there it is a matter of political will and europe coming together to be decisive and decide how to do what they should in terms of helping legitimate refugees and stopping the dangerous flow across the mediterranean and the a and that has taken so many lives. our boss, secretary kerry is constantly on the go. he is doing so in the pursuit of peace. there is the humanitarian side. discussionse those with middle east leaders. and so will the white house. when they are having conversations about u.s. foreign-policy, one aspect of that will be asking governments

to respond to these crises and to treat people better in their own kick -- countries. paleumbers, of course, compared to the large migrations we see overseas, but for many years we have been the leader in a program taking the most refugees from around the world and bringing them to the united states where they can restart their lives. this year, we are seeking to bring 85,000 refugees. so, an increase, and also to -- g 10,000 syrian refugees [applause] anne r.: i get criticized from the right and the left on this one. because friends in one direction say that is not enough and friends on the other side say we are worried you would let terrorists sneak inside the program.

it is the most heavily vetted program of any traveler in the united states and it is ramping up sharply. right now, we have over 40% of the syrian refugees and we will see larger numbers in the coming days. we are all over halfway to 85,000. stay tuned. we have done a lot to try to meet the targets. i mentioned central america. we have a new program to try to reunite children whose parents -- one or both parents -- are present in the united states and bring the kids who have been left behind with grandparents safely to the united states so they do not have to make a trek.ous the numbers are starting to increase, too. the biggest in our bureau, after world refugee day, is looking

ahead to september, when the president will have a leader summit on refugees, and he is seeking other countries to chip in. for those countries that can afford to provide more assistance around the world, for countries who hasn't resettle refugees were taken in a certain number, that they do more or give certain scholarships or work visas or some sort of pathway. and the third piece of that is that countries throughout the years have hosted refugees that in light of everything going on in the world, that they do more , too, that they let the refugees support themselves and allow more children to go to school. three things i wanted to make sure you knew, crisis is global and refugees are not terrorists, and the u.s. leads. thank you. [applause] karen: i have given anne patterson a whole lot of time to think about this question --

[laughter] karen: i'm not going to ask it first. [laughter] karen: i want to follow with anne richard and what you said. you noted the high commissioner made a very impassioned statement and gave you numbers for refugees and also said that against the backdrop, divisive political rhetoric on asylum and immigration issues and disturbing levels of xenophobia are together threatening international agreements which protects us -- we see borders closing. instead of political will, there is political paralysis. humanitarian organizations like mine are left to deal with the consequences while struggling to save lives on limited budgets. is this the perfect storm of issues driving the problem both in terms of the number of

refugees and the reluctance to take them in? is it no money, is it the pure -- volume? two questions that have come to the floor, you touched on this a bit, what is the best thing that concerned citizens could do to make a difference? and how do you get all of these countries that pledge a lot of money, and then we look at the amount of money that has come across and it is not there? >> what we saw is that the countries where the traditional donors to the humanitarian efforts were the western europeans, korea, australia, and new zealand, and canada, the u.s., it was very clear as the numbers climbed in recent years,

because of conflict, new conflict but also conflicts that are not being resolved. that is part of the answer is that we are not able to bring peace to parts of the world because the leaders do not seem intent on peace. they seem to be wedded to continuing a bloodthirsty continuation of fighting. the same donors were the ones leading year in and year out and we have to get more donors to the table, we have to get more giving given the scale of what is going on. we have not succeeded in doing that. we have seen that some of the gulf states have become donors to humanitarian causes but they are not yet fully invested in the system that we have or the

echo system that we have. to one crisis at one point, but maybe not routinely year in and year out. we are also looking for other major world powers to serve on the security council or the g20. we have not seen new donors and -- new donors emerge, other than from the list i just put out. the europeans now, because of the arrival of all the mixed flow of migrants and refugees into their country, they are putting a lot more aid in. but of course, the needs have increased. definitely, the concern about right-wing political parties is driving some of the immediate actions that europeans are taking. they are really focused on trying to stop the flow rather than stepping back the way you could and say, what kind of legal migration might we set up or what can we be doing in peace

conferences to prevent this kind of flow, instead, we are doing things after they have shown up in europe. major donors are themselves involved and are reacting rather than acting proactively. >> in terms of africa, economic what do we call it? fleeing? >> migrating. >> i know it is not popular to talk about nation building anymore. we talk about capacity building. i wonder if you could look at the situation in africa where obviously there had initially been a huge flow of migrants , went down for a while. now it has started up again. how do you separate out economic versus refugees fleeing persecution or violence and as you try to address the problems particularly in countries where , both exist, how do you

prioritize in terms of where the scarce resources will go? >> i wish i had control of my -- prioritizing the resources. earmarkedhey are so that you cannot prioritize the resources. if i had control, i would put more in democracy and government. the key to me is having a stable country that takes care of its people. if you have that, you do not have people fleeing for economic reasons or political reasons. i would put more in that direction than what we are currently doing. we tend to focus a lot of our funding on peace and security. we focus our funding on initiatives that have been earmarked by congress or other

types of initiatives that are all good and contribute in some way to our ultimate goals, but they may not contribute as directly, as we would want them to. for example, if you look at our funding charts, a lot of money goes to health. who would argue against supporting health programs given we still have ebola and malaria and hiv/aids and any number of health issues on the continent? but those issues as well are related to the link strong -- building strong institutions, ensuring that countries are stable and govern well so that funding could go to areas where it is required. we focus a lot of attention on root causes. we know we have to take a multifaceted approach that is not just security, but ensuring that the governments take care of their people, that they are concerned about what they have, thousands if not hundreds of

-- tens of thousands of people who are displaced and who are not able to take care of basic needs on a daily basis. karen: one of the pending crises is kenya saying it will close where, i believe it is refugeesostly somalian are there. is that, how likely is that to happen and what will happen not only in terms of their own welfare, but what will happen if they get sent back to somalia where we have an extremely the -- precarious security situation? >> i would love to turn that over two and. i think we both know. -- i would love to turn that over to ann.

we both worked on the issue. i think my challenge is to encourage to stay the course and to be a credible host to refugees in honoring their commitment under the geneva convention. we have pushed very hard with the kenyans. ofhink through the efforts cr and others, the about insisting that refugees go home immediately. i was in the refugee court in kenya from 1993 until 1996. during that time, the kenyans threatened to send refugees home. it is no different than what is happening in all of our countries. one countries start to have problems, serious security issues, we blame those who are the most vulnerable. we are looking at ways to

address kenya's concerns and at the same time, trying to repair the situation in somalia so the refugees can come home. because they have been living in kenya for more than 20 years. a whole generation of children have been born and grown-up in those refugee camps. none of us see these camps is being permanent. yet they are. anne r.: the goal is that people do not have to live in refugee camps for very long. if they get to go home again, that would be the best outcome. somalia is a tricky place right now. some people have gone back voluntarily, but it is very much an experiment, i think. and that people be allowed to settle in a new country like some who come here, but usually that is only a fraction of the world's refugees. another option is people would be allowed to stay where they

fled and the numbers are so big right now that just saying that is probably the message a lot of countries do not want to hear. what i like about the answer is it shows you the tricky balance act that is diplomacy. as someone who has worked on refugee issues for a long time, and, you know has been in very , tricky situations before. linda was in good golly there was a rwandan genocide. linda is a bit of a legend for our folks, though she is not old enough to be a legend. but she is a legend. because she keeps going back to these tough assignments. and so the tricky balancing act to kenya, no, we're not intense on having this forever as a major city of refugees. at the same time, please don't make artificial deadlines and

please work with us in terms of solutions for people. >> your turn. karen: i think the whole conversation about refugees leads us directly to the middle east. we all know the fears, 400 thousand people dead, half the population of syria displaced or fled the country. and now, this has been an issue for a long time, that has been the subject of a political debate in the country. some people are very strongly saying that not only should we now intervene militarily, but we should have a long time ago, and it ranging from airstrikes to troops on the ground. you have other people, i will not mention any names, that we

should not be in there. we should be directing all of our attention to the islamic state. you have a dissent memo i mentioned that was leaked last week. this is 51 state department officials, many of whom work on the issue, saying, it was a humanitarian situation, saying this is completely unacceptable. we need to do something else. we need to take military action and get bashar al-assad to come to the table and negotiate his own exit. from the administration's perspective how likely is that , to happen? how likely is a policy shift, whether that or something halfway there or something? anne p.: karen, i think you are seeing to stress, the in norma's -- the enormous loss of life, particularly in lebanon and jordan, 70,000 people are sitting in no man's land now.

