while we may be passionate in our opinions and beliefs, let us conduct is process with a quorum with respect for each other and for those who are taking time to speak to us. so we will begin today with session four. today we begin the energy and environment part of the presentation. a theme that touches each and every one of us, whether we live in city, suburbs, communities, all americans want to know energy sources -- that energy sources are available and cost-effective. the environment is respected and preserved for our children and children's children . notone once said that we do inherit our environment from our ancestors, we borrow it from our children. group of speakers will share with us some of the approach is and vehicles needed to make that happen. our first witness will be madeleine foot of the league of conservation voters.

is a representative of the league of conservation voters, which works to make conservation a local, national, and state priority. she has worked to draft strategy on hydraulic fracturing, manage reform programs, and advocate for policies related to climate change and clean water with members of congress. welcome. rep. cummings: is your mic on? >> i believe so. thank you for the opportunity to testify today.

it is an honor on behalf of our more than 1.3 million members who perform -- to inform what issues we believe should be included in the democratic party that form. this includes adapting to a changing climate, ensuring all communities have access to clean air and water, protecting public health from toxic chemicals, creating a fair, democratic, and just society, and preserving the special places and wildlife we hold dear. president obama and his administration have made incredible progress, especially on the issue of climate change. as we look to the future we must build on those. the democratic party should leave the way in ensuring that we leave at clean and they've planet for -- safe planet for generations to come. the urgency of tackling climate change is never been more clear. from power plants to the oil and gas sector and cars and trucks. the platform should commend the historical agreement forced him paris and recognize the threat posed to communities across the country, especially to low income families and communities of color. we must accelerate our access to clean energy and leave fossil fuels in the ground. we should advance the production

and distribution of clean energy. the tragic situation in flint, michigan has demonstrated we cannot take safe drinking water for granted. cities across the u.s. have experienced elevated levels of toxic lead in drinking water and like so many of our environmental challenges, these impacts disproportionately fall on those most vulnerable. providing safe drinking water for all communities should be a priority for all communities as well as the clean water ruled for improvements to our infrastructure. toxic water has become pervasive in our home, buddies, and environment.

did i lose -- oh, and science continues to link exposure to chronic health problems. congress recently passed legislation to give the epa new protections, including for pregnant women, children, workers, and others who are disproportionately exposed. lastly, america's public lands and spaces are some of the public from most prized possessions. we should continue to protect our wildlife and invest in critical conservation programs. we must also continue to bolster the diversity of the sites, stories, and culture of our public lands so everyone feels welcome in them. we thank you for the opportunity to testify. rep. cummings: thank you very much. any questions? [applause] rep. cummings: thank you very

much. thank you. dr. michael mann, from -- with joint appointments in the environment institute. also his research involves -- to better understand the earth's climate system. welcome. >> thank you, congressman, and committee members. i am honored to speak to you about this critical issue. my name is michael mann. i'm a distinguished professor of atmospheric science at penn state. i spend my time teaching, advising students, during

scientific research. fundamentally i am a climate scientist and i have spent much of my year with my head buried in climate data trying to seize out the signal of human caused climate change. what is disconcerting to me and so many colleagues is these tools we have spent years developing, increasingly, are unnecessary because we can see climate change, the impact of climate change now playing out in real-time on our television screens. the impacts -- b food, water, health, national security, our economy -- climate change is creating -- taking a great toll. we've seen that in floods. the floods we have seen over the past year in texas and in south carolina.

we see it in the devastating combination of sealevel rise and more just active hurricanes -- destructive hurricanes which has led to calamities like superstorm sandy and what is now the perennial flooding of miami beach. we see it in unprecedented drought, like that which continues to afflict california, doubling the area of wildfire, fire burning in the western u.s., and indeed, in the record heat we may see this weekend in phoenix, arizona. the signal of climate change is no longer subtle. it is obvious. and like the tip of the

proverbial iceberg, further changes like the melting of the ice sheet to give us three feet of sea rise by the end of the century, may be locked and simply from the carbon we have burned, from the warming in the pipeline due to the burning of fossil fuels. there are some tipping points. there are some we may not have crossed and can still avoid. it is still possible to avert catastrophic and potentially. reversible changes in climate, but only by moving forward, building on the progress, and accelerating the transition away from fossil fuels towards a clean energy economy. the stakes could not be greater. the future of our children and grandchildren literally hangs in the balance. no contrast could be more stark. we have the republican party whose standardbearer and a vast majority of their congressional representatives continue to deny that climate change exists. we have a democratic party that realizes that while we can debate the specifics of the worsening crisis, we cannot bury our heads in the sand and ignore the growing threat. it is my hope that the

democratic party will have a statement about putting a price signal in the market, a price on carbon. it is my hope that the platform will acknowledge the progress that has been made by the obama administration and promised to build on that legacy by defending the clean power plan against attacks by congressional republicans and by ensuring other epa policies to reduce carbon emissions are kept in place. it is my hope the platform will acknowledge that we should hold leave this recorded portion of today's democratic platform hearing to return live to phoenix as the hearing is oning on to its next session health and safety. representative elijah cummings of maryland is the chair.

representative cummings: ladies and gentlemen, we are bound to get started. please be seated. we are about to go into session five. the democratic party believes accessible, affordable, and high quality health care is part of the american promise. that americans should have the that comes with good health care and that no one, no broke because they get sick. social security and medicare are generational promises we have made to our seniors. our next session on health and safety will delve into these others, like our

parties believe that america's success as a nation depends on continued innovation to fight diseases, in treating men and women with respect and dignity when it comes to their health and health choices. will be rachelt .onzales hansen rachel gonzales hansen is the former chair of the national association of health centers, community health centers. she is the first hispanic female to serve as chair of the board ahc -- nahc. she has been recognized for her commitment to advancing the

locally andf health nationally. thank you for being here. we will hear from you now. hanson: ladies and gentlemen, members of the committee, good afternoon, and thank you for the opportunity to speak with you today. i am also the ceo of community development incorporated, a federally supported community health center serving a four county rural area in texas. we were founded in 1984 by residents in the area concerned about the lack of access to quality, affordable health care for underserved, working poor families, and since then, we have grown to a staff of nearly 100 individuals providing comprehensive riemer he and integrated care to approximately 10,000 patients -- primary and integrated care to approximately 1000 patients a day. a result ofgan as

discussions between cesar chavez and bobby kennedy, was authorized under lyndon johnson, was championed by edward kennedy, and has achieved enormous success in recent years under president obama as a result of the affordable care act. as a matter of fact, last year, 1300 health center organizations served more than 9000 urban and rural communities nationwide, serving as a health care home for more than 24 million patients, including nearly 7 million children and nearly 300,000 veterans. it must be said that our patients come from all walks farmworkers, ranch owners, retail workers, educators, and yes, even elected officials. health centers have grown to become the backbone of our nation's primary care system and a crucial element of our health care safety net, and health centers will be needed even more in the future as essential

providers gain coverage under the eighth ea. most reasonably, -- under the aca. most recently, health centers have dealt with individuals affected by lead in flint and individuals affected by this virus. you for the thank support of the democratic party for so many decades. we are ready to do more to ofrove the health communities and patients all over this great nation. health centers are located in underserved communities and are governed by patient boards to ensure we are responsive to the needs of each community we serve. health centers offer comprehensive care to all residents, regardless of ability to pay or insurance database, and this unique model of care

