housing as we know. given the democratic legislature, how will you accomplish this commendable goal? >> we'll accomplish it by -- >> explain to people what it is because it is an acronym. . .

>> a keystone of your budget plan is for municipalities to consolidate services voluntarily. what will you do if they don't get enough more volunteers? will you mandate for services coming together? >> i don't think we will have to force it. we will offer grants to municipalities to study sharing services between municipalities and consolidation of services. s6zyou take that grant and if yu can save money and provide the services you commuter institute the plant and share the services or give me my money back. the people in the town will know that you will either institute a plan or you have to pay the

state back. we need to put pressure on school officials -- state officials to deal with the property tax issue. host: new jersey has communities that are so small that are costly with their own chiefs of police and so forth. guest: i think people are so fed up with property taxes in new jersey that those decisions should be made at local level. host: if municipalities will -- we refuse to come together, will you say that is the reason why property taxes are so hard? guest: that's what we would have to do. host: where you calling from? caller: hopewell.

there has been discussion in new jersey's to branding the funding of stem cell research. where do you stand on this issue? guest: i think it is important. i think it should be done in the private industry. i don't think state government should be involved or as the money to do it. we of the $8 billion deficit and we do not have the money to invest in it. we have many companies in new jersey that do great work in stem cell research. host: pickup the fund. you see 32nd spots for the candidates -- uc 30-second spots for the candidates. before we go to another video call, you didn't arab editorial board with the "star-ledger."

it is said that you do not give any specifics on how you would close and $8 billion budget deficit. guest: i have given many specifics. when i was u.s. attorney and i said i would battle corruption and terrorism, nobody asked me how much the lawyers would be paid and what is the strategy. they said go and do it and i did it and i performed for seven years doing it. when i say i will cut income taxes over the next seven years, i will. host: we have another question directly for mr. christie. caller: what will you do to get more jobs into new jersey. guest: we have the highest unemployment in the region and i think the reason for that is our

taxes are out of whack. we have the highest tax burden in america. business is no longer want to be because it is too expensive to be here. we need to lower the tax rates and lower regulation in new jersey to make new jersey more business-friendly. we are the most unfriendly business tax climate in america for the second year in a row. host: 1 specific action you will take to make businesses in new jersey more business friendly? guest: i will sign an executive order that freezes taxes for businesses. i will get a group to study which regulations to get rid of to make things more business friendly. host: why can you be so is this about that but not go into greater detail about finding ways of to close a $8 billion budget gap?

guest: i am being specific. host: i said more detail. guest: we are talking about $185 million for people who do not have health insurance that was spent by the state. we have wastes of money. that is almost $1 billion -- half a billion dollars. host: you have an $8 billion hole. guest: those are just some examples. host: where are you watching from? caller: i'm watching on pbs. one thing that drives me crazy about living in new jersey is dual office holdings. when trenton does something about it, the grandfather

themselves in. is it anything you can do about this problem? guest: i would never compromise and grandfather people in. that should have been a fight. we have a whole group of people that have dual offices all over new jersey that should not be. the governor should have stood up and fought for that. i am also against a dual public employment. one public seller should be enough for anybody. i would have looked at pass legislation for people to prevent them from having two public salaries. host: we had about 600 questions on line. we have an e-mail question.

nancy wants to know about preschool. do you support public preschool programs? guest: putting preschool is very important. right now, the state of new jersey cannot afford to support towns that have the highest taxes in america. i would keep it in the district we have now and funded there. across the state of new jersey, it is a good idea but not one we can afford right now. host: let's follow-up -- there's an advertisement on the air for the governor that says you have called preschool babysitting. fact or not? guest: out of context. i did not use it pejoratively. host: if you could take back that language, would you? guest: that is not the context

and used it in. host: robert, you are on the line. caller: you have said the traffic stocks -- stops, but would a u.s. attorney get out of getting a ticket? host: we have heard about your driving record. the number of points that to have your druggist license -- driver's license -- it hoguest: it is none right now but over the course of my driving record i think it is six. did not do well of 40 tickets. -- i did not do well avoiding tickets. if tickets were appropriate, they were given to me. host: you were pulled over with