and jordan, but there is a long history in the state department going back many years. i think this was an expression of frustration and dismay by number of people who worked on this very closely. let me assure you that the issues are grappled with at the very highest level of the administration every single day. there are not really any good answers in syria. there are complex legal issues, complex u.s. military deployments. there are a range of complications that result from this. one of the issues, i think that , it is important to focus on,

efforts inerry's this respect because he put together an international coalition, which, despite its shortcomings, and there are many, has at least enabled humanitarian access to get through to 700,000 people who did not have it before and to impose a cease-fire in part of the country. there is an international effort underway under the auspices of the u.n. and this is extremely fragile. and obviously insufficient. it is really the only way forward to solve the situation in syria. i would not anticipate a change in policy. i think the issues are struggled with every single day. but i think to go down the path that the secretary has laid out is really the only prospect that

i see right now. karen: the central parts of the administration of counterterrorism policy, are working on the ground. i mission earlier that saudi arabia has been vocal about his disagreement of some aspects of the policy. there are other disagreements, not only with the saudi's but with turkey and other countries in the region. how long can the coalition hold together, as other countries believe that something else needs to be done? is there some danger, particularly, it would not be likely to happen this year, but if you see a new administration coming in and the opportunity for them to start going along, how important are these partnerships and how do we keep this together amid a lot of disagreement? anne p.: i think the counter isil coalition will hold satisfactorily

because nothing breeds success like success. many others in the administration, how military -- let me stress that. that is a different issue. but how militarily vulnerable isil has proven to be. in most cases, there has not been a direct confrontation with isil. it has melted away and a lot of simultaneous pressure has been put on isil. both in syria and iraq and frankly, now in libya. fairlyturned out to be a -- if not easy, at least manageable military target. i think what you may be asking though is about syria and how long can the differences of view hold together? if anything, it has gotten better. two years ago, policy disputes among turkey and saudi arabia, and egypt and all the other players in syria, they were really quite profound. each of these countries were going their own way and supporting their own proxies. that has gotten better. there have been a number of

efforts in the administration and the secretary's efforts is one of them but there are others to bring these countries together. it is not perfect. as you heard there are many , disagreements that persist. i think there is still a more thaned policy view then -- there was a couple of years ago. karen: this is a question from the audience that i think applies to what all of you do, especially as terrorism and capacity building belong together. -- glom together. i will just read it. it has been observed that the geographic combatant commanders act as super ambassadors with the regional area as responsibility and that they have a lot more resources than the state department has. what is your level of interaction with the commanders?

how often do you talk to them? do you feel like the planning process is fully integrated? any of you like to -- >> why don't i start? -- they are in command. i started with them at the very beginning in the africa bureau and worked with dod on the development. of africa command. at i have seen it from birth to now constantly improve. i speak on the phone with general rodriguez, the current commander, once a month. it is a scheduled phone call, but we see each other as often, more often than that when there are issues that come up. i do not feel they are acting as

super ambassadors, but they had tremendous resources we do not . that is something i wish we could correct. the resources give them entrée into many areas where it is probably not appropriate for the involved, but they have money and it's hard to say no when we see the need. we do coordinate closely. we have annual strategic planning meeting. rod is in town, the two of us will meet with him together to discuss issues of mutual concern. but again, i think the area where we have the most concern on the funding side. >> we see them and talk to them all the time and at various levels, not a day goes by that

we do not have constant contact with them. and i don't think they want to be super ambassadors, because not surprisingly, you do not get to be a general in the u.s. by realizing how the policy process has to work. i don't want the money as much as the people. they have lots and lots of people. i think the budget is 4% of the state budget. it is a question of scale we simply cannot match. at when you get into enormously complex post insurgent situations -- regrettably, it's only going to be dod that has the resources to bring to bear on the situation because it is a question of scale. i wish were otherwise but it will not within our lifetime. we have to adjust to that.

but the personal, institutional relations are just fine. karen: it is the anniversary of operation comfort. i remember covering the balkans. there was a lot of tension between the military and civilian side in terms of who was in charge, who could get organized more weekly. do you see that in refugees? -- anne r.: with colleagues at the office of development, to brief military colleagues would go out and work as policy advisers to brief them about what to do when a crisis erupts so that they understand that you bring the u.s. military in in a quick way, if the crisis is of

such a magnitude and it is a natural disaster where they will be shooting at each other. there is such a magnitude that only the u.s. military has the capacity, a lot of things very quickly. they are not the low-cost option , and they are not an option that can be used without thinking very carefully in those few hours before you deploy them. but they are the best in the world of being able to go across the globe very quickly. in peacetime, that can be a life-saving piece. for most of the time, we have civilian response mechanisms are -- mechanisms. we have my bureau of the state department, the u.s. office of

foreign disaster assistance, the truth for peace office, we have established relationships with international organizations that know what to do in the nongovernmental organization. we work very closely with the u.n., with leadership, and with crises to respond to make sure there is a strong civilian response, so the military does not have to be called upon to get involved. karen: two audience questions have to do with the islamic state. one is, what additional steps if the department taking in terms of social media and second, and i am assuming this is about --amic state and about syria has russia been

>> we have a new office handling social media and it has roughly 100 people on an expansion now and there is a lot of analysis and frankly, people like anne, a lot of this starts in social media. in this countering extremism fight. i think our efforts in this respect have improved. very importantly in my view, we have set up joint in this country because we cannot message muslims as effectively as people who live in the region. we have a good one with a uae. if we are going to do one in indonesia and other countries where you can get the word out to mostly young men who may be attracted to the ideology, on the second question, the relationship with russia has been very complex and not to beat around the bush about it, russia is a player in syria and went in there to preserve their

interests and at least to preserve it temporarily. but the russians will be key in moving him out at a certain time. we're in constant contact with the russians here and we have channels in geneva and people talk to them every single day about the cease-fire and -- in very extensive and detailed conversations. our intelligence people work with them to resolve issues of fact. it is challenging at times. very challenging at times. but i think it is fair to say that the cease-fire has been held in important areas in the country and it is always being negotiated in other parts of the country as well. secretary kerry has been the best to say, he will not taken in by this and the proof

will be in the results. for that matter, the rest of the international community to advance the cease-fire. karen: they have been saying things in recent days with the assad government about moving toward islamic state headquarters. this is a major objective of the force that the americans have trained. is everyone going to come together in raqqa and either shoot at each other or single -- seeing, by all. anne p.: i think they would say it is unlikely the syrian regime could reach that but for us and the coalition, eliminating the state is very important because it is the known headquarters of

isis. they are under enormous and brutal conditions. to free them would be humanitarian in and of itself. it would also be a huge intelligence troth because there is a lot of reference there about foreign fighters. it is very important but again, the military success against isil has been significant. karen: we only have three more minutes. i want to ask you about, you mentioned the syrian refugees, while we're on the subject of syria and the administration was going to take 10,000. i think it was within the fiscal year, by the end of september. they have now taken i believe around 300, are they going to make it? >> yes, we are going to make it. karen: good.