has resulted in huge -- thisance status, and unique model of care has savings.in huge millions of individuals now have cardity of an insurance and the reliability and continuity of a health care home. we stand ready to work with the next administration and congress to build upon the successes of the aca, and with your partnership, to be at the center of a health care system designed around access, affordability, quality, and comprehensive care for all. to that end, allow me to please share it three space -- or three specific areas we would find helpful on our end. bringing truly integrated primary care services to the patients that need it most. this requires continued investment. over the past eight years, especially with the additional

we haveby the aca, brought health care to more than 8 million new patients along with new facilities and jobs. additional services like dental and behavioral health care were added. extended on a bipartisan basis for an additional two years as part of the medicare and chip reauthorization act of 2015. however, unless mandatory funding is extended in 2017, health centers will see a drop in 70% of their funding which will lead to more than 10 million patients losing access to the care they so desperately need, which they have enjoyed today, largely because of the support of the democrats. two other programs would be completely eliminated. such a travesty would level a devastating blow to communities in every state, so our highest

priority is to fix this problem. we must secure and continue the permanent mandatory funding for health centers as well as the health center core and teaching health center program. we hope we can once again count on the democratic party to lead the way. our second priority is to preserve the medicaid and chip program, and to opposany efforts to block or otherwise diminish them. we understand fair crucial importance in coverage to the poorest among us. this includes group reimbursement for preventative primary services and for residency training in health-care settings. finally, we support increased research to demonstrate cost savings through strong prevention and primary care efforts. we are proud of the health center track record, not only because we have been delivering care, but also when it comes to delivering value to the taxpayer and to the health care system as a whole.

thank you for taking the time to hear my reflections today. as i said, we are ready to work with you and the next administration. let's make it better. i am happy to answer any questions. mr. cummings: thank you very much. [applause] thank you. , how have the community health centers contributed to the success of the affordable care act? for the question. there are several, but the top two would be that we were instrumental in helping to register and enroll people for care act ande the insurance exchanges. one in four individuals enrolled were at community health honors. that's a huge number. the other impact is we are taking -- community health centers. that's a huge number.

the other impact is that it not only do they get access, they get additional care. we continue to see those who are underinsured. aretates like texas, we very much needed to take care of those who don't have insurance. are a safety you net. >> we have been that for 55 years. >> thank you for all of the work you have done for a very long time to make sure people have the coverage they so need. i do want to acknowledge this is an area where senator sanders has been a longtime leader and was very instrumental during the affordable care act discussion. i want to ask you a specific question, which is how many people are covered or receiving aca because of the

investment in community health centers, and is that happening in rural, urban areas, places around the country? and what lessons can we take from that? i am bad with numbers, so i am trying to look at my notes. we serve several million patients in all communities, urban, inner-city, rural and frontier areas. we have 1300 communities out there serving 24 million patients. that says a lot about what we've been doing. i think the lessons we have learned, quite honestly, there s that need toing' be done to the aca. i don't think it was entirely built around supporting agricultural workers trying to emergencyance and care. that's one thing that needs to be improved on.

we have some ideas we might like to share later on, but i think it's important we don't ignore those -- that group of people anymore. they have been ignored enough. certainly, they deserve the best just like we all do, right? think, you know, i think the 24 million that we serve around the country is a big number. in our state, unfortunately, a lot of them did not qualify for the aca because they did not make enough money. but there is not enough medicaid. they did not do the expansion. it's very limited. mr. cummings: mr. gutierrez. mr. gutierrez: thank you. i also want to thank you for your work. 12 million undocumented workers in this country were excluded from the aca.

there was an infamous moment on the house floor when someone ,old president obama he lied when he didn't. they were excluded. how are you, organizationally, helping them, and how do we move forward from the exclusion? issue, weblic health do not ask people if they are citizens or not. that's not our job. to make sure that everyone who walks through the door gets treated with respect in a culturally sensitive manner and leads to them having the skills to manage their condition better. we don't ask because it's not our job. our children go to walmart, grocery store, parks, schools with these individuals. if one of them gets sick, they

will all get sick. it's a public health matter. we take care of everybody who walks through our door and that's the way it should be. mr. cummings: representative reeves. reeves: thank you for your work. this is an issue i am passionate about and one of the reasons i ended up running for office. in my neighborhood, they were going to close the community health clinics. we hear a lot about the exchange. would you may be expand on what could be stronger? i know you mentioned renewing funding would be one. is renewing it enough? i have health clinics in my district that struggle to keep .oing the second is about dental care. we have so many adults and children, obviously, who can i

get dental care -- you cannot get dental care and less you are almost destitute. almostss you are destitute. is there something you would recommend? our chairman has talked about safety nets. how would you strengthen those safety nets? let me try to hit on those in the order that you asked. we talked about the money first. always good to talk about the money first, get that out of the way. it is difficult to be able to plan for the future when we are having to struggle if the money is going to come on time every year with a grant. we have to wait for congress. are they going to pass a budget? continuing resolutions are really difficult for us to recruit health care individuals.

how do we offer someone a job if we don't know what it's going to happen in a few months? we need to find a way to make the fund a permanent fund, and we have to wait to see if will continue to get funding. continuing to invest in funding for our health services is necessary. our patients deserve the best. they need the technology. they need the health care .rofessionals that are trained our patients are chronically ill, most of the time. they need medication. if they cannot afford their medication, they might as well not have gone to the doctor. we provide pharmacy, lab, x-ray, dental and that holistic re approach is what makes us a unique model of care that has led the way in the health care industry.

the work force the other piece we talk about. are doing everything we can to increase the workforce. need teaching health programs. we need the national service health court to be funded and permanent. many of us rely on those providers to recruit. it's a recruiting tool so we can recruit them and hopefully keep them in our communities. there aren't enough primary care providers. we have to compete with the entire country for providers. when you are talking about inner cities, rural, frontier areas, we have a big challenge, and we cannot do it without funding. we probably have to offer them a better compensation package. in inner cities more so than urban areas because who wants to go there? it's a challenge. and onlyeople go there

special people can make at health centers and make it well. cummings: mr. booth, then ms. lee, then we are going to have to close it out. mr. booth: thank you, and thank you for your testimony. i think all of us believe health care must be a fundamental right, not a privilege. community health centers have done such outstanding work with serving 25 million americans. i was hoping you could talk could happen if we provided the funding necessary to make sure that the 29 million americans that are currently under an shirt -- currently uninsured and that 30 million americans that are underinsured could go into a community health center and get not only the primary care they need, but the mental care, the dental care, the low-cost prescription drugs. we talk a lot about how much things will cost the federal

government, but i want you to talk about how much money that could save if we invested appropriately in community health centers instead of having people go to emergency rooms. they could go to a community health center for their primary health care needs. tell you right now that if you were to do the number annual basis,an health centers are saving approximately 24 billion with a b dollars annually. and it is because of the low-cost care we are able to provide. i will give you an example. on average, it costs us about $700 per patient and we provide medical, dental, lab, x-ray, pharmacy, health education, a teaching kitchen, and even a fitness center.

