i am struck -- guantanamo bay cuba? and, i am struck by the attack in afghanistan, the chaotic scene in the capital. the "new york times" describes that as revealing a wellspring of anti-american sentiment. secretary carter: with respect to the guantanamo bay naval station in cuba -- general dempsey: i do not perceive a wellspring of anti-american sentiment in afghanistan. at times and places where the taliban reemerge, for periods of time take back control, there's always the notion that somehow we could have prevented that. i think all of us in uniform all of the secretaries with whom i have worked, have always pointed out that afghanistan's future will be one of conflict for some time until they

the key is that the central government can maintain control. if the central government falls, it has to be recaptured. >> i have a question about iran, and military strategy supporting national goals. the media has been a frenzy of stories lately about plan b, if talks fail with iran, bombing their nuclear facilities. the narrative is this is a wonder weapon that can destroy if we need to. predecessors have said since 2009 -- the best you can do is delay from one to three years. you said on cnn a couple months ago that we could set back destroy iran's nuclear program. give us a reality check.

what is the current thinking about the utility of the military strikes, delayed for several years, or do we now have the capability to do a lot more damage? secretary carter: the basic facts have not changed. we continue to have the tools to do that and continue to maintain the military option, because the president has instructed us to because his determination is that iran not have a nuclear weapon and secretary is working on this right now, looking to get a deal -- a no deal is better than a good deal. therefore we are under instructions and have been for years to do that, and the facts are, namely it has set back an iranian nuclear program. obviously anything like that can

be reconstituted over time. a military strike of that kind is a setback, but it does not prevent the reconstitution over time. that basically has been the case as long as we have had those instruments and those plans. chair dempsey: the assumption sounds like it is that we would only do that once. the military option isn't use once and set aside. it remains in place. we will always have military options. >> we only have time for one more. we are coming up on fourth of july. the department of homeland security has warned americans to be especially alert this fourth of july for a possible threat from isis.

do either of you believe that isis is actually become more of a threat to the american homeland now, if not kinetically, psychologically, to america than al qaeda ever could be? and why can't the u.s. seem to be able to combat the kind of social media campaign that isis has managed to spread worldwide? secretary carter: we are always vigilant at holiday time, always vigilant as an institution about protecting our people, and isil is another reason and i'm sure homeland security has indicated for vigilance. it does have to do with the social media angle jim that you spoke to. what that suggests is that the

era of social media and phenomenon like isil, unlike al qaeda of the old days, there doesn't have to be and will necessarily be a command-and-control relationship between somebody who instigates and isil as an organization. they are self radicalized, self organized people on social media. are we concerned about that? absolutely. that has been seen in europe. that is a sign in the united states as in europe that we have to be concerned about it and we obviously are. >> quick follow up. >> do either of you deal as those responsible for the u.s. military in regard to the isis campaign and potential threats do you ever feel that you are powerless or defenseless against that kind of insidious threat?

secretary carter: i will say one thing about that. we are not powerless. the only thing i would say that is one of the so-called lines of effort in the strategy against isil. it just happens not to be the responsibility of the department of defense. it is an intelligence community and homeland security and law-enforcement mission which they take very persistently. the warning that you indicated shows they are doing that at this holiday time for america. chair dempsey: this also coincides with from a done. -- ramadan. we are not powerless. the very things that threaten -- we are a significant threat to isil because everything we believe in is completely opposite of what they believe in , every bit of freedom, diversity, civic and religious

freedoms, is exactly opposite to what they espouse. we will keep pressure on them and they will eventually collapse under the weight of their own contradictions with a little help from coalition partners, partners and stakeholders in the region and military power. secretary carter: with a little reminder of why we celebrate the fourth of july in the first place, happy fourth of july to all of you. thank you. >> defense secretary ash carter announcing at the beginning of the briefing that he's going to recommend that lieutenant general robert kneller be named the next commandant of the marine corps. as his general joseph dunford, the current commandant is being named to replace chairman of the joint chiefs general martin dempsey as the next chair of the joint chiefs. coming up in about 20 minutes we will take you live to nashville. president obama is headed there.

he will be talking about health care today. our live coverage getting underway at 2:30 eastern. until then, some conversation on today's "washington journal" on the tax plans being offered by presidential contenders. host: his advice has been much in demand by republican leaders, especially those seeking the 2016 nomination. nomination. we want to start with your recent piece in the "national review," where you write that president reagan's tax plans have been wrestled as the campaigns get under, even by some republicans. guest: good to be with you john. and thanks to c-span. well, you are right, his tax plans that were put into place in the 1980's -- hillary calls it the federal trickle-down

economics, that also some on the right are wondering what was it that ronald reagan really wanted to do in terms of changing taxes? it is my believe, two things, first of all, when ronald reagan entered office, the highest income tax rate was 70%. that is very high tax rate. for every additional dollar you earn $.70 by definition with the government and you only got to keep $.30. people like jack cap and the "wall street journal" editorial board -- people want investing and people will working less because taxes were so high. when reagan left office, the highest rate went down 28%. over that time, the share of taxes paid by the rich actually increased. so this goes by the way of john f. kennedy who said if you are more revenue, cut the tax rates, don't raise them. and i just had to clarify that.

he also believed that by cutting tax rates, you could make the economy grow faster. obviously, that happened big-time in the 1980's. host: what would be your advice to republican candidates when the democrats say republicans are too focused on cutting taxes for the wealthiest americans? guest: that is the charge, so that is the charge they will make over and over again. let's talk about who will the americans are. those are people who own and operate and invest in small businesses. if you want jobs in this country, you need small businesses. and if you put more money into those businesses, it is pretty self-evident that businesses will be able to hire more workers. i think republicans have to connect those dots that this isn't about giving warren buffett more money, it is about helping small businesses keep more of their own money so they can invest more in equipment and hire more workers.

i think that is the case the republicans have to make. you look throughout history the 1920's when tax rates were cut, the economy boomed. i mentioned kennedy in the 1960's. that was a huge, huge boom to the economy in the 1960's. aunt i would even tell hillary clinton that your husband, or he would -- was president, he cut taxes, too. so i think the history is on the side of those who cut taxes. i don't think anybody is saying -- we have to address also to help with this failing economy you have to this is the spec is the economy, was the system monetary policies, and all these with something to the effect is our one big component. host: and if our viewers want to join in on the conversation, phone lines are open.

we are (202) 748-8000 for talking a democrat -- we are (202) 748-8000 for talking with you more. -- you have a formal role with any of the campaigns right now? guest: so, i have been working the last year informally, not on his payroll or anything, what with rand paul. he is just a fascinating political figure in a think you'll make a big market this race. the kind of libertarian wing of the republican party, which is what he percent to 25% of the republican electorate. and we put this plan together, we call it the flat and fair tax because it has a flat income tax of 14%. after you make $50,000 of income. your first $50,000 would be tax-free. then on the business side, it is

sort of a consumption tax. this would pay essentially a 14.5% consumption tax. and we think this would be rocket fuel for the economy. host: let's let rand paul introduce his own plan. here's a video he put out about the fair and hot taxpayer. [video clip] >> a tax cut for every single american, and the guy with the most lawyers and accountants doesn't matter. you do. my plan will cut taxes for everyone. it will end corporate welfare and special tax breaks. it will create jobs and it will get the irs out of your life. it is the first part of my plan to defeat the washington machine. this will shake up washington and wall street, no doubt, but i'm not running for their approval. i am running to take our government back. with this plan, it starts today. host: just part of the video of rand paul introducing his fair

