and also, if they did not do away with --, they could have gotten a lot of people prosecuted on wall street, but they decided to do away with the glass-steagall act. they made things upthrough the financial crisis. host: frank in nashville. this is rick in florida. hello. caller: good morning. i think the hallmark of this administration, specifically eric holder, is selective prosecution. that, in itself, you roads the rule of law -- erodes the rule of law. unless you look at the thousands of prosecutions that have occurred, this is the top law

enforcement agency of the country -- if you look, overall, at all these prosecutions, you will find a very biased approach including emphasis on racial cases. and those racial cases are what is in the news. that is what a lot of people approve of, and i understand that. if you do not treat everybody the same, we all lose. th to jail for wall street. wall street is run by democrats. democrats do not prosecute democrats. look at jon corzine, losing $1.2 billion. why is he not in jail? you have eric holder and bill clinton -- pardoning the biggest tax cheat in american history. democrats are a corrupt

organization. host: lena, habit. attorney general has -- attorney general holder has begun to break the habit that individuals have become the law of the land. we know there are just and unjust laws on the lands -- in the books that are still to be rectified from his speech. -- i have people come up behind me in line and ask me are you in line? they do not realize how many people ask me that every day when i am standing in line. maybe i need to get a shirt that says i am in line. then i have a gentleman who has me when i am standing in the fast food restaurant to get lunch. i do not even know him. if he wants to speak to me speak to me.

but do not put his 30 hands on me because i do not know where he has been -- host: that was anthony. this is marshall. what you think about eric holder's performance as attorney general? caller: good morning and thank god for c-span. eric holder is not worth to dead flies, in my opinion. an attorney general is the most strongest office in the criminal site -- criminal justice system that you can have in this country. before straining out different problems we have an adjusting the problem in law enforcement. he did nothing as far as investigating with the trayvon m artin deal and the police department. it was clear that zimmerman who was involved in killing trayvon

martin, was coached by the police department. anybody with half a brain could see that was all doctored up. it eric holder did nothing but give lip service. he just gave lip service and give speeches. an attorney general is supposed to be strong and enforce the law. have an investigation, just like republicans with their attorney general's. with clinton and monica lewinsky. they treated him like he committed a federal crime. eric holder should have done that with all of these cases. whether it was police departments involved in these killings of black men and whatever. he was not there. he was just giving speeches -- host: that is marshall in california. the attorney general announced his resignation in september of

last year. here is a portion of that speech. [video clip] >> we have been great colleagues but the bonds between us are much deeper than that. in good times and in bad, in things personal and things professional, you have been there for me. i am proud to call you my friend. i am also grateful for the support you have given me and the department. the vision that you and i have always shared. i often think of the early talks between us, about our believe that we may help to craft a more perfect union. work remains to be done, but our list of accomplishments is real. over the last six years, our administration, your administration, has made historic gains in realizing the principles of the founding documents, and fought to protect the most sacred of american rights. the right to vote. we have begun to realize the

promise of equality for our lgbt brothers and sisters and their families. we have begun to say significantly reform our criminal justice system and reconnect those who are ably served in law enforcement with the communities they protect. host: susan in herndon virginia. what is your view on eric holder and his legacy? caller: good morning. thank you for the interesting conversation with mrs. woodhouse. it was very delightful. i have grown up in d.c. and met mr. holder when i went into a mcdonald's and noticed how much everyone liked him in the community here. reflecting on what he has done as an attorney general, he has begun to change the conversation about minorities. he has a big, uphill fight. i look back at other attorney

generals and how they turned away from iran contra went reagan was president and did not do the prosecution needed at the time. we have to be fair when we talk about politics and who is working for who and so on. this is a great country. we have great african-american politicians now. i look forward to mrs. lynch. thank you for letting me share -- host: that is susan in herndon, virginia. loretta lynch will be sworn in on monday, according to news reports. eric's then maryland. attorney general holder, what do you think? caller: good morning. thank you for allowing me to talk. i can hear legally 10 years ago and earned my citizenship.

in 2007, i was in an american university -- in american university, and among the people who believed in president obama then senator obama. i really believed he was a different kind of politician. i just want to say i am so disappointed. almost eight years later, i am extremely disappointed by what he is doing. eric holder is similar. he is the top law enforcement official in our country. i am very disappointed because he seemed to select the law he is going to enforce. the same as -- is doing as far as illegal immigration. he said more than 20 times that he could not do it because the

constitution did not allow him to do it, but for political reasons now, he is doing it. when he comes to syria, saying that -- all of these lies. it may mean not believe in obama administration -- host: and cause a maryland. this is glover in new york city. caller: good morning. i want to talk about the people that keep calling about the internal revenue. they forget that when you do not pay taxes for the rest of your life, you should be investigated to find out who you are. a guy like holder. host: that is glover in new york city. the "new york times" had a large article about the clinton foundation and its fundraising

and money coming from russia. today, there are editorial page follows up on that. "candidate clinton and the foundation." " hillary rodham clinton's determination to -- is in danger of being overshadowed by questions about the interplay of politics and foreign donors who support the clinton foundation. nothing illegal has been alleged about the foundation, the global philanthropic initiative founded by former president bill clinton. no one knows better than mrs. clinton that this is the tooth and call political season were accusations are going to fly for the next 19 months. and no one should know better than the former senator and first lady that they will fester if straightforward answers are not offered to the public. the donations were not publicly disclosed by the foundation,

even though mrs. clinton had signed an agreement with the obama administration requiring the foundation to disclose all donors as a condition of her becoming secretary of state. this failure is an excuse spirit -- is an inexcusable violation of her pledge," the new york times writes. "there is no indication that mrs. clinton played a role in the uranium deal's eventual approval by cabinet level committee. but the foundation's role in the lives of the clintons is inevitably becoming a subject of political concern." we put the numbers up, so if you want to talk about eric holder you can do so. we have ron on the line. caller: thank you c-span. i want to say i disapprove of his performance. i believe law and order is

broken down in this country. he has upheld the race hatred in this country. it is not reported, but a lot of people are beaten up. his law form represented the quantum on among detainees after 9/11. i totally disapprove of his performance. host: that is wrong in pittsburgh. this is a need a in pennsylvania. caller: good morning. i would like to say that the journal has become my paper it new morning show. i watch every single morning. you are my favorite host sir. also, i do approve of mr. holder's job that he is doing. and i do appreciate that him and

the president's jobs must be the two hardest jobs. my real reason for calling is because i love, love, love mrs. woodhouse. we need more moms like her in this world to keep the peace. thank you for taking my call. you keep being the best host. host: anita, what do you do in pa? caller: i am a hairdresser and right now i am a caretaker. i have a couple family members not well and i love what i am doing. host: thank you for calling in. from "the hill" chelsea hill -- chelsea clinton defends family's foundation. she -- the daughter of hillary and bill clinton maintain the philanthropic foundation would push to be even more transparent this by already disclosing donors on a regular basis.