[applause] karen: and here is a really good question about nigeria, which is, what keeps a nigerian army from the united states and others from hunting down and destroying boko haram. i heard the terrorists are integrated into communities in northern nigeria. is this part of the problem in defeating them? >> i think there is no one answer to that. i think of we look back a couple of years, it was a lack of capacity, believe it or not, in nigeria and the army. the army had been starved for a number of years. changed but it does not change overnight president

bihari is focusing on making sure the army is having the capacity to respond and working with neighbors and other partners to improve the response against boko haram. it is not an easy task. it is an organization that continually marks itself, they are fighting on many different fronts and some of them are in communities, making it very hard to figure out who is who. and where they are. i think with all of our efforts, working with the multinational task worse and the eu, working with the neighbors have suffered recently from a major attack and we were just talking about that, that it will take even more efforts to deal with the issue.

we were concerned about the impact isil would have in terms of what capacity they are giving the group. so it will take some time and i think that is the answer. karen: time for one more? i am personally interested in this is a good question. it's about egypt. it says going forward, what do you see as the best way to balance between the military and support for human rights and civil rights and economic development? anne p.: that is a really good question and we struggle with it almost every day in the department. there is no question that the situation is more unsettled now. you are seeing pockets of isil, not very large ones, but with a population largely alienated from the central government, it has potential to become a problem.

you are seeing a human rights situation that is extremely disturbing. but in my view, in the long term, you are seeing an economy that has not been able to adjust to 800,000 jobs each of needs to -- egypt needs to create every single year. it is important with 90 million people that we maintain contact and we encourage them to improve their human rights situation and improve capacity on the military side. we try to balance our objectives there, which are several. security of israel is one of them, an important one. with human rights situation and encourage political development. karen: thank you all so much. [applause] karen: great contribution. i wish we could go further. a lot more questions. thank you. and thank you all so much for coming.

>> let's thank ambassador patterson, greenfield, and richard for being exceptional role models worldwide. [applause] and karen deyoung you asked the most probing question. thank you and come back soon. [applause] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2016]

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him and it >> tuesday a hearing on the progress made, in the national public safety network for first responders. the senate commerce and science subcommittee beats live at 9:30 a.m. eastern, and you can see on c-span3. later, philadelphia mayor and democratic convention ceo jim

kenney talks about the planning for the democratic national convention. we will bring you that briefing, live at 2:00 p.m. eastern, also on c-span3. >> for the political primary season over, c-span's road to the white house takes you to this summer's political conventions. watch the republican national convention starting july 18, with live coverage from cleveland. >> we will be going into the convention of matter what happens, and i think we are going to go in so strong. >> and watch the democratic national convention starting july 25, with live coverage from philadelphia. >> let's go forward, let's win the nomination, and in july, let's return as a unified party. >> and then we take our fight economic,, racial, and environmental justice to philadelphia.

>> every minute of the republican and democratic parties national convention on c-span, c-span radio, and c-span.org. >> the justice department released a full transcript of 911 calls made by orlando shooter omar mateen, after originally redacting references to the islamic state. in a conversation with c-span recorded earlier on monday, house speaker paul ryan called on the administration to release the complete transcript. he also talks about the house gop agenda and the 2016 campaign. >> joining us on the phone from capitol hill as congressman paul ryan, the speaker of the house. mr. speaker, thank you for being with us. >> thanks for having me. >> we want to focus on the house republican blueprint and its impacts this year, but we want to begin with news.

you issued a statement saying "the selective editing of the orlando shooter's 911 transcript is preposterous. hous" how so? >> i think we should be clear about the threat we face and people should not be spared. wse need to understand -- we need to understand the problem if we will grasp it. unless it is unique to the investigation, which i don't think with the reasoning here, i don't think we should whitewash these things. >> but the attorney general said she didn't want to give any more credence to what he was doing it. >> again, i think we, as a country, need to see this for what it is and not try to sweep it under the rug. we need to be very clear about the threat we face, and i think americans should be treated with respect by seeing this for what exactly it is. >> do you think the administration will change course and released the full transcript? >> that i have no idea. i think it was the wrong decision to make in the first place. >> all this month, you have been launching what you are calling a

better way, six areas of reforms for the government. let me focus on your first priority -- poverty and the economy. how will your approach in any way move the needle? will move think it the needle because it is so different from the approach we have been taking, which has not moved the needle. we still have 45 million people in poverty in america. i would argue that it is a stalemate. there are some things that have been done well but there are many things that have been more or less backfiring. for instance, if you stack up a lot of our welfare programs on top of one another, they end up creating a poverty trap. they pay people not to work, they discourage work. becomingas ended up a workplace and program when it needs to be working herdsman. we need to change the way they work so that they're customized to a person's particular needs, and that we measure success based on poverty programs and results, not input or effort.

that's unfortunately what i think our welfare system has become, which is that we measure success based on how much money are we are spending,, how many people are on the programs rather than truly measuring success based on are we getting people out of poverty. are we breaking the cycle of poverty? are we getting poverty at its root causes to break the cycle? those of the questions we need to ask, and those of the answers that should dictate reforms. that is the kind of reform we are calling for. >> let me remind you of a quote from 1989, your mentor saying that "you can't be conservative, idealistic, and progressive simultaneously." is his legacy and his agenda driving part of this? >> it is. no bones about it, he's a critical mentor to me. his brand of conservatism is the kind i believe in; it is aspirational, inclusive, optimistic, focused on the dignity of every person and making sure they have a chance to reach their potential.

it strives for promoting quality of opportunity so that people can reach their version of the american idea, which is this beautiful idea, that the condition of your birth does not determine the outcome of your life. that is what jack spent his life fighting for. i learned from him. he is the one who more than anyone else inspired me to public service. >> another plank is making the government, in your words, more accountable, and yet it comes at the same time that there is growing frustration by the american people, at washington and federal bureaucracies. how do you change that? >> that's a good question. it's not just president obama, it's administrations -- republican and democrat in the modern era -- that have taken over the long writing function from the legislature. we propose a very comprehensive list of solutions. better.gop, not just a reform the regulatory states, but to reform and reclaim the principles of the government by consent, self-determination.

right now we have this branch of unelected bureaucrats writing andlaws, so rules regulations -- these are bureaucrats we never voted for. now we are more and more living under laws written by people we never voted for, and this takes away from the critical principle that the laws are written by us. so if we want to reclaim self-government, if you want to have a government that is accountable, efficient, accountable as people, then we need to reclaim these long writing powers, article one of the constitution, to the legislative branch. we put out a very copper has a plan to show how to do it. better.gop. >> we should point out that your speeches have been on our website. we want to take you back to the republican convention in new york city. here is what you said. >> we are offering a more hopeful vision to america, by reaffirming our party's commitment to freedom and opportunity for all. these are the economic foundations of the american dream.