and flat tax plan. steve moore helped, but that plan. before we get the calls, just some response that has come up about the fair and flat tax plan. dean clancy writes, among the issues that he has with the fair and flat tax plan is that the plan preserves a surprising array of the post and exemptions, including charitable deductions, child credit, the earned income credit, and the tax exclusion for workplace health benefits. retaining these may seem politically prudent, but is also destroys the plan's simplicity. guest: look, there are thousands of loopholes in the tax system. and we do preserve about four or five of them. and i did want to keep in and income tax credit for low income people who are working. the same thing with charitable. if people make contributions to a charity, the senator believes

that to be something that is allowed. but everything else, all of the other thousands of loopholes are gotten rid of. that, by the way, i think is one of the big attractions of this. you just played that tape of senator paul. i think the way to sell this plan to america is to say, look, all the special interest provisions, they were put into effect because of lobbyists because of who has the most political muscle in washington. now we have a tax system that is a disgrace. it does not work for america. some businesses pay nothing some businesses have to pay 35%. if you want to take power away from washington and restore power to mainstream america take away the power of the structure, which is the tax system. host: let's bring our viewers in. deborah is up first, the line for democrats. caller: good morning. hi.

i am calling just because i have been a tax lawyer for four years. doing namely estate planning. i have worked for dozens of wealthy people, many small business owners, and i never met one of them that got up in the morning and work any less hard because the tax rates were up the tax rates are down, or more hard. the taxes were just not a factor. they are motivated by other things and, in fact, one of them told me he would like democrats to be an office because at least he made money under democrats. he didn't mind paying taxes if he was making money, but he would prefer to make money. i think the motivation is, can you sell your products? guest: taxes matter, too obviously, so if you are texting somebody at 60% or 70%, what happens is because of all these loopholes, as you know, you have been a tax lawyer, you essentially shift resources and

investment from the kind of marketplace to what the government is hoping you invest in. we have the most amazingly ridiculous things in the tax code. you can get tax cuts for investing in wind mills and things like that. get rid of that. get rid of all the loopholes and make it really simple. cut those rates down as low as possible. by the way, the estate tax is one of the most evil taxes of all because people have worked their whole life, people like my father who is 92-year-old -- 92 years old but now the government is going to come along and take half of that away from him when he dies? and not allow that to be passed on to his children. so there are all sorts of -- and by the way, rand paul pot tax system -- rand paul's tax system would get rid of the double taxation. host: the line for republicans

new hampshire, kyle is waiting. good morning. caller: good morning. my question is -- back in the 1950's when the high rate was 91%, we had the biggest economic expansion. and because of the high rate, it's made more sense to reinvest your money back into the business and have the government subsidize 91% of it. and it made more sense because they were more inclined to pay their help more money because it was tax deductible and they would rather give it to the help than the government. so why shouldn't we go back to a high rate? and if you look at how much the corporate people pay in taxes, they paid 700, while working people on income tax paid $1.2 trillion. plus social security paid another $1 trillion. guest: just one point of interest is that under the rand

paul affect, there is no payroll tax. the payroll tax is eliminated. when you ask about the issue of fairness, working-class people get a huge tax break under his plan because let's say you make $40,000 of income, you are going to get a $3000 tax cuts on the payroll. i don't think anyone really thinks that we should go back to a 90% tax rate, although bernie sanders may think that. if we had a 90% tax rate, the investment capital of this country would flee out of the united states and it would go to other places. the last two callers have sort of suggested that it doesn't matter, and the reason i think that is wrong is look at what has happened with our corporate taxes. we have the highest corporate tax of anybody that we compete within the world. what is happening is companies like good king and met tronics and other major fortune -- med

tronics and other major fortune 500 companies are moving to other countries. under this plan, we reverse that. one of the things that people who are concerned about the slow economy and unemployment should find very attractive about this plan is if we put into place a 14.5% flat tax, could you imagine how much capital -- we would just soak up capital from all over the world. they would locate in the united states. that means jobs for americans. in other words, this is a tax plan that will in swiss jobs to the united states, rather than what we have done in the last 50 years. host: we are talking with steve moore, a visiting fellow. he is also the subject of this piece from earlier this year -- the ruling of a washington wonk. behind the scenes, every presidential candidate is fighting over a small pool of advisors.

he is here taking your calls. julian is waiting in massachusetts. the line for independents. good morning. caller: good morning. given the rather heavy concentration of wealth at the moment in the top 1% of the population and also given that george h.w. bush, a well-known republican president acknowledges the pragmatic decision why is it part of the republican platform right now to lower taxes? guest: well, you mentioned george h w bush. he did raise taxes and that is why he lost the election in 1992. not very advisable to raise taxes if you want tuesday in power. that event changed history i think in a way that was very negative for the republicans. the economic point is this. we are -- this is a global economy. we just saw this trade deal past

-- pass. we have to compete against every country in the world. if you want to do that, we need a world-class tech system that creates jobs for americans. i don't think there's anyone on the planet that would look at our tax system today and all the loopholes and the incredible power of the lobbyists and say this is a really good tax system. no, we should bring it up, start over, and create something really simple that great jobs for americans. host: truth to power wants to talk history. reagan raised taxes many times. i know, i paid them. guest: he did three or four times, but overall, the taxes were lower. when reagan came in, the first thing he did was that income taxes 25% to 35% across the board. and then we reformed the entire tax system. got the tax rate down to 50% and 28%. by the way i would say that

that 1986 tax act, which cut the top tax rate to 20%, you will not believe this, but it is true , that passed 97-3 in the united states senate. so there was a very star consensus. even people like bill bradley said, yeah, we have to do this. the one thing that concerns me is the democrats don't team to be interested in this issue anymore. they don't seem to want to fix the tax system. they just want to keep raising rates, which i think would be very negative for the country. host: you say we, talking about president reagan, research director on privatization has held several different roles including how to president -- including founder and president. caller: out of a --

caller: morning on the that taxes are complicated. i have been looking at them since 1975. and so often, they change from year to year. which does make it difficult. i know that some people are talking about flat taxes. maybe that might help. and or the loopholes, but a taxes attacks. if it is taxed, then people will understand that this is attacks. so in general, people will pay that tax. but time to do change. what my real question is this. why don't we start thinking about tax system compared to health care? if we distribute the health care of the entire company, for

example if those 34 governors would take on the health care, that will level out the health care system. also, it would grow companies because of companies have employers that they can hire, the companies can grow. host: steve moore, on the health care system. guest: it is a great question because the health care system in united states has sort of revolved around the tax code. and what you are going to be hearing about the latest of this particular topic of rand paul's flat tax, but as we think about alternatives to obamacare, then what do we -- -- what do we -- what we put in place of obamacare? and without legacy is a system where whether you are individual tax father or an employee, you get a tax break to buy health

insurance. that way, people wouldn't have to get health insurance themselves. if you buy this to the employer, it is tax deductible. so there are also to problems. but we keep changing the tech system every year. it is exactly right. that is exec or what is wrong. there was something like 500 different changes in the tax code in the last five or six years. congress keeps tinkering with this. if you put in place something like the flat tax, it is done it is over. we don't have to tinker with it anymore. you don't put -- hopefully, i'm being hopeful here, but we have a system that can stay in place for 20 or 30 years. nobody would want to be on the ways and means committee because there is nothing to buy or sell. why do you think so many of these members of congress want to be on the tax writing committee? the cousin that is -- the -- -- because that is how they get