your family in the car. there were conflicting accounts. some of the account i read said you made it clear to the officer who pulled to over that you were the u.s. attorney. guest: as the officer was attempting to tow away my car with my four young children in the car, my wife had forgotten to mellon the registration for her car. i get out of the car, the tow truck driver recognized me as the u.s. attorney and he is the one who said it. everybody knew because he said he would not towed the car of the u.s. attorney. host: anything else that you want to say about it? guest:no. host: we will be joined by christopher daggett, the independent candidate. this is a great way to be the most informed citizen you can

they. caller: good evening. mr. christie, i want to know if you are for or against a government or public option regarding health care for the state of new jersey? guest: we already have some top government auctions. we have them the care in new jersey which anybody who is 350% of the poverty level is eligible for. i would continue family care and tried to get more people enrolled in it. there would be many people eligible for it who are not enrolled in it. host: clarified the advertisements. we see the governor's advertisements that say mr. crichristie would not mandate

mammographies for women. what is your personal view? guest: when i was 18 years old, my mother was diagnosed at 47 years old for a mammography with breast cancer. it was pre menopausal breast cancer which was serious back then. my mom's legs was a precocious surgery immediately and she got aggressive -- mom's life was saved. no son who went through that experience would not vote against legislation like that. people who are uninsured, we need to get affordable health insurance and they should be able to pick the option they want. host: did that give the option for some people to pick insurance policies that did not

mandate -- that do not mandate mammographies for women? guest: they can pick what options they want. it mammography is called for by a physician, the insurance company has to pepper host: the government would mandate that? guest: yes, it is a fake issue and it is an issue the governor is using to scare women not to vote for me. host: we will go to our colleagues at "the star-ledger." caller: i am concerned about the budget situation for the state colleges and what your view is on that for higher education? guest: that is one of the few places i have said we need to spend more money. we are 50th in the nation of

public colleges for graduating high-school students. we have cut the funding for higher education. that is wrong. it is shortsighted from an economic perspective and shortsighted in terms of keeping kids in new jersey. 30,000 this year left new jersey to go to college out of state. host: how can you cut taxes and funds colleges? guest: i will cut taxes but i did not say to what degree. we have to make ourselves more competitive. we will make priority judgments and grow the economy in this state which will grow revenue. our revenue is declining because businesses are leaving. host: can you take one more question? you are on the line and thank you for joining us.

caller: what type of campaign contribution reform will you legislate with respect to the money going through different political action committees from one end of the state to the other? guest: there was a great story and the front page of the newspaper about the governor giving millions of dollars of his own number -- of his oown to this allows him to spread money around the state. host: i want to thank you very much for joining us. there is an election on november 3 the three major candidates. go out and make your voice heard. mr. christie is leaving and mr.

data is coming in. -- daggett is coming in. caller: i think the biggest issue facing people in new jersey is taxation and property taxes. caller: the police and the government should work to stop crime in urban areas. caller: i am concerned about the amount of chemicals in our environment. caller: one of the most important issues is the lack of funding for arts education in our public schools. caller: i think everybody should have free health care. i think the governor should make that happen. >> have a question? let your voice be heard. host: welcome back.

we are now joined in the studio by mr. kress daggett who is the in the -- mr. christopher daggett who is the independent candidate. this is a great chance to ask mr. daggett questions. you are on the line. caller: i watched governor c orzine run four years ago and i am disappointed he did not

address our property tax issue. i'm 65 and recently retired. my big fear is that it's my property taxes do not get lower, i will have to leave the state and i don't want to. no one seems to be addressing the real estate tax issue. host: you have put out a proposal calls for a 25% reduction in property taxes. how can you do that? guest: for senior citizen homeowners, it preserves a property-tax cut for seniors. the 25% cut for corporate businesses as well as small businesses and a rollback of the taboret increase in income tax that was put in place last year. i do it by expanding the sales tax to cover a number of services that are not now

covered. accountants, lawyers, it is only business to personal. not business to business. if you are a lawyer and i retain you, i would have to pay a tax on your service. host: let's go to a video question. caller: what will you do about bringing after-school programs to kids that keep them out of criminal activities instead of being gang members? guest: that is a difficult question because it's of the areas where crime is high, we have to expend our after-school programs. we face a difficult budget situation in the new jersey. we will have to rely on people getting together and working in the communities to provide those services that may not be able to be funded formally by government. it is a big issue and something we have to pay attention to.

