claims. if they are right, we will need bold reform.

it is important to understand how badly broken and how deeply corrupt the current bureaucracy is. the current public outcry started when we learned 40 veterans died on a secret waiting list in phoenix. that was only the beginning. in february we learned employees destroyed veterans medical records to hide their backlog. theecame clear that appointment system was pervasive. systemic lack of integrity throughout the v.a.. the final audit confirmed corrupt scheduling practices ofoss the department at 70% the v.a. medical facilities surveyed. 57,000 veterans have been waiting three months for an appointment. with the scheduling practices

are only the beginning. transfer a5 days to veterans medical records. the v.a. and defense department have spent $3 billion over four years attempting to build a joint system for electronic health records before announcing in february they were giving up. as of february there were 400,000 disability claims considered backlog. they had been in process for a hundred 25 days -- 125 days. and electronic records system developed at the v.a. to help manage this problem had cost $500 million but was crippled by poor planning design an planning, -- poor design, and implementation. there are lots of instances of

narcotics that. this is the one that's most disturbing. patients were prescribed narcotics without seeing him a doctor. waiting times are twice the national average. thatoburn's office found the v.a. is spent $200 million may last 10 years in attempt to compensate victims for its mistakes. more than 1000 veterans needlessly died under the v.a. watch. the median payment for a victim was $150,000. most agreed it was not about the money. they wanted the v.a. to be held accountable. ofween 2006-2013, the number full-time employees jumped 40%. 220,000, 314,000.

the budget is up even more. 90%. with 94,000 additional government employees, and twice as much money, the left believes the problem is the v.a. is underfunded. v.a. workforce is larger than the marine corps. compared to 200,000 marine corps. 150,000, shrinking to at which point they would be asf as many a reins -- half many marines. despite the competence and corruption, leadership has seem to reward the officials with performance bonuses. last year, 78 percent of the a senior managers receive these bonuses and got performance ratings of outstanding or exceeds successful. 470 the got successful or

better. employees are performing wonderfully. in some cases, these bonuses were outrageously unwarranted. the former director of the v.a. medical center was paid bonuses even though the inspector general blamed several preventable deaths. the report found that as of february 2017, there were more than 277 v.a. employees performing as union representatives on 100% of official time. they spent $42.6 million in cost related to maintaining official time. on average, private sector primary care physicians have an average caseload of $2300 --

2300. hospitals,ate sector some v.a. facilities close eye 3:00 in the afternoon. getting the truth of the ms. behavior has been hard. bureaucrats have routinely lied to congress. the department misled congress about the number of deaths claiming findings were found on a systemwide review since 1999 when the numbers were based on a handful of cases. the officials looked me in the eye and lied to me. turn theued, at every v.a. has thwarted effective oversight. of cover-up and deceit. the v.a. director in alabama

ensure that employees who falsified records were fired. i have now learned that wasn't true," she said. v.a. silences whistleblowers. the new york times reports staff members at dozens of hospitals across the country have objected to years to falsified patient employee schedules another improper practices only to be rebuffed, disciplined, or fired. the times continues, the federal office of special counsel which investigates complaints is examining 37 cases of retaliation by employees in 19 states. the article tells the story of a doctor, from dallas. aboutan complaining

negligence by nurses who marks the wrong kidney. saidother instance, he medical personnel brought the wrong patient to an operating table. a supervisor told him to let some things slide because of staffing problems. he continued writing complaints. officials considered him disruptive and fired him. watchdog routinely minimize whistleblower allegations by claiming the behavioral had no effect on care. the point is there is a failure of the current system. this litany of deaths, mistry meant, violation, dishonesty, lying to congress, failing to treat our veterans should convince any reasonable person there is something deeply and profoundly wrong to let the

