and later, john mcginnity, the president of the american academy of physician assistants. will be taking your calls and you can join the conversation on facebook and twitter. "washington journal" is next. >> president obama plans to new york-based federal prosecutor loretta lynch as the successor to the attorney general eric holder. you can look for that announcement live on c-span at 11:10 am today. president obama also sending 1500 additional troops to iraq. -- itical reporting that he calls isis al qaeda plus. turning to the economy, unemployment now stands at 5.8%

and there are signs of job growth. president obama just a yesterday in our first weekend minutes. to get your thoughts on who should get credit for the improving job numbers. again, 5.8% is that number. 202 585-3880 for democrats. 202 585-3881 for republicans. 202 585-3882 for independents. if you want to share your thoughts on who should get the the current unemployment picture on our social media sites. us an email.o send if you look at the current figure, like we said, 5.8% is the current estimated figure 4 number of jobs

added was at 214,000 jobs. if you and the unemployment rate, it stands at 5.1% for men, 5.4% for women, and 90% for teenagers. the bureau of labor statistics providing those numbers. also if you develop -- if you take a look at the various sectors, you see the hospital the category g with 42,000 jobs added. when it comes to retail, 27,000 jobs. healthcare at 25,000 jobs and manufacturing at 15,000 jobs. president obama taking time with several meetings yesterday. one with his cabinet talking and t the economic picture what happens now, especially if yes to work with republicans in the senate. >> i am also going to be in listening to them, in terms of areas where

we can think it is possible to work together. whether that is putting people work through stronger manufacturing here in the states and selling more around the world -- one of the major topics we will be talking about drama is a check next week. whether it is how we can build on modest investments -- we know that works and there is strong bipartisan support around the country. let's see if we can do more. of these issues are ones in is a strong possibility of bipartisan cooperation. as long as reset politics aside for a moment and focus on the people who actually said that it. >> we want to get your the first 45 minutes on the unemployment to ure, and when it comes the unemployment number itself, who should take credit

for it. 202 585-3880 for democrats. 202 585-3881 for republicans. 202 585-3882 for independents. a couple of thoughts from facebook this morning. mark marshall says get the real numbers and come talk to me. carol says the companies that hire them. may show those thoughts and you may have others as well when it comes to who should take credit for the job picture. let's start with bobby in key west, florida. bobby, good morning. >> hi, how are you doing? >> fine, thank you. what you think about the numbers? who should take the credit? >> it is very obvious. the democrats and president obama. the republicans never did anything for this. you can see some of the anger

already because when president that speech he made, he basically let them know that, hey, this time he pulling too to be many punches because he couldn't get much done because of all the political things holding him back. most presence do a lot more in their past -- presidents do last two e in their years -- which i think you should probably do because been many, many people -- as many, many people know this country. >> who should take the credit for the current job picture. the dan from maryland on democrats line, hi. >> hi. i think that all the blame has president obama

for the job picture. improvement, there will be a lot of parties want to blame somebody other than him for the improving situation. i think that is wrong. think that the obama administration deserves credit. they get credit because it is good for them. when it comes , -- if you give it to the obama administration -- is there you look at at specifically? >> i think that there is a lot of stuff that they have done for the economy. of ere has been a lot investment in infrastructure and i see people all over where in maryland working, redoing the example of money into to create jobs. john in north carolina adds energy to the next and

talking about who should get credit for the job picture. is on twitter saying that: we go next to the independent line. >> hello, i just want to say democrats -- i mean -- i cannot believe that on are day, the people who democrats, they played dumb. like they don't know obama. i hope they learn their lesson like that lady. you vote ey asked, did for obama? answered yes, e i did. the republicans send jobs two

different countries like bangladesh, china, mexico, you name it. say hen the republicans we promise jobs, yes, but not here in the united states. and some other countries and richer like millionaires, billionaires. they do not care about the american people. they care about making money in their checking accounts. >> let's hear from pam in texas on the republican line. good morning. >> good morning. regarding the unemployment rate, the reason why it was down is because people are retiring. are starting to retire. i do not think it has anything to do with it. >> so there are other factors that knowing can specifically take credit for. that is what you are saying? >> yes.

i think it is because people are retiring. there are a lot of baby boomers leaving the workforce and there are less positions for younger people. >> if the number keeps going down, do you think it could still be attributed to that or they here other factors have to consider? >> i think it is going to go down because of the immigration. here e so much immigration in texas -- there is a 30% minority in dallas county -- and i think we are outnumbered by the immigrants. so i think the unemployment is not going to go down because we more people coming in. and i do not think they are jobs fied for a lot of the we have your, so i do not think it will help the economy this keeps going on. >> marty is up next. marty is in virginia. i know that people

say a lot of things in reference to what the president and democrats together have and have not done. the whole thing is that they get a lot a lot to done if the senate is not to vote on it. that has been a progress -- problem. as far to talk about the border, we do not know how to control the border. not that we don't try, but do we have enough people there? there is not y enough money to support the people in border patrol. maybe we need to publicize to make these people not aliens, but that they itizens so are taxed, so that they do have to work. during the jobs to come back from overseas? absolutely. we need to investigate this

and make some changes that are necessary to bring things back on a command basis. just have freedom of let's tax everything american or an american bias. that is neither fair -- it doesn't make any logical sense. >> that is marty from alexandria, virginia. you are calling in and want to tell us about the unemployment picture and who should get the credit, again the numbers are 202 585-3880 for democrats. 202 585-3881 for republicans. 202 585-3882 for independents. if you are on the line, keep holding on for a few minutes more. we want to talk about other stories, including stories and almost all the papers this morning taking a look at the affordable care act. a new challenge being heard and being heard by the supreme court, as you can see from the headline from the new york times this morning. here to kind of update is more is jeffrey.

good morning. tell us a little bit why the this and what exactly are the hearing. >> good morning. the justices decide to take this case because the issue is to the lower ay courts, but it is not quite at the level where the lower courts take the case. to circuits that have ruled in opposite directions, essentially, on this issue. was, earlier this year of the circuits -- deciding to undo the decision. as of right now, there is no circuit split. going to court is consider is the tax subsidies that are in the affordable care act. supposed to make insurance of more affordable are everybody, if you within a certain insurance bracket.

in the affordable care act, to re are two references the substances go to certain people. in the rest of a lot, it says it to go to anybody. challenges here say that these two references word says just state exchanges the obama what administration enacted. will have to decide if the administration is implemented correctly when he said that anybody could get a subsidy. >> as far as the judges who having, who cision are they and how do they play in this? >> we don't know. only for justices are needed to take a case. don't need to

publicize which for those work need to publicize it. no way of knowing who that is or what their motivation was. case ill be arguing the for the administration? who is arguing the opposition? and what arguments are the bring to the table? >> sure. the attorney general, i would assume he is arguing for the administration, but we will not know that quite yet. it will probably be in march, know a day t even yet. the calendar ut on relatively quickly. he infamously defended the affordable care act in 2012 he will be back. far as the challengers, they have not said who would argue in the supreme court yet, either. as the results then

-- what could effectively happen? >> if the court were to say that the challenges are right, in that subsidy should only go who live in states where the state set up their own exchange, it would have because that nces would mean that more people in this country would not be eligible for the subsidies. and it was one of the key parts of the affordable care act that was supposed to make a lot more rance accessible. i think of the court were to would see the we administration change the definition of who is a state exchange. there is really no technical definition right now. it st people kind of break states to who -- what are using healthcare.gov and exchange by their own name. i think we can see that definition loosened, but we pressure on republican

governors who have now decided affordable care act -- we see a pressure on them to do so. and i think that they would political another obviously whether is ernors are enacting this already a political issue. we have had so much attention on the supreme court's mandates in 2012 -- such -- such a high-profile case for this court, people are calling it the biggest supreme court case in a decade. nearly k we will see as much attention because this case has the potential.

>> jennifer haberkorn with political. thank you for your time. papers this morning -- in the papers this morning, attorney general in question. has been picked -- nominee has been picked -- loretta lynch. us attorneys are almost never chosen for the top job, because they become attorney over al, they vault several rungs of justice department leaders who are currently their superiors. you can see that announcement life here on c-span this morning. we are currently talking about the 5.8% unemployment rate and who should get the credit for it. is anette, pennsylvania on our ary is

independents line. >> hello, yes, i do not think it actually reflects the unemployment line in america. they ard yesterday that are now asking people if anybody in the homework that this month. if your son made $20 shoveling they or mowing grass, might say yes. so i think it is an artificially low number. we also know that the number of people applying to receive and therefore coming off the job has skyrocketed in the last few years. number is nk that quite false and i guess the credit goes to the for cooking the books to make it appear that things are getting better fact, on the ground, there continues to be a lack of sustaining jobs.

>> this is william from west point, mississippi. the democrats line. >> hello. >> hi, you're on. william, go ahead and talk on the phone. let's go to jimmy, on the republican line. >> i think that we need to give a little more credit to governor, arolina the texas governor -- scott walker. turned governors have their states around and they inroads in lot of adding jobs were a lot of people are drinking this to give ically wanted the -- democrat kool-aid wanted to give all the credit to the administration. they were not giving credit the republicans are coming up with, so that has staff some republicans could have done.

but a lot of republican governors have done a great job in their states. barney up next from florida independent line. like to say -- d this to the people is leaving the workforce. will you tell me where they go they leave the workforce. president say anything giving the president credit. i had to go to work everyday -- >> so do give the president credit, then? >> yes sir. the republican party does not want to pass any jobs, so what do you expect? >> so as far as the president getting credit, why do you say that? >> i believe in the numbers. what you think people are going to sit there and tell lies that this is going on. i see it every day.

we can keep workers. >> what type of industry are you in? >> construction. improved for rk you than? we got a big contract to improve the university this there are jobs everywhere. leaving the eople workforce -- i have worked all my life and i want to follow them to see where they go. >> william from mississippi the democrats line. it to say 'm calling that president obama should get the credit. that is common sense. >> linda from michigan. republican line. good morning. >> good morning. i just want to say that the bureau of labor statistics -- when they adjust the rate, they don't count what they referred to as a discouraged worker.

workers are simply give up. when that happens, the job completely out of the ratio. in 2012, approximately 909,000 people simply gave up. were no longer unemployed, which jobs and employment number, but they are still unemployed. so the figures are totally incorrect for anybody who is actually studying the issue. that is i wanted to say. north babylon, new york. the independent line. >> yes, if you don't want to believe the unemployment number, then you can't believe the job creation number. construction jobs -- secondly, those democrats away from the g

president are losing the vote. whites are a lot of poor and food stamps for an social security and obama care. the republicans they elect will reveal these things and they will suffer. the news about iraq in papers this morning. the announcement is 1500 troops being sent there to help in the training people there in fighting isil and isis. they rejected suggestions that doubling of the force amounted to mission creep. the present medical or that we will not be putting us men and women back in congress. this was made yesterday at the white house. talking about the role of the tutoring center rack.