host: we go to our next caller. the election is on november 3. caller: i would like to know how you intend to maintain or raise the rebate without raising taxes? guest: i am getting rid of the property tax rebate program and replacing it with a property-tax cut. that will be 25% less for homeowners. host: why would you get rid of the tax rebate checks. guest: the way the rebate system works, we pay a lot of money to trenton and it costs about 25 cents on the dollar and they send back a portion of it. i am doing a property tax cut for homeowners.

it is a maximum two $2,500 per person. i am expanding the sales tax without raising taxes. the money that we taken from that, we used to allow property tax reduction. host: if certain people will be taxed through your plant were previously not tax, are you not increasing taxes? '=wguest: this expansion will fl most heavily on people with a lot of disposable income. this will be upper middle income people that will pay this. it will not be paid by people in the lower economic strata. host: you are on the line. caller: how does the candidate feel about privatization of county facilities in new jersey? guest: i think we should look at

the privatization of some government services but it has to make sense. it is something that could be provided better by the public service, it should be done. it to be looked at very carefully. -- it should be looked at very carefully. sometimes it makes sense that we should do it and if so, we should consider it. host: i was watching the debate and you and governor coraine said a lot of the same things.

guest: i have said a number of things that are an honest assessment of the problem and i have tried to put forward specific solutions. i have done things that make sense. governor corzine has praised me for it. guest: he has not been an effective governor in the last eight years. host: mr. christie should not e governor because? guest: he has not given us a plan how he will take this state forward. he is a one issue candidate without any experience in state government. host: we go to another question.

hiv aids continues to be a public health issue. how will you specifically prevent new infections and provide treatment to those living with this? guest: we have to continue to do whatever we can by way of education and make people aware of the potential problems and how they can contract aids. we have to make sure that we have programs in place for maybe a needle exchange and those sorts of things. it is for the medical community to advise me best and how to deal with this issue on a daily basis. this is not an issue vatican they will have the kind of knowledge of public health. this -- this is not an issue that a candidate will have the

kind of knowledge about public health. host: another candidate said he will sign gay marriage legislation. guest: i would do that, as well. host: mr. christie said he would not sign legislation like that. he believes marriages between men and a woman. here is another video question. caller: what will you do to keep new jersey clean, clean water, clean air, clean produce, so we can continue to live healthier lives? guest: i was regional administrator of the environmental protection agency. i have a great passion for the empowerment and i will continue to press forward on implementing laws of new jersey and put new ones in place where necessary. we have a good history in new jersey of being aggressive on

environmental protection. i would continue that tradition. host: dwight d. you think the new jersey environmental federation -- why do you think in the jersey environmental federation -- guest: i seek their endorsement. the other candidates did as well. i am happy to put my 25-year environmental record on . the line. host: mr. daggett has gotten and board -- an endorsement from the sierra club. guest: i have, indeed.

host: we go to the state capital. caller: what do you propose involving immigration reform? guest: that is a national issue. we have to make sure we seal airports properly. -- sealed our ports properly. what are the facts here? there are a number of people who should be assisted in getting through the process of getting full citizenship. they have worked here for years and contributed to our economy and we need to figure at a good path to citizenship for them. sometimes the parents are illegal immigrants but the children are born here so they

are naturalized u.s. citizens. we have to figure out a way to deal with them. we have to do it in a way that takes out the rhetoric and the emotion and deal with the facts and put them on the table and figure at as a solution that works for as many people as possible. some people may get deported because they are involved in crime or other activities. host: we go to cherry hill. caller: i live in south new jersey and commute to new york for my job. what are your plans in increasing safety and inspection on rails? some of them look worse every year. host: how long is that commute?

caller: it is about two hours. host: each way? caller: yes. guest: that is a long commute. safety is a primary issue. i am not clear and any safety issues with the transit system in new jersey. zk÷ issues should addressed -- should be addressed quickly should they arise. without that information, it would be hard to respond fully. host: calls are coming in and the lines are open. the election is on november 3. get out there and vote. it is a great opportunity to listen to the candidates. thank you for calling.