that is pretty good savings. pharmacy alone would eat up the $700 in prescription. is theer part of that piece you cannot put a dollar figure two. one of the things we do so well i believe is we help individuals build their skills so they can manage their condition versus the condition managing them so we want to help them understand condition, howir to control it better, how to manage it better, making sure they are following up with all of the treatment plans the providers are giving to them. that long-term is going to be a big cost savings. those are the things you cannot put a dollar figure on now. >> what you just said, is that with all? other words, teaching them about their illness.

i have often said people do ,hings for one of two reasons to gain pleasure or avoid pain. or a combination. that something is going to prevent pain and suffering or help them, they are more likely to act on it. >> that is right. it is fundamental to us that our health care delivery system must include the patient's understanding, their condition better. thatstory was something was really key in our community. we started our teaching kitchen and we have small classes on purpose. we want that sort of one-on-one. of a family,g care a single mother with three teen boys. a 17-year-old, 14-year-old, and 11-year-old. i heard the facts of the story

afterwards but i will make it a short story. a 17-year-old was worried about his brothers because they were already diabetic. not type one, type two diabetes. the mother was working three part-time jobs. they lived in the projects just down the street from the health center. we opened the fitness center so the boys came to the fitness center because the older son was concerned about his brothers. then we had them don't the teaching kitchen. the mother came with the three boys. the oldest son was the one who did the food preparation most of the time. they went through the six week course, an hour and a half a week for six weeks. these are teen boys and so we have to remember that they have a lot of people going on at school about what to eat and what to do. six months later, they had maintained their lifestyle -- iss because that what

what this was about. the 14 your old had been taken off his medication as far as the diabetic medication. the youngest boy on insulin and oral medication was off the insulin and in the next month, had hoped to get off the medication. familyimpact on that economically and as far as their help and the impact on american can't put a price on that. >> priceless. >> thank you so much for being here. i carried the first single-payer bill. personally, i support single-payer.

when i chaired the congressional black caucus, we formed a asian-american, caucus and progressive caucus. we negotiated exactly what you're talking about, the expansion of community health and provisions to look at ,thnic and racial disparities culturally appropriate services. you all are doing just that and i want to commend you for it. the people who fall through the cracks and i have been thinking about this a lot, how we make the affordable care act better. medicare for all, for those who fall through the cracks. how would that impact community health centers? ms. gonzales-hanson: i think the challenge we have is that we have to make sure that whatever system gets put into place is going to go beyond taking care of the doctors visit and taking care of certain pieces. ony aren't putting a value

the health education or the transportation or even the translation services. the care management services. those are the things they tend not to put a dollar value on but we have to provide that end we have proven having those instant place saves money and improve the care of the patient. i think whatever system gets put into place needs to really acknowledge and value those additional services that have to come as a package. i think that is important. i think the other piece is making sure whatever reimbursement plan is there has pays something that really for the services that are being provided. you go to a doctor's office and they are great. you get just the doctor's office visit. when you -- going into a community health center, we have talked about the gamut of services you get and there is a

price to pay but it saves the system money in the long run if you have that holistic approach. the payment methodology must include enough to cover those expenses as well. does that answer your question i think? close? >> thank you very much. thank you. we really appreciated. ms. gonzales-hanson: thank you so much for the work you do. we appreciate you taking the time to do this as well. [applause] >> dr. judy fedder. dr. fedder is a professor of public policy and from 1999 to the served as dean of school of public policy at a georgetown. in an effort to understand and improve the less help system,

she teaches health insurance, medicare, long-term care regularly drawn upon members by congress. thank you for being with us. >> thank you. i am honored to be with you today to relay the importance of assuring access to affordable quality health care for all americans. many of you know the democratic party has championed universal coverage as an essential policy goal for our nation and other president obama's leadership and after decades of unsuccessful attempts, the democratic party took a giant leap toward that goal with the enactment of the affordable care act. it is an extraordinary achievement. the aca has insured 20 million , 20 million americans who were previously without coverage. while the vast majority of

americans continue to receive health coverage to their employers, health spending per slowlyhas grown more than ever before. after decades of trying, the passage over came an anonymous political hurdle. for decades, congress failed to pass health reform legislation in large part because its -- nent proves that charge to be false. to achieve affordable access to quality care for all americans now is the time to build on the aca. we must defend it against repeal and continue to work to improve it and we have plenty of work cut out for us. we have not yet reached everyone who needs help insurance and for too many people, coverage remains too expensive and insufficient, leaving too many

people still facing unaffordable costs. party platform should support the goal of universal health insurance coverage and explicitly apply passages of the aca. on thecommit to building aca to ensure affordable access to quality care for everyone in the nation. most importantly, that would require us to support measures to make premiums more affordable and reduce out-of-pocket expenses not just in the marketplace is but an employer-based health insurance as well, continue to encourage all states to expand medicaid and the affordable access to care. and support transparency and to hold insurers, providers, pharmaceutical companies accountable for delivering the benefits of the aca promises. room forgram has improvement, even long-standing successful programs like social

security and medicare. now the job of the democratic party is to advance the aca achievements by every means possible, including administrative and legislative action. universal health care coverage should be a cornerstone of the democratic party platform, establishing the aca benefit as reliable guaranteed of affordable access to quality health care for all americans. thank you. >> thank you very much. [laughter] [applause] >> questions. no questions. thank you. joining us via skype is roseann oro, the -- dem

executive director of the national nurses united. although not a nurse herself, her ability to effectively organize and champion the rights of nurses as well as the many americans who are uninsured or struggle to afford health-care has earned her widespread recognition. modern health care magazine named her as one of the top 25 women in health-care. welcome. we have a slight technical difficulty. we need some sound. try again. can you hear me? >> yes. >> thank you. i actually have longer testimony but i understand we are on a timeframe here. i would like to submit in writing most of my testimony and just highlight what i have written.

mr. cummings: that would be wonderful. moro: when patients are in jeopardy because of the lack of health insurance, it is essentially immoral. what we find other countries are able to do -- what we find other countries have been able to do that we somehow cannot figure out how to do is to provide a more cost-effective health care to provide health care that provides greater access. there are multiple things about what is going now with the aca. it has fallen short on a number of issues and the premiums are going to be going up significantly so we have deep concerns about what is happening theeople falling outside system. they are underinsured, premiums are going up, co-pays are going

up and what is written in the plans are limited. even though the goals of the aca were to expand health care, and they have and have opened up the avenue for other people to get into the insurance industry. it is inadequate to take care of america's patients. in the testimony, we argue very andngly that both the aca what clinton is proposing in terms of transparency as a solution to the problem is inadequate. 30% of all money and health care made from profit and that profit goes to lobbying congress to keep big business, pharmaceuticals, hospitals and insurance companies and health care. an overhead cost and when premiums go up, it isn't because -- they aren't consumers, they are patients.