>> they have approved the of up to 1500 a noncombat role to initiate a comprehensive a training effort for iraqi forces. secretary hagel made this recommendation to the president. the us assessment is due to development of a coalition. command will al establish to central expeditionary centers in locations outside of baghdad to provide assistance at the brigade level and above. be protected will by an array of abilities. they will have to accommodate iraqi ining of 12

brigades. coalition partners will join personnel at these locations iraqi capacity and ability. commander-in-chief has chuck hagel to deploy -- to deploy to iraq of 1500 additional us personnel over the coming months

personnel over the coming months in a noncombat role -- >> again, if you want to see that. and the pentagon yesterday, you can do so at again, if you want to see that. and the pentagon yesterday, you can do so at our website at c-span.org. the interview is set to air -- he is asked about iraq, specifically about regrets. the president tells cbs that his regret is that a violent group of people have risen up again. this is al qaeda plus. they need to be defeated and i hope we do. when he was captured -- this is saddam hussein -- i just didn't believe bush, he said. he can to the full interview tomorrow on not only cbs's sunday morning program, but also face the nation. in who o the economy joshua from north carolina, your next. >> i think obama should get credit for it, even though i am unemployed. looking for a job, hard finding een

of ob, but there are a lot jobs out there which i'm not physically able to work. take anything right been off use i have the job and i have really been i rough some hard times, but still think that the president is a good man and this great country and i hope we can all come together because this is just a mess, man. >> joe is up next from pittsburgh, pennsylvania. >> hello? >> you're on. >> us want to clarify one thing. we hear people that are just no longer looking for jobs. actually, those are the people whose unemployment has run out. they have not quit looking for jobs. they 't know why describe them as, you know,

discouraged or not looking for jobs. it is just that their unemployment has run out. still ure they are looking for jobs. >> so what do you think about the 5.8% unemployment figure and, if you believe it, we should get the credit? i think the figure is way too low. those people are not counted in the labor force. that is what they describe as you know, discouraged workers were not looking for jobs anymore. but doesn't say the fact that their unemployment has run out. >> that is joe from pittsburgh, pennsylvania. one of the takeaways talked about wages. the wall street journal has a breakdown of the hourly wages. when it comes to the information sector, the average wages $38.28. construction, $26.86. health care and social assistance, $25.05.

going down to retail trade, that is about $17 an hour. the average hourly wage according to the wall street journal. and when it comes to leisure and hospitality sectors, about $14. letter from thomas from daytona beach, florida. >> yes, how are you doing this morning? >> fine, go ahead. >> my comment is that we have people in this country who have selective memory. were forget how things when the bush administration left office and left us in the mess we are in. have said it here and i listened to the deal you know, the democrats, you know, nothing getting through congress. the reason nothing went to congress is because for every bill that comes out of of representatives,

they passed a repeal to the aca to it -- that has let go to the floor. some of the d that unusual cannot point that out host: when it comes to employment by share of population in october, 59% of the population categorized as employed but when it comes to total labor force and the unemployed that figure rises to 62.8%. under the category of hidden unemployment in the millions, those working part time, but wanting full time work about 7 million, people who currently want a job, 6.1 million goes on from there. these are from the bureau of labor statistics. we're asking you about who should get credit for the current unemployment picture, as it stands at 5.8%. texas is up next. irving, texas, here's michael, independent line.

hi. >> caller: hello. although i am from irving i'm actually calling today from the beautiful great smoky mountains. gorgeous out here. i wanted to comment on a comment made by a previous caller, when she indicated that there was manipulation of the unemployment figures. i think we can all agree that there is always some political manipulation of these figures, but i think we may also all gree that it is a bibipartisan manipulation. every administration will manipulate them so they can assume some stay kiss there and i see the number going down. i am a technical recruiter for an i.t. company and i can speak only in the i.t. industry, i am overwhelmed with open job positions, but i will state that unfortunately hen i search for candidates for these roles i come up with very few people who

are u.s. citizens. most of the candidates for, at least the i.t. roles that i'm h 1 v. ng for, pulled visas so i could leave you with that comment. host: here is herman, independent line. caller: i do believe the president, mr. bernanke, mr. paulison deserve a lot of the credit for the resurrection of the economy. remember what happened in 2008? and you got to also factor in the scorched earth resistance to the president. no matter what he did, they hate the guy, probably from the color of his skin. it's been that way since the day he announced the presidency. hey have resisted him at every

turn. but i do believe that the president will look favorablely in history. and i thank you for your time. host: that's herman from south carolina, four days from election day we're getting updates when it comes to specific races, turning to the virginia senate race. ed gillaspie has conceded the race to mr. warner, saying this was an obviously hard fought race and i'm proud of the campaign we have run, i've loved every minute of it. well, maybe not this one so much, a disappointed and grateful gillaspie told friends. the former republican national committee chair came in less than one percentage point of unseating a popular incumbent higher ambitions of office. that's the richmond times dispatch this morning. when you go to california, taking a look at the house rates there, this is reported by the sacramento of the associated press that democrat scott peters on wednesday won the second term

to represent a large swath of san diego and congress following a bitter campaign. peters led with 51.3% compared lead -- they estimated that between 10,000 and 15,000 ball lots remain to be counts. the associated press determined it is insufficient for him to overtake peters. if you go to the pages of the los angeles times this morning they have a poll that was taken about their two senators from california, boxer and feinstein, asking them specific questions about whether they should run again. when it comes to your impressions of these people, how favorable do you feel for them? unfavorable.%, 35% for feinstein, a 48% favorable rating and 32% unfavorable. would california be better off if our senators continued to ran

for election or new candidates became our u.s. senators. 39% say they should continue to run and 59% of those said they would like to see new candidates. the full breakdown of that is in the los angeles times this morning. maryland, independent line michael, good morning. caller: good morning. i just had a quick comment. i just -- people are talking about the unemployment rate going down and they're not fact oring how many people have left the labor pool. one more comment, i think it's interesting that we talk about oh bama as a president who is supposedly bringing peace, but what did you think was going to happen if you with draw the army right after a victory. basically we left a huge hole and now we have to go back to fight for something we lost thousands of troops in the first place. host: connecticut, you are next, democrats line. caller: hi, yes. obama should get credit for the .8 unemployment.

gave him credit for the 10% unemployment. our years ago. host: rachel is up next, republican line, good morning. caller: yeah, on the 5.8, i think it's a bad number to even look at. it only counts for people who are receiving checks. if we had a long enough recession we'd have zero because everyone else -- on top of that we have the illegals and legals coming in with 200,000 people a month, that's hardly generating any new jobs. so i think looking at the 5.9 it's just the wrong number, particularly when students are trying to fight like heck to get jobs and have loans on top of their backs. i'll hang up and hear your answer. >> 214,000 jobs added, that's

off of twitter commenting this morning saying i don't think the president of the united states or congress can dictate the businesses how many full time workers they should employ. the president set to take a trip to asia to attend several meetings plus meet with leaders in china. the "wall street journal" says that this trip according to its headline will test the crucial asia agenda. this is carolee and others writing that the success of the asia policy hinges on several areas in which his aids say he will focus next week, achieving the trade agreement known as the trans pacific partnership. that's in the "wall street journal." if you go to the pages of the "new york times" it gives you some insight on how china's leaders and its government there is preparing its country for the

trip. again in the pages of the "new york times," they report that determined to offer visiting heads of government including the president a cleaner, emptier version of china's capital where is air is often dirty and the streets often full. they are ordered doeses of temporary changes that are upsending people's lives. thousands of factories closed and thousands have been reduced emissions by 30%.

cru can find that in the "new york times." ali from new york, good morning, how are you. caller: good morning, how are you. host: fine thank you. what do you think about this number and if someone should get credit for it. caller: well, let's say i'm very discouraged with my country. president obama from the day he was inaugurated, there was a plot, and it's all well documented by the republicans to obstruct everything. and they made it, they did it. they did it. and this man deserves credit for just tolerating the obstruction and the lies, and you know what disappoints me is nobody ever

asks anyone where did you get your facts? where do you get your facts? he has done for everybody in this country, tried. he's not perfect, man. but he's a damn good man and i'm elling you i am just truly disgusted. canada is looking better every day. host: so let me ask you when it comes to specific policies that the president has put into place to improve the economy and job numbers, what would you point to? caller: what would i point to is getting the unemployment down. first of all, there has to be a demand. there has to be a demand. and we know that the big corporations have certainly stopped, because they have found how they could work more efficiently without all these people. everything has changed, and you have to change. when the demand is there, what type work, they blame the

immigration, they blame -- he has done more for the border than any other president. he was left a disaster, and no one ever asks these people that call where did you get that information. host: that's ellie in new york. the washington post talks about the city of detroit, a judge there approving a plan for it to get out of bankruptcy. this is michael fletcher writing this morning. he adds that the road map approved by judge steven rhodes would reduce pensions for former city workers by 4.5% while cost of living increases will be eliminated. former police officers and firefighters would see cuts to their pensions cost of living increases while bond holders in short variety of substantial cuts. the plan also contemplates detroit investing 1.7 billion over the next nine years. the money will go toward computer systems, fire trucks, ambulances, and other infrastructure aimed at reviving city services that in many cases

have failed to function in recent years. sherman oaks, california, thanks for holding on on our independent line, good morning. caller: hi. everyone that's calling in is going in like different directions like china and other things. they don't concentrate on the issue of unemployment. i'm quite familiar with it. it's one of my favorite things. all the numbers and everything are like mumbo jumbo. unemployment is one of my passions because i've heard this on c-span a few years ago, an expert who explained how the labor department, it's not even the labor department, it's a private company. they sent 60,000 surveys to people out of work to find out if they got their job. meanwhile a lot of people died, people get fired, people quit, and so all these numbers don't add up. it's about the economy, stupid.

everybody should remember that. this is all it is. host: so joel, what about the 5.8 figure. do you believe it or not? caller: i don't care about the numbers, they mean nothing to me. host: it's the best indicator we have to show you, so i suppose you don't think anybody should get credit for that figure as well? caller: absolutely zero, it's useless. this is not what it's about. it's about people, about imports that are killing and taking away all of our jobs from nixon to clinton. are you there? host: so the president heads to china next week to talk in part about trade. what do you think about this trans pacific partnership? caller: it's going to exacerbate the system and make even more people out of work. it's supposed to be 160 million people working in this country. you know, we need to protect -- host: apologies for cutting you off short, i really do apologize for that. let me tell you about our news

maker program. it's with berny sanders, the independent senator from vermont talked about a variety of things, veteran affairs, the future of the senate, now that it's in republican hands. one of the things he talked about is whether or not he'll run for president. >> if you're going to run as an independent, if i decide to run at all, if you're going to run as an independent, wow. you're going to have to set up a political infrastructure in 50 states in this country. now, in the state of vermont i think you got 500 signatures are on the ballot, not hard. but north carolina, other states, it is very, very difficult. so you would need to spend a lot of time and energy and money trying to establish and develop that type of ininfrastructure. so that kind of a country, the quandry i'm at right now, and what i am doing is going around the country and speaking to a whole lot of folks on the phone. these are the questions i'm asking people. number one, are you prepared to be involved in a campaign which

is going to take on the billionaire class? and let's be clear, you know, whether it is the coke brothers, whether it's wall street, the drug companies, whether it's the military industrial complex, these people have unlimited sums of money and incredible power, control over the media. it would be a very, very difficult undertaking. host: that program available to you tomorrow at 10:00. you can see it again at 6:00 on c-span. couple more calls, here is carol, pennsylvania democrats line, hi. caller: hi. the gentleman who was saying about the economy really does drive the jobs, well everybody knows that. but there's a very clear difference, and i think it's very telling difference between how europe recovered and how we have recovered. now we have not recovered completely. europe did exactly what the republicans wanted to do. they did deficit reduction, they

didn't do any stimulus. they didn't do the things that they did, they concentrated on reducing the deficit. and it got them into trouble. the economy is stagnated and they're now talking about stimulus, q.e. and the things and following the things that we did. the i.n.s. did the same things to some of the countries going into bankruptcy. they demanded that they cut back and reduce the debt. the united states did not -- did as much as they could, but under the circumstances, but the republicans, the republicans tried to stop everything that they're democrats wanted to do. they reduced the stimulus, they didn't want to do it at all. if we hadn't done a stimulus it would have been over the cliff. they complained about the banks, listen, i didn't like rescuing the banks, but it was absoluteliness. otherwise we all would have gone