you are on the line with christopher daggett. caller: what will you do to keep atlantic city more competitive? guest: that is an issue we will have to address. out we attract more gaming interests into atlantic city -- one people things talk about is trying to put sports gambling in atlantic city and attract more people. it is a difficult issue. we lost a window of opportunity to put it in place. the federal government give us an opportunity but the question is whether we can recapture that. we need to do something to continue to work on attracting people. one thing i have done in my proposal for property tax cuts

includes an expansion of the sales tax to include shore homes and condominiums and use $20,000 because we have let that dwindle over the years. host: you would spend more on tourism? guest: absolutely, that is part of the plan i have in place. i said that i would expend the sales tax to include condominium rentals and home rentals. it is about $130 million for that asset class of additional services that we would tax. we would have $100 million dedicated to an open source of funding. $20 million for increasing tourism and $10 million for allowing communities to have full beaches. host: what would you do if you

became governor to change the makeup of the new jersey supreme court which is considered the most liberal bent in the nation. ? guest: i am interested in someone on the supreme court who is even tempered and as a track record of being fair, this passionate, listens well, takes into account the facts, and makes decisions that are in the best interest of public policy. i do not have a litmus test that i put on people for social issues or political parties. i want people who have a track record of integrity and honesty and a strong willingness to hear people out and make reason that decisions. host: past court decisions, judicial decisions, is that fair game? guest: sure, you will look at how they handled the court

decisions they had. host: if they disagree with you on a particular decision, -- guest: it would depend on the issue to some degree. for the mostp# part, i am lookg at people who demonstrated and even tempered and fair way of going about the process. host: thank you for calling. caller: how do you propose to reduce the stranglehold of unions and the out of control municipal salaries of the state? guest: we will have to engage unions and looked at having a contract round or maybe there is a salary cut or freeze. we will probably have to contribute more to their salary or pension benefits. we get that done by getting them to a knowledge this is a budget problem.

we have to look at all employees to work on this problem together. the unions are tough. when they're faced with the fact, they will do the right thing, i think. host: thank you for joining us and being part of this interactive process. in just a couple of seconds, we will have governor john course i. corzine. caller: the number one issue is health care. caller: i think the property tax in new jersey is too high. caller: i have two daughters and i am concerned if they can get the best education possible. >> i would like to see more people in new jersey with health coverage. >> i think employment is one of the most important issues.

i was a public transportation would be second. >> do you have a question? host: welcome back. the governor is with us. we appreciate you being here. we'll go right to the telephone lines. you are on the air. caller: in view of the budget situation, is there a need to spend money for a lieutenant governor position? guest: it is established by the legislature. i think it is a decent idea because there are lots of representative elegance that a governor has to go and take on.

there are a host of issues that you can delegate some responsibilities to. i have someone i think will make sure we don't lose track of the values and make sure that we don't turn our backs on our children or our women and make sure we hold to the highest standards. loretta weinberg was known as the conscience of the legislature. i think she will be a very effective partner. host: we have a video question for you. caller: if we have universal health care, how much more will new jersey residents have to pay? guest: i think you're asking a question if we had universal health care coming out of washington. it does not sound like that's what we will get. host: could we get it in new jersey if washington doesn't get

it done? guest: i think it would be better than it is now. to have a completely changed over, the cost would be too much to bear. we could incrementally moved up the income scale and provide opportunities through health care. we have insured 100,000 more children in the years i have been governor. we are one of five states that saw a decrease in the number of uninsured in 2007-2008. 150,000 additional new jersey folks off roll. there is a new proposal with plaid -- family-planning help centers around the state that will get more women, pre- conception, and into health care systems. we will keep working up the income scale and broadening out the number of people.