the insurance companies and the other arms of health care want greater money. it's all a question for money. ultimately what we come down to is a dilemma -- can we really afford to keep profit and health care? we argue strongly in our paper that we cannot and it is a national disgrace that we don't provide health care to everyone and as america, the highest level of health care imaginable. we are urging the democratic party to put patients before profit and to make health care for everyone basically a right. -- ie talking about that it's stigmatized. what it means to be part of the society is to have the right to health care, the right to education, and a number of other rights. thei do want to mention the

transpacific partnership and toed the democratic party take a very hard look at that and what would happen with pharmaceuticals if that were the past. it only reinforced our opposition. i'm going to read this part of the paper and i will leave you find people to do your health care thing. propertyp intellectual chapter, we are particularly appalled by the monopoly pricing protection for giant pharmaceutical firms. that could be a death sentence for countless patients in need of affordable medications around the world and the expansion of the ability of corporate giants to use corporate tribunals tuesday to overturn public health and safety laws. the tpp should not -- cannot be fixed, it should be defeated.

our help should never be for sale. a commodity. not we expect the democratic party to step up and treat every patient as unique and not to charge them to stay alive. think you very much. mr. cummings: thank you very much. [applause] you have a fan club here. >> it is a deep earning. people are scared out there. they are losing their homes. the loss of jobs could mean the loss of their health care. having to care for your patience -- the nurses are in tears constantly because patients are cutting their medication, they aren't getting the health care they need, they are afraid to go to the doctor because they make choices between what they can afford in their lives and they to put theirforced health against their houses. that is ultimately bankruptcy

and there is so much. it's just common sense and its human decency to make sure that everyone has the care they need. mr. cummings: thank you. >> thank you so much for your comments and i really appreciate the focus on universal health care as a right. i think we all agree that health care is a right and there are folks who have been working on that issue not for just a few years but two decades of their lives. i wanted to ask you two questions if i could. first, could you talk about countries in europe and the developed countries who have universal health care systems who do not have single-payer but have alternative systems that do seem to be much more effective than ours?

demoro: i don't think what we are arguing is for a national health care system. even though it would be nice to have a national health care system that covered everyone and that the government essentially took care of. there are other countries that have mixed models. what a national health care system. we would like to have the federal health care -- government take control of health care. as indicated here and in some other countries where there is health care and where people have access to health care through multiple funding mechanisms but ultimately here, it's very easy to construct a model where you could have even some of the better hospitals still remain in business so to say. large hospital organizations

here, we could have the subsidies for medicare like we have that go to the patients that they could essentially go anywhere they want. kind of the most unique systems of these that have all components of health care contained in one setting. you have integrated health care systems that provide all of the care the patient needs when they go and you have other countries where you have clinics and a variety of delivery mechanisms. in all cases, health care is a human right and here, it is a commodity and i think that is the distinction. >> to clarify, germany has private health care systems but it is also universal so they have a universal health care system but i absolutely agree we need a universal health care system and we should take steps to ensure we have universal health care but it is one that also incorporates for-profit as

well as not-for-profit. my second question to you -- demoro: it is privately funded. it isn't really a national health care system in germany. >> exactly. demoro: we have to have a commitment to provide the care the people need and to not charge them for staying alive and that is our role in society. was someone from england and just listening to the compassionate care this persons father received when he was dying, how they cared for his life and respected his life and the dignity that came to him and i hear the stories from the nurses here who basically have such a around his care. i think why couldn't we have that here? what is wrong is the 30% overhead.

facilities to do that. we have the capacity to have the best health care system in the world and what happens is it is cut short because of profit. one thing i very much want to do and introduce into this conversation is the voices of people who have health care who are alive today because of the affordable health care act and you recently heard from someone, from rachel from iowa who told me that she had breast cancer previously, lost her job, didn't have health care, got health care through the affordable care because is alive today the breast cancer came back and she spotted it early because she had health care through the affordable care act and i think everyone in this room would say we need to get to a system that has health care for every american.

when you to work toward that and improve it. i just want to have the voices people who love waited a long time for health care and have it today because of the leadership of the democratic party to make sure it actually happens and we need to improve upon it but that was not an easy task and it's important to our knowledge that. moro: you're not going to ever corner the nurses into saying it's adequate. it provides an opening for other people to have care. the insurance company was not allowing people into the system. the affordable health care, we do think it is an improvement and we do appreciate the fact the democrats did that. we wish they would have fought harder for single pair obviously. i think what we have seen in this campaign is when you fight for single-payer health care, it

has the public support. 50% of the american population supports a single-payer health care system. toasked the democratic party go back to its roots, find its commitments come and fight for americans. it is not good enough. our premiums are going up 25%. people are still having to ration their health care and people are afraid to use the system so it's not good enough. mr. cummings: one more question. >> thank you very much for being here with us and thank you for everything you are doing each and every day to make sure the public, that we understand and the public leaves and deserves the fact health care is a basic human right and it should not be a business nor an industry. the affordable care act -- and we fought and i have to say as a democrat, every single democrat in the house fought very hard

for either single-payer or public options. we got as much as we could get as democrats. we put into the bill they have the option to enact single-payer. we put the public option language in the affordable care act. it may not have been strong enough. say todayd have to that democrats fought very hard for single-payer and for public options. -- it was close to 20 million people now have health care as a result of affordable care act. that is a big deal. i lived in great britain for two years and i know the difference between having the national health service versus what we had here so i get it. but also note that we need to build upon the affordable care act and i want to see if you believe that we can build upon it with the public option, with single-payer.

have you built on this with some of the options out there that we need to hear from you without really messing with the individuals and people who have covered under the affordable care act. ro: thank you for your work. the problem is it is very difficult to take a system that has profit in it and this is what we find in the aca were so much money is taken out of the -- we haveto think some computer difficulties here. resolveare going to that. matter of political will and i think that things have changed. 58% of people believe in single-payer. i don't know that that was the case and i do know you have fought hard. i see the dynamic happening here and you think that i'm

criticizing the democratic party for not fighting hard enough for single-payer health care system and i think that is probably accurate. [laughter] lee: well we fought very hard. ms. demoro: what i would like to have seen is everybody have the spirit. for everyone to do what we have done in this campaign so far and i think there is a model in this campaign and that is when congress and the republicans say no to initiatives that we get out into the population, that we organize and ask the communities who are the 58% that want single-payer, let's bring them to their constituency. this is not an inside washington deal. see the political will from the democratic party to fight for a single-payer and i don't think we can cease because

i don't want to have that on my conscience that anyone has died or suffered because i didn't have the political will to fight and i will use my position forever to fight for people to have a single-payer health care system. lee: i just want to make sure you fight for the people that are covered under the affordable care act. demoro: i deeply appreciate it. we just need to go so much further. look, i'm saying the aca was an improvement. please hear that. i know that you are a fighter for single-payer. i understand that. the fact -- it saves a lot of lives. it actually expanded coverage but now what is happening is it allowed to basically the same conditions that were in play before it actually be

accelerated in some ways, privatization, mergers and acquisition at an all-time high. is happening is the health care industry -- and it's an industry, not a system. the health care industry is scamming the aca. even the intent you had is falling short because they have rooms of accountants and all of the players in health care that are figuring out how to game the system and that needs to be cleaned up fast but more importantly if we had a single-payer health care system, everyone was covered, generally universal, that have different settings where health care was provided. a lot of hospitals are afraid they will be out of business. it would expand their business wouldn't be a business actually, it would be a

service, which is what health care should be. i don't know how to answer that in a way that is going to satisfy some of the people on the committee. i can just say this, that we will be behind you is you step up and -- if you step up and fight for single-payer, do whatever we can to support you and we will fight for every person who takes a stand for the american people. that is all we were looking for. this should be a unifying issue and that is our fundamental commitment and fundamental fight. mr. cummings: thank you very much. [applause] jocelyn. junior at the university of arizona, a proud board member of planned parenthood of verizon and the vice president of the college democrats of arizona. welcome.