down with the ship. host: that's carol and we'll take one more call. this is from kathleen in florida on our republican line. caller: good morning. host: hi. caller: i think that probably the biggest problem that no one seems to address is that our work force is so uneducated at the entry level. host: go on with that thought. why do you think that? caller: well because we had a small business and i know what we encountered when my husband was alive. i would like to see the return of the trade schools. i think that boys and girls, but more especially it seems with the boys, when they're about 14 or 15, they know pretty well whether they're college material or not. and at that point i think we should start thinking about giving them a trade that they can earn a living. they come into these entry level jobs and they want a lot of money and now they don't

understand that they really are not worth that much to the employer because they can't produce. and i think that would cure a lot of our ills if we had more young people who were ready to be hired and go to work when they're hired, as opposed to being trained which costs the employer about $20 or $25 an hour. host: that's kathleen from florida and she'll be the last call on the unemployment rate and who should take the credit. we'll continue on with couple of seg mens taking a look at the result of the mid term elections. our first guest is bill allison from the sunlight foundation, he'll look at the price tag, $4 billion cost for these mid terms. he'll break down who spent what and what was the result. later on we'll look at a couple of ballot measures, particularly ones that dealt with marijuana on the ballots across the 50 states. we will talk with the brookings

institution about that topic. if you go to the white house's flicker page by the way, that's the photo you can post photos on, there is a photo of president obama and the presum tive possible, let's say majority leader in the senate having a private conversation. and this was part of a larger conversation that the president had with congressional leaders. you can find that on the flicker page at the white house. and by the way, speaking of senate mort leader mitch mcconnell he released one more campaign video post the election on his campaign's website in kentucky, talking about the results of the election and what goes forward. ere's that campaign video. > we know a few things about endurance, tradition. commitment. hard work and home runs.

every generation of america has felt an obligation to leave behind a better america than their paternos left behind for them. and through world wars and civil wars and depression, every generation of americans has indeed kept the commitment. and it's up to us to keep that commitment to the next eneration. kentucky will always have a champion in the governor. you'll be proud of the united states senate once again. i will restore the senate as a place of high purpose. i will carry out my office with dignity and respect for the people of this state, and this country. these are the values i learned as a young man in kentucky and i intend to practice them.

how do we get america pack on track? we can take the reigns of power away from harry reid and make this president accountable. entucky will lead america! but tonight we begin the work of changing that. >> "washington journal" continues. host: our first guest of the morning is bill allison with the sunlight foundation, good morning. guest: good morning. thanks for having me on ed pro. host: for those that don't know, what is the sunlight foundation?

guest: it's an organization that basically tries to make government more transparent at every level, state, local and we also have international activities and we try to make government information more accessible and open to the people so they have a better understanding of what government does and can hold them accountable. host: one of the things you take look at is election spending. est: we look at campaign contributions, lobbying, any kind of interaction between special interest and the government. host: how much did it cost? guest: we won't know the final numbers for a while. we get the end of the year report but so far it looks about $3.7 billion that went into this election which is just a tremendous amount of money. of that, you know, everybody's focused on the outside money, that's about $777 million outside groups spent, which obviously not even half. if you look at one of the biggest sources of money, it was

political action committees, it was traditional, old fashioned packs with labor unions and corporations have. they pump 1.2 billion into the campaign coverers of candidates. they made independent expense churs. so they still account for a huge amount of what's spent in elections. host: those also include the ones on capitol hill. guest: absolutely. these are the ones that are usually tied to some kind of interest that's lobbying the federal government, whether it's a teacher union pack, whether it's a pack for an oil company like exxon mobile, a defense contractor like lockheed martin, a bank like bank of america. host: when it comes to spending by party, do we know yet who spent more, republicans or democrats? guest: right now it looks like republicans, if you add up everything, that includes the outside spending that was tied to basically promoting one party or attacking the other one. republicans have a little bit of an edge. these figures come as the latest

tally and they came up with about $1.75 billion for republicans versus i think $1.64 billion for democrats. host: you said about four billion dollars for this cycle. the "wall street journal" has a map that takes a look and compares it to 2010, almost the same kind of numbers. i think people think this was a more per say, but the same kind of numbers from the last cycle. guest: i think it's a little more than that 2010 cycle. but i think the thing to remember is since 2010 was fought under the same rules, which is citizens united, which is the supreme court decision that opened the door to outside spending it led to creation of super packs which we didn't have before the 2010 cycle and it's also led to the ability of groups that do not disclose their donors which we call dark money to or spend money on election. that's opened the door to a lot of spending.

i think the other effect that we're not really looking at is if you're a member of congress, and you're running in a race and you know that some outside group can drop $500,000 in your district in the last week of election which is a huge ray mount of money you have to raise more money. we're seeing members of congress spending more and more time on the phones raising money than they have in previous cycles. that's one more impact of this new environment we have for campaign spending. host: to your point, bill allison, if you take a look at that graph we just showed going back to 2006, forbes citizens united, spending at that time less than three billion dollars. guest: exactly. in some way it goes up every year because we have inflation, but i think the inflation alone doesn't explain the huge growth and has gone up more than 25, or about 25% and that's a huge increase. that's largely citizens united, the impact of that decision. host: bill allison joining us to talk about the four billion

dollar price tag. if you have questions for him about it, here's how you can talk to him -- we hear the term return on investment, bill allison. is there such a thing in this political world where people donate money to campaigns and what they get back from it? guest: definitely there is. one of the things we look at is, there are two ways we think in term. one is about elections. we just have a post up on the last couple of days right after the election actually, where we looked at the big super packs and we found that for example, crossroads g.p.s. which is a group associated with karl rove, 96% of their spending, i think they spent around $25 million elected candidates that they wanted to be elected. so that's a very good return on the amount of money they spent. i'm sure they wish they had spent more in the state of virginia which turned out to be closer than anybody expected, and then the flip side, if you

look at like a tom stier who ran super pack, an environmentist, former hedge fund operator, his super pack was called next jen climate action. his return of investment was only about 32%. most of the money he either went supported, candidates who lost or who attacked candidates two won and didn't get the return investment the he wanted. the second way to think of it is a lot of people putting money into campaigns, whether it's a packed contributing the numbers of congress or somebody giving money to a super pack have an interest and business that's going on in washington. so as a result, they're not interested in the election so much, they're interested in governments, and what's going to happen, what's going to happen we have a lame duck session coming up. one of the things we're talking about is extending tax breaks for certain types of businesses. that will probably go through on

this lame duck session. that will make a lot of people who gave a lot of money to members of congress happy. that's the kind of return investment that's much harder to track. host: independent line, you're on with him, go ahead with your question or comment. caller: my comment is if we take the same people and ask them to nvest in infrastructure in the melessness, in the people in the health care crisis, the same people would not invest a dime. that's why the whole world is looking at this country for what it is. or 80% i can tell you 75 are e people that invested caucasians, and they do not care about nobody underneath them.

host: did you give any money yourself to political campaigns? caller: no i didn't. i would rather give it to the homelessness or to the poor. host: mr. allison. guest: i would say, it is true that the vast majority of americans do not contribute to members of congress, or to political campaigns and do not give money. it is a very small subset of americans who do. if you're talking about the americans who give the maximum contribution to any member of congress or any campaign which is $2600 in this cycle, that's like a fraction of a fraction of a percent. so it's a really select group that does give to political campaigns. obviously, i don't mean to voting is obviously critically important in determines who will be in the congress, there's an awful lot of members, every single cycle there are members who learn that the voters have the final say, but in terms of the money, yeah, you're right, it does come from a very small group of people. it does distort what congress does. there's been a couple of

stories, again, after a bad election cycle, the leaders of the parties come under criticism. you know nancy pelosi, the house minority leader is being criticized, harry reid, the senate currently majority leader is being criticized. politico has reported that nancy pelosi raised $100 million this last cycle for democrats. there was another story in a conference call supposedly she said she knows where the money is and the party should stick with her. if you think about somebody that's raising that much money and the kinds of people who are money to give to political campaigns, she's spending time with wealthy donors -- it's not just nancy pelosi, i don't mean to pick on her. you do get a skewed view of what the country's priorities are. and you're not spending a lot of time with homeless people, you're not spending a lot of time with people who are eeking by in a middle class existence and it does distort the policies

and the priorities of members of congress. host: next democrats line, helen, good morning. caller: good morning. o me it seems the price, the money that people spend on campaigning is sos a stronom cal it's so unbelievable. yet there are people like myself that we live on a budget. we work, yes, we work minimum wage jobs. i have epilepsy, i would have a seizure one day and i would go back to work the next day. i worked for minimum wage. and every time you would try to get a raise, every time they would tell you no. and to me it's unbelievable that certain people would have the

money to spend on campaigning, but yet when it comes down to spending on people, people, and usinesses, say no. guest: the thing i would say to that is you know, there are a number of people who criticize campaign spending and will do things that americans spent more on halloween costumes than they do on politics. i don't know what the right number is to be spending on election. obviously it is a huge amount of money. but i think that one of the things that you end up seeing is that as the special interest, the different organizations that put so much money into politics get a lot more attention from washington than people making minimum wage, now democrats are talking about raising minimum wage right now. but, you know, i tend to think what you see in washington is

that there is a disassociation, or a distance between what members of congress focus on and what the american people are worried about. and part of that is that they do spend an awful lot of their time raising money. host: republican line, david, good morning. caller: you know, we spend a great deal of time, and fact i think too much time discussing spending in politics. the amount of money that we spend in politics is minuscule. when you consider the fact that j.p. morgan is fined $12 million on a case that the feds could not even get to a jury. the bottom line is this, the feds have robbed the banks, and they did so on purpose. instead of taking people and putting them in jail for alleged wrong doing in the fraud that took place in 2008, they made a conscious decision to stiffen up

their coughers but going after the banks, putting the pressure on them to let them know we might put you in jail, but at the very worst we're going to ruin your reputation, and not only are we going to ruin your reputation, but it's going to cost millions to defend the activities that we think we might be able to convict you, which they probably could not because i still don't know of anyone that was accused of doing something fraudulent. host: bill allison, to his first point, the former charmente of the election committee has something in the washington journal, titled how shocking little is spent on the mid terms. he says the money spent on this year's mid term elections is less than 0 .1% of the nearly $4 trillion in federal spending. in other words for every thousand dollars in federal expenditure, he also had a single private company, proctor and gamble spent more on advertising than all political

campaigns combined for the federal offices spent in the two year cycle. general motors came closer. what do you think about the comparisons. why are those fair or not fair in your opinion? guest: well, i think it's very hard to say what the proper number is to spend on campaigns. but you can pick, cherry pick any number in the economy and say that oh look, we spend, i think social security spending is coupled with trillion or more a year and oh, we spend so much less on politics and we give to senior citizens. that's like a ridiculous comparison. there's 150 million people getting social security, there's 4 pa house seats, there's 33, 34 senate seats up every cycle. talking about the amounts of federal spending, we have a

project coming out where we're looking at what the big donors do get out of washington. we're not ready to say yet, but in a week or so we'll have the study up. but the companies that do invest in politics, and we're talking about lobbying spending and we're talking about campaign contributions, and we're talking about companies like j.p. morgan chase and like bank of america and defense contractors and so on, these are the big spenders on politics. federal government activities are part of their business plan. and they do get a tremendous amount of business from the federal government, and that's part of why they are political players. so, we'll be looking at that later but i think for politicians, you know, they're raising the money they need to get elected. they do it based on how much television time do i need to buy, what do i need to for get out the vote, for campaign buttons and all those other things. they raise the money they need

to do that. i think there's a certain point in raising money when you get beyond the rate of return, how many more ads running are going to, you know, if you do five more negative ads a week will that put you over the top as opposed to not doing them. in terms of getting back to the question of how much we have spent compared to other things, i think it's a ridiculous comparison. the real problem is that we've done away with so many limits on outside spending and who can spend and that we've created this kind of arms race that candidates just feel under pressure to raise as much money as possible. the outside groups are raising as much money as possible. and all those people giving money at some point want something in return. and they have much more access to washington than the average person and the average c-span viewer. host: bill allison joining us to talk about the cost of mid term elections.