"i very much believe that that is the right policy, that we will be even more transparent," she said. she is the vice-chairman, by the way. she said the organization what not take any new funding from foreign governments but that the work will continue as it is. betty from louisiana. you are on c-span. good morning. caller: good morning. in reference to eric holder, i think that the measure of any man doing his job is whether or not he does it fairly and evenhandedly. i do not think mr. holder has done that. he should have investigated the irs. he should have done quite a few things. that he seems like he avoided doing for political reasons rather than for legal reasons. whether or not there was any need to do so. thank you for letting me have my say. host: that's betty in louisiana.

this is sarah in new york. caller: how are you? host: how are you? caller: pretty good. i have a question about the lois lerner thing. i have a question for you about the irs thing with lois lerner. is that not -- host: is that not what? caller: is that not still in court? host: why is this an issue that you are concerned with? caller: well, and they are criticizing eric holder for not investigating. but then, about five months later, all the e-mails magically show up. and then you did not hear anything from congress or the

senate. what i am wondering is do they still have to investigate those e-mails in order to prosecute lois lerner if she did anything wrong? i think that eric holder did a really good job. if you notice what happened in ferguson, when the police game to interview witnesses, they played -- they pretty much closed their doors. when the fbi got there, they pretty much open their doors. because they trusted eric holder. even though he could not get a conviction. they trusted eric holder. and i trust him. host: sarah in new york. this is rafiq in texas. hello. caller: good morning. i am on the fence with eric holder in the sense that, for one thing, the question is like

a -- question due to the anti-obama sentiment in this country. it is dishonest to pretend as if america is still not suffering from the racial bias that it went through after the civil rights laws was passed. the fact that the system is corrupt, so eric holder and president obama are just reading from a script. we really need to look at the entire system. this is just -- not just a republican-democrat situation. we have abdicated our responsibility as citizens and allowed these political parties to run a month -- run amok. we keep getting caught up in either/or situations when that

is not really the case. it does not matter whether a democrat or republican is in office. we will still get the same results because system is corrupt. host: bc venice tweets in that eric holder was negligent in his failure to pursue terminal activity by wall street and its banks. this article in the hill says that being is open to deal to ease spending ceilings. speaker boehner said he would -- if there is a way to reduce mandatory spending that would give relief, have at it, he told reporters, referring to the agreement -- struck in late 2013 that word relieve spending ceilings and 2014 and 2015.

boehner said that it could happen again and acknowledged that the gop congress would have disagreements with the white house over spending. carl you are up next. troy, montana. what is your view of eric holder and his legacy? caller: i am a first time caller and probably last time caller. you need to get a guy on this program named leo hnenry, a democrat, to talk net neutrality. he predicts c-span will lose half of its bureaus because of it. on eric holder, the voting rights act, 29% of the american people do not know who joe biden is. to me, it would be the stupidity of the american people that will destroy this country. wall street, no one went to jail for wall street. wall street is run by democrats.

democrats do not prosecute democrats. look at jon corzine, losing $1.2 billion. why is he not in jail? you have eric holder and bill clinton -- pardoning the biggest tax cheat in american history. democrats are a corrupt organization. host: lena, seven valleys, p j. what is your view on eric holder? caller: i think eric holder did a job. a lot of callers are saying he did not do anything. what do other attorney generals do? i know reagan's, a lot of drugs were in america and they are still here. what does he do, nothing. that is why we have crime and what not in black neighborhoods. drugs are in america. these other attorney generals

did not do anything about it. you talk about the irs. they were also, as far as the naacp, they challenged them, one in to know what they were doing with tax money and whatnot. they also -- under other administrations, they targeted entertainers about taxes and so on and so forth. was everyone outraged about that. you talk about the fast and furious under eric holder. that started with the bush organization. they talk about our president lying. i looked on the internet, they said that bush lied 935 times. he also lied about the iraq war. i do not know why everybody keep calling and talking about and

colder and our president as liars and they did not do what they were supposed to be doing. look at what the republicans did -- host: that is lean. the front page of "usa today," an exclusive interview with charles koch. the headline, koch: not all about moeny. charles koch and his empire are mounting an aggressive new defense of his company and its political advocacy, with the billionaire insisting his work to help elect republicans is rooted in his decades long quest to increase well-being in society. -- that is so ludicrous. i do not know how they can say that with a straight face, he said. we oppose many are more things that would hurt us then benefit

us, talking about his or refinery of the keystone xl pipeline and his opposition to the import-export bank, who subsidies aiding u.s. companies he has decried as corporate welfare. that is in the "usa" -- "usa today" interview with charles koch. fred in new york, eric holder and his legacy is the topic. what is your view? caller: i think this administration and eric holder and president obama had an opportunity to shine in the above board and open. they have not been. this country has been dumbed down. no area has improved an iota.

they protected the wrong people and are concerned about the wrong agenda. -- will not be settled. the irs scandal and all of the fast and furious, and the way they have upset major -- between the races has been terrible. the country's -- host: this is john in cleveland. you have the last word. caller: accepting in the bank industry, when compared to john mitchell, gonzales ashcroft, a bunch of water boys who are running the country. the justice department was polluted. the current if the eye director resigned because they were trying -- under reagan, the whole bunch of them. i am not saying eric holder was great area that except in the

financial industry, every one of them were bought by presidents because they were water boys during the political election. shame on them. i am 79 years old. >> holders last days attorney general's today. he made a speech in the call of the great building. [inaudible] [applause] [laughter] [applause] atty. gen. holder: thank you. please take your seats. [laughter] ok.

a couple of business items. my portrait hangs on the fifth floor of the justice department. it has not been mentioned, my kids names are hidden in the portrait. if you look on the button of my jacket and on the wings of the eagle, you will find three of them. that is the lore that i want to come out of the portrait, find the names of the holder children. i want to check to make sure that you know you are on annual leave. [laughter] in my final act as attorney general, screw it. [laughter] this has been a great six years.

being at the justice department has -- i say the last six years, but the reality is that i've been at this department since 1976 off and on. i started as a lawyer in the public integrity section. it is going to be hard for me -- not going to be, it is hard for me to walk away from the people who i love and who represent this institution that i love so much. it is time. it is time to make a transition. change is a good thing. i'm confident in the work that you have done that we have laid a foundation for even better things over the course of the next couple of years. i think that as we look back at these past six years, what i

want you to understand is that you have done truly historic -- historic and big things. no matter where you look. if you look at, at the basic stuff. this department is restored. it is restored to what it always was, and certainly what it was when i got here, and what it always must be. free of politicization, focused on missions, and making sure that justice is done, without any interference from political outsiders. we have expressed fate in the greatest court system in the world, and brought the toughest national security cases into that system, and with unbelievable results. the notion that we are still having a debate on whether or not cases should be brought in the article three system, or in

military tribunals is over and is dead. that is again due to the great work that prosecutors and various districts have done in putting together wonderful cases and successfully trying those cases. we have had an impact on the environment, and companies that would help spoiled -- would have spoiled our environment. historic wins in that regard as well. if you look at financial recovery, related to the crisis, and huge amounts of money that we recovered. tony west is here, and he deserves a special thanks for that, and what was done with the money, tried to give it to people who suffered the most. [applause] the thought was never to simply take that money and put it in the u.s. treasury, but, with ways that we could get people back into their homes, or somehow try to reduce the debt

load that they were dealing with. our antitrust division lives again and has had a tremendous impact in our country and in positive things that they have done for the american consumer. we announced, or her, today, that a merger -- which i think would have been extremely anticompetitive and not in the best interest of american consumers -- has been abandoned. that is due to the great work of the antitrust division. disallowing the practice that had for too long gone on way people squared away money. indian country. you think about the tough history that exists between united states and our native people. we have put on track, i think, the ability to write some really

historic wrongs. we have done, i think, a great deal. much work remains to be done. this justice department was committed to addressing those problems in the best way possible. criminal justice reform. if you look at statistics, you see incarceration rate goes like this and then it goes up and about 1974, late 70's. we are a nation that incarcerates too many people for too long and for no good law enforcement reason. it is time to change the approach is that we have been using for the past 30-40 years. through the great work of people in this department, we are starting to reverse that trend. again, more work remains to be done. civil rights. the algae to be -- the lgbt community is something i tried to focus on.