of the v.a. nothing in the bill will get at the underlying corruption and the network of bureaucrats to protect each other and punish those who would blow the whistle on bad behavior. tophe reform bill, only the 400 of the 314,000 people who work at the v.a. are affected by the fire and procedures. some have expressed worries about expedited procedures for 1/10 of 1% of the v.a. workforce. there are six different unions at the v.a. four masterare -- union contracts. this includes employees at taxpayer expense. toy are an enormous barrier

reform. if we were serious about helping veterans these union contract would be suspended just as contract would be suspended in the private sector. all of the sistine reform bureaucracy with virtually nothing changing. bureaucracy has deep patterns of self-defense and self-preservation. it would adopt a new work ethic, a new commitment to transparent accountability, and enthusiasm for whistleblowers is asking for failure. the scale of change we need to ensure the best possible care is greater than the recent reforms and be on the conference zone of the traditional political system.

two missingd are components. imagination and a spirit of replacement rather than reform. first, imagination. imagine the 21st century veteran services. the greatest failure in washington is a lack of money. it is a lack of power. it isn't too much partisanship. the greatest billiard washington is a lack of imagination. washington is so absorbed in its own petty gossip, daily activities, definition of practical and realistic, it is very hard for washington insiders to relax and let their imaginations develop the possibilities that are all round. there is a simple fact that can open up everything to the imagination. everything which currently exists and government was imagined by a president, congress, and decor.

our generation has as much responsibility and as great a right to develop a new generation of solutions as did any generation before. i want to focus on one technological breakthrough. to illustrate how dramatically imagination based on practical reality can open up the entire system to new thinking and possibilities. the smartphone is an empowering breakthrough that exists all around us. it has not begun to be integrated in the public policy solutions. think of smartphones as empowerment devices. the first and the important question is what and we grew up in the bureaucratic world else around clerical processes in the manual typewriter. the bureaucratic procedures that define what happened wil. they'll define the relationship. in this world, the amount of

power citizens have over the bureaucrats is remarkably small. the amount of power the bureaucrats have over the citizens is remarkably large. too often, we the people have become weak, but bureaucrats. -- we, the bureaucrats. this extends far beyond the v.a. they were only an office for a brief. . enthusiasm ofand the new secretary of veterans affairs will presently run up against bureaucratic rules, hopelessly and intentionally complex policies, especially in information technology, and unwieldy union contracts. it has outlasted every president and every secretary. it isn't that secretaries were incompetent. he was immersed in the system

that simply ignored management and asked for polite applause for enthusiastic speeches and then went back to bureaucracy as usual. the smartphone shatters this shifts thec -- it location of power to the citizen. as is the potential implied in the new book, "the responsive city." we are organizing and empowering people with smart phones. if every veteran had a bertphone, they would empowered to gather information, to interface with health systems 24 hours a day, seven days a week. the v.a.urther that adopted this model for the 21st century. digital, mobile, virtual, personal. the smartphone with electronic records in the cloud and instantaneous decision-making could become the new center of gravity which would replace the bureaucratic model with the veteran centric model.

consider a v.a. app for the smartphone which would enable veterans to skiable his or her appointments. you know how this works in your own life. think of your app for restaurant reservations. food youthem what want, what neighborhood, a list of options with reviews, you tap reserve, you get an e-mail, the system walks off the table -- locks off the table. there is no question if you made the reservation. it has been around since 1988. zotdoc is the equivalent of opentable for doctors. you tell them what insurance you have and what type of specialist you need, it gives you 27 june youn your area. , they get anctor

e-mail with all your paperwork and insurance information. you show up when they are ready for you. no inspector general to investigate why you didn't get an appointment. than 24ait time is less hours. 25% lastave up to minute capacity for patients who canceled and rescheduled. 15-18% of patients would otherwise be going to the emergency room. ocdoc was founded in 2007. it is now serving 5 million patients. about as many as the v.a. they have 400 employees. repeat those numbers. it serves 5 million patients a month in scheduling, about as many as the veterans administration schedules.