>> i'm actually president. mr. cummings: i'm sorry. [laughter] >> no worries. thank you. i am here today to ask the democratic party to make sure the 2016 platform protects women's health and improves abortion access and comprehensive sexual health education. i can personally attest to the need for copy hands health education. -- need for comprehensive sexual health education. i was given abstinence only education. we were shown slides of untreated smacks -- untreated sexual transmitted infections. i was told sex results in nothing more than harm, infection, shaming and public ridicule. looking back i can't help but

feel shock that politics interfered with my education. the democratic party must stand firmly in support of comprehensive sex ed and make sure funding only goes towards evidence informed curriculum. it is critical the platform speaks strongly to immense health and abortion rights and access. one in three women will have an abortion in their lifetime. this is a number we all know. is time to stop thinking about abortionist taboo and recognize it for what it is, a safe and legal health care service that is essential to women's health well-being and a time to me. for many women abortion is inaccessible. abortion opponents have carried a policy that excludes abortion from medicaid coverage. and hostile state lawmakers, which we have here in arizona and across the country, have expanded laws that make it

harder for women to have access to abortion. i am concerned about the supreme court's upcoming decision in a ruling that upholds texas restrictions on health care centers that would reverberate throughout the entire nation. i am troubled by recent state actions to target and exclude planned parenthood from participating in critical public health programs, like medicaid, title 10 family planning program. these federal and state restrictions are just few of many laws that impact women's access to abortion. my parents were immigrants. i'm acutely sensitive to the fact that our health care system is often off-limits to taxpaying immigrants. affirmot enough to abortion actions, it also requires addressing the other structural and institutional barriers to health care that have hit the intersections of

economic status, race, gender, and sexual orientation. color, immigrants, lb gt q individuals, and those struggling to make ends meet are disproportionately impaired by policies that limit access to care and often do not have .lternative means to access i'm a proud democrat, a young a proud planned parenthood action fund's member. i also know our party can do more. it is absolutely essential that we a stare down conservative lawmakers who are trying to effectively the race row v wade .- effectively erase row v wade no matter her income, insurance coverage or citizenship. thank you.

>> i first of all want to say thank you. i have two daughters about your age. they live in a different world than my mom lived in or even grandmother lived in. because of the courage and determination of so many women and men. you, we arey thank going to protect you, we are going to defend you. i can provide for the education of my daughters, i can make them free and independent. but i have to have the law on their side so they can read -- taken control their reproductive rights and be truly free and and -- withhe men

the men in their lives. >> just say no, my mom is your biggest fan. just so you know, my mom is your biggest fan. [applause] [laughter] >> thank you for what you are doing. this is exactly why we need a democrat in the white house. [applause] >> thank you. wanted to applaud your andage to come forward fight for the support of comprehensive sex education among the national immense research center. we very muchhing fight for, the protection of women's rights, to help care for women's rights to feel protected and safe. i very much applaud you. because we understand such a high rate of rape and the drape happens here in

the united states and across the globe, had we take those approaches to work when you mentioned comprehensive sex education? where does the comprehension come from and how would you recommend we take those steps? >> as an activist i have had some experience working with this. what we like to talk about his -- especially young men my age, who are often do -- often the ones who do the crime of rape, and everyone having a conversation about sex and being open about it and understanding what consent actually is. we are implementing it to this year at the university of arizona. we're hoping to have as many students on campus take the scorch -- take this course.

i think that's something we can do. >> if i heard your testimony correctly, it is equally important to elect different people to the state legislature in arizona. >> that is what we are working on. we are hopefully going to get the senate or even flip it here. >> this platform we are writing here is not just a platform for washington dc and the white house, is a platform for the whole country? >> thank you, i appreciate that. to be with honor you, you are a very courageous young woman. >> thank you. >> we hoped you would continue on your journey.

i had a chance to talk to some people in maryland. i didn't even know how my friends i had here, counselors, and they would tell me how empowering it is for them to work with other young women to of things theyt simply did not know. planned parenthood has been before my committee on several occasions. the way they have been treated is so unfair. and the good things they have done for so many simply phenomenal. if we did not have a planned parenthood we would have to invent it. thank you very much, we really appreciate it. >> monica simpson.

monica simpson's executive director of sister song, the national women of color reproductive justice collective. specifically against civil and human rights violations. and the systematic physical and emotional violence inflicted upon african-americans, with an emphasis on african-american women and the african-american lgbt community in the south. you use interactive is him to bring -- >> thank you for reading my bio. it is really an honor to be here. i am.you for saying who

i am excited to be here as a tounteer and advocate provide information about the importance of reproductive justice and highlight how the platform might adjust the priorities, experience, and struggles of women in color. onlyw up in a town with one stoplight and a town where the racial divide was lately drawn by railroad tracks at split town from the haves and have-nots. signing up, that would lock us into abstinence only sex -- abstinence only sex education, which we were given -- only givene over the course of one course period. every young woman except the us were pregnant before

graduating from high school. the nearest abortion clinic was 30 miles away. there were no sidewalks or public transportation systems, even if they wanted to have one. most stuck in the town limits were the job was basically nonexistent. and then a newly built private prison that needed to be filled was a constant reminder of the system thattice separated so many young mothers from the fathers of their children. you can see how the overlapping issues like race, economic barrier, and criminal justice makes it difficult and sometimes impossible for marginalized communities to access services that they need. systemit's because of these tyf the -- stories that black women can come together and establish the movement 20 years ago. it envisions liberation for the most marginalized. we believe reproductive justice will be achieved when people have economic, social, and political -- stories that black women can come together and establish the movement 20 power and the means to make decisions about their bodies, sexuality, faith and family. as you can imagine we have a long ways to go.

to ensure the health and safety of women of color i urge you to address formidable terriers. complete the work to ensure health care by expanding medicaid nationally and passing the health equity and accountability act. disparities.lp dying duringre pregnancy, childbirth, and the postpartum. is a public health crisis and a national shame. we must stop it in its tracks and avalanche of state laws that put access of legal abortion out of reach to people of color. thatwill end the amendment put a ban on insurance coverage for abortion and passing the women's health protection act, which removes barriers to access.

our ability to make real decisions cannot be separated from the economic realities in our lives. needs to feel safe, especially mothers and pregnant women, especially pregnant women dealing with substance abuse are being overly criminalized in states like tennessee. and women like -- endingiminalized for their pregnancies. the intersection of criminal justice and our reproductive lives are real and something we cannot ignore. ever women of color are standing up for the issues that matter to us and demanding change. change in policies, change in political discourse and change in leadership are needed to ensure our communities are no longer ignored. this is not a one no plan. heroes said we cannot have single issue movements because we do not live single issue lives, and to ensure our people in our family have the opportunity to thrive our political platform must be intersectional, so that the most marginalized are centered and

our whole lives are honored. i skipped a lot because i thought i messed with my time but i am excited to be able to talk with you more now. thank you so much. [applause] >> first of all thank you for that really powerful statement. i wanted to mention this when the former witness was before us, but it is probably even more meaningful after your testimony. i figured about the international perspective of american leadership. as horrific as our justice is sometimes in our country, it is nothing compared to what women around the world have to face, whether it is reproductive rape and violence being kept out of their communities completely for the choices they make.