independent line. caller: yes, your guest is right. the reason why nancy pelosi can -- nothinging to run as been changed. this is every voting time that we have. it's is same problem. it's part of the political system. time for the american people to stand up say enough is enough, then things are going to change. guest: the one thing i'd say, if

you look at what recent history and elections, in 2004, we had a republican sweep with actually 2002 and 2004, we had very good elections for republicans, in 2006, mid term election, democrats did fantastic, they took over the house and the senate after republican rule of the house since 1994. 200, democratic president sweeps in with even more democratic members of congress. they got to a point where they had 60 senators where they could override any kind of legislation, overcome any kind of phil buster to pass -- filibuster to pass legislation. you get to 2010 you have a republican house. 2012 a good year for democrats but republicans hold the house. now we had republicans sweep in. i think the american people are trying to send the message to washington that they want things to change. and the question is, is either party going to be able to figure out what that is. i think there's a lot of, the

frustration of the country is because of governments and because of how what members do when they're in washington and they're not campaigning. and you know, what the executive branch has done and i think that that's really the history of the last several cycles is the american people are trying to send that message and we'll see whether or not this congress gets it right. host: john from north carolina, democrats line, good morning, go ahead. caller: yeah, i wanted to talk a little bit about the breakdown of the vote. tell me why particularly here in north carolina tom continues to rack up votes long, long after many of the polls in the outlying areas which is his stronghold were closed and 100% of the votes were counted. he didn't turn any of the major population even purple. the same thing in virginia. at least virginia beach went purple. but long after the votes were counted these people kept racking up votes.

same thing in florida. johnny chris won palm beach, he won daytona, he won out on the i 4 corridor. he dent win pensacola, but in the college areas he won handily. the same thing colorado. the governor squeaked out that race in a statewide race, but the senator lost. people don't break up their tickets. they usually run straight party line tickets. it's some kind of an anomaly happening here. there's not that much of a demographic shift to the rural outlying areas. there's not that many people out there in north carolina that lives out in the rural areas. it is a statistically impossible for this guy to have racked up 58,000 votes here in north carolina, now after his strong areas had reported 100%. guest: i'm not an expert on the

election demographics. there's always after elections on both sides people who will talk about whether or not polls were fair, where things counted properly, was there cheating, was there, i think it's one of the things, fair amount of distrust of washington that are used to these kinds of questions. i don't know in the specific examples though and it's really not my area of expertise about how things happen with polling. i will say in north carolina you had $107 million spent, it was the most expensive senate race. the republicans spent a lot of money improving their get out the vote operations and identifyinging voters that haven't gotten to the polls before. this is one of the trends in election spending is basically things like microtargeting messages to people, finding ways to reach individual voters as

opposed to the ads that everybody sees, finding ways through social media, through mailers, through contacts from campaign volunteers. and democrats have been very successful in using this kind of technique in 2012, and 200 they did it. actually republicans pioneered it in the george w. bush campaign in ohio in 2004, had an incredible turn out the vote operation in other battleground states as well. this kind of data mining and analysis and outleach is not cheap. it's one other thing that will start fueling, in addition it used to be tv time was the most expensive thing that drove campaign fund-raising. now we have all these new technologies like big data, get out the vote operations that are going to increasingly consume a larger, larger chunk of campaign budgets which is only going to drive the spending higher. host: not only will they give you break downs of the various

committees that were spending this election cycle, how much they took in totals and what they spent, just to give you example, $777 million taken in, spent by super packs by party committees, a billion dollars, by senator committees, $613 million. other packs $1.2 billion. then bill allison nothing listed for dark money. why is that? guest: that's how much money they raised. these are nonprofit organizations and they file an annual tax return and so they can set up their fiscal year whenever they want. they can do it from july to july. they can do it from november to november. and then they have four months after the end of their fiscal year to file a tax return with the internal revenue service. they can get an automatic four month extension. they can even get a four month extension after that. so we won't know how much crossroads g.p.s. raised, for example the karl rove group,

because i believe their fiscal year ends in october, we won't know how much they raised for at least another six months. so, how much dark money is floating around out there we just don't know. i think that's one of the things that helps explain why candidates raise so much more money. at least with the super pack that you know is targeting your race, you can see how much cash they have in the bank. if there's a dark money group, again nonprofit, you don't know anything, you don't know how much money they have, you don't know how much they're going to be able to spend. s a result, you're operating in, i think there's this precautionary principle that politicians have that i better have enough money, i think it was mark hannah who said the two most important things in politics are money and money, and i can't remember what the other one is and that's how a lot of politicians think. that's what's driving this increase in what's being spent in elections.

>> how trans poisht are they about what they take in and spend? guest: it depends on the organization. super packs do disclose their donors. they file either monthly or quarterly reports. this is how we knew in the 2012 election that they were putting $92 million into super packs. now we knew this cycle that tom stier the environmentalist was giving about $70 million to different super packs. so they do disclose. sometimes they only give partial disclosure. one example of that, if i'm a super pack i can take money from one of these groups that doesn't disclose its donors. so we found examples where the first one we found, i'm probably going to butcher the name because all these super packs have names, but i believe it was working for america.

i think we call that dead end disclosure. but i think that said, we could use, we would benefit from a lot of reforms to election law on terms of disclosure. one would be the senate campaigns still file their campaign finance reports on paper, which means that the federal election commission has to type in pages and pages and pages of these reports now. the campaigns don't keep them on paper, they have them in computer databases that are set up that couldn't file electronically that the senate prefers not to do that so that creates a huge problem for people trying to follow money in senate races. another thing we could use more frequent disclosure. we do have 48 hour and 24 hour reports hen campaigns get more

than a thousand dollars down when you're getting close to the election. but, if we could have monthly disclosure for campaigns during the election season, during the whole year because again special interests aren't necessarily interested in election. they're interested in governments and policy. and they do donate during odd years when there isn't an election and they do donate when there's legislation being concerned. and i think having more frequent disclosure of campaign finances would help the public a great deal. host: let's hear from bert, the republican line. caller: yes, how are you doing. i'd like to ask you what you think about these local people that get together, they're like the local mayors, the local councils and they will go to the legislator and they will ask them to put on the ballot a superb local option sales tax, or local option sales tax that

one comes off within five years, or they reach a certain amount of money and it comes off. in fact the school board and stuff. that's the way to get the legislator out of the raising taxes. i've always said let the legislator do their job. let them tax you and still you're voting for yourself to be taxed. guest: you know, ballot initiatives, even on the local level can be very contentious. this time there were a number of ballot initiatives about raising the minimum wage, i think passed in arkansas. it was on some other state ballots. it does happen all the way down to the local level. i think it really you know depends on the jurisdiction and when i lived in philadelphia years ago when they proposed an additional couple of percentage points on the sales tax in the

city because there was a horriblely unbalanced budget that they were trying to close some revenue short falls. it's one of those things that i'm not an expert in finances in raising money. i will say that some of these local ballot initiatives do draw a huge amount of money. there was just one in california dealing with energy. fracking that a county tried to put restrictions on what energy companies could do to get oil and natural gas out of the ground. i believe chevron was spending, it was a near record amount trying to fight this ballot initiative. it does draw attention from outside spending sometimes and from different organizations. but it really depends on the measure and a lot of times the sales tax measure won't draw that much. and you're right, it does ask voters to decide how much they'll be taxed. but i think a lot of voters would say they sort of like

that. as opposed to legislators making the decision. i think it depends on where you are as a voter. host: democrats line, georgia. caroline, good morning. let's go to joe, independent line. caller: good morning pedro and good morning bill. hope you guys are doing well today. thanks for coming on the show, bill. you're providing very good ialysis and insight from the, guess, conservative perspective. to t have a quick thing throw at you. ,ust from the basic fundamental just from real basic and fundamental, doesn't all this inordinate money flooding into

he from sess just inherently open the door pretty darn wide to corruption? guest: you know, i would say absolutely. corruption, the appearance of corruption, and but you know, i think as an average, reasonable american that you can look at and let me give you an example, n the 2012 cycle you had sheldonned aleson, that he and his wife contributed to super packs, they had a a horrible election, they didn't really elect that many republicans. barack obama was obviously re-elected. the senate in 2012, they did not pick up the senate seats they wanted in states like virginia where george allen was running against tim cane. there were other races. but you know most of the money that sheldonned aleson contributed to help elect republicans didn't work. but in the last congress he had

lindsay graham among others introduce a bill that would ban internet gambling, sheldonned aleson is a casino owner. he is very much against internet gambling because it would take revenue away from or potentially take money away from his casino operations in vegas. he has some that he's invested in pennsylvania, invested in casinos internationally. and so he's very much against internet gaming becoming a reality. and republicans introduced this bill for him. it didn't pass, but i think that's incredible that here's this priority of this big donor and a bill introduced and a lot of times things do get passed, or its special interest that they're looking for. there's tax extenders, these are basically tax breaks in the internal revenue code for specific industries, sometimes specific organizations, blue cross companies have their own particular tax break that cost

the treasury about $400 billion a year. i'm sorry, $400 million a year, which is not a small amount of money by any means. they will lobby and they will push for and blue cross companies, they have big political action committees, they're big donors, among the biggest donors in the country. this is the kind of thing you see in washington all the time. whether or not it's corruption, all the stuff is perfectly legal but i think one of the frustrations for the american people is they see special interests get special attention because they have the access, because they give to the campaigns, and the american people don't get that kind of attention. i'm going to guess that you don't have a special tax break in the tax extenders bill coming up, where as some of the companies that gave to your member of congress and other members of congress may very well have those kind of breaks.

i think that's one of the reasons why when you look at congressional approval ratings for the public they're hovering around 9% or 10%. when you look at the executive branch isn't doing all that much better. i think part of the frustration the american people have with government is the sense that the people who pay for the elections, the people who contribute to candidates are the ones that get taken care of first. host: oak ridge, tennessee, democrats line, henry is up next, hello. caller: good morning, pedro and bill. i just wanted to say one thing. i went through this recession that we had here and it didn't affect me at all. i wanted to ask bill two questions. question one, do you know kenny rogers, the singers, the gambler. he was a great man, i like kenny. i went to his shows. do you know another performer, we used to call richard pryor. he was another performer that i went to. kenny rogers was a gambler, just

like a politician, these are rich people. they gamble every day with billions, millions. the voters out there, hey come on, i vote, i voted democratic. but here in tennessee i knew i wasn't going to win. it didn't make me angry or nothing. richard pryor said something that i stuck with long time ago. money talks, be walk. i never forgot those words. so what i want to say to the country is hey look, we are dealing with millionaires. these people are wealthy. iss pelosi, mr. reid, mr.izen, $200 something million dollars. guest: members of congress are generally much wealthier than the average measure. there's even a time in the 1990's when both parties were looking for people who could sell finance their campaigns as a way to lighten the load on party fund-raising and

fund-raising for candidates. if you have somebody like a john corzine for example who financed his own campaign when he ran for senate of new jersey, when he ran for governor of new jersey, means you raise a lot less money. i do think though that just so you know, i'm a fan of both richard pryor and kenny rogers, and when i was a kid silver streak was one of my favorite movies. host: let's look at the other side. one thing the sunlight foundation did is categorize them as the biggest i.o. umplets's. these are people who lost money. who lost the most? guest: a number of candidates spent more than they raised. and went into debt and we found, i think it was 400 campaigns where you had basically people taking out i.o.u.'s loans, sometimes to their own campaign ate in the race.