they have 400 employees, total. the v.a. employs a thousand programmers. zocdoc covers more than 40 specialties, 1000 types of procedures, in 48 states by the end of this year. their market cap is $400 billion. if zocdoc went to the v.a. and offer to help with their scheduling software, which they know how to integrate with lots of insurance companies, the v.a. 17ld tell them about the self-imposed requirements that prevent us from using zocdoc software. including the requirement that zocdoc has to make all of its software open source. so that i can be custom built from scratch by the v.a. they will be prepared tomorrow

morning to provide the services. the bureaucracy won't let them. medical has app. -- an app. you can book appointments and communicate with your doctor, send pictures, send electronic prescriptions. you don't need to take an hour out of your day to go in. imagine if a 21st-century v.a. had this capability. doctors could see dramatically more patients in a day. veterans could get dramatically faster care. imagine if the veteran smartphone had a prescription app. every doctor could see every prescription. sometimes you need to go to the doctors office and they can take your bvitals. one app takes your temperature, your blood pressure, your heart g, in your lung

function in a couple of seconds. it costs $199. togine if instead of going the v.a. medical center, they could send this information to their doctor right from their smartphone. greatgottlieb had a paper, asserting that the fda will say that it subjects the smartphone as a medical device. another example, there is a company in california that is automated the 1000th most common medical lab tests, all of which can be performed using just a few drops of blood. out invice was rolling walgreens. give a few drops of blood, have the results e-mailed to your smartphone by the time you walk out the door. chargingcommitted to 50 percent of the medicare

reimbursement rate or less. imagine if instead of waiting months for such tests, veterans could go to their local pharmacy and have it on their smartphone in the afternoon, all at cheaper costs. there are enormous challenges with veterans and mental health. imagine if instead of waiting for problems to develop, support started immediately, reaching the veterans over there smartphones. apps could help walk veterans through the process of transitioning back to civilian life. imagine if online support similar to facebook could help veterans form a community to talk to each other about their shared experiences and help identify veterans who may need a higher level of support, all at very little cost. other challenges, like homelessness, begin to compound.

systems, thethese scheduling applications, the doctors visits, the prescription functions, were automatically available. the veteransoth and the higher levels of the v.a. of problems in a timely way. los angeles could not have deleted the names if the information was on the smartphone. that's profoundly different. all of this is very different we willhe department need to continue to expand the use of digital technology to free human resources that can be applied to the care of veterans." one of the key tests of rethinking the administration is whether the primary focus should be internally, on improving and strengthening the bureaucracy, or externally, on empowering and strengthening the veterans. in his keynote address, secretary mcdonnell described the traditional philosophy

perfectly. "we are going to judge the success of our -- veterans outcomes." v.a. is the customer service organization. we serve veterans. if we fail at serving veterans, we have a lot of work to do. there is a huge jump between serving veterans and empowering veterans. the bureaucracy remains the center of activity in serving veterans. in empowering veterans, the veterans become the center of activity. mcdonald does not understand how big is imagination must become to be successful. are updated the antiquated appointment scheduling system, beginning with near-term enhancements to existing systems, leading to the acquisition of the copperheads of, state-of-the-art scheduling system.

i believe the department will need to continue to expand the use of digital technology to free human resources." e muchal challenges ar larger and more complex then he can imagine. nothing in his business career prepared him for the regulatory, legal and bureaucratic barriers which make progress in washington so difficult and so slow. believewhy i replacement, not reform, has to be the goal. take advantage of modern information technologies and empower veterans with smart homes, we have to do more than marginally reform obsolete bureaucracy. we have to think through the principles of organizing human activity in a world of mobileous, real-time, computing and information available 20 47. personalized to each individual connect the vast computing and data storage of a worldwide network.