lobbyists. host: good morning, mike. caller: good morning. i want to put a couple things out that i think the gentleman is living out and i think a rather important. one of them is that every time a president presided over the reduction of tax rates, not only did it left the country out of a recession, but it also created money for the treasury. it is kind of counterintuitive, but cutting tax rates creates so much more economic activity because the investing class is willing to put capital at risk of loss in business ventures to a much greater extent. and what creates jobs really is the fact that people are willing to put their money at a risk of loss and ventures. when more businesses are being either bolstered or founded

because people are willing to put their money at risk of loss because they think that when they succeed, they are going to keep more of what the investment pays them back, you can only expands the economy. the second thing i want to point out -- i remember the articles that were written during the 1990's when the tax rates have been cut -- excuse me, during the bush administration when the tax rates have been cut and the experts were writing in places like the "new york times" how surprised they were an astounded that the rich were paying more taxes than ever before because the tax rates had been lowered. they couldn't understand it. host: steve moore, i will let you jump in. guest: that is the point of my "national review" article. every time tax rates have come down, we have actually gotten more growth in the economy. and as this gentleman points out, the share of taxes paid by

the rich has actually increased. john f. kennedy said this very eloquently. he said this in, i think, late in 1962 that it is a paradoxical truth that when tax rates are too high, tax revenues are too low. he said the surest winter raise the revenues for the treasury is to cut the tax rates now. that is absolutely true. it is 250 years ago and it is still true today. when the top tax rate was 70% in this country in 1980, the richest 1% pay 90%. when the tax rate was cut to 20%, the richest 1%. almost 30%. today, they pay almost 40%. when you have 1% of the population paying 40% of the income tax, that is a pretty progressive tax system. but i believe they pay almost more under this type of flat text we are talking about.

host: and as you point viewers to that july addition, -- if our viewers want to read the full piece there. lansing, michigan, the line for democrats. good morning. caller: good morning. we at talk? good morning. thank you for letting me speak on your program. i heard you state that talking point, the republican talking point earlier that republicans are committed to the improvement of conditions that will benefit small businesses. if there is such a love for small businesses over corporations, why is it that subsidies are available to corporations but not too small businesses. bailouts are available to corporations but not small businesses. no big contracts are available to small businesses. grants to cover mergers are available to corporations, but

not small businesses. corporations are getting the title, job providers. host: we got your point. guest: i think he is exactly right. i work with rand paul and another faction to eliminate corporate welfare. you're going to have to look at rand paul very closely. he wants to eliminate all the special interest favors and all the programs that benefit corporations and not small businesses. we need to create an equal playing field. a good example is the program called the export import plan. the big fortune 500 companies -- here is the interesting things. republicans want to get rid of

that corporate welfare program. republicans and democrats near to go after corporate welfare. we could save $100 billion a year. we have to give corporate america half the dole. i am 100% with you. we did have been bailouts of insurance companies and banks and i think it was a big mistake. host: you mention the export income bank expiration, we will be talking about that in our next segment. we will be talking about that with a washington post reporter. read is waiting in the union washington. caller: good morning. thank you c-span. i will have a quick couple of comments. i am a libertarian like you are. every time you're on air, i agree with you. i wish the media would explain this, and rand paul would win

the election if they did because i am for that. to point out the circle that crosses over between liberals and republicans. i wanted to touch on that. if he could get that point across, to show liberals on the left, like the michigan caller who i agree with that 100%. it needs to be emphasized. i like to say that people need to understand that if you reduce corporate tax to almost nothing corporations in america would have a choice. for every two dollars that are produced, one dollar has to go to wages. if they could reduce corporate tax to nothing, the government would realize that the payroll taxes that is offset from that money it would be realized in payroll taxes. it would be produced organically.

organically, corporations would have to pay more for every worker. that is my comment. guest: i think that is right. one of the things that is attractive about rand paul is that he is, i am a republican, i want to see the robins win in 2016, rand paul appeals to a base that public's don't normally win. >> we will break away here and take you live to tennessee where president obama is speaking this afternoon about health care. he is in madison, tennessee just north of nashville. [applause] >> in september of 2011, i was diagnosed with breast cancer. through the graciousness of my employer and the benefits they

provided, i made a full recovery and return to work. two years later i decided to make a career shift. before my benefits ran out, i went for a routine checkup and the mammogram found that the cancer had returned. we were shocked by this development. the second time around meant average treatment regimen and major surgery which would have made it impossible for me to work full-time. with the help of healthcare.gov and the affordable care act, i was able to find high quality assurance -- insurance i could afford. it is a comfort to me and my family knowing i can concentrate on getting better and not afraid of losing everything in the process. as health care professionals you know the when one person in a family is sick, it affects the whole family and community. i would like to take this moment to thank our congressman jim cooper, who worked so hard to get this wonderful bill passed. my clinical payment my two best friends and surrogate sisters,

megan and suzanne, my mg who supported me from afar, my parents, richard, kathy, my brother ricky, my wonderful friend taylor, and especially in most importantly, the love of my life and my partner, jason, who fought right beside me and made sure he was always there when i needed him and was never alone. seven months ago, i wrote a letter to the president to thank him. i never imagined in my wildest dreams that anyone would read it, let alone him. i living proof of a president who listens and cares about the american people -- [applause] and i am truly, truly honored to welcome him here to our great

city of tennessee -- nashville, tennessee. ladies and gentlemen, barack obama. [applause] president obama: hello everybody. everyone have a seat. it's good to be back in nashville. i like nashville. i come back here quite a bit. first of all, can everybody give kelly a big round of applause? [applause] in addition to being a wonderful and somewhat feisty spirit, as i've learned, she also has the distinction of possibly being the first person ever to be

picked up at her house by presidential motorcade. which i thought was pretty cool. it turned out it was so close to the school, we said we might as well swing by and get her. i want to thank the school for hosting us here today because i know it's a lot of work when we come into town, very much appreciate everybody who was involved in that. you have a great mayor who is here third. -- here. please give him a round of applause. [applause] with his wonderful family right there. family stand up. there's his family. [applause] you can't imagine what a family has to put up with when you are in public service. we really appreciate all of them. kelly already mentioned them, but somebody is what you want out of a member of congress.

he works hard, he calls it like he sees it, he's willing to do courageous stuff even when it's not popular, he is a gentleman one of my favorite people, jim cooper. [applause] also here is somebody who knows health care well, was a health care professional, a doctor, and executive, and knows a little bit about politics. when i first came in, he and i had a chance to work together on a number of things. you has been a terrific advocate on behalf of health care for a lot of people. -- he has been a terrific advocate on behalf of health care for a lot of people. [applause] with that, i think i will take off my jacket and get a little more relaxed here. part of the reason we came to tennessee, in addition to me

just liking nashville and liking the state generally is that tennessee has a history of innovation when he comes to health care. doing some very creative stuff health care professionals, doctors, nurses, hospitals, and executives are working alongside nonprofits and public sector to make sure that people are getting the very best health care they can, and also being able to control costs in a sensible way. ethics to the affordable care act and the efforts of people like jim who took some very tough votes, we now have about 166,000 tennesseeans to have health care, folks like kelly. [applause] in addition to the people who are able to buy health insurance through the exchanges, through

the marketplace is a were set up through the affordable care act i think it's important to remember that everybody who has health insurance benefited and continues to benefit from this law, even though a lot of folks don't know it. if you have health insurance through the job, you are able to keep your child on health insurance up until they are 26 years old because of this law. that has provided millions of young people across the country with health insurance who may not have had it before and that is especially important as young people are transitioning getting their first job. the may not always get a job that has full benefits. this way they're able to make sure they stay healthy. if you are a senior citizen, or somebody who is disabled, it turns out that you are getting discounts on your prescription drugs that you may not have noticed, but are saving you