people who win their races, the new senator for arkansas ended up with debt, he's having a fundraiser right after the election to retire his debt. in other words he's not going to pay that debt, he's going to look for special interest to give him that money. he's an incoming senator -- host: he'll find it. guest: exactly. if you don't win it's harder to retire your debt. it happens to presidential candidates. after hillary clinton dropped out, she had about six million dollars in debt she had to find a way to retire. it's not just members of congress. what it shows is how important money that they're willing to go into debt to try to win. and secondly, you know, when they get into office and they come in, it's not like the elections even and they can stop

raising money. e have a site called political party time.org, where we have the invitation and we'll see a flood of them now with new must bes coming in. but we'll be seeing just a lot of activity raising money because you know that's in washington, the money's so important. host: let's take one more call. canton, illinois, bill is up next. caller: yes, good morning c-span. the majority of people in united states want term limits and illinois, governor tried to introduce it but the democratic machine defeated it. i have a solution to campaign finances. and this is a solution. if you put a cap limit on each race, say for example state representatives can only spend $250,000 campaigning money,

verything over $250,000 is 75% of it will go to united way. and save the president two million dollars, everything over two million dollars that's raised 75 cents out >> it is an interesting idea. been talk there has but anyways you can use the tax code. is that incumbent members have an advantage -- have this ways comfortable cushion and communal, maybe attacks that are 100%. i think one of the problems is a supreme court decision that says that if you are an individual, you can spend whatever you want. it is your first amendment right to spend whatever you want. try to spend -- put those limits on candidates to money from other sources,

you can have a millionaire know, n and spend -- you state legislative caplet -- somebody who is a billionaire can come in and times that amount and the supreme court says he can do it. very, very ve been tough -- courts have been tough on this -- taxing and different kind of ways to limit what the courts consider our first amendment right. a very attractive idea, and announcing that is not worth exploring are pursuing, but you do have some impediments in the way. on a lot of information the website about spending this election cycle. are just joining us is bill allison from that organization. thank you for your time.

>> thank you. >> another aspect of the 2014 midterm elections was ballot measures. we will specifically look at one dealing with marijuana. john hudak from brookings institution will join us for that. then later on, a discussion of role of physicians assistants, as a support to medical professionals. discussion with john mcginnity later on in this "washington the journal" continues next. ♪ >> this weekend on the c-span tonight at 8:00 pm, a debate on the future of the internet. travis smiley on his

latest book. and author jeff chang. on "american history tv" on tonight at 8 o'clock, the social prejudices immigrants faced in the 18th century -- 19th century. by the television and let us span.org know what you think about the programs you are watching. call, email, or send us a tweet. during the c-span conversation. like us on facebook and follow us on twitter. veterans day coverage begins during journal" with an interview of verna jones.

then attend, the gala featuring martin dempsey. and we are alive at 11 from arlington national cemetery for the tradition at the tomb of the unknown. later, selections from this year's medal of honor ceremony. >> the 2015 student can video competition is underway. open to all middle and high school students open to all middle and high school students to 7 minute 5 documentary on the three branches and you. showing how policy, law, or action by the federal government has affected you or your community. there is 200 cash prizes totaling $100,000. for a list of rules and how to get started, go to studentcam.org. "washington journal" continues. now is john us hudak with the brookings institution's. a governance studies

fellow and one of the things he studies is ballot measures. we are specifically going to talk about a ballot measure in four states. the topic was marijuana into states and the district of marijuana. considering the recreational use and in florida, they were considering medical marijuana. >> so for states, or is that abnormal? >> when it comes to marijuana, everything is a little bit abnormal. in 2012, we had two states consider marijuana for recreational use. washington and colorado both past. the expectation is that in we'll see more states. >> talk about the three overall. what were they looking at and whether similarities and differences in the states? >> there were definitely similarities and differences between organic, alaska, and the district of columbia.

the district of columbia was of t unique for a lot reasons, but mostly it did not set up any type of regulatory structure around that. a lot to do s with the initiative process in d.c.. home it wasn't authorized growth of marijuana and a removed criminal restrictions from that. the city council had to take charge to set up a regulatory to set up a commercial market, and have legislation pending to do that. in oregon, the authorized home also authorized a regulatory and tax structure around the marijuana market that would allow the state to adjust or modify or create the around ncentives behavior involving marijuana. and also to reap the tax benefits of it. and alaska, which is a state very limited medical marijuana situation in the sense that it doesn't have market like other

states, they set up with a allowed home growth, but they with charge the states -- good control commissions -- liquor control commissions -- to be the regulatory agencies. >> let's turn to florida because they took a different approach in a different outcome. >> that's correct. it was too quick for medical purposes. there is some debate about how purposes in dical florida were, but regardless, that was the purpose of the initiative. florida, like in colorado, the ballot measure was the constitutional amendment. but in florida, constitutional amendments require 60% of voters to approve in order for it to effect. so well a majority of favor -- voted in over 57% -- it fell short of that threshold. >> when other rollout stated

how ready are the states to work towards that? >> while, the ability to homegrown marijuana -- that a limited number of plants in your home or premises quantity of limited marijuana flower, marijuana fairly rolls out quickly. the regulatory structures around licensing the commercial market, creating regulations, implementing tax structures -- and oregon and alaska, it be an organic rollout requirement e, the is for the city council to set up the markets and regulatory regime. >> you talk about alaska, alaska being considered a red state. what does that say to you? >> that is something we have on on our xplored

blog where most states that consider a marijuana -- particularly recreational tend to be - liberal. but what is unique about the that it a issue is attracts strange sides. liberals come together -- so in alaska, you have a state that has a very liberal streak in it, and a very libertarian streak at. some conservatives in alaska different, we will say, and enough of them to pass ether recreational marijuana and the rollout will begin in the future. >> if you're interested in three states t the are incorporated ballot measures, here's how you can talk to our guest. john hudak from the brookings institution. 202 585-3880 for democrats. 202 585-3881 for republicans. 202 585-3882 for independents.

of course, marijuana being one ballot measure. there were others. we wait for callers, phone is on the wendy underhill with the national conference of state legislatures. good morning, miss underhill. >> good morning to you as well. >> besides marijuana, what of the hot topics? >> the big ones from our perspective was about minimum wage. that was on the ballot in five states. four of them, in fact, raised the minimum wage. state, which is illinois, had a positive outcome it was a yes vote, but it did not have an effect in changing the minimum wage. so, five states moving the minimum wage and the others were of interest to. nebraska, and

arkansas -- states with republican leadership there as well for the minimum wage issue. >> were there some other to ukuleles, nes besides marijuana is first and ultimately can develop measures? >> absolutely. i noticed was that measures passed. york ad measures in new -- $2 billion for education. california -- $7.12 billion for water conservation. hawaii, maine, rhode island, and new mexico -- if it was a bond measure, passed this year. >> what about social issues gay marriage and abortion? >> let's take it one at a time. abortion, yes, we did have three measures that related to abortion. two were of the same kind, is a personhood kind

which recognizes an unborn fetus is a human. that was on the ballots in colorado and north dakota and it went down in both states in the mid 30's in favor of those things. coloradans have loaded on it vote is fore and this the highest that this amendment has received their. mention the tennessee vote. that put in the constitution the right to for the legislature to enact regulations around abortion. so the vote itself did not is nge whether abortion legal and tennessee or whether regulations and rules around it are, but it did make it right rules to be made and we might expect that they will put forth some bills after generally first. what was the other thing you asked? >> it was about gay marriage. to the short this time -- did show up this time?

show up this t time, along with no voter id on the ballot. >> how many specific measures were there this time around and how many past? as far as the total number, contract for years past? >> in one way, we were the same as previous years. in other ways, we were not quite the same. we had fewer measures in total than most years. we had 147 measures that on 41 state ballots and also the district of columbia. the average should be around 162 170. a high year -- 160 to 170. high year would be 180 to 200. overall, about two thirds said yes. if you break that down by which ones are put on the through by the people

citizens initiative process, versus through the legislature, the one the citizens put on of e a lower adoption rate about 44% -- that is about the it has been -- and the ones put on by the legislation has about -- >> miss underhill, thank you for your time and talking to us about ballot measures. i appreciate the opportunity. joining a set specifically about marijuana ballot issues. from florida, go ahead. i can't because i come in theory, it am quite open to i voted marijuana, but against it because i do not think it belongs in the constitution. will we have going on right now is the move towards ruled by plebiscites.

no ere's no debate, regulations set up -- a regulation that said authorize establish ature to rules and regulations and that granted people the right to have access to legal marijuana -- medicine marijuana -- this everything t voting by popular rule is what is actually hurting our republic. >> well, i think that there are two issues there. one is the consideration of how democratic the process it is. i think some people would with you that legislative process is important. others may say that a ballot issue process which gives everybody to have a say is a democratic version to consider. deeper l that said, the issue here -- and i think it is a good one that you touch on is whether the constitution

in the state to consider marijuana legalization. what it presents as a challenge is that constitutions are hard to amend, so doing a once as a challenge and if the state does not get a read on the first try, it is all that much harder to try and re-amended. where's the legislation responsive to the states and more responsive to changing policy dynamics kings eally allow three of the policies. things that colorado's effacing is that paths to legislative fixing it -- so state needs to consider whether the legislative process is the go in a state, or whether constitutional changes the right way to go. to the independent line. arrested es, i was

back in 2011. i had a few plants growing in the backyard. was facing $11,000 fine with 11 years in prison. on a $55,000 bond kids off we send our to war, marijuana is the number one cure for ptsd. >> so in this case, it wouldn't have helped them in florida, but in other cases "certain amounts. the yes, and i think that caller is hinting at a bigger point that goes on in these initiatives and that is we need to think about the criminal justice side of this and who is being arrested for medical marijuana -- that is an hink

important expenditure. voters need to think of is money well spent and what types of positive and negative effects can come as an effect of either recreational marijuana, or medical marijuana. ptsd is one of the areas that has robust debate around it. whether medical marijuana is effective in its treatment and estate should consider that as one of the elements that should be considered by cannabis. the that from virginia, democrats like -- pat from virginia, the democrats line. >> i hope you don't get tired of me, but here's what i wanted to say about this. we have had three presidents the last three presidents -- that all have admitted to dabbling with this drug. george washington grew it -- the father of our country. it was legal until 1937 in this country. it is time, just like the

gentleman gestated, to quit gestated, to quit expending all this money and our people in jail and destroying their lives believing it started for a plant. i'm going to take several of different marketable herbs that i used to supplement this morning with my juice in my breakfast, okay. austere and for to end pocrisy -- us this hypocrisy. for us being hypocrites and laws and the people that they did not keep themselves. >> that -- that color certainly has an important his pective and i think point about prohibition is one of the advocacy community has talked about pretty relentlessly. that is that we have had 80+ prohibition rijuana

in this country and the results of that -- it is hard to show that it has been effective. marijuana use is still quite rampant. we have an inability of states control product or to really bring in the system at all. in the advocacy community say prohibition is failed, we need to try something else. we need to get states above, we need to give regulators about to try get a grip on this problem. so from that perspective, legalization is that is opening marijuana, es for control ying to behaviors around marijuana that have the ability to create social benefits or limit social costs. in colorado, you see industrial growth. going to see this in state surpassed those lost? on how l, it depends states regulated. there was a limit on the number of people could

grow -- or the types of individuals who could grow. in colorado, you can only grow you are marijuana if an existing medical provider. this is good for regulator, particularly one state regulated new policy area, but what also did was limited supply and that limited the size of the market. since then, it has opened up to where there are open licensing processes. and so there is some thought marijuana big the market will get in colorado and whether the supply and demand will really find that equilibrium. >> our guest is added from on the independents line. are down ium deaths like 25% in the states that have medical marijuana legalized. to ask your ke

guests that i read that some of the republicans -- and the harrison's name i remember -- drugs n one of the safest on the planet be illegal? you're talking about all this regulation. the few nly one of drugs that you get overdose you cannot open. of the other drugs. marijuana cannot. >> thanks for your call. you are absolutely writes that, particularly on the marijuana issue, time is really changing minds. we have seen pretty dramatic changes in public opinion over 10 to 15 years were americans in general -- and residents of certain states -- are becoming much welcoming of marijuana and to try and get a grip on it.