who shareamericans the stream, regardless of party, to join us, to make the tax cuts permanent, to make the tax code simpler and fairer, so every worker in america has more control over their economic future. >> speaker ryan, you were talking about the bush tax cuts in 2004. is that a big part of your agenda? >> tax reform is. i want to go beyond that. i want to go beyond trimming the code, which is what the proposal was at the time. we will beweek, offering a very comprehensive overhaul of our entire tax system. the tax system has grown out of control, the irs is too intrusive in people's lives, and more importantly, we are losing our economic competitiveness, our edge of the country and the economy, because of our tax code. we will be proposing conference of tax reform that is good for families, small businesses,

keeping jobs and businesses in america, and that is something that i think is one of the crown jewels of our economic growth package. we really have to take on the issue of tax reform if we are going to help our economy reach its potential and help people get ahead. we will be offering very comprehensive. >> on the issue of repealing and replacing the affordable care act, what do you want to do? >> that comes before. we will be offering that earlier. we will be offering that this week, the fifth and sixth installment of our better way agenda, which is a plan for patient-centered health care. everyone knows we are against obamacare. what people need to know is that we have good ideas for what we are replacing it with, that reduces the cost of insurance, that gives people more choices, that doesn't create entitlements that bankrupt the country, and that is a patient centered system. we will be offering a comprehensive plan to replace the affordable care act, which has become mor

unaffordable, and offer our blueprint for tax reform, which we think is critical for getting jobs and growth back to the economy. >> we will be covering the speeches here on c-span. will congressional republicans be running on these planks? >> that's the whole purpose of this. these are not bills we will pass in 2016 with the president who disagrees with us. these are reforms we are going to be offering in 2016 so we can earn the right in the mandate to put them in place in 2017. we think the things the reforms are necessary to get the country back on track. we are going to not only offer them now but campaign on them all year so that we can earn from the country this choice, so we can earn the mandate. we want an affirming election so we can say here is our solution to get the country back on track, in a better direction, and if we win that election, we have earned the right to put these reforms in place in 2017, and that is what we are seeking. >> mr. speaker, is this your

version of contract with america? >> you could call it that. we call it a better way, but it is a similar objective. i have spent many moments with the nominee to make sure we are on the same page. i am sure we will disagree on this detail about detail; that is to be expected. congress always negotiates the finer details of the of illustration when it comes to legislation. but on the critical aspects of his agenda, on the foundations of it, on the base principles, we are in agreement on these things, and that is why we are moving forward on this platform. >> how did you come up with these six agenda items? >> through consent. through bottom-up in congress. we met as a house of public and conference and discussed, what are the big agenda items we want to take to the country, that we think are the critical issues that fix our biggest problems? this is not solve every problem; it's not meant to.

what this does is it unite all republicans around common principles and solutions that improve people's lives, that we also think are appealing to people who don't think of themselves as republicans. this is not only a unifying agenda, it's a clarifying agenda. we think it's an agenda that attempts to fix the big, pressing problems facing our country that are in urgent need of solutions, so they can go forward with the unified front. >> and finally, do you think the senate republicans will be in the majority next year, and that the republicans will be in control of the house? >> certainly our goal. i do think we will, but i also think we will be a stronger majority in the house and senate if we're reelected based on an agenda, amended to get things done. that is what we are looking for. >> do you feel you have settled into the job? >> i do. i had to redesign it with my own strengths, to that my own style, and because i have been able to do that, i feel like i have

grown into a pretty well, and i have been able to make it work for me. i am a younger guy with the younger family, which has its and i unable to redesign the job to fit my personal issues. i also prefer being more of a policy maker than typically speakers are, and i have been able to maintain that. >> one day after father's day, have family issues in the biggest challenge? >> no, we have been pretty good about that. i have been hypervigilant about our schedule. #the conference knew it was a nonnegotiable condition upon taking the job. most speakers are empty-nesters, so they have no problem traveling every weekend; i can't do that. my other challenge was to make sure that we came together, reached consensus on an agenda, agenda together in a

bottom-up way by listening to constituents and offering it to the country. those are the two critical things i wanted to focus on as part of my speakership, and i am pleased we are here. >> house speaker paul ryan on capitol hill. agenda together in a bottom-up waymr. speaker, thankr time. >> thank you. >> next, veterans affairs secretary robert mcdonald on veterans health care. the the a disability claims processing in the agency modernization efforts. secretary mcdonald took part in a discussion hosted by the brookings institution on monday. this is an hour. s institution on monday. >> good afternoon everyone. i am the director. the center for effective

government here. it is my great privilege to open on, can be veteran affairs be modernized? let me introduce the secretary and then i'm going to introduce one of my colleagues here. the secretary will speak and and alsoill monitor take your questions. we will have a hard stop at 3:00. he served as brigade and was recognized by the royal society of arts, manufacturing and commerce.

that is quite something. he served with the 82nd airborne division. he earned the infantry badge. on leaving military service captain mcdonald was rewarded the meritorious service medal. career spent most of his at proctor and gamble. under his leadership, proctor and gamble significantly calibrated its portfolio. he grew the firm's organic sales by 3%. just about two years ago, president obama selected robert

mcdonald to be the secretary of veteran affairs. yearthe course of his 10 the v.a. has expanded veterans access. it has continued to drive down thanks in part to large partnerships across the federal government with both profit and nonprofit organizations, it has focused on prevention and treatment for veterans homeless. brieflybe interrogated by our very own norm eisen. he served in the obama administration as special government ethics.

he then went to the czech republic where i first met him. and iwith us at brookings am very pleased to have him. he will be talking with you afterwards. with that, please give secretary mcdonald a round of applause. [applause] secretary mcdonald: thank you for that kind introduction. i want to start by answering the question asked today, can the department of veteran affairs be modernized? the answer is absolutely yes. not only can it be modernized, it is already being modernized and we are ready seeing the results.

based on what veterans are telling us, we have already seen improvementant -- from the v.a.. we completed 5 million more appointments than in the previous fiscal year. almost 57 million appointments and 20 million appointments in the community. past march, we set a new record of completed . we had 433,000 authorizations for dear in community in march. these authorizations will result 2 millionan

appointments in the months ahead. the clinical workload is up 11% in the past two years, nearly 9% inside the v.a. and 27% with be with -- with -- v.a. community care. that means over 7 million additional hours of care for veterans. the results? 97% of appointments are now completed within 30 days of the veterans preferred date. 86% within seven days. and a 22% to our same-day it appointments. average wait time last month five days for primary care, six days for specialty care and two days for mental health care , but none of those numbers tell the whole story. they are important. what really matters is whether veterans are satisfied with

their experience at the v.a. so we are asking veterans what they think using automated , kiosks at our facility. more than half a million have responded in recent weeks. one of the questions we ask is how satisfied are you that you got today's appointment when you wanted it? nearly 90% say they are satisfied or completely satisfied. less than 3% say they are dissatisfied or completely dissatisfied. and, i don't know how patients in the private sector would answer that question, and i suspect our results would compare pretty favorably. but guess what? care,we improve access to more and more veterans are choosing v.a. care for the quality, convenience, and cost savings. i'm sure you have heard it said, if you build it they will come. well, we are building a better

v.a.. that and it know are coming to us for more of their care. so even though we are providing more appointments than ever, some veterans are still waiting the longer than they should have to wait. but that is not a measure of our failure, that is a measure of our success. , wee provide header care are providing more care. care, we are providing more care. veterans are waiting less time for care and so they are coming to us for more of their care and they are telling us they are satisfied or completely satisfied with the timeliness of their care. how does that not spell success? but until all veterans are satisfied with their care i will

not be satisfied with v.a. nobody will. but i am satisfied that we are on the right track and we're making progress and that progress is undeniable. though of course some people are determined to ignore it. i have had some experience running very large organizations and i know you cannot accomplish a major overhaul of appropriations culture and operations overnight. i also know the v.a. has several areas of excellence it can brag about. the american customer satisfaction index has rated our national cemetery administration number one in customer service five times running. jd power has rated our mail order pharmacy best in the country in customer satisfaction six years running. we are a leader in many fields of research. traumatic brain injury. spinal cord injury. prosthetics. genetics. the first implantable cardiac pacemaker. the first successful liver transplant.