potentially hundreds or even thousands of dollars, and there are millions of people across the country who are benefiting. that is because of this law. if you don't fall into those categories and you are just somebody who has health insurance on the job you now are protected so that let's say if you lost that job or decided to move to a job or start your own business, you can't be prohibited from getting health insurance because of a pre-existing condition. that is a protection that everyone is benefiting from as a consequence of this law. [applause] if you are a woman, you can't be charged just for being a woman as a consequence of this law. [applause] the last i checked, that is over half of the population, so that is a pretty large constituency. you are able to get free preventive care, including

mammograms, as a consequence of this law, on your insurance. there are a whole host of things that fall under the affordable care act that are benefiting 150 million people. they just may not be aware of it. what it has done is made health care stronger, more secure, and more reliable in america. we don't always notice that until you need it, the way kelly needed it. that piece of mind, that understanding that if you get sick, you are not going to lose your house, you are not going to lose all your savings, but you will be able to get quality care. that is extraordinarily important. i have said before that the scariest day of my life was when sasha was three years old -- three months old, my daughter and she got meningitis.

the only reason we knew is because we had a great primary care physician. we were able to rush to an emergency room. the doctors and nurses that extraordinary work -- did extraordinary work. i was feeling helpless, but i thought, what would happen if i was in the same situation i did not have health care and i did not have a primary physician to call in the middle of the night because we noticed she was not crying the same way she usually cries? because of the law we passed there are parents who just are not going to have to face that. that is priceless. the good news is that contrary to some of the expectations, not only has the law worked better than we expected, not only are 16 million people getting health insurance who have not had it before not only do we now have the lowest uninsured rate since we started tracking people and how much health insurance they had, but it has ended up costing

less than people expected. health care costs have been held -- the inflation on health care costs have actually proved to be the lowest since the affordable care act passed in the last 50 years. we are seeing less health care inflation and part of the reason is because the law also encouraged health care providers and doctors, nurses, hospitals to start thinking more creatively about how can we get a better bang for our health care dollar. how can we make sure that rather than spending a lot of money on unnecessary tests or readmissions or encouraging really high-quality care that is good for the patient but also good for health care spending. this is another area where tennessee has been really innovative. it won a $65 million grant for

state innovation, where you have got hospitals and doctors and nurses and on for profits and other groups working together to figure out how can we identify potential diabetes patients early, make sure they are getting healthy quicker preventing some of the worst elements of it, and even though it might involve little extra spending on the front end, it turns out it saves hundreds of thousands of dollars on the backend. improves quality of life improves quality of care, cuts costs, which is good for our economy, good for patients, and good for america. i'm feeling pretty good about how health care is going. [applause] the thing i have never lost sight of is that this is about

people. this is not about politics, not about washington. it's about families and loved ones, and the struggle and the fear that comes about when you have a serious unless i knowing you have got not just your own family, but a community that has your back. you heard kelly talk about her story, sitting right next to kelly is a wonderful person who came down with me today. she is from ohio. she wrote a letter to me pretty similar to kelly's back five years ago, back in 2010, when we were still in the middle of this fight to try to get health care that is affordable for everybody. had been diagnosed with cancer had bea itt it back, was buying

health care on the market, and the costs were skyrocketing and she could not afford it anymore. she wrote to me a passionate letter about why we need to get those done. i would always refer back to her letter whenever things got a little bleak, and congress was not behaving as sensibly as jim cooper behaves. when we finally signed that bill i had the letter framed with the pen i signed the bill with just to remind me that this wasn't about politics, this was about people. i'm so glad that all of you are here. part of what i'm hoping is that with a supreme court case now behind us, what we can do is -- [applause]

i'm hoping what we can do is now focus on how we can make it even better. it's not as if we have solved all the problems in our health care system. america still spends more on health care than any other advanced nation, and our outcomes are not particularly better. we know there's still a lot of waste in the system. we know the quality of care isn't always where he needs to be. and so my hope is that on a bipartisan basis, in places like tennessee but all across the country, we can now focus on what have we learned, what's working, what's not working. are there further improvements we can make to improve quality are there more ways we can encourage people to get preventive care so they don't get sick in the first place, so we have a health care system instead of a disease care system. are there ways we can do better to provide the support we need for outstanding primary care physicians and nurses who

oftentimes are coming out of school loaded up with debt and are not always given the support they need and are not always able to practice the way they want to practice. there is huge areas of improvement, and there's still a lot of people who aren't insured. part of the design of the affordable care act was that some people are going to buy health care on the marketplace in some cases we were going to allow states to expand their coverage through individualized programs in their states. because of politics, not all states had taken advantage of the options that are out there. our hope is that more of them do. we still had to sign a bunch of people up. we have covered about 1/3 of the people who were not covered before this law passed, but that means there are still 2/3 out there who are going to the emergency room at the last minute when something goes wrong. we want to educate people, we want to listen to folks we want

to hear good ideas from all sources, we want to think about this in a practical american way instead of a partisan, political way. if we do that, i think they're still great strides to be made. i want to thank all of you for being here. with that, i'm going to open it up for question straight you can ask me about anything, but probably you should ask me a couple questions about health care. i'm also willing to talk about the women's soccer team and how we're going to be whoever it is we're playing up in canada. -- beat whoever it is we're playing up in canada. i can talk about the nba free agency. i can talk about the predators and hockey. and i can talk about other things other than sports. the way we are going to do this is -- this is very casual. i'm just going to: in folks.

the only rules i'm going to lay down our would you raise your hand -- wait for a microphone so we can all hear you. i would like you to introduce yourself. i'm going to try to make sure that we go boy-girl-boy-girl so it is all even. ok? we will start with this young lady in front. do we have a microphone right here? member to introduce yourself. go ahead and hand her the mic. sometimes we tell our folks to hang on to the mic because people keep them for too long. but this looks like a pretty well behaved group. >> i'm jackie, i may tennessee volunteer -- i'm a tennessee volunteer in enrolling the affordable health care act. [applause] we live in a city with a lot of

health care companies and great medical facilities who can take advantage of some of the things you mentioned. what you think of people who are volunteers or ordinary citizens, what can they do to help make our health care system and health insurance system better? president obama: first of all, i want to thank you for volunteering. so much of our challenge these first couple years is just getting people information. there was so much misinformation out there. for example a lot of people don't know that through the exchange, through the affordable care act exchange plan, there is enormous choice of plans. tennessee has benefited from some of the widest range of choices of just about any state.

i think there are 70 options to choose from for people throughout the state, and about 80% of people who are purchasing health insurance through these exchanges because they are getting federal subsidies, they are spending less than 100 bucks a month for good quality care. that is true nationwide. part of our goal here is to give people good information. in fairness to folks, before i started tackling this whole health care thing, when i got a job, i did not really pay attention to health care benefits. you go to the job, so many from hr hands you a foreman says -- somebody from hr hands you a form and says, phyllis out. you need to choose from 2 or 3 plans. you ask them, what do you think? they say, that one is pretty good for you sign up for it very