every process of the current bureaucracy works to prevent this from happening. for example, one of the most successful scheduling companies offer to provide its proven technology to the v.a. and was told that federal law and self-imposed internal regulations made it impossible. what is true of v.a. information-technology acquisition is true across the entire federal government. president obama outline the information technology last year, and explaining the gap between the brilliance of his two campaigns and using information technology and the failure of the obamacare website. "what is true is that our i.t. systems, how we purchased technology and the federal government, is cumbersome, complicated, and outdated. where, on a situation my campaign, i could simply say, who were the best folks out there, let's get them around a table.

are doing it at the federal government level, you are going through 40 pages of ands in this and that, there are all kinds of laws involved and it makes it more difficult. it is part of the reason why federal i.t. programs are over budget." sadly, the president didn't leap from this absolutely correct analysis to propose that congress profoundly overhaul the information technology procurement laws. google founders noted the same artificial challenges and health. -- in health. "generally, health is just so heavily regulated, it is such a painful business to be in. it is not how i want to spend my time. even though we do have some health projects and will be doing that to a certain extent, but i think the regulatory burden is so high that it would dissuade a lot of entrepreneurs."

secretary mcdonnell will soon departmenthe defense and administration announced in february that they were abandoning a multibillion-dollar project. entire sections of law involving have toion-technology be replaced is not merely reformed. -- and not merely reformed. only one congress steps up to the plate will we be in a position to start using our imagination to develop the replacement system which is necessary if we are truly going to help our veterans. there are first steps we can take for the 21st-century veteran service system. ideally, president obama would recognize that the overwhelming bipartisan vote for the v.a. reform bill, the speed and that there- indicate is a rare zone of bipartisan

opportunity to develop a better system. if you would reach out for the congressional republicans and pursue new thinking, he could have an enormous positive response. a series oflaunch visionary hearings, bringing in new technologies and new capabilities and exploring how to move from bureaucratic centered systems to veterans and power systems. secretary mcdonnell has an opportunity to outlined changes -- outline changes. such a the a is patriotic and compelling cause, the secretary wolf wind pioneering leaders in every field who will work with him to develop a new 21st-century program. each of us can tweet, facebook, even talk with folks about the new potential, the new opportunity, the new obligation we have to bring the best to our veterans by empowering them with all the tools the 21st century.

thank you for giving me this opportunity. [laughter] [applause] we will take questions. if anyone has a comment, question. i am peter, a law student. how would you address a privacy issue concerns? veterans might be a little hesitant of putting their information on the cloud. >> i think there's going to be a permanent challenge of privacy. we have very draconian laws about violating privacy, particularly as it relates to medical records. on the other hand, i would suggest -- if you look at the way records have been handled the v.a. right now, you can make it optional.

if you don't want to take the risk, you can continue to be in a bureaucratically centered system. my experience with most people is that people are more and more willing to have the convenience, accuracy, speed -- then we have to have systems that are fighting against hacking. i think we should have very strong laws for people who violate privacy. it is threatening the whole society. >> mr. speaker, i was part of the united states air force. there seems to be a clear lack of bipartisanship and a clear lack of leadership from all sides of government, a government that can even reform too manye, that was pages long so that the experts can't even tell you what's right. you get charged, lose your money. what makes you think that any

change to the ba system is going to ever happen? just had a all, we bill passed by a very large, bipartisan majority. the bill contained a surprising amount of reform, much more than you would expect a year ago. the secretary was just approved the fastest approval of any secretary in recent times. it gives us an opportunity to talk to this. it rapidly becomes hard. reason these bureaucracy survive, they are very good at fighting to protect their turf. that leaves towards the partisanship. i do think strong ideas that are supported by the country have a tendency to bring people together because the country forces them together. on the global policy fellow. -- google policy fellow.

are you proposing to give smartphones to all veterans? how would you suggest digital , teaching veterans to use smartphone technology if they are not familiar? , my am biased because 82-year-old mother routinely plays "words with friends" with four different people. routinely keeps up with facebook. five years ago, she would've thought it was impossible. people learn and adapt. this is true if you are dealing with populations the size of recognize, the smartphone system, the sheer computing power, it would enable you to put things online that are audio and video. for somebody who literally can't read all, you can give them an audio opportunity, video opportunity to be informed you would not be able to if you were in a bureaucracy.