i have many brothers and sisters on the pbs channels. host: we go to our next question. are you there? we lost that question. let me follow-up -- no candidate has seen the other candidates and are not here to comment on specifics. you have an advertisement on the air that has said that mr. christie has advocated that the government not mandate that insurance companies make sure that women get mammographies. he responded to it. you heard his response and you have debated him. explain how you see it. guest: mandates are requiring insurance companies to take on certain responsibilities whether

it is to provide care for mammograms or provide extended stays for new mothers and babies or screening autism and therapies. if you do not require it, insurance companies do not provide many of these elements that are part of the health care system. i think that women come first. when you say the mandate-free that means there is no requirement. the mandates that we have in new jersey, what is for over 40- year-old women and one is for under 40-year-old women. it would not take place. host: teach you in any way apologize to mr. christie for the end because because his mother died of cancer? guest: i am thrilled his mom had a mammogram. fifth it is not a matter of

apologizing. are we going to require insurance companies to provide for family care like mammograms, prostate screening for males, and that is the issue. mr. christie says he wants mandate-freight policies in new jersey. when you say you want a mandate- free policies, you are arguing that some of those things that new jersey provides would be out of those insurance providers. there is a fundamental difference between mr. christie and myself. host: we go to livingston. here is an e-mail question. why do certain school district in urban areas get so much state education funding while taxpayers in towns like mine are forced to pay for schooling?

guest: one of the basic body is that we believe in is to make sure that everyone gets a quality education. if you do and have the economic base, -- if you don't have the economic base, then the only way to make that opportunity happen is to state aid. a long time ago, almost 40 years ago, the supreme court said we had to provide parity between those places that had the ability to pay with respect -- it leveled it out. that is a fundamental value that all children should have access at the same quality education. one of those variables is how much you spend. host: mr. christie has said he is in favor of expanding the number of charter schools.

he says your administration has not moved quickly enough to support a charter schools as in the alternative -- as an alternative to public schools. guest: i don't need to go into this. i'm a strong supporter of charter schools. we have expanded the number of kids in charter schools from 14,000 to 22,000. we have expanded the charters that exist. they have moved into different areas and we want to hold charters accountable to the same standards and better standards than other places. it is a misinterpretation of the fact that the numbers are not as large as the number of kids a growing. we had nine new charter schools authorized for next year. we will be over 30,000 in the next few months. host: we have our next question.

caller: what are you doing to keep the taxpaying citizens of new jersey. there are so many houses for sale around may. we were thinking of moving out, as well. guest: there are many people who've lost their jobs who are looking for jobs all over the country. they are not finding the economic environment much more attractive anywhere else. some people like to pretend that new jersey is a loan and suffering through the worst recession since the 1930's. the fact is, our property taxes are the highest. if you make under $150,000, about 80% of new jersey unscom about what they earn. -- new jersey population is what

they erred. people making more than $1 million have high rates. the issue is we do men have a lot of options in a time when we need to finance their education. we should not be backing away from educating our children. it is a fundamental value. we have the best school system, broadly based, in the country. we are closing or achievement gap. nape scores have closed by double digits. we do better in our suburban schools than any place in the country. we have great performance. host: 9.3% unemployment rate? guest: it is actually 9.7%. i would like that to be 9.3% or 5.3%. the national average is 9.8%. host: is new jersey suffering

economically -- guest: new york city is 10.3%. we are one of the five states that had median income go up. most dates had their median income go down. we actually insured more people as opposed to having the insurance rolls shrank. we had an 11% decline in the number of uninsured. we have a lower foreclosure rate than the national average, about 1/3 less. the most important thing to remember is we have to create jobs. we have to get the economy of our nation moving forward. i cannot understand why anybody would not want to take the stimulus dollars from the federal government to help ease our burden and get our economy going.

that is what mr. christie said. we had an independent, objective agency that is $5 billion he would turn down. it is inconceivable we would turn that money down. he can say whatever it is for the office of legislative services made an independent judgment of what the strings attached with me. that would raise the taxpayers -- the property tax bills $2 billion because it would help to pay down educational dollars. host: let's go to another video question. caller: how can we enforce township to share services so we can reduce property taxes? guest: that is one of the best questions. we are doing a lot on this. we put a 4% cap on what townships and towns and counties can raise their property tax

levies. we got a lot of heat for that. mr. daggett has a tighter caps. that is forcing communities across the state to look for certain shares services, if not consolidations. we're providing incentive dollars for studies going on across the state to see whether barging certain borrowers is a good idea -- whether merging certain boroughs is a good idea. we will not be able to provide all the state aid the people want to keep taxes lower. host: why have you turned a blind eye on this much corruption going on in the state, particularly in the democratic party? guest: we have turned no blind eye.