-- it. most of us do not think about health insurance until we get sick, unfortunately. getting people information, that is something that is really helpful when it comes from neighbors, friends, coworkers, your church, because you have some more trust. sometimes people do not trust what they see on television, especially on something that became a political football. the other thing is for citizens to share their stories of how it has helped them, not only with their friends, neighbors coworkers, but also with their state legislators and their governor, and writing letters, and letting them know that this is helping people. it makes a difference. tey hey then recognize this is an

important need and worthy of support. and then you have to take care of yourself. but you look really good, so you are obviously getting exercise and eating right getting regular checkups, all that good stuff. that is helpful as well. that is part of how we keep costs down is, making sure people are well informed about what it takes to live a healthy life. great question. this guy has a good-looking beard. let's get the mic. >> it is an honor and privilege to be here, mr. president. my name is kenneth. it's about 50 miles north of chattanooga. i'm representing the people uninsurable in the state of tennessee.

what we need is we ain't got no insurance, we can't get no insurance, we don't make enough to pay for insurance but we make too much to get a subsidy insurance. i would like to know if you are aware of this or are there any movements or acts that you can make. president obama: i appreciate your comments. there is something that can be done, but it's got to be at the state level. it is important for state legislators to get together and find a uniquely tennessee solution to the problem. but understand the way that the law was set up was that states would have the option of expanding existing programs like medicaid, and then you would also have people who are buying health insurance on the marketplace and getting

subsidies. the point you are making is if the state has not taken action on one part of the program, then even with the good work that is being done for people who are getting subsidies and purchasing insurance, you are still leaving a bunch of folks out. here in tennessee, that is a couple hundred thousand people who could benefit if we really focused on how to fix it or it -- it. tennessee has a history of bipartisan, smart, state specific efforts to expand health insurance. i don't expect that what is good for tennessee is automatically going to be the same as what is good for california or my home state of illinois, but given the strong history of innovation in health care in tennessee, and given the high quality of

doctors and hospitals and nurses and networks that are here, you all should be able to find a solution. the federal government is there to help and to work with those states that are ready to get going. the states that have taken full advantage of all the federal options available they have an even lower uninsured rate and a healthier population, and more people signing up for the options that are available in those states that of not taken full advantage of those options. it is unfortunate that getting this thing done got so political. washington is kind of a crazy place. but that doesn't mean every place is got to be crazy.

i would like to see some good sense spring forth from the great state of tennessee, seve we can get this thing done. [applause] yes, >> thank you so much for being here today and sharing with us. from st. thomas health, one of the administrators. so the work that has already been done, the exchange, we know we have work to do with expansion. what would you envision are the next steps we need to take in health care in general for our country? president obama: you know, the areas where i think we can still make the biggest difference, in addition to making sure everyone is signed up for the options that they have is to really

think more about the delivery system of health care. and this can get real complicated, because we have got a complicated health care system , but i can boil it down maybe into layman's terms. right now, we spend too much money on the wrong things and not enough money on the right things so health care, generally, is very expensive in this country but if you look at how that money is spent, we don't give enough incentives to health care providers to really focus just on the patient and the quality of care. first of all, there is way too much bureaucracy. there is way too much paperwork.

that wears out the patient. that wears out the doctors. that wears out the nurses. they don't like it. the second problem is that because of the way that we have designed to be payment system in health care, historically, what happened was let's say hospital or a doctor had a patient come in and says i have got diabetes or i have, i think, maybe diabetes, but the hospital or the dr. would get paid to amputate the leg of a patient what they would not get reimbursed if they just hired to somebody to monitor whether that individual was taking their medicines on a regular basis and monitoring their eating habits, right?

so what ends up happening is you don't end up helping the patient who might have kept their leg if they were keeping up their regular regimen of looking after themselves and the doctors do not feel good about it, the nurses do not feel good about it, but they just do not have time because of the economics of the health care system, and one of the things we're trying to do across the board, and tennessee is actually doing some good innovation on this, is let's reimburse people for the outcomes of the quality of care people are getting. so when that patient comes in, instead of worrying about i'm going to bill for this test and will for this surgery -- and bill them for this surgery let's tell them that the better the outcome, maybe the bigger the reimbursement and now it may turn out that it is a good

deal for the doctor to spend an extra half an hour with the patient, very carefully going over the medicine they should be getting, or the hospital may say, you know what? we're quick to sign you up or a health club -- we are going to sign you up for a health club and make sure you are getting regular exercise, or we are going to book you for a smoking cessation program, and all of that produces a better result, but we have got to make sure that we have got a payment system that follows that logic of patient-centered care, and as i said before, we are already seeing that happening. part of the reason that we of actually seen health care costs slow, the inflation of health care slow is because patients are starting to get reimbursed in different ways, and healthier

groups are starting to organize themselves to focus on the quality of care as opposed to the amount of care. if we can do that -- see, what that does, first of all, is it frees up resources. it is not good for anybody when health care costs to go up because not only does the federal government have to pay more the state of tennessee has to pay more. that means there is less money left over for doctors, for nurses, for health education. it means higher premiums for the patients but it also means if we are saving -- if we just cut 2% or 3% on the cost of health care, that is hundreds of billions of dollars that we can now spend on something else. we can spend that on education. we can spend that on job training programs. we can spend that on fixing some potholes, and it can improve everybody's quality of life, so that, i think, is the area that we are want to be spending a lot of focus and a lot of time, in

addition to making sure that people are able to sign up for the care that they need, because there is still a too many people out there who have not signed up or cannot sign up for the health care that is available to them, and if we can clear away some of the politics, that will help, as well. the gentleman right here. >> good afternoon, mr. president. my name is eric brown from nashville, tennessee, and i work with a small, local congregation here. my question is more towards veterans with health care. i have a family member who is a veteran. she would like to have a female doctor. i just wanted to hear more about that, to help her get the health care that she needs and also the safety that she needs. president obama: ok, as most of you know, the ba system is an entirely separate health care

system -- the v.a. system is an entirely separate health care system from the system that most of us use. there is a basic principle. if someone is wearing the uniform of the armed services of this country and sacrificing and putting themselves in harms way to protect us, we have got to give them good health care when they come home. we have got to make sure they get the very best. [applause] president obama: now, the good news is that the overwhelming majority of veterans are very satisfied with the health care they receive once they get into the system. the bad news is that because a lot of the processing and systems in the v.a. system are outdated, sometimes it has taken

a long time for folks to get into the system, to get an appointment, to make sure that they have got a doctor that they are comfortable with. there are areas where there are still shortages. for example, in mental health. there are a lot of folks coming back with dsd, and there has not been historically enough mental health services provided for our veterans so my secretary of veterans affairs, topic donnell -- bob mcdonnell who is a veteran himself but also a former ceo of procter & gamble, so he knows about big corporations, he has been doing a good job of revamping how the v.a. system is organized, in general. it is going to take some time. it is still not where it needs to be. with respect to your sister,

your mother-in-law in particular, we will get your name and your mother-in-law's name, and we will find out exactly what the issue is, but generally speaking, we have actually made an investment in women's health care in the v.a. system, reflecting the fact that we now have extraordinary women who are serving in the armed services, and the health care needs of women are not always going to be the same as the health care needs of men, and so we have actually been trying to boost the kinds of specialties and training that are needed to provide health care to women our women veterans, and we have been at spending that, and that is something i am very proud of. we have made a significant inroads in that area, ok? tell her thanks for her service. all right. it is the young lady's turn. we will start here, and don't worry, i think i will be able to

catch everybody, but she does have an obama pin on, so i thought -- i figured i was going to give her some props for that. [laughter] >> thank you, mr. president. thank you for coming to tennessee. i am a member of the tennessee house, and there are number of members here, and i want you to know that we support you and that health care is the right thing for everybody, and especially for tennessee, and i went to ask you with your background also being in the senate are there strategies that you could share with us? [laughter] that we could encourage our governor to stay on the journey and continue to find solutions to present ensure tennessee and to bring some of our colleagues on the other side so that we can take the politics out of it and help them to understand how