that is something that will likely continue into the future, that change in public opinion. on marijuana, those most opposed to it are older voters. those who are most favorable toilets are people who are turning 18 and becoming younger voters. so as demographics change you ugh natural lifecycles, will see more public support for this overtime. nationwide and in state. point about andy harris and his interest in limiting -- >> who is he, by the way? >> he is a congressman from maryland. his main point was having congress veto their initiative. a question in any law that d.c. passes. i think you'll face an uphill because for d.c. to

veto this -- i think it is to be a tough task for mr. harris or anyone in congress. that 51% of hows respondents said yes to legalizing marijuana. 58% of those said yes, and 39% of the said no going back. to think those numbers are changing? >> i think the experience is certainly informing voters and informing other states. other states are looking towards colorado and washington to see what happens. to ates are generally scared move into new and innovative public policy areas. marijuana has risks. the legalization of the drug has risks with it. to think that no state wants

be the state that screws it up. that you are right that people are being informed about this. colorado nothing in disaster -- i have written colorado being quite successful in its rollout to legalizing marijuana -- as people see that, that is going inform the public opinion and that will answer to the changes. on the iel up next democrats line. >> good morning, gentlemen. mr. hudak, my impression -- which a -- i moved to in 1987 -- anyways, my impression is -- the trade there heavily taxed that

is still in underground economy. it will still elicit gangs and underground activity. i think marijuana should be throughout the land; although, i regret ever having been involved with the stuff. in my early teens, life is such a miracle, you don't even need to enhance it with anything of a so-called psychotropic or psychedelic activity. the point i would like to make and your viewing audience -- as long as they're such heavy taxation on it, be an underground -- a criminal underground. thank you for your time. sure, daniel, thank you. you raise an important point have artie hat legalized and -- already were ized and states thinking about legalizing and that is the goal to displace

the black market. colorado, and especially washington, the base price of legal marijuana is higher than street marijuana. of that e taxes on top create disincentives from people to move from the black market to the white market. and this is particularly going to be an issue in organic washington right now. it or a gun legalizes, creates a border in which marijuana is legal on both sides. in oregon, prices will be much lower than they are in washington. so that will create incentive the state of oregon, and it will create incentives across the border in washington about where they may purchase the marijuana. so that is something states really need to think about if the goal is displacing or getting rid of the black market. but at the same time, prices need to be considered, as well.

marijuana tes where and ces are few, prices harvests are low, prices will be quite low. the medical marijuana market taxes in colorado -- about 3%. of the retail market can have taxes as high as 40%. up happening is that while colorado wanted to move people from the medical to the recreational market if they do not actually have a legitimate need for cannabis, they have no incentive to do that. >> christopher from florida. good morning, on our independent line. >> i'm in florida right now, did it legalizing here and i know people affected by ere

this -- there's one who has cancer and this would be a great use to him. and because there are bad guys out d the there that they want to push away, so this is not allowed for people who are suffering. i think it is constitutional of the fact that all men are created equal and that stream of consciousness reflects the self empowerment that people should have. and it really boils down to education. if we only educate our to be en and families self empowered, to be able to reason and have logic and be able to have discretion, then we don't have to label this and that and the other as evil. than from society -- well, the caller -- christopher, thank you. medical marijuana is much more

states in the united the recreational marijuana and i think that make sense in terms of its use in the people that it is helping. there are many different ways to consume medical marijuana. that have intoxicating effects that we think of. ones that e are intoxicating the intoxicating

substance within marijuana -- and focus on cbd that half the -- are believed to be medicinal properties of marijuana without the intoxicating effects. so i think that most people think of medical marijuana as a yes or no, but in reality, it is a continuum of products that have different effects, sometimes positive effects for people with rheumatoid arthritis, people with cancer -- and i think that is an easier argument for advocates to sell than it is for advocates to push recreational marijuana. but what i think is important in florida is that demographics worked against florida in the selection. but florida has more opportunities to legalize marijuana, whether it is through the legislative process or whether it is through a more liberal electorate. what i would caution anyone in florida, on either side of the argument, is to think that the film ballot initiative this year is the end of the story. real challenge in one that the -- edibles are a real challenge in

state do and one of the is working towards handling. different les look no than regular products -- cookies or cereals -- and that can lead to accidental consumption. so we have some stories out of thought where people they were eating a standard actually d they were eating a thc- laced cookie. at the same time, there is a bigger issue in colorado that the governor's office is concerned about. it is one that i have written about. use colorado, you cannot marijuana in public. that is still against the law. you can't use it in hotel rooms, you cannot use it in any public place. marijuana tourism is a booming industry. so you have to is coming to the state ready to use cannabis and they have no place to use it. so they moved to the edibles market. edibles market is unpredictable because of the gets into your c system, the timing of it, the quantity of it. up happening is

that tourists are naïve users to edibles and it can cause of the negative effects. that is a challenge for colorado. >> charlton, south carolina. you are up next. >> hello. what is going to happen to people who have been arrested for using and selling marijuana have now tates that legalized it? also, students who might have lost financial aid and so forth. >> well, that is an important need to that states deal with on a state-by-state level. can do ing that states is write into a ballot initiative or legislation is sort of will be any retroactive forgiveness of marijuana violations. and if the state is willing to declare marijuana legal, that is certainly a consideration that can be taken. at the same time, in some in most states,

rather -- governors have pardon power. so for those in jail for marijuana violations, governors could pardon them. but, caring, you make a good make a good n, you point. marijuana can follow people around for a long time. it may be hard for them to get who and for states deal with that, it is something that is important not just for the consistency of public policy, but from a social positive perspective. it is something that the pressing community is very hard for states to address. >> oregon, alaska, and the district of columbia approving ballot measures. are a guest is here to talk about those. he is john hudak from the brookings institution. for ny in july, thank you

holding on -- in north carolina, thank you for holding on. your on, go ahead. to say that it e helped our wounded americans and they can do them a good deal to have that stuff. why can we not get it legalized in our state because our government was stopping at. comfort and it for to sleep because, you know, the shell shock and stuff like that. it hurts me. >> thanks, danny. yes, thank you, danny. that is something that marijuana advocates and veterans organizations are really coming together to at least have a conversation on. whether the use of medical marijuana is helpful in the treatment of ptsd.

given that we have a generation of new veterans in seriously ry who are suffering from ptsd, that is something that will only become for society llenge moving forward as these veterans called. if medical marijuana is shown to have really positive effects, i think it is something that states are going to consider. for the advocacy community, actually help the to get f they are able veterans -- who tend to be conservative -- to get on board. >> states are approving it, still in rally, it is illegal drug. the disconnect there -- where is the disconnect there? dozen states two have legalized medical marijuana and a couple states that have legalized recreational marijuana.

the controlled substances act still states that marijuana is illegal. for the federal government, it is really hard to enforce that in all the states. with the obama administration a fairly is take to states approach where legalized and said that as long as you are not allowing her marijuana industry to certain bad behaviors -- dealing with cartels, selling to minors -- and you create a robust regulatory system around marijuana, we are not going to bother you. but if you deviate from that, we will step in. for the federal government, it is a way to save face. there is no way they can do with a nationwide, so they cannot deal with it. in the states, it gives them a new area to experiment in public policy. >> linda from ohio and the democrats line. in hi, i have three points point is that if

marijuana is going to be legalized, why not legalize everything? except for medical marijuana because i do not understand that one. number two is how much money is being spent and keeping drugs out of our country? and number three, how would you like to have a pilot was flying your airplane and he is high? >> so, linda, i will start with your last point. there are many rules in place that have tes legalized it. court lorado, the supreme ruled that any employer can fire a person for being high on the job. states are sensitive to the issues that you bring up. in the same way that pilots can be fired for showing up that , i can tell you

there will be concerns in that community about whatever conditions the pilot shows up with. if that happens to be marijuana intoxication, you can bet that others will stop that from happening. so the issue of thc in the workplace is an important one, think that fears about planes falling out of the sky because of marijuana is something that is a bit of a hyperbole. >> or a gun, one of the states -- approved a measure oregon, one of the states that have approved a measure for recreational marijuana -- we have a caller on the line from oregon. good morning. on the ballot is not state -- it do anything about smoking in public.

husband currently works -- i was growing up around the hip area -- and the problem area is the secondary high. when we are s that walking down the street and somebody a smoking or you're public place like a park, from what i have heard, it stays in your system for a very long time. how is that going to infect employers and employees. he gets tested -- he has it never will -- what does an employer do because of a contact high? >> before you go, why did you not support the measure? >> because of that concern. is the biggest thing, you know. it st do it in your home, do

clubs car, they have be do it, but i do want to exposed to it. public just to clarify, use of marijuana is going to a legal in oregon, but your point about contact highs in is an important one. contact ties much more difficult to get. but indoors, it is a real concern. in colorado, the law enforcement community is quite concerned about the opening of allow or bars that marijuana use because if police have to going to conduct of action, they can what you om exactly

described -- inhaling marijuana smoking and testing positive. of course, law-enforcement statewide in colorado has a zero-tolerance policy. so that creates an interesting problem. at the same time, the use in the use and restaurants is true for individuals who may want to go to an establishment, but they do not want to use marijuana. you cannot go to a marijuana using establishment and not expect to get some sort of contact high. so those are some considerations that states are thinking about in their consideration of whether these establishment should be opened. it is definitely something is not being ignored by states like colorado, and certainly oregon. >> our next guest is from albuquerque. this is kevin. >> hi, there. first of all, i am in favor of decriminalizing the possession of marijuana and, probably, many other drugs.

on the other hand, because ion scares me of america's experience over the last hundred years with cigarettes. corporations checked the american public into thinking that smoking was cool. nicotine is highly addictive; however, we had perhaps 50% of the population smoking back in the 50's and 60's. corporations can be very smart and very powerful in persuading people to use their products. so what -- brings up a er point that a lot of individuals who oppose legalization are concerned about, and that is marijuana big business. and the point to the tobacco as an important model

that should be avoided. was reality, tobacco use marketed quite probably and it ended up being used quite broadly within the population. marijuana is still something small s used by a very segment of society, particularly regular marijuana users, and the expectation is in any at will not grow dramatic ways with legalization. individuals who use it occasionally with regularity, but the regular the way of ot follow tobacco. actually a really interesting area of policy research right now. because decriminalization to get a ticket for marijuana in the same way that you can get a parking ticket. of the research suggests

that what this does is that incentive as his police officers to conduct a more marijuana arrests. in the sense that they do not have to go through the processing times of getting and to the playstation processing them -- police station and processing them, but instead they can simply issue them a ticket. so more people end up getting charged with marijuana violations than they do under strictly illegal marijuana system. that is one of the possible drawbacks of decriminalization. from one more color. this is valerie from florida on the democrats line. >> i am wondering -- i wanted to ask mr. hudak about in florida did amendment 2 to go down? >> any constitutional amendment require 60% of the voting public to approve it.

that is an effort to make the constitution hard to amend. the u.s. constitution is very hard to amend, it has been done only a little over two dozen times. so some states put the same of restraints in place, so that there is a little bit of continuity in the state constitutions. because it was a constitutional measure, it did not pass. one of the reasons that is the case is because ford intends to have an older population -- the national average -- and older voters tend to be opposed to marijuana in general. as a result of that, 25% of a turnout rate -- of in florida were voters who are 65 and older. up the largely, made difference -- that 2 1/2% that would have been necessary to pass this. so demographics matter --

turn on hics matter to that issue. >> if we had four states this you around, what are expecting for 2016? >> a lot of things are going i think der this and they are a lot of politicians were -- there are a lot of scared of s who are this issue. there are only a few states considering doing it but the ively, marijuana community hhas a lot of wins under its belt. are a lot more liberal voters turning out and, voters who are likely to support marijuana legalization. i think you're going to see them try and take up that torch. >> john hudak studies and write about these things for the brookings institution. thank you for being a guest.