the first nicotine patch. three nobel prizes. seven lasker awards. and, look at what we have done with the backlog of disability claims. not long ago we had a backlog of over 600,000 claims, more than 125 days old. that was all you heard about in v.a. in those days. we implemented an automatic claims processing system and today the backlog is just a fraction of where it was. it is down almost 90%. so, the idea that the a cannot be fixed or that we are not fixing it is nonsense. v.a. can't be --v.a. can't be fixed or that we are not fixing it is nonsense. we are fixing it. we are just not finished yet. we still have work to do. our vision, the goal we set for v.a. is being the number one customer service organization and the federal government. we are building a high-performance organization,

and integrated customer centric enterprise leveraging the v.a.'s scope and scale on behalf of every veteran we serve. to achieve that goal we are applying best practices and standards of customer service businesses. 12 of our top 17 executives are new since i became secretary and all 12 have top level leadership experience in business, health care or government. together we have conceived and organized a transformation initiative which we call up "my v.a." because that is exactly how we want veterans to see us. customizede proud of

customized for them. we are committed to five long-term strategies. first improving the veteran experience. second improving the employee experience. it's not a surprise that the best customer service organizations in the world are all of the best places to work. third achieving support service , excellence. forth, establishing a culture of continuous performance improvement. and fits enhancing strategic partnerships. for the near term we are focused on quick wins for veterans. 12 breakthrough priorities for 2016 that support our long-term "my v.a." strategies. eight of the 12 are about directly improving service to veterans. first, improvement the veteran experience. increase access to health second care. ,third, improve community health care.

fourth, deliver a unified veteran experience. modernize contact centers. fifth modernize contact centers. sixth, compensation and pension exam. seventh develop a simplified appeals process. and continue to reduce veteran homelessness. four of the 12 priorities are critical enablers designed to help the previous eight. those are improve the employee experience. staff critical positions that are vacant. transform our office of information and technology. transform our supply chain to increase responsiveness and reduce operating costs. those critical enablers are about reforming internals systems. giving employees the tools and resources they need to provide great service and consistently delivering an exceptional veteran experience. for employees serving veterans growing a high-performance organization means equipping more teams to dramatically

improve care and service delivery to veterans. that's what our leaders developing leaders program is all about. ldl is an example of continuous enterprisewide growth spreading best practices across the v.a. we launched ldl last november and have already trained over 19,000 employees. we are also training employees on it and business techniques like lane six sigma and human centered design. executive performance ratings and bonuses are being tied to veteran outcomes, employee surveys, and feedback. growing a high-performing organization also takes world-class collaboration and strategic partnerships. vast networks working together to serve veterans. it's why we have enabled a national network of 50 community veteran engagement boards.

these are designed to leverage community assets not just v.a. assets to meet local veteran needs. our goal is to have 100 of these are the and of the year. that's why we are capitalizing on strategic partnerships with external organizations to leverage the goodwill resources and expertise of partners such as ibm, johnson & johnson, amazon. university of michigan health system and many more. that's why we are working collaboratively with world-class institutions like usaa, the cleveland clinic, wegmans, starbucks, kaiser permanente, hospital corporation of america and many others. and it is what we have brought

together the diverse group of business leaders, medical professionals, government executives and veteran advocates who serve on our my v.a. advisory committee. growing a high-performance organization takes a clear purpose, strong values, and enduring principles supporting sound strategies. we already have a clear purpose. our mission, caring for veterans and their families. we have strong admirable values. they are values of integrity, commitment, advocacy, respect and excellence. they are foundational to everything we do. growing a high-performance organization also takes strong passionate leadership and we have that. a growing team of talented making innovative changes. it takes the kind of responsive systems and processes we are

building, veteran centric by design. we believe veterans should have same-day access to primary care and that new patients should receive a same-day mental health is the smith and immediate care if needed. this could mean a same-day appointment with a primary care doctor or it could mean a call from a nurse with medical advice. or a telehealth or mental telehealth encounter. for a secure message. prescription refill. or they walk into a clinic or emergency facility. we have put in place a system to identify best practices in our veterans hospital administration and implement those best practices throughout dha. we are already doing that. it is based on the shark tank model. we invite employees to submit ideas. we take a couple dozen of the best ideas and then we have employees present their ideas to a panel of sharks. the ideas that survive are assigned to a team to oversee implementation throughout dha. it's an ongoing effort aimed at continuous improvement in

operations directly affecting the veteran experience. nobody else in the health care community is doing it. v.a. is leading the way as it often does. we are improving access to health care in many other ways as well. we are making it easier for veterans on the road away from their regular va hospital to receive care or refill prescription at another v.a. facility. we are making it possible for veterans to enroll for health care on line or over the phone beginning july 5. we are already calling every new enrollee to welcome them to v.a. and offering to schedule an appointment and telling them about other v.a. benefits and services. we have called 200,000 veterans so far this year and the response has been tremendous. we have created a mobile app that lets veterans schedule, reschedule or cancel

appointments on their smartphones. thousands have tried it and loved it in the field tests we conducted and we expect to make it fully available later this year. we are creating a single phone number and a single website so veterans have a one-stop source for information rather than asking them to navigate our complicated internal structure. we are also working to give veterans more opportunities to provide immediate feedback on the quality of the care they receive. these channels will be in place later this year and that feedback will help us meet the needs of veterans. we are committed to doing everything we can for veterans advancing along all these lines and many others. but important priorities for transformational change require congressional action. the president's fiscal year 2017 budget request is another tangible sign of his steadfast devotion to veterans and his commitment to transform v.a. the senate appropriations committee approved a budget

nearly equal to the president's request. the house markup proposes a $1.5 billion reduction. let's be clear. that reduction will hurt veterans and it will impede some critical initiatives necessary to transform v.a. into the high-performing organization veterans deserve. so we are encouraging congress to fully fund v.a. at the request level. more than 100 legislative proposals for v.a. are in the president's 2017 budget and 2018 advanced appropriations request. over 40 of them are new this year. they require congressional action. some are absolutely critical to maintaining our ability to purchase non-v.a. care. in mid-march, i testified to congress about the most important requirements to help us serve veterans better. deputy secretary sloan gibson will be testifying for the house

veterans of heirs committee affairs committee again on thursday. we need congress is help monitor rising and clarifying the v.a. purchase authorities. above all else is needed to get done to ensure a strong foundation for veterans access to community care. we need congress's help streamlining care in the community systems and programs. last october we submitted our plan to consolidate and simplify the overwhelming number of different programs and improve access to v.a. care in the community. we need congress to enact legislation that will allow us to better compete with the private sector to get the best medical professionals to choose to work in v.a. that makes flexibility on the 80 hour pay period limit and compensation reforms for network

and hospital directors. likewise we need to treat health care executives more like their private sector counterparts. that means expanding the title 38 authority to vha senior executive level medical center directors and other health care executive leadership positions. then we can hire these employees more quickly with flexible competitive salaries. and operate under strong accountability policies. we have to be more responsive to veterans emerging needs so we're asking for modest flexibility to overcome artificial funding restrictions for veterans care and benefits. and we have urged amtious action on our disability claims appeals system. we cannot serve veterans well unless we can come together and make big changes in the appeals process. it's a heavy lift. we have met with veteran service organizations and we have gotten their assistance in putting together a comprehensive appeals modernization legislative proposal which we made it to congress in a world and updated earlier this month. i believe congress is responding on the senate side, chairman

johnny isakson in partnership with ranking member blumenthal is working on the veteran's act, a large omnibus bill that includes many of the legislative solutions we have been urging. on the house side chairman jeff miller has been working closely with us as well. our window of opportunity is closing fast. we need congress to act on the proposed legislation before they leave town in it to life or their extended election year summer recess. if congress does not act on these transformational changes the v.a. will not be able to complete its transformation and veterans will have to settle for a v.a. that is not as risk wants it to their needs.