i think that is a civil rights issue of our time. this whole issue of same-sex marriage that will be resolved by the court over the next couple of months or so hopefully that decision will go in a way that i think is consistent with who we are as a people. i also think that that is a sign, an indication, one part of the fight for overall lgbt a quality. i think the work that you have done in that regard will be an integral part of this legacy of the department. the thing that is some ways animates me, angers me, is this hold nation -- whole nation of the right to vote. we celebrated this year the 50th anniversary of the passage of

the voting rights act. i went to selma to commemorate bloody sunday. john lewis was here earlier. this nation fought a civil war, endured slavery, dealt with legalized segregation. a civil rights movement in the mid to early 60's transformed this nation. the notion that we would somehow go back and put in place things that make it more difficult for our fellow citizens to vote is simply inconsistent with all that is good about this country, and something that i was bound and determined to fight. our civil rights division has done a superb job in crafting lawsuits based on an act that was wrongfully gutted by the supreme court. i think we will see successes from those cases that have been filed. that, of all things, can simply not be allowed to happen. the right to vote must be protected. [applause]

i want to thank my family, my lovely wife, for the sacrifices they have made over the years. not only to allow me to be attorney general, deputy attorney general. honey, you have any rock in the family. [applause] you have allowed me the opportunity to do the things that really animatedly and allowed me to work with all these great people. i also want to say some thing about the folks that you see standing here. my detail. these are people, men and women, who literally sacrificed their well-being in terms of their interactions with their

families, they travel with me, they missed weekends, they work long and hard hours, and are prepared to do ultimate kinds of things. i cannot do this job without them. they will not smile because they never do that. i see mark is a smiling a little bit there. [laughter] he is also smiling. [laughter] [applause] then, i just want to thank all of you. all of you. you are what makes this institution great.

we have a great building and it is something that is historic and its nature. it is only kept great by the dedication, the commitment that all of you show on a daily basis. i hope that you all will understand that the jobs that you have -- there is not a routine job in the department of justice, given the great power that we are entrusted with, the responsibility that we have. i don't want you to ever think that -- it is just tuesday, i will get through the day. that is not who we are. it is not who you are. i think that has certainly been shown in the way that you have conducted yourselves, and the way that you have accomplished so much over the last six years. i said earlier that when we celebrated robert kennedy's anniversary, the swearing-in in

2011, people said that that was the golden age for the u.s. department of justice. i think 50 years from now, and maybe even sooner than that, people will look back at the work that you wanted and say that this was another golden age. that is how good you all are. that is how dedicated, committed, and wonderful you all have been. the focus on justice, focus on helping those who cannot help themselves, you have to stick with yourself -- you have distinguished yourselves. every now and again, at an appropriate time, a group comes along that is worthy of special recognition. you are one of those groups. i'm proud of you. proud of you. i will miss you. i will miss his building, this

institution, and more than anything, i will miss you. this building will always be home. you all will always be my family. wherever i am, and whatever i'm doing, i will be rooting for you from the sidelines. we have these bands that i have been wearing for the last whatever number of whatever is. i can officially take this off now. [laughter] [applause] i think we can officially say now that eric holder is free. [laughter] it is not necessarily something that i want. i don't ever want to be free of this great institution. i don't want to ever be free of the relationships that i have

forged with so many of you. i don't want to ever be free of the notion that i am a member of the united states department of justice. this is something that has meant the world to me. it has helped to define me as an individual and lawyer, as a man. for that reason, although i got rid of those bands, i am free in one sense. it is really not consequential as the way i will never be free nor want to be free of the united states department of justice, or free from all of you. thank you for your support over the past six years. i look forward to all that you will do under the great new leadership of a wonderful attorney general who will be sworn in on monday. i expect you will do great things over the course of the

next two years, and beyond that for those of you who are career employees. i expect that you will do great things as long as you are part of the justice department. there are some of you here who will be here 20 years from now, 30 years from now. i believe your biographies will be littered with wonderful things. again, thank you so much. i will miss you. as i said, as i ended a previous speech -- this is my third going away. [laughter] i promise, it is the last one. i will end this one, i love you all madly. thank you. [applause]

>> looters as supreme court will still argument on whether gay people have the constitutional right to marry. today lawrence hurley tweeted out this picture of people already lined up to hear the same-sex marriage case, which is four days away. c-span1 of audio of that argument on tuesday afternoon, right after this recently -- it is released by the supreme court. >> she was considered modern for her time. call mrs. president by her detractors, and was outspoken about her views on slavery and women's right. as one of the most lithic

writers of the first ladies, she was unique in her look on colonial life and american life. abigail adams. first ladies, examining the public and private lives of the women who filled the position of first lady. sundays at 8:00 p.m. eastern on c-span three. and as a confluence of the series, c-span's new book is now available. first ladies, presidential historians on the lives of 45 iconic american women. providing stories about these fascinating american women creating an illuminating and inspiring read. it is available as a hardcover or e-book available through a bookstore or online bookseller. >> the white house correspondents association dinner is saturday night with

president obama consistently strong -- and cecily strong. we spoke about how the choose the entertainment for each year's dinner. >> they chose musical acts, juggling acts, but since the association started having comedians come and serve as the entertainer, she is the four th woman to do it. it is always a late height white guy, but it is important to have a different perspective recommended that a phone like that. i think she is funny, sharp, and counting it will bring it a little bit. best part of the fun. >> letters saturday night. our coverage getting underway at 6:00 p.m. eastern. sunday on c-span, ohio senator

sherrod brown talks about regulating wall street and why he opposes so-called fast-track per trade promotion authority. >> here are a few of the book festivals would will be covering this spring on book tv. this weekend we will be in maryland's state capital for the book festival. we'll hear from the attorney general alberto gonzales, and author james risen. we will close on may at book expo america, in new york city where the publishing industry showcases her upcoming books. and then we are alive for the chicago tribune printers row lit fest.

that is the spring on c-span to book tv. >> now from the sport's washington journal really a conversation on how the government pays doctors retreat medicare patients. i do not think you can blame her for taking the position her boss did. >> "washington journal" continues. host: on your screen is dr. john noseworthy, president and ceo of the mayo clinic. he is in rochester, minnesota. dr. noseworthy, the so-called fix -- doc fix law was signed into bill. -- sign into law. how does that affect you? guest: it takes the uncertainty out of year-to-year payments of medicare payments to health care organizations and puts us on a path to moving to pay for value better outcomes for our patients rather than pay for

the volume of services we do. we think this is a step forward in the right direction. this is a path we have been advocating to the government for some time. host: how much of your funding, dismissed, deals directly with federal payments and the federal government? guest: approximately half our patients are receiving government payment for their medicare services. that is across our campuses in the upper midwest, florida, and arizona. a little more than half of the services we provide our for patients over age 65, he could as generally have greater health care needs. host: howell has the affordable care act, now that it has been in place a couple of years affected the mayo clinic? let's put the numbers on the screen so we can get viewers involved. guest: of the affordable care

act has done one thing rather well. that is to get more americans insured. that has been something we have been advocating for and supported. we think patients should have access to health care. the affordable care act on its own and the changes in the health care marketplace has affected the mayo clinic quite a bit. it has placed downward pressure on reimbursement for health care, not just from the government pay, but in the private sector. it has driven many health care groups to consolidate with others and form large health care groups around the country. we have taken a different path from that. in a sense, it has been a good thing. driving us all to create a sustainable, high-quality health care system. health care reform is not done