>> thank you for having me. >> our next segment, we'll look at physician assistants and the role they take in society. that is the "washington journal" continues next. ♪ c-span cities tour takes to the road, traveling to us cities to learn about their history and literary life. next week, we visit madison, wisconsin. is a glorious service -- the call comes to every citizen. unending struggle to make and keep government representative.

probably the most politically important figure in wisconsin history. he was a reforming governor . defined what progressivism -- he defined what progressivism is. he was an opponent of world war i. he stood his ground advocating for free speech. above all, he was about the people. civil war, america changed radically from a nation of small farmers, small producers, and small by the turers -- and

late 1870's, 1890's, we had we centrations of wealth, had growing inequality, and we had a concern about the influence of money in government. so he spent the later part of the 1890's giving speeches all over wisconsin. if you wanted a speaker for group, bob your would give your speech. event nt to every kind of you can imagine and built a reputation for himself. run 1900, he was ready to for governor advocating on behalf of the people. he had two issues. one, a direct primary. no more selecting candidates in the convention. two, stop the interests. specifically the railroads. >> what all of our events from madison next saturday starting eastern on c-span two and next saturday afternoon on c-span three.

"washington journal" continues. guest is the president of the american academy of physician assistants. he is john mcginnity. >> good morning. >> tell us a little bit about the role of the physician assistants. >> the simple way i can tell you is that they practice medicine. they work in an environment that you would see a physician. i tell patients that the same expectations you have any good to physician's office, is have the same expectations for apa. we have been around for about 50 years now changing medicine on a daily basis. >> are they doctors? >> know. it is -- no. it is a graduate degree.

i train in detroit where we the largest medical campus in the states. so pas are train side-by-side with physicians. we collaborate with physicians. these programs are intense and came out of world war ii putting more of practitioners other. started the 's they rural areas ss in where, perhaps, a physician would not go. so pas have grown over that time and increased access to health care for americans. >> we hear about dr. shortages in the united states. what is that mean for someone who's serves as a pa? >> first and foremost, if we to improve health

outcomes, it has to involve pas. pas are ready to expand to improve that care. we have over 100,000 pas in america right now. we are generalist trades -- i my career doing angioplasty. the last three seeing whole een medical visits for internal medicine. so that flexibility is invaluable for pas. is collaborating with physicians to go to areas where other physicians may not urban and lso, in other settings, to improve care. >> john mcginnity, if someone a doctor's office with the mentality that they want to see a doctor -- a survey last year as that

if you had to wait for a physician, would you prefer to wait for a physician or would you rather see a pa? 65% of those surveyed said they would rather see a pa. what i would love americans to harris and are recent see showed it -- that 93% pas as the healthcare improvement. costs and ecrease improved access. with the others recognizing the pas value. >> the role of the physician assistants in the united states for this final segment with john mcginnity. ask questions o

for him, he can do so on the following lines. 202 585-3880 for democrats. 202 585-3881 for republicans. 202 585-3882 for independents. if you are a pa and you want give your voice, 202-585 -- >> we are practiced in all 50 states. in all 50 cribed states. our te regulations affect scope of practice, so they do vary from state to state, but the ability to practice in all 50 states. the did you take a role in affordable care act? >> not a dramatic role. i will let the politicians they were the political aspect of it. profession, we are about team care. we need americans to spiel to see a provider. it is a shame that folks can't do not have access to a

provider. that is really where we would like to see the approach to. >> from our phone lines, we aside a special line for pas. jeremy, hello. >> i would like to echo what mr. mcginnity is saying about the profession. we are the only profession that is specifically trained in and where designed -- team-based care and where designed to work in that environment. as the situation changes, we need primary care providers to serve that role. as we transition and the need for specialist arises, we can do that as well. . california, we have found that it increases access to care. nearly 1/4 of our employees work in the federally approved senders. time in our citing

profession and the healthcare system in california. >> jeremy, thank you for that. one of the key messages is only are pa's engaged in primary care, surgeries and other areas involve pas. so pas have an incredible to deal f flexibility with the distribution areas that we're seeing in medicine these days. that flexibility -- also, our recertify every 10 years. not only do we take that certifying exam the first time, but every 10 years we are improving our knowledge. that flexibility and lifelong is a real key to the profession. on a republican line, here is rick. did chiropractors get

the exception for medical doctors in the practice? secondly, a lot of people the ably don't know that term medical doctor comes from dr. comes from teach, medical comes from which comes from physics, which comes from so you have natural are, obviously, medical doctors if they pass the licensing tests. you have n assistants, nurse practitioners, so maybe there's a lack of understanding there on the etymology. finally, as far as a policy, about a direct care -- direct care supplemental loan needs tested at the local level so that people can get universal access the cost for care?

aspect l, on your first about the chiropractors, i'm really not as familiar with their scope of practice, but what i would in a you is that pas clinical environment -- when offices, to be in the they call me pa. as want pa to be recognizable as md. i think you're seeing a lot of transition amends in these days. pas in rural g areas where their physician may be available via telemedicine. we are doing that by collaborating with physicians. that is the key. if we're going to change medicine in america, we need to be able to come together and figure out what is the best way

to do that. it is best done at the local level. that should be done with apa, a rse practitioner, and physician deciding what are our strengths and weaknesses what our community needs. >> mike is next. host: apa from washington state is next. i can tell you that pa training is in many instances superior to that of help professionals. i work with osteopathic and allopathic doctors, and many of the people rely upon the pa training to give them more insight into problems as well as resolutions to the problems, and ea --k the recognition of of pa's is something we have to look for.

thank you for that. one of the key messages we would love to see people understand is the fact that even though i spent 18 years in cardiology, i had to maintain my skills as a generalist, and that gives the flexibility of the profession, unlike any other help the fishing, so give me the ability after 18 years to transition into internal medicine and go see patients in detroit and still have the skill set to be able to do that, so i think that flexibility and our training makes us unique and makes us ready to address the nation's health care needs. host: primary care is the top specialty for pa's. do they get malpractice insurance? guest: absolutely. malpractice tends to be lower because we typically do not have as many suits, but, yes, we have

the same malpractice, the same recertification requirements as them, the same continuing it -- medical education requirements, and like i said before, we continued to take our boards to maintain that expertise. in a surgicallved situation would apa go? cardiothoracic surgery is a great example. while the surgeon may be opening the chest to get the patient ready, the expert on the fans is the pa. they might be first to assist in a hip or joint replacement. north shore university out in new york took the cardiothoracic pa's after bypass surgery to see -- you know, we are trying to change medicine and improve value. they said they wonder if they put apa in a patient's home after they were sent home -- could that make a difference? just by sending apa to that patient's home those two days, they cut readmission rates by

22% and cut their infection rate making ao pa's are difference daily in subspecialties as well as primary care. host: next, indiana, democrats line. caller: my dotted treaty went back to school to be a nurse, and she is going to be a nurse practitioner. i would like to know what the difference is between a nurse practitioner or a physicians assistant, and i will take my answer off the air, and i thank you very much. guest: great. thank you for that. i would tell you we probably have more similarities than differences. we are both graduate trained, both diagnosed, and we both treat patients and order tests and prescribed. there are some subtleties in the way we are trained versus the nursing model versus the medical pa's have, really, the flexibility and tend to be

in a more variety of medical specialties, and we are not trained by specialty, so the generalist training does make us different and unique. host: a viewer from twitter says -- a master's degree, typically, so they have to have their bachelor's degree, and they would go through an intensive 26-month on average training after their bachelors degree. host: does the bachelors degree have to be in some type of medicine? guest: it depends on the program, but usually that is the case. in my program at wayne state university, we have 10 applicants for every seat in our pa program. the average ga of the applicant we are accepting this here is a 3.7 cumulative gpa. and an incredible -- incredibly competitive process and rewarding process once you get through it. host: our guest is the president of the american academy of

physician assistants. tom on the republican line, also a pa. i have been in rural medicine all my career, out in the tip of the state of washington for 20 years. i primarily practice in a very .mall community i can actually see canada from my office. my doctor that i work with in collaboration with is at the hospital, which is over 30 miles away. without pa's in the rural area, we have no access for those people out there. , and as johny well said on the line earlier, the access to care for our people especially extreme, when we have such a very small community involved.

as apa and as a generalist, i am able to do pretty much what with practitioners can do, the exceptions of major surgeries and things like that. however, i work in the hospital theell on my patience, and patients out here really do not have a problem differentiating between a physician, a pa, or and him p as long as the access to care is there. you dothank you for what every day. you are making a difference in your community, and its effect around the country that i'm quite proud of. practice inst either rural or underserved medical areas. that is something we are doing every day to improve access, and to me, that is what america needs. host: next call is diane from utah, democrats line. caller: i was just calling to say that i have two doctors who have ea's.