i want to thank you for what you do and for your example and what you do around the world as a for what justice ought to look like. the single best predictor of increased gdp is girls education. the reason for that is girls education leads to economic opportunity. it leads to basic sanitation and health care. you may haveschool a private toilet you may use. i thank you for what you do and there is nothing more powerful than reproductive justice and the justice that comes from women around the world. >> dr. west. >> thank you so much for that powerful and eloquent presentation.

i was thinking of nina simone. who put to an emphasis on song. there is a sense in which there was on both sides of the bloody red sea. all you could do was sing a song in this strange land. but you sing that song with a style and a smile. it is often the case that both political parties don't deliver the way they are. poor black women may be elevated during the election. the suffering still goes on. even with the democrats and republicans set such a low bar.

what do you say to our precious brothers and sisters who are poor, dealing with this on both sides of the bloody red sea's? i would think specifically about the kind of suffering and the song that flows from that suffering. >> this is the power of grassroots organizing. it is the power of our personal stories that really helps us to .onnect to those on the ground in order to see a culture shift to be able to see the shifts we need to see in that will improve it for at least the least of us. it really starts from the grassroots. making sure people see themselves reflected in the work. processin our political

a lot of the communities we do work with on the ground, it is very difficult to see themselves reflected in the work. as much as it is possible for the platform to do is to raise to allow people to see themselves reflected in all parts of the work that you do. that is what then moves people. that is what we strive to do and how we do our work, amplifying and making that groundswell happens of people see themselves reflected and that then moves them towards change. >> thank you for your remarks and i am taken on the focus of intersection analogy and a whole range of issues. at a wholetionality range of issues.

concerns about the parties, we do face a today one-sided attack on women's rights in the country and reproductive health in the country. see this from republican state legislatures in the south, and the west area i would love for you to spend just a minute telling the committee what that means for reproductive justice women, women of color, the kinds of attacks we where we're going to see the destruction of all women's health clinics in an area. what does that mean for a low income women? what does that mean for a woman making $15,000 per year? this is an arena in which the parties have very stark and what that means

for that woman. >> it is a very scary time for folks and state. can you imagine what it feels like for folks to know that there is only one place that to accesso to be able the services they need? the fact that, medicaid expansion is not a real thing for some states. thousands ofeds of people who are without health care access. it is a scary time for people on the ground. what does this mean for people? it means a choice between life and death. i don't want to make it seem so grim, for a lot of people that's what this boils down to. we have to understand that the decision-making that one goes

through, whether they continue their pregnancy, and their pregnancy come or deal with the ,ssues they have to deal with those are the tenants of reproductive justice. wherever there is a barrier or lack of access, that does not .quate health it means the opposite for that. difficult to live where they feel like they can be a part of a political process, to be active members of their society and do all of their not feelhat they do like they have what they need to be able to live healthy lives. stories constantly from folks who have to make the decision around food and health care. or have to make the decisions about taking care of their children.

the decisions are so real and so fast. that is what drives us. just singing the disparities and why to help people they address those. >> as i'm listening to you i'm , weking we as democrats the things that affect people on a day-to-day basis. a lot of people don't even know a lot of people go through those kinds of fears. i was thinking it was so good when we see young people like -- and

the democratic party in that fashion is in good shape. we must let your passion be contagious and we must act. >> thank you very much. i want to say thank you very much. with all of our women, young women of color, with this movement, reproductive justice, you are making a huge difference. this is one meeting where i can be really part of sin. with regard to comprehensive sex education, i carry the legislation on capitol hill. most of us remember the days of

back alley abortions. the height of amendment has been in place with the nine comprehensive health care access, primarily to low income women. a couple of years ago we decided as democrats, i introduced the appeal at the height of amendments. i don't see a name republicans on my bill to repeal the height of amendment. we have 119 democrats on it. all of the issues you are bringing up, that all of the young women are bringing up today. it is democrats who have been champions. there is a difference between democrats and republicans.

it is because of you and young women around the country. lot of hope we are going to win these battles for justice. i have to say i can't be too partisan during the week. there is a big difference between democrats and republicans that affect young women and women of color. >> thank you very much. dr. stephanie -- is a practicing primary care physician professor in the school of public health.

she codirected the medicine program and practice primary care for internal medicine and became -- the dr. is a frequent speaker and has written on administrative overhead and the uninsured. >> in 1986i cofounded the nonpartisan organization national health program. the journal of american medical association and most recently the american journal of public health. the aca does not stop the health care crisis. americans are uninsured today and 25 million will remain uninsured even if they were to accept the medicaid expansion.

millions more have some skimpy hollowed out coverage. 255% in the gone up last year. and deductibles average 3060 $4000 per person. when we were both professors at harvard, we found medical of 62% ofre the cause personal bankruptcies and the majority of the medically lying corrupt -- medically bankrupt had private insurance that failed to protect them. the consumer financial protection bureau reported unpaid medical bills are by far and are common that's running -- are ruining the credit scores of millions of families. been forced into narrow network ensures that limits the choice of doctors and hospitals.

medicare for all would assure everyone a free choice of doctrine hospital. health and equality are soaring. the wealthiest american men live on average 15 years longer than the poorest. meanwhile the life expectancy gap has fallen in canada and canadians and europeans live three years longer than americans. provide-payer systems coverage while spending half as much per person as we do. numbersy the economic to add up for single-payer. it would be fully offset by out-of-pocket costs. markets are designed to expand

and they do especially when they are heavily subsidize. by replacing a private health insurance and overhead average at 12% with single public insurance. single-payer would also slash the paperwork that ensures inflict on doctors and hospitals. doctors would attend all bills to one place, using a simple billing form area hospitals would stop spending -- stop sending bills altogether. administration consumes 25% of hospital budgets in the united states, versus 12% in single-payer nations like canada and scotland. did a study with the

international consortium by health experts. i'm happy to talk about international systems if we have time. single-payer would save $6 trillion on paperwork over the next decade, enough money to cover all single-payer could save an additional $2 trillion over 10 years by using its leverage as a monopoly buyer to drive down to pacers -- down drug prices. this has allowed europeans and americans -- canadians to get drugs at half-price. medicare buy-in or public option simply will not work. while it would improve choices americans, it would go to garner most of the administration savings for single page. the medicare advantage program, overall process would -- cost would go up because private insurers would cherry picked healthy patients and charging

unprofitable patients with the public option. we have seen this dynamic work with the carafes -- collapse of the aca. is popular, most doctors and according to a recent gallup poll, the public now prefers single-payer to obamacare. in summary, single-payer is the only route to affordable and sustainable universal coverage. the democratic party cannot pretend that minor tweaks to a failing health care system is going to fix it. thank you. >> thank you. [applause] >> thank you. we really appreciate your testimony. i think you have done a good job you were talking about perhaps getting into the international comparisons. i hope you will do that.