asto a v.a. that is not responsive to its needs. there is no question about that. if congress acts we will all look back on this year as the year we turned the corner for veterans. those are a few points about our progress and challenges. some of argued that the v.a. can best serve veterans by shutting down v.a. health care altogether. they argue that closing vha is bold transformation veterans and the families need, want and deserve. i suspect that proposal serves some parties pretty well. but it's not transformational. it's more along the lines of dereliction. it doesn't serve veterans well and it doesn't sit well with me. president reagan gave veterans a seat at the table of national

affairs nearly three decades ago. my v.a. is about keeping veterans at that table, in control of how when and where they wish to be served. thank you for sharing this time with me this afternoon. i look forward to your questions. thank you. [applause] >> thanks very much. >> thank you, mr. secretary for that fascinating overview of all that you and your colleagues at the v.a. are doing.

to take the next step, to modernize the veterans administration. to better serve our veterans and to make all of america proud of the care that we provide to them. it is an enormously challenging enterprise to come into government and attempt to reform, and modernize. remind everyone here and everyone in our viewing audience viewingn and in our audeince on c-span tha we are

i amtweeting the event and email.ckin g my questions from the twitter feed. you can direct those questions. they have been coming in at my twitter account. @normisen. we will also take them at #vasec. first i want to talk about the question i have for you. what has been the biggest surprise for you coming from a distinguished military career and a private sector career good and bad? the biggest surprise in your tenure as v.a. secretary. mr. mcdonald: you will not find this surprising and i certainly didn't find it surprising. i think the amplitude of emotion is surprising. that is the ability to do a good

thing for a veteran on any given day. i like to think before i go home at night about how many veterans did i help today? how many did i help through i did the systemic or transformational changes we are making or even how many called me on my cell phone. you know i gave out myself for a number out my cell phone first nationalmy septembererence in 2014. veterans every day. and i enjoy that because i like to listen to the voice of the customer. i would not say it was surprised but i think the amplitude of satisfaction is surprised. surprise on the other side i think is the difficulty, the sheer difficulty of trying to get things done. we have a lot of stakeholders and as i mentioned in my talk we put together what i think it an outstanding transformational plan for the v.a. but frankly if we don't get the budget and we don't get the law changes we need from congress, we are going

to fall short of what we could otherwise do. we are working very closely. the great thing is we have relative unanimity within congress. we are hoping we can get these bills on the floor and passed. they generally have gone through committee. we want to get them passed before the congress leaves in july. norman eisen: on your amplitude point you remarked in your speech about the new customer service kiosks and you got just under 90% satisfied or entirely satisfied and just 3% dissatisfied or completely dissatisfied. i will say that every one of those 3% sent me a tweet with a tough question for you, mr. secretary. mr. mcdonald: that's a really interesting point. because we run a health care system and there are roughly 21 million veterans in the country,

9 million attached to our health care system. 6 million use it frequently. so 3% is still on except double. -- unacceptable. anyone will tell you that even one unsatisfied or dissatisfied customer is one too many. that's why no matter how much we transform this is an ongoing process that we need to continue. one of the themes in the twitter question, a recurring theme. this particular tweet that i'm looking at is from robin mitchell. a recurring theme is your comment that wait times are important but they are not the only measure of veterans experience and that's what veterans are telling you. in the time around which you made that comment you analogized to how corporations measure and you mentioned disney and that created somewhat of a furor. i thought i would give the

opportunity and response to the veterans. myself as a child of a veteran i experienced some of that amplitude myself. to give you a chance to respond to that point and to the many tweets we're getting on that issue. mr. mcdonald: as that occurred and as you know, i put out a statement right away that said, basically if any veteran or any american looked at those comments and thought in any way that we were not taking access to care seriously, i regret that. what we're trying to do is build a world-class health care system for veterans. access has been the primary focus of everything we have done as i came into office. we have added 4 million square feet of physical space. we have added over 1200 new doctors. we have added over 2300 new nurses. we have added evening hours, weekend hours. we are doing everything we can

as i mentioned in my remarks, to get people access to care. one of our priorities for this year is to be able to have same-day access to medical professionals to resolve issues. right now we have that at 34 of our facilities. about 25% of our facilities. we have a team of people dedicated full-time to figuring out how to do that in every single facility. so access to care is a top priority for us. norm: while you answered that question, 15 additional questions came in on @normisen and #vasec. keep them coming in. i'm going to ask one. that is not perhaps strictly within your purview but because of the commitment to caring for veterans for your fellow veterans that you've articulated, i myself was

curious. it jumped out. although the health care needs of veterans are the primary focus of your work, veterans do have a full spectrum additional set of needs. there have been recent studies. josh protus says there have showingent studies insecurityof ffod among veterans. have you thought about that at all and how in general, when there is such critical requirements in the core health care mission that occupies so much of your day, how do you deal with the additional needs of our american vets?

sec. mcdonald: that's a great question. one of the things we did when i actually started under sloan gibson was a long-term study of, where do we want to take the veterans hospital administration? one of the thing that differentiates v.a. care from the private secretary is it is integrated and holistic. we deal with mental health, physical health, spiritual health. we deal with nutrition. one of the things we want to do is move care from curing disease to preventing disease. one of the things that bothers me, and into about 300 v.a. facilities -- i have been to about 300 v.a. facilities and one of the things that bothers me is seeing obese veterans. obviously that creates all kinds of bad outcomes. these are individuals who at a time in their life were exercising every day. were taking physical fitness

tests. become thatet them way? why can't we work with them in order to maintain their fitness once they get out of the military service? we are moving toward preventing disease and we have a special medical advisory group chaired by jonathan perlin who is the chief medical officer of hca. he is helping us along with other medical professionals to design a program focused on prevention rather than cure. i think that's the direction we need to go. think of the savings for the taxpayer. norm: mr. secretary, i don't want to neglect the real-life human beings who have filled our room here at brookings in favor of

virtual reality. i'm going to ask questions in the room now and i will begin with this young lady in the third row here. yes ma'am. hold on. for the sake of the viewing audience we need to give you your microphone. i will remind everybody. if you don't mind, say who you are when you ask a question. i will say this is the reason i think brookings invited me to be a member of the family here. i will ask everybody to make their questions questions. please limit yourself to a one or two sentence question. i will be ruthless in enforcing the no filibuster rule. it may be allowed elsewhere in washington, but not here. >> i'm dr. dana robinson. i would like to thank you very much for coming and spending a portion of your day with us. i also served in the navy for almost 25 years as an enlisted member and as an officer. sec. mcdonald: thank you for your service.

>> absolutely. it was my pleasure. i recognize the importance of modernization. as a primary care provider i know it is important that we stay up to date regarding all of the new standards and best practices. however, take into consideration that more than 600 veterans are committing suicide every single month. is it responsible to utilize the money for modernizing this system as opposed to addressing the problems that are within the v.a. system that are causing veterans to even come to the v.a. to commit suicide? sec. mcdonald: it's a great question. obviously one of our 12 priorities -- please, you can sit down. is to reduce the number of veterans committing suicide. as you know we have estimated in the past that about 22 veterans take their life on any given day.