yet. we saw this coming for about five to seven years before the health -- of the affordable care act was passed. we put together a strategy so we could be successful for our patients, regardless what happened in the external environment. that allowed us to make important, strategic investments, which are paying off for our patients. host: such as what? guest: we saw that there would be a drive to increasing the scrutiny of outcomes for patients. how well was health care being deliberate, where we bringing cutting edge services to our patients, where we providing more efficient care -- more quickly getting accurate diagnoses and getting people out of the hospital more quickly. about 10 or 12 years ago, we ramped up engineering efforts to drive up more quality and value

and more efficiency into our already efficient systems. the other thing we did, quite different from what others have done is said that mayo likes to share what we have with others. it has been part of our heritage last 150 years. we took advantage of the digital age and digitized our knowledge into tools that physicians and providers could use. we created an affiliate network with 32 sensors, who subscribe to mayo clinic knowledge so they can provide better care locally. that was our answer to the merger and acquisition strategy we knew others would go forward with. we thought that would provide better patient-centered care. we were not sure that a large consolidation would do that. it has proved effective. nearly 90% of the patients that receive mayo knowledge from

their positions across the country can stay home and not be transferred to a large center like mayo clinic. the 10% or 12% that need to, we know a lot about them. host: if you could, give us a snapshot of the mayo clinic. one of the revenues, number of employees, can anyone go? guest: we just celebrated our 150th year. we started in rochester, minnesota, our home for the last 150 years. we branched out to phoenix and jacksonville, florida. those are now large sites as well. in rochester, there are approximately 39 thousand employees. 4000 physicians. 400 physicians in the jacksonville campus. 60,000 employees we are the

largest employer in the state of minnesota. about $9.5 billion in revenue each year. patients can come to the mayo clinic without a referral. they simply need to contact us. that is how things are working at the moment. host: are you a for-profit or nonprofit? guest: we are a not-for-profit humanitarian organization. we have a strong research and education component that has supported the practice the last century. research is a big part of what we do. our research programs support the needs of the patients. we bring in approximately $225 million a year in nih funding. out of its income, the mayo clinic invests about $275 million a year in research. we have one of the largest training programs in the country for graduate, special its best

specialists, and primary care physicians. also postdoctoral scientists. we are a large, academic research driven, educationally supported organization. host: if you could make a change to the way medicine is delivered in the u.s. or the way insurance is, what would that be? guest: number one, it would be wonderful if we could make sure our citizens get more engaged in their health care and life decisions. so much of health is determined by what people do. staying active. eating properly. avoid excess alcohol. not smoking. understanding the risks in their family history and dealing with those early. if one can predict what a patient may become ill with, one can often prevent that. in terms of providing optimal

care, what we would love to see is that teams of physicians and nurses and other health care professionals work together with one focus the needs of the patient and their families. that has been our core value. we would like to see, as we move forward with reforming medicare and perhaps the next largest up award under the doc fix bill, is to put in place performance measures that recognize and reward better outcomes of lower costs. it is important for primary care and peter and its services -- and preventive services and those with complex health care needs. how do you identify the complexity of a health care issue and reward that are outcomes at lower costs? that is a complex series of

questions. with that, the country will move in a more sustainable direction for better outcomes at lower cost. physicians want to do the right ring and will start to work together more and work with community services and so want to produce a healthier population. host: this tweet from -- how does this value or outcome based health care measure? who makes up these rules and measurements? guest: those are made by the regulators working with health and human services. many of us in health care are providing advice to those rule makers, if you will. that is the hard work that will about -- that will begin. ultimately it comes to health and human services. lots of us will provide input from health care as well as the private sector.

in forming what is it we want to drive to in terms of debtor outcomes. this is complex work but it can be done. host: another tweet from myland. they want to know how much the doc fix will cost america in increased taxes and debt? guest: i am not a political expert or pundit. i am a physician. we understand that the doc fix did not entirely get paid for by the legislation and there was something in the order of $140 billion that was unaccounted for the next decade. that is for congress to sort out. one of the reasons the doc fix was passed this year was that there has been reduced health care spending, compared to a historic averages over the last number of years. the cost to the government was

substantially less now than it would have been a few years ago. that motivated this incredible union of forces between democrats and republicans to come together and get this done with an overwhelming majority. it was striking. host: as president and ceo of the mayo clinic, how is your time divided? how much time do you spend paying attention to washington and internally at the hospital, etc.? guest: that is an important question and a balance. it is a balancing act. my first 2.5 years in this job i was still seeing patients, but that had to go by the wayside. i had to focus on bush's more than the other. we have plenty good urologist to do the other work. 70% of my time is focused on the mayo clinic and its 60,000

employees, and the 1.3 million patients we see every year, and the 60 million patients we touch electronically every year. 30% is an federal and state government work. host: 60 million electronically every year? how is that? guest: we have a gold city developed a meaningful relationship with 200 million people per year by 2020. we have created a number of digital tools that allow patients to interact with the mayo clinic. we have another -- a number of products and services patients can access or employers can purchase for subscription services and so on. in this digital age, folks want to know more about their health and more about what they can do to stay healthy. this has been an area we have

been developing to deliver our knowledge, no only face-to-face but to anyone who wants to have a relationship with mayo clinic. host: dr. john noseworthy is head of the mayo clinic. numbers on the screen. our first call is from indianapolis. caller: i wanted to ask the doctor if he could speak to the delivery of health care and nursing staff? i have to nurses and my family. one is a dialysis nurse, another a nurse aide trying to become a nurse. the dialysis nurse, it is not uncommon for her to work -- come in at 7:00, leave at 10:00. 13 to 14 hour days. that is going to impact her ability to do a quality job. the one in my family that is trying to become a nurse has been on the waiting list, looking at the costs.

it really seems like the process is working against her becoming a nurse because the schools sees this as lucrative because of the demand. i do not see a big-picture view. host: any comment for the caller? guest: yes. you must be proud of your daughters. it is something to have nurses in your family. we are proud of them. the future for nursing is outstanding. we are going to see physicians and nurses work more closely together. it is important that nurses and other health care professionals are able to work at the peak of their licensure to make sure they can keep health care affordable. it is very stressful to be in health care. i am sure both your daughters feel that. it is an emotionally draining profession that is very rewarding.

it sounds like each of your daughters has significant stresses at the workplace as far as work life balance and the length of time they are there. those are local issues that they need to deal with with their supervisors in order that they can continue to feel great about their work and do a great job. it is not ideal, but the future for nursing and other health care professionals has never been better. host: christina in michigan. caller: good morning. thank you for c-span. dr. noseworthy, i cannot tell you how impressed i am with the philosophy of the mayo clinic. my background, i am 59 now, my background was when i was 25, had four children, a divorce, i

got my r.n. because of a federal nursing loan, which helped provide for my children. got a wonderful future for my kids and myself. it was due to the government. i worked in surgery for 30-some years, mainly at nonprofit organizations, they called themselves. but it seems years ago -- you are doctor who is ceo of the mayo -- business people did not understand anything about health care when people took over the hospitals. it all turn into big business. i retired about 10 years ago. i am seeing such changes. i worked for a major corporation in detroit, the biggest corporation. what goes on is amazing to me. my husband has been a patient had a lot of surgical spine

problems and stuff. the amazement i go through with what gets paid for with back braces and stuff, but nobody cares. i am so impressed with your philosophy, the teamwork of everybody taking care of -- host: i think we got the point. let's hear from dr. noseworthy. guest: thank you so much. what a great story. the mayo clinic is a physician- led organization and always has been. our physicians are salaried. that is an important part of how we work. it works well at the mayo clinic. there's lots of work to be done. our physicians and nurses believe that when physicians are leading the organization, they understand the health care needs and of the professionals delivering the health care. it works well for us. i appreciate your positive comments. host: how do you figure out the salaries of your physicians?