important this is to the quality of life for tennesseans? president obama: well, i do not presume to know. i do not presume to know as much as you do about tennessee politics, so i will leave the expert advice to folks like jim cooper maybe, but here is the one thing i do know, is that elected officials responded to public opinion, and i think one of the challenges we have had throughout this fight has been that there has been a lot of misinformation out there and so if you stop the average tennessee and on the street, and you ask them, do you support making sure that insurance companies cannot bar you from

getting health insurance because of a pre-existing condition eight out of 10 of them would say, absolutely, i support that. the overwhelming majority of her publicans would support it just as much as democrats. now, if you asked them, you know that the affordable care act is what is guaranteeing you do not get blocked from getting health insurance with a pre-existing condition, you would get an argument, with at least half of those folks. that is not what it is doing, so part of it is just providing people good information. that is really important and if ordinary folks feel it is important, then usually elected officials start responding. i think the other thing to emphasize, which i know you are already doing is recognizing

that not every state is the same and that the truth is that there are a lot of different ways that states are approaching this problem, and if everybody will just acknowledgment people should get health insurance that they should be able to get affordable care when they need it if that much is acknowledged, that basic principle, then you can say to them ok, here is our ideas for how to do it. what are your ideas? and, you know, people can come up with good ideas of their own. i will say this. people tend to forget that the affordable care act model, with health-care exchanges and buying

in the marketplace and getting subsidies on the federal government, that was originally a model that was and braced republicans before i embraced it. it is the model of mitt romney in massachusetts. it is the model that conservative organizations like heritage foundation thought were a good idea, so my hope is that maybe now we can return to a constructive conversation about -- if folks have better ideas you should accept them. my general rule is i have no pride of authorship you. i just want to make sure that kelly has health insurance, and i went to make sure that this gentleman gets health insurance and if there is a better way of doing it, let me know, but it turns out that it is hard so

it has to be an idea that actually works. it cannot be an idea that sounds good but then does not work. that is the only danger, so if somebody tells you that, well, we are going to prohibit insurance companies from barring you from getting health insurance if you have got a pre-existing condition, which is popular, but we are going to allow people not to get health insurance if they do not feel like it, then the truth is that does not work, and the reason it does not work is, if you think about it, if you knew that the insurance company could not prevent you from getting health insurance once you were sick you wouldn't pay all those premiums until you got sick, and then you would go to the health insurance company and they

there is a law that you have to sell me health insurance and you would save a whole lot of money, but, of course, the whole insurance system would collapse. it would not work. so there are just some basic things, basic realities about the health care system that have to be taken into account, but i think you should be open to other ideas. like i said. look, i did not mind dealing ideas from mitt romney. -- stealing ideas from mitt romney. [laughter] president obama: you know, the bottom line is what works. what works, and if her public and legislators have better ideas, they should present them, but they have to be realistic. they have to be meaningful. ok. the gentleman right here in the glasses. how are you doing? yes.

>> i work with family and children's service. with the marketplace, i want to thank you so much, and on behalf of the many people i have been helping especially the get affordable insurance, and we really thank you very much also i just want to ask you have any plans to expand this affordable care act for a fresh not have documents is something that still live and work here for a long time? thanks. president obama: well, we were very clear that the affordable care act cannot live you will not here legally, and that is the law, that is another example

after if a lot of his this. the law says that if you are undocumented, if you are not only: you cannot benefit from subsidies in the program. the real answer to your question is i don't have integration firms have immigration is a a long time or our otherwise abiding citizens oftentimes have children who are u.s. citizens who are contributing to this society and are willing to pay their dues, pay taxes, get a background check, why don't we give them a pathway so they can be legal? [applause] president obama: you know, if we can do that -- you know, if we reformed the immigration system which is all broken, then this problem that you just mentioned takes care of itself.

i mean, look. we should not be encouraging illegal immigration, but what we should be doing is setting up a smart, legal immigration system that does not separate families but does focus on making sure that people who are dangerous people who are gang bangers or criminals we are deporting them as quickly as possible that we are focusing our resources there. we are focusing on a strong quota. we are focusing on those points, but we could do more if we had immigration reform, and we almost got that done. we had a bipartisan bill come through the senate that was very smart and was well-crafted. it was not exactly what i wanted, but it was a good compromise among a lot of different ideas. the house of representatives

declined to call it for a vote even though i think we had a majority of members of the house of representatives who would have been willing to vote for it. i have taken some administrative actions to try to improve the system. for example, us not deporting some young person who grew up here and has been here since they were three or four or five years old, brought here by their parents, have not done anything wrong, are going to school with our kids, our friends with our kids, and in some cases did not even know that they were not citizens, and then they are suddenly 18 years old and cannot get a college scholarship, because it turns out they do not have the legal documents, and i said administratively, that is not who we are, to just then those kids back. in some cases, they have never been to the country that their parents are from. don't speak the language. what do you mean we are going to

send them back? some have served in the military. so we have done a lot administratively, but ultimately to find a solution to the problem, we're going to have to get congressional action, and i suspect this will be a topic of conversation during the upcoming presidential campaign. i should note, by the way, that michelle is very happy that i cannot run. [laughter] president obama: that is good for the health care of our family. [laughter] president obama: [chuckles] yes. >> thank you, mr. president. from algeria tennessee, and thanks to the aca i was able to retire and still get insurance. my question is to now how to

manage the premiums area i do not know that you have noticed that the insurance in tennessee has announced an increase after the one they had for 2015. president obama: keep in mind that the affordable care act was designed so that there is competition, and folks in tennessee benefit over the last two years -- not only are a lot of healthy competition, more insurers came in offering plans than just about any other place. it was really impressive but tennessee's premiums were also substantially lower than a lot of other states and have been over the last couple of years. the insurance companies have now come in, requesting higher premiums. the good news for the people of tennessee is that this has to be reviewed and approved by the insurance commission, and if last year is a good example

last year, there were a number of states where the insurance companies came in requesting significant spikes in premiums and there were a lot of stories in the newspaper, just like there were this year about, oh premiums are skyrocketing, and it is going to be terrible, and all of that. when all of the dust settled and the commissioners who were empowered to review these rates forced insurance companies to justify what they were seeking what you discovered was that the rates actually did not go up as much as people thought, so i think the key for tennessee is just making sure that the insurance commissioner does their job, not just passively reviewing the rates but really asking ok, what is it that you are looking for here, or why would you need very high premiums and my expectation is

that they will come in significantly lower than what is being requested, but i think that this emphasizes the need for us to not let our foot off the gas when it comes to the delivery system reforms that i talked about earlier, because part of what is happening in terms of health care costs is that as technology changes, and there are more yours for more diseases, people utilize them more and if we are not smart about how we spend our health care dollars, if we want everything right away, even if it is not shown to be particularly effective, then that shoots up health care costs, and ultimately, premiums are going to keep on going up,

so we have to think more carefully about this. the best example of this, by the way, is prescription drugs. i mean the biggest spike in health care costs is around prescription drugs. now, some of this is just because drugs have gotten better , and people are able to deal with cholesterol or deal with other chronic problems through a drug regimen, and that is a good thing. you should be happy about that. but when you have got a situation where the brand name drug costs $100 a pill, and the generic drug costs $10 a pill, and the generic has been shown to cause just as effective as the red name, it is good for all of us as consumers to make sure that we are generally using the