17 of those are not connected to the v.a. 5 of the 22 are. we know that if we can outreach people the program works. so, a lot of what i was describing in the modernization was ways to improve that outreach. for example, hiring more mental health professionals. i talked about same-day access to mental health care. i talked about if you show up at one of our emergency rooms, we have somebody trained there. our veterans crisis line where we need to add more people and make sure there are no dropped calls. we need to make sure that if you center,.a. medical whereas in the past it would have said if you are in crisis

hang up and call this number, we are putting in place a system that says if you are in crisis, press 7. the people who run our crisis line that was shown in the h bo documentary that won an award -- outreach is critical to do. we have to make sure the entire population is working together to recognize the five signs. the five signs when a problem is coming. because we can't wait for veterans to get connected. we have to connect them. similarly i think we have a problem in this country. we tend to see national problems perhaps before they get into the news. we are not creating enough mental health professionals in this country. one of the things i'm trying to do is work with medical schools. we train 70% of the doctors in this country through their residency. i don't know where you did your residency. v.a., itve been at the

may have been in the navy. but we've got to create more residencies. if we have residencies, the deans of medical schools tell me they will increase the throughput. and we have to get more students to study mental health. we were able to increase the number of amount of loan payback for people starting mental health. we have to increase the number of mental health care professionals in this country. sorry, that was a filibustering answer. norm: well, slightly different rules for the guests. but only slightly. i will go to twitter for another question. on the reform and modernization front. i know i found this when i was advising president obama and had government reform in my portfolio earlier in the administration. there are limits to the innovations, the lessons of the private sector that one can bring to government. you have referred to the need for congressional approval in order to take some of the big next steps. administrations change.

you don't have an infinite amount of time. i have a question from aisha cho audry. do you feel you have to speed up some of your priorities? if so, which ones and how you -- how do you deal with these horizons moving from the private sector to the public sector? sec. mcdonald: that's a great question. as i said it does take time to

transform an organization. that the administration would change at the term of the year is what caused us to take those five long-term strategies and turn them into 12 immediate priorities. notice i said by the end of the calendar year. these are the 12 things we want to get done. what we did, i actually asked for a congressional hearing and i know that's unusual. but i asked and chairman isaacs in the senate had a hearing for me to review what progress we made in 2015. what progress are we committing to in 2016? what are the veteran outcomes? like having your appeal decided in 12 months. getting more people into community care. these are things we committed to providing we get the budget and we get the legislative changes that we need. so that was the reason we did it. if you came over to our building and i invite you all to come over, we have a room where we have literally by week, by month, the accomplishments for

each one of these 12 that we track every week to make sure we are making progress because we want to make sure we deliver. we want to create irreversible momentum for this transformation by december 31. norm: is that the biggest thing you would say you have brought over from the private sector? setting the benchmarks, using data? sec. mcdonald: i don't know. i think so. this is my first time in federal government other than when i was in the army. certainly that is a practice that we have. we have to set and sharks and goals and hold people accountable to achieve them. >> i'm going to go to the back

of the room now because i don't want to neglect people who are sitting at the back. i have three great questions from veterans that i'm going to combine into one question for you after i go to this lady here in yes ma'am. >> julie davidson. can you talk about your decision not to implement the discipline procedures in the veterans accountability act and what you are doing to improve accountability? sec. mcdonald: yes. since i have been secretary we have terminated over 2900 employees, julie. and we are holding people accountable. we think accountability is very important. we think it means more than just firing people obviously. means providing feedback and training and development they need to get the job done. we have taken advantage of the accelerated process for nine senior executives service individuals. what we decided recently is given that that part of the law has come under question, constitutional question, we did not want to continue to follow the procedure since what we

don't want to do is have a different area process go on and then have it overturned later for a technicality because the laws decided to be overturned. so we are using the old procedure. the old procedure is fine. frankly the new procedure really just affects the amount of time for appeal. it really doesn't affect the process all that much. the answer to the whole thing in my opinion and i would say in the opinion of at least the senate is what we have in the veterans first act. the provisions that senator isakson and senator blumenthal have put in the veterans first act we all support.

ca supports them. the republican party in the senate supports them. the democratic party in the senate supports them. we really think that is the ultimate answer. i'm hoping the veterans first act will get passed soon. it has already gone through committee and it will go to the floor and get passed in the senate. i'm combining three from twitter. i have one veteran who asks, where do nonprofits that serve veterans go to navigate to find their door into the v.a. bureaucracy which even after your efforts remain substantial?

sec. mcdonald: let me deal with the first one. norm: i hope i remember the other two. sec. mcdonald: it's very easy. e-mail me. bob.mcdonald@va.gov. when i took the job i very quickly realized we cannot do this by ourselves. there is a lot of goodwill for veterans. we need strategic partnerships. matt callier who has a very successful career running companies came in and leads our strategic partnership efforts and we have set up a number of those. there is an organization called give an hour which is an organization of psychiatrists and psychologists who do pro bono work for veterans. we have set up a strategic partnership with them for the reasons i mentioned earlier. it's hard to get mental health professionals. these individuals can help serve veterans. that's an example. this is important for two reasons. strategic partnerships are force multipliers.

they help us expand our outreach and ability to care for people. but there is a second very important moral issue which is by law we cannot care for people with dishonorable discharges and so if a veteran comes to us and they may have a dishonorable discharge and have not yet enabled to get it changed, we have to be able to have those private sector partners who can treat them because we are not able to. norm: great. and that tweet was from @militarysaves. you heard the e-mail addresses. you don't mind if i retweet those later. my thumbs are not very good with all of this. a second question is about whistleblowers at the v.a. the question is because of the importance of whistle lowers for accountability, what are your plans to improve the situation for whistleblowers? that is a situation dear to my own hard because when i was like you when i was in the white house i gave my phone number and e-mail to whistleblowers so they would have somebody personal to call.

sec. mcdonald: sure. we honor whistleblowers in the v.a. who have identified things we need to improve. if you have an organization focused on customer experience especially for veterans you want to know what you are not doing well in order to improve so whenever i go to a site -- i have been to roughly 300 locations -- i always meet with the whistleblowers separately, privately without the leadership.

we also work very closely with the office of special counsel. we were the first organization in government certified by the office of special counsel for dealing with whistleblowers and we taken very seriously to make sure they are protected. many of them have become great advocates for the transformation we are doing. a lot of the transformation we are doing right now -- after the fourth of july we will start enrolling for health care either by phone or by the internet. that was unheard of before but that idea came from some interaction that we had with whistleblowers to do everything we can. i want to create a culture of continuous improvement. this is why we are training to you all in lean six sigma. we should have everybody at the v.a. working to improve the systems that they work on. as i was going out and doing town hall meetings which i have done at all the sites i have been to, employees were telling me they felt like they were victims of the system they couldn't control. what i'm trying to do is say, i want you to control that system. i want you to change that system. the best high-performance

organizations in the world are run by the employees. norm: you are a strong evangelist for bringing best practices from the private sector, but what is the limit? where have you hit the wall and where have you learned that what doesn't work in the private sector just doesn't work in government? sec. mcdonald: it doesn't work where there are laws that encumber you. i went to a bunch of medical centers and discovered we were outsourcing our rooms. to me, outsourcing your emergency rooms seems like a relatively poor business. what i discovered is there's this 80 hour work period law which prohibits us from operating emergency rooms with 12 hour shifts. i went to the private sector and everybody works 12 hour shifts. so we are not competitive. we cannot hire the doctors and nurses we need to run in a room because of this law.

this law was not designed for hospital system. it was designed for government. a different part of government. are we going to treat this like a business serving customers or like another art of government? there are other examples. this appeals law i was talking about is 80 years old. we have over 400 thousand appeals waiting to be dealt with. it would require over five years each one of those to be just cited. we have to change that law. rather than ignoring that, i believe in the part of the west point cadet prayer that i grew up with. we have everybody in the room

under the leadership of sloan gibson, veterans service organizations, members of congress. we said, we are going to lock the door and slip the food under the door. you are not coming out of the room until you come up with a new law. we now have the new law but it has to be passed by congress. if we can get these laws passed veteran outcomes -- we said if we can get this law passed as we work down the backlog eventually we will be able to deal with an appeal in one year. not five years plus. it's just a matter of solving the problem but then you have to get congress to pass the law. norman eisner: ok. coming back to our audience. yes sir. just hold on one second. we're going to get your microphone. >> i would like to say that this vietnam veteran thinks you have turned the corner. we are definitely making solid progress.