guest: our salary structure is based on market data for similar organizations. we have a range of salaries given. it graduates after the first six years on staff, until you have proven yourself and are a full consultant. then it is tied to the marketplace. host: william's calling in from rochester, minnesota. hello. caller: hello, how are you doing? i want to say you do a great job at the mayo. i am a patient out of there. the service is top notch. the doctors are first class. they care. a doctor called for me and wished me happy birthday. the service, outstanding. host: are you out at the mayo now or do you live in rochester? caller: i live in rochester and

am a patient at the mayo now. you said something about a disease, if you have a disease and it will eventually take your life, it should not be counted against the doctor or hospital or wherever. we will all pass away. there is -- guest: i am glad you are getting good care. host: maverick tweets in to you, would the good doctor comment on our current health care system fee-for-service model versus single-payer. guest: thanks. we have had a fee-for-service

model and still do in this country. medicare has been a fee-for- service model. this doc fix is taking us down a path away from that. as we talk about more paid for better outcomes, and so on. the other point i should have made is that this doc fix, as we move more to pay for defined outcomes, safer health care and so on, will help that medicare on a sustainable path. many of us feel it is on an unsustainable now. this is a social contract the country needs. we need a strong sustainable medicare program, because it is good for our country. the single-payer system, which we do not have in the u.s., is in place in a number of other countries. it has been debated heavily in the united states. it is a political issue. i am not sure where things will end up 5, 10 years down the road. in the countries where there is

a single-payer system, almost every one of them have evolved to have a second system, which is a competitive insurance-based, market-based plan for those who wish to pay up and have more choice in their health care insurance and where they go for care and so on. because they do not feel that the single-payer system in those countries is working. i am not aware of a country that has a single-payer system only, because there are others in the population who want to have more choice than generally comes from such a system. host: what is your policy when it comes to medicaid patients? guest: we see medicaid patients who live in minnesota and adjacent states. we provide the best care that we can. all of our patients get the same level of care. it is biggest on medical need.

host: what is your top line view of the medicaid system as currently constructed? guest: i am not a health care policy person or elected official. it is an important safety net for those who are disadvantaged in our country. there is politics whether it should be government at the federal or state level. there are strikingly different opinions about that. we are seeing that play out now especially with the supreme court case coming up. it will bring some of that to lie it. from our standpoint at the mayo clinic, the needs of the patient comes first. if the patient lives in our state or and adjacent state, and they have medicaid, we are honored to see them. host: next caller, david. you are on with dr. john noseworthy. caller: good morning.

my concern is having commercial insurance at the table. in helping decide how value-based health care will proceed. when you look at relative values and how medical services are paid for now, at least two independent, freestanding doctors' offices, they are pretty much taken advantage of. you have a relative value that medicare has set, and the average commercial insurance has kind of muscled these doctors into accepting lowball contracts for their services. what is your sentiment on having commercial insurance involved in this process? thank you. guest: thank you. the payers, whether it is government or the private

sector, the private companies are at the table because they are paying the bills. the mayo clinic has and continues to work with the government, advising government about what is best for it the patients. same with the insurance company. we work with dozens, though there are a few dominant ones. what we are seeing is an evolution in terms of large insurance companies, that they recognize that what is needed is to identify what works in health care and pay for that and less so for things that do not work as well in health care. this bill and the movement of the field forward will be driven by data, not completely, but by data. many of these insurance groups

are putting together large databases to best understand what is working and health care and see if we can push more and that direction. the mayo clinic is the founding partner of something called often labs. there are now 30 countries in big pharma, and others, and we have partnered with a subsidiary of the unitedhealth group. we can together and said we understand outcomes and health care, quality, survival, good service, and so on. but the insurance companies have access to claims data, what people actually spend on health care. in this partnership, we are trying to find a better answer for the american people. bringing them -- or being at the table with them is part of this learning curve for the united states. i see them staying at the table. i do not think we can keep them out, no more than you can keep out the providers or the government. i am seeing good progress in

that regard. these are complex issues, but i think we can get better every year as we move forward. host: $9.5 billion in revenue for the mayo clinic last year. about 60,000 employees at all its branches. michael is calling in from minnesota. caller: good morning, doctor. i was curious. what is your opinion of the v.a. health system? i have a daughter-in-law who is a nurse at mayo and they would rather have me -- i got some upcoming surgery and they would have me go to mayo rather than the v.a. guest: i haven't worked in the

v.a. health care system and a lot has been made, recently, of the troubles they are having there. the new leader is moving as quickly as possible to improve the services to our men and women in uniform and our veterans. i think with your family, you need to make a combined choice of where you want to get your health care. i am certain you could get outstanding health care in the v.a. i promise you would get great care at the mayo clinic, but that has to be a personal decision for you. i think the v.a. has opportunities to improve, as we all do. host: a tweet to you, dr. john noseworthy about electronic medical records and how private are your clients medical records and how extensive do you use that system? guest: thanks for that question. we are a completely -- pardon me -- everything we have is electronic health records.

that has what mayu has done for a large number of years. patient privacy is our number one concern. increasingly, that has been a problem in the business sectors and others with the risk of tampering with or entering the systems for bad purposes. we have seen that with banks retail, and so on. we have a excellent group of folks to ward off cyber security, manage it, and keep our patient records completely private. it is an important concern for us and we focus on it every day. host: larry, rapid city, south dakota. hi, larry. caller: good morning. one of my concerns is you -- i have had so many friends that live across the street, older guy, broke his leg falling down the stairs in his basement.

emt showed up, took him to the hospital, and i talked to him and he says he would be all right. two weeks later he is dead from a staph infection. rapid city regional hospital probably has one of the worst records around. what bugs me is they have bought out every hospital in the whole black hills. every little clinic is now a regional hospital, and they start putting urgent cares up. and then they push out insurance companies because they say if you work with this insurance company, we are not going to work with you. to me, it is one big monopoly conglomerate that looks at the bottom line and not the main line. host: that is larry in rapid city, south dakota. any comment, dr. john noseworthy? guest: earlier we mentioned that could be a move in the

marketplace to merger and acquisitions and these bigger systems. one of the drivers for that is to drive up the purchasing power from a smaller organization to a larger organization. for them to be successful, they must put the needs of the patient first. mayo clinic decided to take a different path and to share our knowledge, but not to become a much larger owned organization as you are saying. it feels like a monopoly. i guess what i would say, larry, is that in the move in america now to more transparency of outcomes, hospital-acquired infections, like your friend unfortunately suffered from, and falls in the hospital and mistakes that can be made, those are being rooted out by this competitive transparency environment that we are living in. that is a good thing. good doctors and good hospitals

will be hopefully recognized and rewarded. and those who need more help in terms of higher quality will be motivated to do so. otherwise, they will be paid less money. i hate to say that way. host: barbara, miami. caller: i am a patient of mayo for the past 26 years and i wanted to say how grateful i am for the mayo clinic and it is worth the trip if you want to travel to rochester. the diagnosis i had in miami was not accurate, and when i went to rochester, it was discovered even of the same tests were performed. also, perhaps dr. john noseworthy can mention the history of the mayo clinic and the mayo brothers. guest: thank you. i am pleased we have been able to help you. you describe the situation and the country where the quality varies quite a bit. you mentioned miami -- i won't say anything about miami's