generic drug when we can, and a lot of times sometimes we are very insistent because we have seen some fancy ad on tv. you know, people are running around, looking happy, until they read that thing about this may cause serious side effects, diarrhea, migraines. [laughter] president obama: [chuckles] i always laugh at those ads. but oftentimes because of the advertising, you will have some of the coming to the doctor and saying, i want x because i saw the tv ads, and the doctor will say, well, actually, y actually works as well but is cheaper, and people will say, no, no, i want x, and the system is set up

that if you are getting x, then your premiums are going to go up. if you want your premiums to stay low, you want your doctors and nurses basing their recommendations on what is proven as opposed to what is being advertised, and that is one example of how we have to make sure about the money staying in the system, because if costs keep going up, and everybody wants everything, and it is not smart about how we are spending our health care dollars, then, yes premiums are going to go up too high. pay attention to what the insurance commission is doing. ok. i have time for one more. i'm going to take two. yes, sir. this gentleman right here. >> i am walter davis, a director of the tennessee health care campaign, which does both enrollment and advocating for

the governor of tennessee. it is wonderful to hear the success, but here in the south we need help from the government and from supported institutions that talk about the people being left behind, and i want to make sure that you meet davy crockett before you leave today, over there with the tennessee justice , and there are important stories about the people who are left out because of the decisions by legislators, and we love the legislators who are with us, both parties, but the other legislators need to meet people in the gap. president obama: ok, i think this is like a handoff, so we will give you the mic, dave. hold on one second. is your name really davy crockett? that is a cool name. but you do not have a beaver cap. all right. all right.

davy: my name is dave crockett, and i live in bulls gap tennessee, and i have been turned down four times more social security. is there anything you can do to maybe pushed it through or something? [laughter] davy: i mean i have been turned down, and i would like to be able to get some help. president obama: all right. here is the thing, davy. i do not run the social security administration. but when i ask a question, i tend to get an answer pretty quick, so i tell you what i'm going to do. i am going to get your information, davy, and i will give it to the social security administration and make sure they expedite it.

ok. davy crockett. do you all remember that tv show? a lot of people rto young to remember it. ♪ davy, davy crockett ♪ when people tell their stories it reminds me of why i am doing what i am doing. margaret: thank you, mr. president. my name is margaret, and i am a retired teacher and administrator in the great state of ohio, and i moved to tennessee to be with my son and my grandchildren, and my grandson patrick said for me to say hi to you. president obama: tell patrick i said hi. margaret: at the time, it was

after the death of my son and being off of health care immediately after he graduated from university, and through the process of his illness and his death, how it affected me economically, and paying cobra and getting shots and in the context of being a school administrator, as hard as that might have been to me, it was worse for my kids at school going through much the same thing or worse with no support system like i had, especially as we went through the economic downturn in the country and being a high school principal and watching my kids be homeless and transient and mobile and much harder to grab a hold of and they would be into crime or

stealing or whatever for survival on the streets, and they would show up at school, where they would get off the bus and come down and say, dr. mcafee, i need to go to the clinic because i am sick, so our clinics became their health care, and sometimes even their parents would come and say, can your nurse checked us out? and when time, we had one nurse for seven schools, so in terms of people who are lost in the shuffle, especially at the secondary level, transient, homeless children, we had a huge population of homeless children and they kept my head on straight through the grief i felt in our family, because they are so compelling. you know, teenagers do not let you sit around and whine. they pull you forward into life, and my concern for the school

systems in this country is where the massive health care issues that walk in the doors of school systems who do not have nursing care, who do not have clinics that are staffed, who do not have the resources, and many of the teachers in america take care of the kids out of their pocket. school books seed children, slip them -- feed children, slip them a little bit. i know that many of my kids only eight with confidence -- only ate with confidence, which is one of the reasons why i love michelle obama. [applause] margaret: with school lunch, i can remember walking into a school system, and the lunch they served was a little piece of cheese, and a little short, pasty breadstick, and a tiny little tomato sauce cup, and

that was lunch until mrs. obama brought focus to what was being served to our children, so the kids in the country who are homeless and to private and transient, you know, as soon as a kid gets 15 or 16, it is hard. they come and they show up once in a while, or they go off, and they bounce from home to home or ready to buddy or situation to situation. they are the ones i am worried about falling through the cracks, and i am worried about our school system and the focus that we spend more time and effort about taking tests instead of seeing to their health care needs or their mental health care needs and support needs so that we can wholly educate a child in the united states of america. [applause] president obama: that is a great comment.

well, first of all, margaret, we are so grateful for you sharing your personal story because it reminds us of the goodness and generosity of the american people. when someone like margaret is going through her own pain, but she is thinking about people other than herself and her family, that kind of spirit is to be found all across the country. it is not unique to one party. it is not unique to one region. there are good people like margaret everywhere. a couple of points i just picked up on that you mentioned. number one, when we talk about the health care system, we have to just remind ourselves of the economic impact of the health care system on families.

it is not just feeling bad. obviously, when you are sick, your most important concern is getting well, but what is also true is when you get sick and you do not have health insurance, then that is draining your resources for other things. bankruptcy because of medical expenses is a huge portion of the bankruptcies in america. when families lose their house or a parent has to stop working because of an untreated illness or they miss too many days at work because they never go to a doctor and then lose their job or losing comes from those days they do not work, that can send a household into a spiral, and then once a household starts breaking down because they lose

a home or they lose a car or they lose a job, you start having people in shelters, and people on the streets, and that then affects kids, and then their capacity to learn, and then it creates cycles of problems that are much harder for people to pull out of. so part of the reason that it is important to get the health care issue right is so that people have at least a stable base from which to then focus on all of the other issues they have to focus on in their lives and if we can, as i said before, continue to do a better job of providing high-quality care to everybody but in a more efficient way, then that will free up resources so that, for

example, we can address the underfunding of schools, and we can make sure that we are having additional resources inside the schools for things like mental health, and the number of underdiagnosed young people who end up getting in trouble or dropping out of school, just because they did not get the same health care services -- the better off families get, that is substantial, and once they dropped out, you lose them, and then they end up in the criminal justice system. we then and that paying for their incarceration instead of them paying taxes because they're able to get a good job and support a family, and those cycles can ill -- can build. one of the most challenging things as president for me is to try to get folks to recognize

that investment in people oftentimes saves us money in the long term, even looks like it costs money in the short term, and we make this mistake over and over again. you mentioned school luncheons for example. -- school lunches, for example. we know that children's grades and test scores tend to go down at the end of the month, on average in low income communities. why is that? because food stamps start running out at the end of the month, and kids are hungry, and they are not focused, and now it may look smart for us to restrict those benefits except

ethan even half of those kids end up doing better in school and didn't drop out and ray able to get a job, the society would he much wealthier. if we are focused on mental health services, then we could cut down on the crime rate. if we invest in early childhood education, and we know there are improved outcomes that save the society money as a whole, and let's face it. part of what prevents us from making those investments in the short-term is we have gone through some tough times. the middle class feels strapped. people's incomes and wages have not gone up, even after recovery, where we hug ourselves out of the crisis. we still have growing inequality where a huge amount of the increases in income are still going to folks at the very top,

