the advantages and disadvantages of this agreement. there are disadvantages to this agreement. iran gets a lot out of it. we get something out of it. what it is is something we're not very good at, domestically anymore. it is a compromise. >> on that note, thank you so much to our panel. >> coming up in 10 minutes president obama addressing 500 young leaders from africa. during a white house summit. during that washington fellowship program to help young

people build skills and our partnership. it is scheduled to start 10 minutes past the hour and we will take you there live for his remarks. >> the republican presidential candidates are in manchester new hampshire for the first presidential forum. today at 7:00 p.m. eastern. we are providing live coverage of the two-hour forum on c-span, c-span radio, and c-span.org. along with media organizations from the early caucus and primary states, are sponsoring this forum. following the forum you can provide your input by joining our call-in program or adding comments on facebook and twitter. road to the white house 2016 on c-span, c-span radio, and c-span.org. >> ahead of tonight's forum, you can share your thoughts on c-span's facebook page on what you expect to hear from candidates. you can weigh in at facebook.com/c-span or send a tweet that c-span.

leticia writes things to help the middle class that's not abortion, benghazi, terrorist. paul writes i want to hear about legalizing the growing of hemp strengthening native american relations and getting tougher on illegal immigration. we read more comments i had of the forum. while we wait for the remarks of the young african leaders summit we will take a look at washington journal. host: medicare markets 50th anniversary. here to discuss that the former administrator from the centers for medicare and medicaid services from 1990 to 1992. dr. robert berenson the acting administered are from 2000 to 2001, thank you for being here. i want to show viewers and you what president lyndon b. johnson had to say 50 years ago when he signed this legislation into law.

pres. johnson: there are over 50 million americans over the age of 55, most have limited income and are threatened by illness and expenses. through this new law, every citizen will be able to in his years to ensure himself against the ravages of illnesses and old age. this insurance will help pay for hospitals, nursing homes, or in the home. and under a separate plan, it will help fees with the doctors. here is how the plan will affect you. during your working years you will contribute through the social security program a small amount each payday to the hospital insurance protection. the average worker in 1966 will contribute one dollar and $.50

per month. this will provide the funding to pay up to 90 days of hospital care in case of illness and diagnostic care. and it will provide the same health benefits up to 65. beginning in 1964 you will be covered for up to 100 days in a nursing home after a. -- period of hospital care. and under a separate plan when you're 65, you may be covered for medical and surgical fees while you are in or out of the hospital. you will pay three dollars per month after you're 65 and your government will contribute anyone amount. under benefit of the law are varied and broad as the. modern medicine itself

host: president lyndon b. johnson signing into law medicare, here to discuss our two former administers of the program. gail lewinsky, is medicare working like explained there by president johnson? guest: in general yes. medicare was designed to meet a very particular meeting for the older population of america to make sure they would have access to insurance coverage or hospitals and physicians. a challenge to most seniors even those that were not low income had a great deal of trouble getting insurance. it changed a lot, the coverage has broadened, we have 55 million people on medicare now. almost 10 million of whom are disabled. and under 65. preventative services, many are covered. outpatient prescription drug coverage has been expanded.

in 2003, through legislation. the financing has changed significantly, but the need that medicare was designed to respond to, making sure that seniors would have access to care has indeed been that. guest: i agree with her and i add a few more items. one is that health care delivery has changed dramatically since lyndon b. johnson gave that speech. in those days, most people got their care and hospitals by physicians. over the years there has been a great need for a bunch of those sources of care and new kinds of providers in scared best skilled --in skilled nursing environments. it has been a challenge to reorient to the program but i think they have met that challenge and survived over the

past 30 years with new payment models and delivery and the current focus is to address quality. quality has not been as good as it should be and u.s. health care in general and medicare specifically. we are taking steps to try and address that. host: we want viewers to weigh and. here is how we have divided the line. if you are a medicare beneficiary, 202-748-8000. doctors dialing to 202-748-8001 all other style into 202-748-8002. let me ask both of you this. how would you fix it? guest: will you asked did it meet the directive that president johnson laid out? yes, in terms of providing ready access. as health care is evolving significantly, some of the focus has been on quality as an important issue. as an economist i worry about that as well.

the delivery system has changed a lot. medicare has been slow in that area. it has been somewhat draining. it has been dreading the movement in terms of trying to promote value and better quality. physicians are expressing frustration less than they have been because of the document was passed in april. it is not perfect but it solved a frustrating problem for many physicians which is not knowing what would happen to their fees every january with threats of reductions as high as 31% although they never happened. even more dysfunctional in the sense that it did not reward those clinicians who are providing higher-quality, better value of care. a big movement to give patients more knowledge and to let them be more active in their own.

>> we are going to leave this online taking life for remarks by president obama at the young african leaders summit. [applause] >> good morning everyone. hey! thank you so much. you are the best ever. my name is grace. i am from the presidential precinct. [applause] i am a nigerian.

a music artist. a disability rights advocate and a peaceful promoter. [applause] 10 years ago, i was involved in a motor accident. it almost clean my life. -- claimed my life. it was difficult thinking about my life after that experience. coming from a continent where people with disabilities face various challenges to access and inclusion. by the challenges, i have grown. i have become a contributing member of my country and society. i have become a voice for the voiceless. i am for filling my dream as a mandela washington fellow. [applause]