health care -- but miami is multiple small care groups and so on. there is quite a bit of variability around the health care around the country. there is also a difference where patients go from one doctor to another and they don't talk to each other, tests are repeated. that is what drives up health care costs. mayo clinic began 150 years ago with the father, dr. william mayo, who was employed by abraham lincoln to provide medical services to the union army. he was a surgeon, he had two sons, will and charlie. a tornado ripped through minnesota in 1880's, through rochester, destroyed the town. the sisters of st. francis came together with the mayo brothers and said they needed to build a hospital to serve our patients. they raised the money. that happened. the mayo brothers applied scientific method to their

surgeries and they provided a great deal of learning, and it became a mecca in this small city in southeastern minnesota. it is an interesting story. host: all right, here is your chance. wild and wonderful tweets in -- one of these days, a health segment will explain the infamous $25 hospital aspirin. why do we get charged so much? one of these days, a health segment will explain the infamous $25 hospital aspirin. guest: peter, i missed -- i was with you until the -- explain what? host: the infamous $25 hospital aspirin. why when we get a bill does it sometimes -- seemingly normal products charged at higher rate? guest: yes, well, this is a complex area. the billing and pricing and

transparency of hospital costs is a complex web that is beyond any single hospital system to rectify. we all recognize we are committed to more transparency and more predictability upfront as to what the hospitalization or the medical evaluation will cost. the way the pricing is done and the costing is done is things have to be allocated across the hospital. and you see some of these unusual bills that are printed that says a suture costs $1000 or $25 aspirin. the system is broken. we recognize that as a national problem, and we are working with those who can exit to fix it but there is not a quick fix for that, unfortunately. it is very troublesome to patients than it should be. host: can the patient get a line item of their bill?

guest: yes, they can. some patients request that. the way the billing is done, of course, you have to pay for the building, the depreciation of the building, the work that is done by the doctors, nurses, and technicians. everything has to be accounted for -- the gauze, the cleaning staff, and so on. that leads to a very strange bill that looks and people say why was my aspirin $25 when that is the relative allocation of a very complex process. host: next call for dr. john noseworthy, head of the mayo clinic, ron, who is close to rochester. caller: good morning, c-span. thank you for taking my call. dr. noseworthy, i had surgery at st. mary's hospital three years ago in august. i had not been to a doctor in 44 years, so it was a great

experience for me. i just want to say that mayo has a great organization, absolutely outstanding. and the people that i worked with and i still work with, the hospital in albert lea, and you people do a great job and i want to thank you. guest: thank you very much. i am glad we were able to help you. you better look after yourself. you've got to see the doctor more often than every 44 years. host: dr. john noseworthy, he referenced st. mary's. what is st. mary's? guest: st. mary's hospital is the original mayo clinic hospital, if you will. it is the large hospital in rochester, minnesota. we have two, the methodist hospital and the st. mary's campus. we have about 1000 beds, a large hospital, very busy. the largest surgical services hospital in the country. that is where he went for surgery.

host: here in the washington area, i think i saw in the paper and ad that said mayo clinic is now associated with the virginia hospital center in arlington, virginia. what is that association? guest: we built this non-owned affiliate network around the country as i mentioned earlier. we have 32 sites in the u.s. mexico city, and puerto rico. these are very high quality hospital systems that have wanted to affiliate with mayo clinic. they join us as part of our mayo clinic care network and the doctors and nurses that are seen their have access to mayo clinic information, digital tools the doctors and nurses can use every day. if they need additional assistance, they can call us. we can have telephone consultations or electronic video consultations.

if that does not work, perhaps 10% or 15% of the patients need additional face-to-face care and we are happy to see those patients. as you mentioned, there is an affiliate in the washington, d.c., area. host: dana, a few minutes left with our guest. caller: thank you for taking my call. i have a question. when i called to get my son into the mayo clinic and he has medicare and medi-cal, i was actually told that i would have to pay for the first consultation only with his medicare. an additional 640-something dollars. and when the doctor's talking about taking medicare, i wanted to know if there is any foundations or anything because he is very sick and i basically didn't get an answer that i

need a letter from his position and i can't get that because of the situation where he was -- after he had surgery. i really did want to bring him there, but with the additional cost because of medicare -- so i was wondering about his statement earlier regarding taking medicare and the additional costs were not mentioned. host: go ahead, dr. john noseworthy. guest: i'm sorry about your son's illness, it must be very tough for you and for him. obviously, i don't know the specifics of this unfortunate case, and there are some complexities in many of these cases, particularly from afar with complex illnesses. we have a staff that tries to sort that out to help our patients understand what the

expected costs would be. we don't charge over the medicare rate. that is not permitted, and we would never do that, so i am uncertain what that $600 was before. it may be something that medicare does not cover and there may have been something with the insurance. i'm sorry, i don't understand. it is unfortunate that your son's physician won't write a letter and share with you and with us what needs to be done. it sounds like he may have a retained foreign object from surgery or something of that nature. perhaps, off-line you could be in touch with us and we can see we can help you with that. host: gail in oxford, florida. you are on with dr. john noseworthy, head of the mayo clinic. caller: yes, thank you for taking my call. my husband grew up in rochester and he was born at the mayo clinic. we have a question.

we are now in florida, and we do come back to the mayo clinic. we were back last summer. but when we try and go to jacksonville, they will not take our insurance. we have blue cross blue shield medicare advantage. but when we come rochester, they do. so my question is, why do the different locations take insurance differently? host: thank you, ma'am. guest: that is exactly right. there are differences across the regions, and it is confusing to patients. we are going to fix that, gail. there are reasons for that are business reasons that relates to a number of, if you will accounting concerns that we have

found over the years. but it creates confusion for the patients and it just doesn't pass the face of test, and we are addressing that up. host: ron in florida. caller: good morning, dr. noseworthy. i've got to give props to dr. schaeffer, 2002. he fixed my heart, cardiomyopathy. that was up in rochester when i moved up in minnesota. that was where i was born and raised, moved to florida, and developed graves eye disease. i went over to jacksonville and they strained up my eyes and saved my eyesight. the real reason i called is i want you to explain all the research that is the follow-up. i get forms from the mayo clinic

to follow up on my diseases, and i think that is the big key that happens. once again, they saved my life. i am very grateful, and i do the v.a. now, and i got to tell you, they do the same kind of services, and i wish you guys could get tied together a little more because that would really help out the servicemen. once again, thank you. guest: thank you, ron. i appreciate your comments, and what you address is so important, that we get engaged in our health care and we follow up on things to make sure we are doing all we can to keep ourselves and our families healthy. thank you for your nice comments. host: comet in richmond, virginia. please go ahead. it helps if i push the button.

comet, you are on the line. caller: yes, i work for a hospital, and i have united health care and work at a hospital in richmond, virginia. when i was in an accident, i had to pay it united health care about 1000-some dollars out of my money because they told me that i had to pay back the money that they paid for the services that i received at another hospital, which i went to after the accident. so i dropped united healthcare and i went with hca because i am paying all this money out of my pocket for this insurance company to takethe needs for something like what happened. anytime i had to take money from a lawsuit and pay them back

money that they paid at the hospital, i thought that was insane. host: any comment for the caller? guest: i think that is another great example of how confusing the system is right now for our patients and our citizens. it is virtually certain as we go forward and build a sustainable health care system that all of us as citizens will be pay more out of pocket for our health care. it is terribly important that we build a system -- the nation builds a system that provides transparency and helps educate the public about the decisions they are making when they invest in their health care. buying an insurance product is a complex business transaction. what many americans are moving toward are the high deductible and low-cost health care plans that they can afford.