i'm going to do something i've never done before, i'm looking at a chart by the peterson foundation from a third of 2016. it says, united states per capita health care spending is more than twice the average of developed countries. the spending about $8,700 per person on health care. abouteans we are spending three times more than we are in the english do and we are spending over twice as much as those in canada. i would like you to address that. , we do also like to say believe the affordable care act some major strides. no questions about that. we still do have 9 million americans that are uninsured. i believe there about 31 a

31 million underinsured. before the affordable care act, there was a study by harvard university that said 45,000 americans die each year because they did not have access to affordable health care. i would like to ask you, how many americans do you believe right now will die or get much sicker because they still remain uninsured and how can medicare for all single-payer health system address that? >> thank you for the question. the study that said 45,000 people died annually due to lack of health insurance was my study. , we followed a large cohort of patients for 12 years and did very detailed analysis to see the difference and death rates between people with insurance versus people without. if you have one million people

uninsured people, about 1000 of them will die in the course of the year due to lack of health insurance. we talking about 30 million uninsured, we are talking about 30,000 unnecessary deaths in this country this year because personal health care. in this circumstance of the state that refuse to expand medicaid, i think there are about 5 million people who are not insured because the state refuses to expand to another 5000 people there that, having implement obamacare. nonetheless, obamacare was never going to cover 100% of americans. it was going to leave 25 million uninsured and, to me as a doctor, 25 million uninsured, play 5000 deaths is unacceptable and, frankly, that is unacceptable to the doctors. we, like the nurses, you just

can't pretend we solve the problem here with affordable care act. we don't need to tell you the strawman about aca. what we're saying is what we have now, is not a solution. dying,l have people still have people not getting care and we need to be moving forward. mentionedglad you strawmen. that is helpful. isn't aware, there person running the nomination of this party who said the aca was all we had to do. all the candidates have put forward ideas to expand coverage. i think is helpful that you mentioned that 25 million remaining. their ideas on the table to have that number get smaller and smaller. i also wanted to note that i really appreciate you mentioning senator warren who i know is a

strong champion of the affordable care act and the progress we have made. finally, i want to ask you one question about your statements about the public option and why willublic option necessarily fail. some postaland, support the public option, you would have a public option within the exchanges that also continue the requirement of guarantee issue. he would not have a situation where insurance companies to cherry pick and i would know today, as congresswoman lee has stated, they could do single-payer system and i wonder planu were working on this or the state plan you could -- moving as we speak. it be good answer -- if you could answer, that would be good. plans, manyof state

plans work from state plans. i personally don't. i'm from the state of louisiana and i fear they can about what that would mean. --- thinking about what that would mean. we should be working on a national plan. that is the priority. there are a lot of barriers to the state implementing single-payer. vermont was not given permission. they could never really do a single-payer. we need to work on this at a national level. i'm sorry, remind me of your other question. the public option. havey would you necessarily cherry picking? >> the public option was studied by the congressional office in 2009, as part of the obamacare legislation. they also said that there would be turned picking. that happens whether or not the

guaranteed issue. for-profit insurance companies are very good at getting around regulations to cherry pick. for instance, plants the united states, this plan to put all drugs that people need on a very high tier. the city will have to pay a lot of money for the drugs you need to stay alive. own insurance their harvard university, i'm an early retiree, my own insurance plan has decided to put everything sot hiv drug on the top tier that people have to spend $5,000 a year per drug if they had hiv. that is cherry picking. that is telling hiv patients, don't come to our plan. they put everything a psychotic tellingthe top-tier sisley mental ill people, don't come to our plan. they put every single multiple cirrhosis drug on the top-tier,

don't come to our plan. it effectively cherry picks and pushes people to look for another plan. a plan they are looking to would be the medicare type plan, the public option plan. adverse definitely get selection. what happens to you if someone else cherry picks and you don't. that is how the co-ops went under. no, whenou don't failed, theytion look for the nonprofit co-ops. guyshad these good eyes -- to go out there into the plan. the other plant in new york had every single cancer patient enrolled in any plan and ended up in the co-op plan. all the for-profit plans managed to avoid those patients by not covering. the have lots of ways to cherry pick. you can write it on a piece of paper. the private insurance can cherry

pick. that is not the same thing as actually avoiding terry picking. >-- cherry picking. >> i would agree. it really regulated system. >> it can't be regulated. option, thatlic was one version of the public option. not a particularly strong one. other person for the government has bargaining power are a lot more attractive to people. >> i begged to differ. >> let me say this. i listen to these arguments back and forth. i don't think there's anybody that i know of on the democratic side of the congress who does not want everyone to be insured. i really mean that. i don't want anybody -- i don't think you are saying that. i don't want anyone to get that impression.

it is how do we get there? it's not that simple. a lot of us don't have the desire to get there, it's that we have some major forces. we strive to get their everyday. there everyday. >> thank you, mr. chairman. i think one of the things, coming from ohio, we did expand with medicaid, a tiny being in the state legislature where that is going to turn over to new folks, i think it is important, i would to find out from you, i don't want us to get off track with our chairman and congresswoman lee on the committee and congressmen who

have had to go up against tremendous odds as a young councilwoman, i got to see first lady clinton ticket take a beating tried to get health care from people who did not want it. she got beat up that. for me now to be a state representative and been able to see president obama go from almost nothing, we had some people uninsured to what we have now because of the democrats in , igress, can we talk about don't want to throw that away. that was a hard journey for us to get there. our party was at the forefront and took a lot of beatings, a lot of false starts, a lot of obstacles. how do we build on that? there are a lot of people around the country and in my state, over 100,000 additional folks voted and supported president

that, how do we build on with our platform? not going to throw that away or start something new. is there a statement -- i have some republicans that i have to go home to who everyday people he up with obamacare, obamacare, dad, bad. -- bad, bad. i don't want our party to play into that. with that, help me not just the white house platform, but it platform that people on the ground to say we have made some progress more you to continue -- needs to continue? >> we need to build on that and therefore to single-payer. the polling data actually shows a lot more support for single payer and obamacare, including % upper republicans who

support federal funded. >> the republicans are not moving forward. >> this is gallup poll. i'm not talking politicians. >> the people who have to vote for them. >> we should not assume that a halfway measure gets more support from the american people and something that action solve their problems. many privately insured people do not see any improvement under obamacare. i feel like many middle-income americans feel like they are falling off the bottom of the american dream and they are. life expectancy is falling for white men in this country. it is stagnant for white women. no developed country has ever seen that before. things are really wrong out there. a saying that they are really right and that the aca has fixed that does not hold water without

nurses orrs or voters were not seen improvement. i support the aca, i know some people got improvement. a lot of people do not and we have a long way to go. we need to talk honestly to people about that. >> we will hear from two other people and then we will move on. two questions. from your laughter marks, you would support requiring the states that have not done medicaid spansion to do tha -- expansion to do that? >> i supported but there's a supreme court standing in the way. the closest counterpart to single-payer which is the veterans health care system, what would you recommend to strike and reinforced v.a. health care? bei think the pa needs to