sec. mcdonald: thank you for your help. >> the 630,000 are going to be the most vocal. the question i would like to ask is can you give us the status of data on choice, the choice program which is designed to help those that are further away from the v.a. facilities? sec. mcdonald: yes sir. in the fall of 2014 in response to the access crisis, congress passed the choice act. the idea was to have greater capability of sending people into the community for care. we were already sending people in the community for care. but the choice act was an attempt to make it even more broad. there were certain limitations put on the act.

things like 30 day time limit, 40 mile originally geodesic distance and then driving distance. i was given some authority if there was a geographic area. what we are seeing is dramatic growth. in the choice act and in the authorization. that we have given for care in the community. dramatic growth. the issue we have had is we have seven different ways of providing care in the community. each one came from a somewhat different law. each one has different selection criteria. each one has different reimbursement rates. it's very complex. as a result of that confuses veterans and confuses the employees. last october we put together another proposal for change in the law that would take all those different seven ways and make them one.

one criteria, one reimbursement rates and make that the new choice act moving forward. we have had hearings on that. there are pieces of it that are part of the veterans first act in the senate we are thrilled with. the house is dealing with pieces of it. to me that is the ultimate response is how do we make this simpler? we also looked at everything we thought was wrong with the original act. as you work overtime you learn how to make it better. we have put that in the new veterans first act. we're thrilled if the senate can pass the veterans first act and the house can pass parts of it as well -- as well that we will do a better job of the community. thank you sir. >> ok.

we are coming down now to the last minutes. so i'm going to ask one from the -- you have been too good on twitter. there are literally hundreds of tweets that have flooded in. i apologize to those of you. the secretary and his team will get them and address the issues and questions therein. shifting again to another one of the non-health care needs because i promised some of the veterans organizations that i would ask about those. financial literacy issues. there have been reports about the struggles of some veterans with financial issues about being subject to predatory lenders and other financial scams. what are you doing to help address financial literacy among veterans? sec. mcdonald: that is a very important point and i am glad we are going to talk about more than just health care because v.a. is one of the largest mortgage companies in the country. we insure mortgages. the g.i. bill is how my father and father-in-law went to

college and how i went to graduate school. i think the ultimate answer to financial literacy is what we are trying to do with the transition. they're going to be roughly 250,000 service now each year. it's unacceptable for them to have a gap in their service from active duty to becoming a veteran with full benefits that a veteran should get. we are trying to do is take that transition process and push it upstream working with the department of defense and secretary ash carter is a great partner in this. we get the servicemembers maybe 120 days before they leave the service. i have participated in these programs. they are called transition assistance programs. we go on base and the commanding general stands with me and says, we're going to help your transition. we train the noncommissioned officers how to help with that transition. we then do a number of things. we try to get them the medical examiner they need to qualify for benefits. we signed him up for health

care, for the g.i. bill. and so forth. and then at the end of the program we actually have a job fair. we have had tremendous success in terms of placing veterans right on the spot. so that there is no transition time, in transition time from the time they leave the service. i have to say it's one of the reasons that veteran unemployment is virtually at an all-time low of about 4%. mr. secretary, it's 3:00.

we could go on for hours. the fascinating analysis of what you have done in the v.a. and the implications it has for the rest of government in a time when we are approaching transition in the need for congressional approval and other limitations on the model the fire systems to work together. many additional tweak, including one from a whistleblower. i will personally make sure that the secretary's attention is drawn to it. i want to thank everybody in our audience here. everyone in our virtual audience , on c-span, on twitter, and on social media. it's been a great privilege welcoming the secretary. sec. mcdonald: thank you. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2016]

>> coming up on c-span, a discussion on u.k. membership in the eu. then, tributes to british cox, whot member jo was killed last week. then a discussion on transgender protections. journal,washington live every day with news and policy issues that impact you. this morning, the report looking incoming ability and all 50 states and how it has grown. talkron paul will be on to

about gun and privacy laws in the wake of the orlando shooting and offer his opinion on the 2016 campaign. executive editor of the washington journal will discuss donald trump's campaign managers recent of firing. be sure to watch washington journal, beginning live at 7:00 a.m. in eastern. >> today, federal reserve chair jim on yellen delivers the thetary policy report to senate banking committee. we will have that live at 10:00 a.m. eastern here on c-span. not onlyalize, this is something i would love to do but something that could be different from the time books had been written about mccarthy

and the past and a way to was,nk who this person what his significance was, what his virtues really were that made him one of the most ad adjudicated figures in american history, but also -- and inhis flaws many ways unpleasant and he even hated i same people. >> a look at the life and career of douglas macarthur. one of the things about macarthur you have to say. he saw the future more clearly than he saw the the present. whether it was america's role in asia, the role of china. between china and the soviet union which east foresaw

but also the state of american to mystic politics. announcer: that is sunday night on q&a. vote on whether to leave the european union. next, a discussion with margaret thatcher's former speech writer. afterook place one day british parliament member jo cox was killed in leeds. [applause]

>> thank you very much and welcome. it is my great pleasure to introduce my very good friend mr. sullivan. i have known john for over 15 years and met him when i worked for lady thatcher's office in london. he is one of the most gifted conservative writers of his generation. he is responsible for crafting some of margaret thatcher's most powerful speeches. he joins us today to talk about margaret thatcher and brexit days before the historic british referendum on the membership to be held on june 23, next week. he served as special advisor to prime minister thatcher from 1986 to 1988. he assisted her in the composition of her best-selling memoir "[indiscernible] currently, he is editor of the -- called -- quadrant magazine in australia and president of the downey institute free market transatlantic think tank in budapest, hungary. he is also a senior fellow at the institute and editor at large, or he served as chief for over one decade. in four decades, he was a writer

and editor on both sides of the atlantic. john sullivan served in prague as editor of the foreign policy national interest and editor-in-chief on united press international. his book "the president, the pope and prime minister" was about the revival of western market. it has been published in seven languages. join me in welcoming john sullivan. [applause] mr.sullivan: ladies and gentlemen, many thanks for inviting me today. and for giving me such a generous introduction. say, johner used to just doesn't seem to be able to hold down a job. you have given me a highly controversial topic, namely brexit.

and next week's referendum. the trouble on that question has been briefly stilled in britain by jo cox, who was murdered yesterday in the most brutal and horrible fashion by one of her constituents, who was mentally disturbed and not some kind of political fanatic. most of us here in this room were not sure of her politics, but she was very spirited, a funny opponent, a wife, mother and someone who had risen from a poor background and the first member of her family to go to college and to the anteroom of high political office. we should mourn her passing and we should seek justice for the murder. all quarrels halt at the grave. we carry on disagreeing here. my topic is thatcher and brexit. a few months ago, it was almost the first battle of the referendum campaign and there

was the question, what would maggie do? more precisely, how would maggie thatcher felt the next thursday's referendum? it was a quarrel between mrs. thatcher's former aides, friends of mine. but not household names outside of that small circle, but it was the well-informed debate. what is more interesting, even in the outcome is the fact that fully a quarter century after she left office, margaret thatcher is one of only two postwar british prime minister the other is churchill, whose role remain contested and important to a large number of british people because whatever other criticisms may be leveled and may be believed, both leaders aren't recognized