bureaucracy will produce a brochure no one reads. people don't like to read very much. you have to know everything about the brochure to understand the brochure, so you don't read it because you can understand it. if you go to something like go, whicho -- duolin teaches separate different languages for free. duolingo has more language students and all the language classes in the u.s. combined. you can imagine a circumstance will people like duolingo have literacy for people who speak english. they will be able to go online to learn how to be literate. want toargin, if you say, here's a person with a severe mental problem and they have a severe set of wounds and they have a -- they are 86 years

old, you can create specific people for whom none of this works. the current v.a. doesn't work, either. have a better chance of inventing someone that will work then the current bureaucracy does. i'm a researcher. when this crisis erupted and veterans decided to go out and see anyone that was willing to see them since the weight was so long, the government indicated that they would pick up the tab. through some means, the v.a. would pay for it. we need to develop special rates for this kind of activity? as a way to solve the crisis? why not like something like medicare? theors would pay for care, same amount of money, something

has been done that should be done? i don't know smartphones was assessed. >> i do know the details. because theeptical v.a. has to regulations for the implementation of all of this. i wonder how easy those would be. actually -- is it does it increase the income of positions? there is a 25% cancellation rate, which means 25% are not making any money. they just increase their income by a substantial amount. how do you have an interface with the doctor is winning and the patient is winning? the best is a free society is for everybody to win. >> good afternoon.

i live here in the district. you gave a massive push for changing the bureaucracy, and it is clear to me that a lot of that effort would have to come from the citizens, to push the congress to make those kinds of changes after careful debate. as a retired veteran, one committed to assisting veterans, also believing in good government, also wanting to have conversations with people and am certainnment, i that the faces and voices that look and sound like me are heard and seen. what i would like to do in front of everyone here is to invite me andhave dinner with

my friends, veterans, from a grassroots level, ordinary ideas,n citizens, your so that people don't always have .o go outside of washington there are people here in the district, even though the veterans in the city don't have full equal voting representation in congress as they should. they would like to invite you to have dinner in my home. we could talk and get a schedule. you could, one of your regular visits to the nation's capital. it is up the street from cnn. video chat with vince afterwards, we will find a time. chat with vince

afterwards, we will find the time to get together. i'm a policy analyst with the american heart association. he talked about the regulatory uncertainty regarding mobile application. the report, which i am sure you are familiar with, categorized mobile applications based on wellness applications, clinical, and health care giving. they didn't really define them. is thisdering, how initiative going to progress with such regulatory uncertainty? >> i think there are bills in both the house and senate that are bipartisan, that pushed back pretty hard against the fda. what you had to have is some ability to measure whether or not something works. that is a retrospective, not a prospect of ability. if you make it a hurdle to actually launch into these things -- the fda has been in

charge, steve jobs would not have been able to found apple. microsoft wouldn't exist. the wilds were in environments making lots of mistakes and developing products, many of which didn't work. there are now 93,000 medical apps or health apps. the idea that the fda bureaucracy is going to slow down their admission until some bureaucrat has approved them, i think that should horrify everyone. you probably have a standard which i think exists in state law, in terms of fraud -- we someone with an ekg on his smartphone. we bought 12. one, too.