but they realize they can afford the insurance, but they can't afford the co-pay or the deductible that comes with it. so it is an awfully important life decision in terms of investing in your future. most of us won't get seriously ill each year, but ultimately, we all get ill and one needs to know what is covered, what's not cover, what if something catastrophic happens, where can i go for health care? right now, that system is in turmoil, as our caller articulated. host: dr. john noseworthy, do you see much impact from medical savings accounts? guest: i can't say that i see much impact on that, but if one is buying into a medical savings account, they have to actually put money in the medical savings account. as they say, i'm going to buy low-cost, high deductible health care plan, but i will save up in case i get really ill.

it requires the discipline to do that. host: nancy in raleigh, north carolina. you are the last call. caller: good morning, dr. john noseworthy. i have great respect for the mayo clinic and i come from a medical family. i wanted to address the question from the caller earlier about the $25 aspirin. my husband had major surgery, a knee replacement at a duke facility in 2008. i wondered if the same conditions would apply. i took all of his medication with me. the pharmacist could not give him what he needed. i asked the nurse, may i administer all medications to my husband? and she said you certainly may. that saved us over $800 because we did have charges that i took for line by line item and i took

responsibility for calling the hospital and assuring them that they never gave my husband any medication at all. they accepted this, and i just wondered, would this same condition apply at the mayo clinic or for any other person who was trying to save on a medical bills? guest: thank you for asking that question. we do not encourage our patients' families to give the medications to our patients in the hospital because of the concern of dosing and accuracy of the pills and so on to protect the patient's -- in terms of their safety. to be completely honest, there may be a better answer to that but i am not aware of it. i appreciate your concerns and your questions and your solution, but i don't really have a strong answer for that. i'm sorry. host: does the mayo clinic

operate emergency rooms? and how much do you have to write off in unreimbursed medical bills each year? guest: thank you. yes, we have emergency services and helicopter services and so on at our hospitals. the debt and charity care and unfunded cost from insurance companies and government pay is about $1.3 billion a year, total. host: out of revenues of $9.5 billion, or is that subtracted from the $9.5 billion? guest: no, that is out of that. host: dr. john noseworthy, president and ceo of the mayo clinic. we appreciate you coming on and talking to our viewers. you have done it on a regular basis over the years, and thank you very much.

>>," "washington journal" study about gun rights. then the executive director of the best discusses a system in the u.s.. a reporter will discuss president obama pot use of executive action. you can join the conversation on facebook and twitter. i've at 7:00 a.m. eastern on c-span. >> the white house correspondents association dinner is saturday with remarks from president obama and cecily strong. had a victim of the staff is busy preparing for the arrival of the president, the first lady, and more than 2600 guests.

we spoke with the hotel possible general -- hotel's general manager. >> our staff is 1000 team members in the hotel. we have about 50 greeters. we have three folks who do nothing but focus on tying bowties for people. you would not believe the number of people who do not know how to tie a bow tie. >> fairly often in the sa past several years -- >> our chef began 11 years ago. his first night working was for the dinner.

we broken in love. they also have a longest-serving team member who celebrated 50 years with the hotel. he served all 47 dinners. >> tell us about the menu. you said there is a process in choosing it. what is it this year? >> the menu is very unique every year. we are looking to source local ingredients within 150 miles of the hotel. we are interested in what is going to serve well for 2600 people in a ballroom, and on the time constraints and the schedule. it involves secret service timing, the show timing of the event. it is about what holds welcome move quickly on to the table and what will be fresh and hot in front of the guests. >> and the day of, how early does the kitchen staff start preparing? >> a day or so in advance.

there are some ingredients we're working on a few days in advance, stocks, that they are on-site about 4:00 a.m. beginning that final preparation process. >> the white house correspondents association dinner saturday night at the washington hilton. coverage begins at 6:00 p.m. eastern, live on c-span. sunday on c-span, sherrod brown talks about regulating wall street and also why he opposes fast track trade promotion authority paid senator brown is our guest on "newsmakers" sunday at 10:00 a.m. and 6:00 p.m. eastern. >> in 2003, judith miller wrote stories. vice president's cheney's chief

of staff. sunday, she talks about her time in jail as well as her new book, "the story." >> i was in jail because i refused to reveal the identity of a source whom i thought the not want his identity revealed. in our business, as you know, protecting sources is the lifeblood of independent journalism. and i really felt that the people that i routinely spoke to who had access to classified information, unless they could trust me to protect them, my sources would dry up, and eventually i would just be writing -- so i felt this was a question of principle that i did not have much choice. >> sunday night at 8:00 p.m. >> next, today's white house

reading. most of the questions focused on the counterterrorism operation that killed hostages in the afghanistan-pakistan border region. mr. earnest: ok, good. yeah. molding young minds as we speak. what i'm trying to say here. let's go straight to your questions. >> i wanted to ask you about the hostage policy review ongoing. can you talk more about the scope. is this focus on improving to medications with the families? mr. earnest: that is the principal focus, is to examine the manner in which the federal government interacts with and committee gates with the

families of those who are being held hostage around the world. the reason this is a particular challenge is that there are a large number of federal government agencies that are actively working to try to rescue our citizens be who are being held hostages. that means you have certain limits of the intelligence community, state, defense department, a range of law enforcement organizations, and the white house are typically involved in these efforts and are involved in the communications. and making sure that that communication is streamlined and integrated to provide information as regularly and clearly as possible to these families. it is particularly important because these families are in a terrible situation. unthinkable to imagine what it would be like to have a loved one being held against their will by a terrorist organization. so there is a premium on clear

direct specific regular, reliable communication with these families, and that can be difficult when you have a wide range of agencies involved in those conversations. the effort is to streamline communications to make the communication is more effective and sensitive to the needs of the families. >> is there a call for a hostage czar to do some streamlining come is that under consideration? mr. earnest: there is, and one of the proposals is the creation of a -- a fusion cell, a working level group of federal employees that would enable a whole of government response to overseas hostage event's. this usually sell would incorporate elements of the fbi defense, state, intelligence community, all of them are

involved in the mission to rescue american citizens who are being held hostage. this is one of the proposals on the table. as you know, throughout this process, the administration has been committed to incorporating the viewpoint of families that have been unfortunately involved in this process. and so we are interested -- we have on the front end solicited input from families of those who have been held hostage, and we are seeking reaction from his family's to this specific proposal. but as soon as we have more information terms of final recommendations, we will let you know. >> are there any other considerations at this point? >> i have no information beyond what is shared. >> i know about this review going over the u.s. government policy, does it include review of the policy toward -- mr. earnest: i will have to check on that.

the policy that is advanced by the u.s. government is a policy that does -- that prohibits offering concessions to terrorist organizations. as i mentioned yesterday, this is a painful policy, particularly when if you are -- if you have a family member held overseas and the notion that by offering a concession or a payment at that could result in the release of your loved one that seems like a rather attractive option. unfortunately, this is a policy in place because considering options like that, being ransom to a terrorist organization, may result in the saving of one innocent life, but could put countless other innocent lives a greater risk and that is the reason for this specific policy or one reason for this specific policy, as painful as it is. >> who is running it?