answered of adequate funding, i think the v.a. does a good job. they are quite cost-effective and provide the care. that is not an opinion, that is based on studies if you look at the quality of the care which is superior. it needs to be adequately funded in the efforts to privatize the v.a., to say, let's turn into an insurance company. that is a bad idea. >> thank you so much. malcolm x. used to say, you don't step books in the back nine inches and pull it out six inches and celebrate your progress. it seems we need to acknowledge that affordable health care was a major breakthrough, but it

fall short. it does not mean both parties of the same. we agree with that. it also means that you can't solely look at it through practical lens. the republican party that that such a low bar as opposed to a visionary perspective that keeps track of the suffering. we can celebrate the progress all we want, but those citizens are suffering. here the question becomes, how then do we blend the visionary and practical in such a way that is not going to a question of looking backwards, but try to hit a finish line in which we care isdge that health not market-driven. it is a moral right. it is not reducible to market calculations. that is the difference between

universal insurance, market-driven, efficient, versus single-payer. that is a moral ground markets can never capture. that for me is crucial in this discussion. where is the moral vision? do you resonate with my formulation? >> i do. i think there is a moral reason to say that health care needs to be a service and not a market driven business, but the numbers i've been giving you are economic and that in nations that organize health care as a public service and not a business, people live to your longest and spent half as much money so what is standing in the way is private insurance industry in the pharmaceutical industry and i think we need to decide what is more important,

the health of the american people or serving the needs of those industries? >> thank you. >> thank you. [applause] >> joe wilson, president and chief executive officer of institute. privateer found in the institute, he served as the director of policy and planning at aids project los angeles from 1993-96. the court nader for the city of los angeles from 1990-93. welcome, sir. 1.2 million the americans living with hiv aids, and that tens of million people living

worldwide with hiv, thank you for inviting me. i have to say that i am less nervous seeing the familiar friends in the room, including brother,hairman and my without a doubt, but perseverance and commitment, we have made commend his progress in the fight against hiv aids over the last 35 years. we are extremely grateful that thanks to the care act, national hiv strategy, smart investments and research and affordable care an present level are nottivism, we expressing the kind of devastation we experienced in the early days of the epidemic. let's be clear, aids is not over. even worse, we are losing ground and risk losing ground in some communities and countries.

37 million people are living with hiv worldwide and 20 million of them have no access to life-saving treatment. 2 million people are infected every year. 1.2 million people die from aids annually. according to a recent cdc report, black gate bisexual men in two chance of becoming hiv-positive. retrovirus effective therapy, they can have treatment or prevention, we now have the means to curtail the global and hiv epidemic even while we continue to search for a vaccine or cure. however, hiv continues to be a major public health burden in the u.s. and around the world. disproportionately affecting minority populations, gay,

bisexual men, transgender women, and other populations. we must scale of the available epidemic to end the and cap five recommendations for the platform committee. aidsr one, commit to and as an epidemic in the night stays by 2050 by dramatically reducing infections, ending aids deaths and limiting disparities between quality of treatment and prevention. develop and fund a national blueprint to reduce the number of new hiv infections each year less by12,000 cases or 2025. number two, pledge new funding aids pandemicbal by 2030 increasing the budget of the president's emergency plan for aids relief -- relief by 2 billion per year by 2020. and supporting at least one third of the fully funded new

financing of the global fund to tuberculosis, and malaria. this would double the funding people on treatment and lead us to putting 30 million people on treatment by 2020. we also need to increase production. number three, maintain u.s. leadership and hiv research by substantialo increases in the budget. number four, ensure access to medicine for all by supporting trade and other policies that reduce until actual property barriers to medicine rather than break them. in particular, we asked that the next president to pledge to stop the ccp. number five, and the debilitating stigma, determination, and criminalization of people living with hiv. people with hiv do not pose any danger to society or public health.

serioussents the most area to public health. we must repeal the hiv criminalization law that flies in the face of science and sound public policy. tohave an urgent opportunity take historic action to end aids and a more aggressive blow a deeper federal commitment to end the national and global hiv epidemic. at the to act swiftly required scale will result in more hiv infections, more hiv related deaths, continued human rights violations, and health equity and increased costs to i've been living with hiv for 35 years, i personify what can happen when people with hiv have the love and support of family and friends and the care and treatment we need and deserve. sadly, too many of our citizens are not that lucky. gay institute, we

still get called. we get early morning calls, we get middle of the day calls, we get late evening calls. we have calls from others who are grieving the loss of their children and dealing with the guilt of sometimes having thrown them out because they were gay. we get calls from a lot of young people who just found out that there hiv-positive. they either did not have had a protect themselves or even worse, did not think their lives were worth protecting. we can do better, we must do better. the question of whether or not we can end the epidemic has been asked and answered. the only remaining question is do we have the political and moral and ethical will to make it so. ? [applause] >> thank you, mr. wilson.

you mentioned action item number five, criminalization. can you expand upon that? >> absolutely. we have, in many cases, some of the very necessary tools to prevent hiv transmission. people can be arrested. if you are a sex worker court trance woman and you are rested with condoms, back in be used to further criminalize you for prostitution, just because you have condoms. needle exchange programs are critical part of risk reduction to protectable from tripping hiv. but if you have that paraphernalia, there are laws that can cannot see. their disclosure laws that are not about disclosure, but actually about proving you disclosed. even if you disclose your hiv-positive, even if there is no transmission, even if you use

a condom, in fact, using a condom can further criminalize you when you're trying to protect another person, even in the face of science, if you are byerly suppressed, the likely -- virally suppressed, the likelihood of tripping the virus is 99%, they disproportionally impact women and people of color. >> let me ask you this, i've stood on the institute of human and ity board baltimore seems there is this, people believe, and you hit on this in your discussion, that the eight situation has been solved -- aids situation has been so lved and i bet there are people watching out for may be shocked,

and both we have the second highest rate in the nation in the zip code i live in, because second,est if not the and is trying to -- it's like, the problem, you said, we know it can be solved, but obviously folks are being left behind. why is that, why is that? >> and number of reasons. number one, aids in america today is differently than 35 years ago. aids in america today disproportionally impacted black and latino and poor people. we live in a country that whether we like it or not, our policies are driven by whether we proceed the lives -- perceive whether the lives of the folks worth saving are worth saving. we have made tremendous progress, i for one do not want to go back.

it was easier to address the issue when literally, everything the day we saw in our newspapers and television's people dying from hiv and aids. we are doing better. but we are not doing a good enough job and those are some of the reasons why we don't see the attention that we should be seeing. >> thank you for your work. congresswoman lee. >> thank you so much for being here. your voice, testimony, and aidsng on achieving an regeneration. given doing this for so long. all of what is still talked about today, for example, the decriminalization, there are already four states that have -- 34 states that have become a rosacea was on the book -- criminalization laws on the book. the obama administration through

the justice department is helping to do that, but we have a long way to go. what the 2012 you in the credit party platform says. party platform says. i would to see what you would do in terms of recommendations to add. we have increased overall funny did combat hiv-aids to record levels. president obama established the first ever comprehensive national hiv-aids strategy. and thehe outside push president is that on world aids day. responding to the domestic epidemic which calls for reducing hiv incidence and increasing access to care, optimizing health outcomes and reducing hiv related health disparity. this is an evidence-based plan guided by science and takes direct