it takes an ekg and says that your cardiologist. it's amazing. if somebody says, i am making an ekg, they are liable for fraud. you don't need the fda to approve it. there ought to be a fraud standard applied for the stuff, but it does not require that the government bureaucracies become primary hindrances to the system. i think you are going to see an extraordinary revolution in the impact on smartphones, and i only use smartphone as a generic concept of mobile capability of communication on the 24/7 basis. i think it is going to explode in the next few years. thank you for offering us more of your best and brightest ideas. we are very appreciative. it is extra start if you start -- smart of you to start with

the v.a., because veterans are crossing all boundaries. almost all american support veterans will stop thank you for starting with them, to help improve the bureaucracy. do, which suggestion do you have, for the people who will lose their jobs because of this long needed rollback in cleaning up of this bureaucracy at the ba and other departments in washington? >> i think it depends on which people you're talking about. if your member that long section on what's wrong, those people should lose their jobs. i have no problem saying that -- a nurse who substituted water for morphine should be fired this afternoon. second, as you shrink, -- you

put in a hiring freeze. they discovered that with a hiring freeze, a west virginia state employment dropped 10% year. that number of people retired or left or moved on. oughtd suggest that they to have a retraining program. they will give you the right to bid on another job. you have to mean make people unemployed, that is the same challenge every business in america faces. we have been through a tough economy. bureaucrats don't have an automatic right to say you owe me a lifetime job. there is a political reality, which is how hard they will fight. you want to make it as unthreatening as possible but you do want to manage a dramatic

transition. i am a strong national security hawk, but i tell people i am a cheap hawk. i think we ought to shrink the pentagon to a triangle, because there is no reason to have 31,000 people pushing paper at the center of the defenses to many more. that was the tip of the iceberg. when you look at the distributed people who work at the pentagon. always, i'msay, as delighted to be back, we appreciate the audience -- i was grateful that you introduced me. i hope you found this a useful starting point. the actual texts available are available at gingrichproductions.com, and aei. tank y

you will hear from a mary barra and kenneth feinberg, manager of the victims compensation program at 8:00 p.m. eastern next tuesday here on c-span. tonight, c-span prime time looks at the cdc's disease detectives. experts helpalth prevent the spread also. they preview. -- here is a preview. >> one of the reason researchers veryvestigations is this thing, emerging diseases in people are often traced back to animals, and one of these situations occurred in 2003. we had thatnt

something had gone terribly wrong, you can see in this picture, this is a three-year-old girl who lived in wisconsin and she developed these very odd, very disturbing skin lesions. i am actually too young to have been vaccinated for smallpox. researcherse many at cdc who dedicated their early careers to eradicate this disease from the world, and they took one look at this picture and said that his smallpox. so we were very, very worried, especially when a second case was reported just a few days later from another part of wisconsin. these two patients did not know each other. one is a three-year-old girl, one is a businessman, but they had one piece of history in common. they had both been bitten by sick pet prairie dogs. >> the cdc's disease effectives tonight on c-span at 8:00 p.m. eastern.

here are some of the highlights from this weekend. friday, 8:00 p.m. eastern, a history tour looking at the civil war. saturday at six: 30 p.m. eastern, the communicators visit the technology fair on capitol hill sunday on q&a. political commentator, author, and former presidential candidate pat buchanan on c-span2 friday night, book by hillery clinton, barack obama, and edward noted. on "after words," daniel halper. on c-span3 for tonight at 8:00 eastern, the negro leagues kansas city monarchs. saturday is as :00 p.m. eastern on a civil war, the depiction of slavery and movies, and sunday on "reel america" at 4:00 p.m., it an interview with president herbert hoover. and call us at 202-626-3400 or

e-mail us at comments@c-span.org . join the conversation. like us on facebook, follow us on twitter. live today on c-span, "washington journal" is next. at the :00 a.m. eastern, the national business group on health releases its report on large businesses and health care coverage. at 12:30 p.m. eastern, a discussion on south korea, japan, and u.s. trade relations. coming up in 45 minutes, eleanor of the feminist majority, on the impact of recent supreme court decisions on the women's rights movement. then at 8:30 a.m. eastern, filmmaker and editor dennis michael lynch talks about the situation at the border and his documentary on illegal immigration. -- at 9:15, eleanor smeal

christine gorman of scientific america focusing on the 40 year war on cancer. >> we will stay on iraq and get your action on whether inaction in syria caused the