and so if you are a middle class person, and you're already struggling, and things are tight, then sometimes you feel like, well, why am i going to pay more taxes to help folks at the bottom? that is, i think, the mentality a lot of folks have, and it is understandable, but part of what i have been trying to argue, and i know jim and i know jim tries to do it, as well, is to recognize that we don't have to choose between middle-class families working hard and trying to get ahead and low income families who are working hard and trying to get ahead, if those of us who have been extremely blessed are just a little more open hearted about how we can help everybody, and, you know, it is -- [applause] president obama: i would like us to just reflect the generosity

of spirit that margaret expresses, because if we all have that generosity of spirit if we all look at every child as a member of our family, if we think of everybody as part of a single community then we can solve a lot of these problems, and it will not end up us -- it costing us money. we will not necessarily have to pay more taxes. we will just be spending it in different ways. in some ways, we spend things on stuff we do need, and we neglect the things we do, and we do not end up healthier as a result. that is not just true for the health-care system, it is true for our economy. you know, we waste a lot of money on stuff we do not need, and we under invest in those hangs that will make sure we

have a healthy society, and politics oftentimes gets in the way, and part of what i have tried to encourage my own democratic party to do is to recognize that not all of the money that we spend at the federal level is smart, and some of it, some programs do not work, and we should end those when they do not work and the honest about what is working and what is not. part of what i have also tried to do is to say to the republican party open your hearts and think about the people here in tennessee who are working hard, who are struggling and just need a little bit of help, and if we give them that help, it is going to payoff in the long term. this will be a stronger state. employment will be higher. folks will be paying taxes.

we will prosper. we are all in this together. that is what i believe. when america is together, and we have a certain generosity of spirit, even if we are hardheaded about making sure stuff works right, and we are not wasting money though we are doing what is needed to give everybody a shot in live, that is when a grows. that is when we prosper. i know that is what you believe two, margaret. you showed it in your own life. thank you, everybody. ♪ [captions copyright national cable satellite corp. 2015] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] ♪

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♪ this train faith will be rewarded this train, hear the steel wheels singing this train bells of freedom ringing ♪ ♪ >> ♪ just know you are not alone because i am going to make this place your home ♪ ♪

announcer: president obama goes back to washington this evening and back on the road tomorrow. he is headed to the university of wisconsin at la crosse, and we will have live coverage 2 at:20 p.m. -- at 2:30 p.m. eastern, and we have four interviews with republicans elise stefanik, brad ashford john ratcliffe and don beyer who compares selling cars to politics.

don: comparing cars to politics, a lot of the steps are the same. you have to go to people you do not know and find a way to be friendly and connect, find something that you have in common. a lot of it is sales. and sales is most about meeting people's needs. we have sold 65,000 cars over the years, and i never pressure a customer into buying a car. that is the worst way to do it. the best way is to say what are your needs, what are your needs, what works for you and your family how can we meet that need? and politics are the same kind of things. the things they do not function in society. how do we move forward and try to listen carefully. announcer: again the

conversations with freshmen members of politics coming up tonight at 8:00 p.m. on c-span. announcer: c-span is you the best access to congress, live coverage of the u.s. house bringing you events that shape public policy, and every morning, "washington journal" is live with policymakers and journalists and your comments by phone, facebook, and created by table companies and brought you as a public service by your local cable or satellite provider. announcer: now, a discussion on the presidents write your teas in his final 1.5 years in office. we were here for a former deputy chief of staff as well as the head of a marriage equality group and with this other baptist convention. lydia ko correspondent mike allen moderated the event -- political correspondent mike allen moderated the event.

it is one hour and 40 minutes. >> politico correspondent mike allen. mike: thank you very much, and thank you for coming out. the first breakfast of july. welcome to july, and thank you so much for being there. welcome to all of you out in live stream land, and we are very excited to have a meeting lined up today on president obama, and interview to our colleagues and the staffers, the kinds of people who are going to be here, who came together over the weekend. president obama had this amazing week. we should have a conversation about this, so here we are. and just a second, standing in the wings is ambassador michael froman, at after that, we will

have to go you'll conversations about marriage. evan wolfson has worked on this for over a decade, and then the president of ethics of the southern baptist convention is going to talk to was about what he is telling his pastors about how he should talk about this issue now, and for the big finish, a lot of you know jim messina, who was the architect of president obama's reelection. he is going to talk about where the progressive agenda goes from here and how president obama has changed in the time he has been working area before we kick off i would like to thank bank of america for support of this series on the road, breakfast cocktails, snacks. we really appreciate the bank of america supporting these conversations about the biggest issues in washington. they have been a great partner for a couple of years, and we are really appreciative for them

for making these conversations possible, and now without further a do, i would like to welcome ambassador michael fro man. mike: congratulations. michael: thank you. mike: some people in the press -- michael: they were wrong. mike: you have known president obama longer than just about everybody, longer than michelle obama. michael: we have known each other for a long time. we were in law school together. mike: so you have been calling him mr. president. michael coleman yes, back then. mike: and what quality would you say he had that you can still see? michael: well, actually, you can see a number of the same

qualities, but if you can remember back in the mid-1980's, there was a lot of division between conservatives and liberals, and president obama was elected in part because he was determined to try to bring people together from different parts of the law school community and have a cohesive group put out the journal, and he did a very good job of building consensus and building everybody, and ice some of those same -- i see some of those same traits today. mike: and he does not smoke in public. michael: he has much more gray hair. there has been a lot of continuity between how we was back then and how we has evolved as a political leaders since. mike: and starting with the news, today, there was a great story on politico. a copy of the tpp intellectual property chapter headlines

what is in the obama trade deal? backing big pharma, and there was a recent draft of the transpacific partnership free-trade deal that would give u.s. pharmaceutical firms on president its protections against competition from cheaper generic drugs, possibly transcending the patent protections in u.s. law. big pharma. michael: first of all, we do not comment on supposedly drafts, so i do not know what he has. but on the issue, when it comes to the intellectual property rights protection, and particular leave those involving pharmaceutical products, our view is on the one hand, we want to incentivize the development of life-saving treatments. much of the research and development is done here in the united states by americans. on the other hand, we want to assure that there is access to

affordable medicines particularly in evolving countries, and that is consistent with the direction we received from congress with regard to how to deal with this, so we try to strike a balance. we have 40 million americans whose jobs are dependent on intellectual property in sensitive industries, so we do think intellectual property is a right for these jobs. at the same time, it is critically important to that we maintain and increase access to medicines, and we as a country have done this in a way were now 85 percent of all prescriptions filled are filled by generic producers, so we do not think there is a contradiction between promoting innovation and other and we are doing that internationally, as well. mike: a pretty accurately draft. michael: well, i do not know about that. first of all, in the negotiations, in this is true

with any trade negotiation nothing is agreed to until everything is agreed to, and this is one of the chapters where there are among the most outstanding issues, so according to the article that was a draft that was prior to the last round of negotiations in june, so it is already evolving, i imagine since then, and it will between now and the close of the negotiations. mike: isn't it a danger of this provision that it could mean fewer generics, higher drug prices? michael: no, i think what we have found around the world is you can only have generics if you have innovative medicines. you have to have innovative medicines to feed the generic pipeline, as well, and that generic pipeline is critical to maintaining and controlling health care costs in the united states and around the world. it is something we want to encourage, butmike: please tweet us

here. i that the twitter machine and i will ask questions. let's set the scene a little bit. we are going to be talking about the president plus historic week, trade and the agenda ahead. joe klein had a column this week that talked about obama path defining moment. he boarded those who fought to -- it was upheld by a conservative supreme court and his trade policies opposed by progresses, including hillary clinton, were passed by republican congress. how did you pull let off? michael: it was a good week across the board, for marriage equality, for the affordable care act, who