one thing that i appreciate is that they have more time to spend with you than the doctors do. when the doctors have critical cases, they can take care of me, and i do not have to wait as long in the office, and in both situations, i have a lot of faith in these individuals. host: what kind of services do you get from the pa as opposed to the dr.? basically theo same thing. i have two problems -- one is cardiac, and one is hematological. they review the blood tests. they review all the examinations , and if they have a problem, they go to the doctor and get any clarification on anything i need. host: diane, thanks. guest: i am pleased to hear that. i get asked the question numerous times -- why did you not just go to medical school? for me, it's about iran. my core value is taking care of

patients, and i can focus on that. i can take the time to explain the issues to the patient at their level, but yet, i have the training to do an awful lot in medicine these days. host: i suppose the cost of medical school factors into that as well. 50% of peers students graduate with 100,000 dollars in debt. because of our education as high as well -- not as high as medical school -- but the ability to treat patients like diane is priceless. host: lexington, south carolina, a pa from there. thanks for taking my call. -- i also can speak to pa's working in a specialty. it is important for them to go out there and help provide access to care. are also meeting

that. there is dermatology need in rural areas. there are huge urban needs with a few dermatologists with six to eight-month waiting lists. by providing a pa, you are able to have more access to high-quality care where we are able to collaborate team-based care with our physicians and provide these services, whether it be medical dermatology, dermatology, or existing and specialized surgery. even now, the up-and-coming tele-dermatology that seems to be helping especially moral able to fitpa's are that role in the specialty of dermatology. guest: that's a great example. you could also look at places like the cleveland clinic that are not rural where they instituted a fast track in their emergency room. prior to that, they had wait times in the emergency room of three to four hours. after instituting that decreased, wait times by two hours. increased satisfaction,

and they did not see an increase in misdiagnosis. that comes from a piece in "the new york times." there are many of those types of cases happening across the country where we are teaming with our physician partners in making a difference. host: as part of the recertification, is it just states that determine what qualities are needed? guest: we have a national certification that pa's would take every 10 years. thanks for taking my call. i teach a section of .heumatology i teach a section of rheumatology in six schools. here's my question -- we all have recognized over the years that there has been a fairly significant shortage of practice access for patients in the marketplace, and i also, since schools, know

that there has been a significant increase in the number going to pa school and schools that are actually coming online. my question and my concern is -- is access to adequate rotation the primaryt only care components but also the subspecialty components, which all of us need access to when we -- i'm wondering how the educational process is actually approaching that significant increase demand. >> great. thanks. we have worked closely with our academy with the education association of physician assistants to help address that issue. there's no question that all providers, whether you are a physician, a nurse practitioner, or a pa -- that is kind of a rate-limiting step, how we train additional folks when we do not have the training response to put them at, but what we see

when you talk about access -- we thought 2013 was a banner year for pa's when 22 states may legislative or regulatory changes to improve the barriers practice. in 2014, we have 48 states that have made regulatory or legislative changes, so we are practicerriers to pa drop and fall left and right. we've seen the national governors association come out and say that the pa workforce is a sophisticated, flexible workforce that governors should look to removing these barriers. we are seeing others recognize it, and i think it's a matter of time and we will get there. st. paul, minnesota, republican line. to give a little different slant on this. the nurse practitioner -- we have had them since the civil war. i remember as a little boy, nurse would call in our house, and the physician assistant is

,n outgrowth of world war ii and the medical corpsmen are outgrowth to that, along with the emergency room at the mash hospital. when i'm trying to say -- why are we doing this? why don't they just come doctors? we always have medical -- i got saved by one in korea. we always had medical corps men, and that is the physician assistant. well, thank you for that. we are quite proud of our military history, and those corps men have saved many lives and continue to do that, and that is kind of how i look at the pa role. we continue to improve access, decrease cost, and we have been doing team-based care since the 1960's. it's just been lately that others are talking about team-based care, but it is in our dna. we been doing it for a long

time, and we will continue to do it, so thank you. host: a viewer on twitter asks -- guest: i think the solution is that we have been proactive in the fact that we have the same continuing radical education requirements as physicians. unlike a lot of help officials, we have stepped up and said, "listen, we are willing to be take our board exam every 10 years to prove our competency. we work collaboratively with physicians and constantly share information back and forth. the half-life of medical knowledge is about four or five years. all of us have to stay up to date on this. it is critical and something that is in our core values. is up next, democrats line. thank you for c-span. i have a question regarding a pa . i was under the assumption that

i was an individual who was going to be an indie or doctor of some specialty. i was always under that impression. my question is -- is it 26 months that you are degreed for a pa, or is it a four-year college or university, and then you move on to 26 months? could you explain this to me? i have a granddaughter that spent over $60,000 for an rn degree. she is not a nurse practitioner. she is an actual nurse. i am kind of in the middle of the road on this. i don't quite understand. guest: thanks for giving me the opportunity. goes on to four years of college and then they go on for extensive training after that on average about 26 months after they have completed their bachelor's degree. some of your confusion may come into the fact that pa's are so likearly trained

physicians that that may lead to some of the confusion, but, no, to becomet go on physicians most commonly, and 98% of people who train to 's.ome pa's stay pa 'srveys show that 85% of pa have high levels of satisfaction with their job, which is almost double other practitioners. pa's are trained vigorously like physicians, side-by-side with physicians, and improve health outcomes. host: next call is from kentucky. like to sayll would that i was i had known about the program when i was growing up. got into the program myself as an rn. is aboutnted to ask 10 exams being taken every years, they ought to make doctors and nurses do that.

know nurses get their nurse practitioner thing, there is a law that focuses on what they call the nursing process. in my opinion, it does not help that much as far as contributing typical part of this. much medicine how arehow much biochemistry your cost in terms of taking care of patients? i don't think nurse practitioners have that much. for that.nk you when you look at physician assistant training, it is a medical model. we spent over 2000 hours in clinical bedside hands-on with the patient training during our experience, so you have an medicine,clinical pathophysiology, core courses ,hat any physician would take train them to practice medicine,

and, thank you. i am quite proud of the fact that we were willing to step up and retake our boards and prove competencies. physicians now do that. most board certification with physicians is also 10 years, so i think we align very well in the medical model, and i think we can improve health outcomes without a doubt. host: according to the association, 3500 patients are seen annually by a typical pa. -- annual median salary $95,000. guest: not too bad. pa's typically do well, and it is high demand. guest: what is the starting usually -- host: what is the starting usually? tost: usually $80,000 $90,000. host: next call from illinois. caller: i have been a heart patient. i'm 50 years old. i'm going to add this extra

letter because i have very much respect for my pa, but she is a pac, and she has worked alongside my heart doctor, which is down about two hours away in springfield, illinois, and i could not have made it this far without her. to has been a great person work with, and she is in a rural setting, so i actually drive about 15 miles to see her, but she has been the best, and i have very much respect for pa's. that is all i had to say. host: what is a pac? certification. that shows we have maintained our certification and retaken the exam. most commonly, you'll see our initials as pac, but when we talk about ourselves, we simply say we are pa's. -- is it on aram state university, private university? guest: you have 191 programs

around the nation right now. in 1992, we had about 50 programs. we are seeing an explosion of pa programs because people are, quite frankly, seeing the value. health systems, legislation, insurance is -- everybody is seeing the value. there's a huge growth. you will see them in academic medical centers, private institutions. they really very on where you will see the program. host: you said cost was about $100,000? guest: let me correct that -- 80%average pa student -- graduate with $100,000 in debt cumulative from their bachelor's and matches theirs -- masters degree. that's why salary is commence a toy. host: a student joins us online. this is chris from ohio. caller: i'm in my first year here at the university of pittsburgh, and i agree -- i will be in about 100,000

dollars, maybe a little over with some side expenses in debt, which is not bad at all for my bachelors. my question is -- how do you feel about the specialization of physician assistants in the workforce, going into maybe orthopedics or interventional radiology as opposed to the general family practitioner that, you know, is one of the main reasons our profession was created? host: before you go, what drove you to be a pa? caller: i got a job at a hospital and loved it. did not even know what a pa was, and they told me i should look into it. they do quite a bit, but you will not be a physician, never really be running the show, but if you are interested, you can make a decent living. the big key point is that i have physicians tell me, "you can go to your kids' football games. you can have a side life, a family life," and i think that was the clincher. host: does anyone ask why you

just don't be a dr.? yes, and even in school, you get the question. we just need to do a better job of educating the community about who we are and why we are doing what we're doing. practice to be able to medicine, have a personal life, have a family, you know, and just do it. guest: thank you for that, and good luck in all your endeavors. you point out the uniqueness of are inhe fact that we some specialties but have to maintain that knowledge is priceless. like myself, i was in cardio cousin -- cardio cash and angioplasty for years. they have practiced in at least teen of medical specialties in that time, whether they work full-time and one and movement and another to maintain skills, or they have transitioned. that flexibility is something

that america needs right now. we need to be able to deal with this distribution area or problem, and i think pa's can be part of the solution. host: let's hear from rachel and oregon. she is also a pa. caller: i'm a physician assistant in a small, coastal, rural area, and i have a very broad scope of practice because rural. the closest community is about two and a half or three hours away. my practice, because of where i am, requires hospice care, and pa's can i signed an order because of a federal issue. .'m curious where things stand guest: great. that has really been an issue. because we are so new, we have these barriers that when the law

was written, if you are not named in the law, you obviously cannot do it. we have worked at this at the federal level for a couple of years now, and we continue. unfortunately, as we have seen, there have not been a lot of laws changed in this regard for any health professional, but it is sad -- when you have a pa like this who may have taken care of a patient for 20, 25 years, and then they come to hospice situation, the fact that they cannot stay with a provider that they know they trust is disappointing. on the federal level, we need to remove some of those barriers, and we are working every day on your behalf to be able to do that. thank you. democrats line, crockett, texas. caller: thank you for taking my call. my question is since the world is woefully short of doctors, and the big confusion down here in texas -- we have a lack of doctors, and i see most of the doctors -- they are older

people. my thing is why we can't train new doctors? 's like these pa young man who called earlier seem like they should be able to transition into a doctor. my problem is we have the bar up too high. the holyg a doctor is grail. it is a loadable profession like anything else. this note made accomplishable by normal people. people just cannot get to this level because of money or whatever. host: thanks. guest: thank you for that. you are seeing medical school around the country expand. we are addressing all providers to address the nation's need of more patients coming in. we all need to do it, but what

we need to do is allow those that are trained to practice at the top of their license because we need to do with costs, and we need to deal with mal distribution and access. by working with the providers and allowing them to kind of do what they are trained to do in the best way through collaboration, through a team effort, that's what's going to make a difference in america. host: as an educator, what do you tell your students? always about the patient. the patient comes first. our core values to improve that patient's health and outcome. i tell every student graduates in my program, "the day you graduate, you can take care of my mom." we have a caller on the independent line. go ahead. caller: i just have one comment to make. i wish i would have called earlier, but i just saw that the show was on. the one problem i have with the

physicians assistants -- my husband, i have talked to other little bithey need a better bedside manner, if you will. you ask them -- like you said, this is fairly new. if you ask them, "where is my ?" i have gotten "well, i assure you isis 10 in all his procedures." they tend to take it personally. i think a little more bedside manner, and if a patient asks the question, they should provide an answer or maybe go get the doctor. thank you for that. i'm sorry you had that experience. that really should not happen in today's medical world. 's to be abouta

the patient, and we're perfectly comfortable collaborating with physicians. we have seen with the harris poll that americans trust and value pa's. , presidentmcginnity of the american academy of physician assistants, thank you for your time. tomorrow, we continue analyzing election day this past week. the pulling manager of "the washington post" will join us, and we will talk about polling results and attitudinal factors that shaped the results. we will also talk with the representative from the center of congressional presidential studies, and he will talk about the topic of divided government. then we will look at the 25-year anniversary of the fall of the berlin wall. all that, your phone calls, and a look at the papers, too. "washington journal" continues tomorrow at 7:00 a.m. we will see you then.

[captions copyright national cable satellite corp. 2014] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] >> today on c-span, a look at the latest research being done on ebola. then we take you live to the white house where president obama will be announcing loretto lynch as his choice to replace outgoing attorney general eric holder. later, a discussion on the midterm election results. >> this weekend, tonight at 8:00, a debate on the future of the internet. sunday evening at 8:00, author and television host tavis smiley on his latest book "death of a king."

tonight at 10:00, author jeff chang on the idea of racial progress in america. on what makesson us human and different to other species. on american history tv on thean3, tonight at 8:00, social prejudice immigrants faced during the 1800s. sunday night at 8:00, the 20 than a verse or he of the fall of the berlin wall. find our television schedule at www.c-span.org. at 8:00, theht 20th anniversary of the fall of the berlin wall. join the c-span conversation. like us on facebook, follow us on twitter. institute of medicine recently hosted an ebola workshop at the national academy of sciences. doctors and other health professionals involved in the study and treatment of ebola presented research data on the disease and highlighted areas where more data was needed.