is it lisa monaco? can you say about when it will be ready? mr. earnest: i do not know who the point person is. the white house is heavily involved, and lisa monaco is intimately involved in this process. i didn't know if she would describe herself as the point person. she is someone who is intimately involved in it. i'm not aware of any impending announcements at the conclusion of this process. i would anticipate we would see some more information about the conclusion of this review soon. ok, roberta. >> can you explain more about how this fusion cell would differ from the current situation where you have people from all these different agencies working on a problem? mr. earnest: the concern is you have representatives of these agencies who are involved in this effort and the idea behind the creation of a fusion cell is

that would ensure those efforts are closely integrated, both in terms of the steps taken by the agencies to secure their return of the hostage, but as it relates to the communication with the families of hostages. that is what the fusion cell is designed to achieve, to optimize the integration of the efforts to seek the rest of the hostage but also to streamline communication with a hostage's family. >> the efforts to rescue the hostages are not integrated right now? mr. earnest: roberta, the observation is that there are always improvements that can be made in that process and this review reflects that. >> yesterday you talked about a review of the operation. which is doing that review? mr. earnest: i do not have

additional information about review other than to tell you it is being conducted by the relevant inspector general. >> can you tell us who that is? mr. earnest: i cannot. >> the other internal review can you talk about the parameters for that. is it a review of the operation specifically, or is it broader than that, and review of the initial strike policy? mr. earnest: the review will be focused -- and this is something already underway -- focused on this specific operation, and understanding what led to the tragic unintended consequences of this operation, which is the death of an incentive american hostage -- innocent american hostage. in the hope is that there may be some improvements to the policies of particles -- protocols that could be implemented as a result of what was learned from this incident. >> last year, the

recommendations from the task force on you as drone policy and one one of the recommendations was that responsibility for strikes transfers from the cia to the military. can you tell us whether that was considered at all or is being considered? does the administration ever look at that? mr. earnest: the president alluded to these kinds of policy questions in his national defense diversity speech in 2013. and the department of defense does have some unique capabilities that they use in a variety of areas to protect the american people. for example, it is the routine of the department of defense on

a daily basis, now, i believe put out information about operations that the department has carried out against isil in iraq and syria. it is not uncommon for those notifications to include references to strikes that were taken by u.s. department of defense unmanned aerial vehicles or drums. -- drones. that is an example about how the department of defense has worked to implement a policy that offers greater insight into transparency -- and transparency into our efforts, including against extremist organizations. ok john. >> to follow up on the subject of the drone strike that killed the hostages, i asked yesterday

if they were is any regret, you said no. hewas killing the hostages and accident -- an accident? >> the word accident leaves one with a connotation that the consequences of the action were negative. as i mentioned yesterday these two individuals were al qaeda leaders. they were playing an influential role in an organization that was planning against the united states. they were frequenting a compound that had been identified based on extensive intelligence as an al qaeda compound, and strikes were taken that operations were conducted that took them off the battlefield. and as a result, that has improved the safety and security of the american people. >> so it was not an accident? mr. earnest: for that reason i would not use that word to describe what occurred.

>> it was also not intentional? mr. earnest: again, i mature that is accurate either because as we were talking about -- >> these strikes were intended to kill adam? mr. earnest: the operation against the compound was carried out with the intent to take off the battlefield al qaeda leaders that frequented the compound. that was the intent of the operation, and in that respect the operation fulfilled its mission. now, in one respect, there was a tragic unintended consequence which is that the operation also resulted in the death of an incentive american hostage -- innocent american hostage. that was unintentional and that was annexed sentiment the death of this innocent american hostage. >> would targeting the individuals explicitly been lea

gal? mr. earnest: there is a specific legal process in terms of policy being made to specifically target a u.s. citizen. this is a process that was put in place around the decision to target and morewar al awlaki. he had important operational response abilities at a qqap and it was a decision to take him off the battlefield. there is a separate process for doing that before making that decision to target an american citizen. that was not done in the case of these individuals, because they were not identified as high-value targets. however, there is ample evidence to indicate they were al qaeda

leaders. the fact they were frequenting what had been identified as an al qaeda compound is the reason that they were claimed in this operation. >> does that mean it would have been illegal to intentionally target them because if you had not gone through that process -- it is hard as he how either one of them would have met the threshold the administration set out with targeting an american citizen? mr. earnest: that is a question i cannot render just you -- judgment on. i'm not familiar with the details how a process like that would be carried out. it is hard for me to render judgment one way or the other. we have tried to be very clear about -- about what led to the death of these two individuals which is they were not specifically targeted, but there is no question that they were previously identified as al qaeda leaders and they were individuals who were killed in thean operation against an

al qaeda,. >> the president indicated there would be a movement to take the drone program out of the cia and put it in the hands of the pentagon, as part of the process to make it more transparent. what is the status of that? mr. earnest: well, let me start by stipulating you're asking a question about a reported -- purported cia activity that i am not in a position to comment on. >> at least well-kept secrets -- mr. earnest: not that i am prepared to confirm. i want to get tothat out of the way. what the president also made clear in the speech was that the

afghanistan-pakistan region is one that is unique from other regions where the department of defense is carrying out counterterrorism strikes that includes the use of drones. this region is previously home to a large number of core al qaeda leaders. they have been decimated, but there are still a number of dangerous core al qaeda leaders that are hiding, friendly, in this region of the world -- frankly, in this region of the world. by hiding there, they pose a unique threat to american military personnel that are currently stationed in afghanistan. there are about 10,000 u.s. military personnel in afghanistan right now, and there is a special need to ensure that data to try to ensure their safety. it means and this is something

the president acknowledged in the speech, it means that there is -- there are some different rules that apply to our ongoing efforts, a difference have the of policies and procedures that apply to our counterterrorism efforts in that region of the world as opposed to other regions of the world where extremists are operating. >> ok. we will come back to that at some point. a quick follow up on the others, the issue of donations to the clinton foundation. we now know that there were some $2 million in donations that came from uranium 1 to the clinton foundation that were not disclosed at the time. can you acknowledgment these that did not meet up to the standards that were expected aced on the memorandum -- based on the memorandum of understanding? mr. earnest: in terms of compliance of the memorandum, i will refer you to the state department or the secretary's team. >> you made it clear at the time

that the donations were going to be made public. this was not a promise that hillary clinton made off to the site. this was an agreement she had with the white house, the president. we now know $2 million in a day nations -- in donations from uranium 1 even aside from the approval of the transaction, the fact that you had such a large donation group of donations coming in, that were not disclosed, does that not concern the white house of dolls, that that meant -- white house at all, that that does not live up to the standards? mr. earnest: what is clear, and this is noted in the story today, there's no proof whatsoever no evidence to indicate the donations have any impact on this particular policy decision. >> and what about the fact that the donations were not public be disclosed? mr. earnest:mr. earnest: i've been

in a position where there have been conservative authors who have written books based on what they purport to be serious allegations against the president of the united states. i'm often in a position of responding to those incidents and trying to defend the president from accusations that are not rooted or accompanied by evidence. my point is right now that is what is happening to secretary clinton, and there is a spokesperson she has hired that can answer these questions. reporter: i'm not asking if she sold favors from the state department. i'm just asking about whether these should have been disclosed. i'm asking about disclosure. mr. earnest: right, and that is something secretary clinton's team can talk about. is how they handle this but together incident. reporter: i asked yesterday, you said you would go back and check on this question of the approval