the attorneys general have indicted 252 public corruption cases. they have convictions on at least 200 of those. we are constantly doing that. we have done all democrats, five state legislators, that the attorney general's have indicted. we have been absolutely true to enforcing bill law and i have come up with bans on dual office holdings, forfeiture of pensions by public office holders who are convicted, we are making sure there are caps on pensions so there cannot be what we call pension padding. over and over, we have had an aggressive corruption record. host: next caller --

caller: i am from rutgers at the brunswick campus. since i am a college student and i am doing this for all the students here, how can you make college more affordable since we students are getting into a lot of debt especially when the graduate? guest: we put a 3% cap on the tuition of all our state universities. we want to hold down the costs. there is double digit increases going on across the country at public universities. we have put real incremental increases in tuition aid for our young people who are modest and middle income families. we have put more money in the growth of our tuition aid grants. we have an expanded our stars

program and our community colleges and carried over into the four-year programs because we want to give financial support to young people like the lady who just ask the question. host: we have a video question. caller: elections these days are nothing more than mud slinging. what is one specific thing pertaining to the economy that you will do as governor to help the middle class? guest: we will spend a lot of time and effort growing small business activity in new jersey. last fall, we proposed a $3,000 grant for every business that created a new job and held it for one year. we had 33,000 applications. we will get those funded and will extend that for a program going forward. we have put in place a new tax

incentive program to build businesses in our urban communities. it is for people that understand these kinds of technical issues. it is incremental finance that will draw new businesses into our urban areas. we very aggressively are working with small business to get banks lending. we're working alongside banks to get them into the market. we have a number of programs about getting people back to work. the most important one is building schools and highways and tunnels and putting in solar panels across the state. host: we have an e-mail question -- trenton the board voted to replace the transportation trust fund. -- trenton borrowed to replace the transportation trust fund. would you support the idea of increasing the gas tax which is lowest in the nation? guest: we hear about how high

taxes are. is nice to have one that is at the bottom. we would like to keep it there. we will have to come up with a proposal in the legislature. if you take the money out of some other tax, you will end up polkaing another hole in your budget. we have a big decision sometime in the next 18 months. host: we want to thank you for being with us and we want to thank mr. christie and mr. daggett for being with us. we want to thank all our partners. becky to everyone who called them. the election is on november 3. make sure you go out there and the boat. we learned a lot to tie -- we learned a lot tonight. remember, democracy is not a spectator sport.

>> new jersey and virginia are holding elections for governors of this year. >> the race in new jersey is about governor john corzine. it is tough for him. that is a democratic state. if he loses which is possible, it could be an embarrassment to the white house. it will make the republicans happy. it will make it easier to recruit money for the republicans and recruit candidates. i do not think there will be too much significant national consequences from that.

recent polls have shown that jet -- governor corzirne is doing better. mr. christie seems to be doing well. >> he is a former prosecutor. he is very tough and good at keeping governor corzine on the defense. the governor did a good job of turning his back on him especially on issues like taxes. mr. christie refused to take federal money for the state.

it appears the biggest impact he has is providing the anti- corzine vote, thatg i8s mr daggett. in virginia, we have creigh deeds, a state senator who has been around a long time and bob mcdonnell, former attorney general. creigh deeds became the democratic candidate after a pretty contested primary. creigh deeds is from downstate. he is a moderate. he is a soft-spoken guy. he was endorsed by a "the washington post."

he has not been doing well some people find them boring. he is treading on taxes like -- he is dripping on issues like taxes. virginia is a state which has been slowly moving to the democratic column. president barack obama was the first democratic president who won their since lyndon johnson. many people look to that race and say they would like to hold onto virginia. one interesting thing is that many polls show that a lot of independent voters, ones who voted for obama last time, are moving towards the republican column.

>> why is that? >> it is because of the identification by the white house about increasing the deficit and spending on programs like health care and the stimulus. independent voters tend to be uncomfortable with those issues. the governors' races tend to be about local issues. if the independent voters go to the independent side, it is some significance. >> how much as the republican national committee put into the race for the candidate, bob mcdonnell and what about on the democrat side? how much as the dnc put in for creigh deeds? >> the republican national committee has put in about $5

million. they have put in about two-one over democrats. should bob mcdonnell win, it will really upset things. it will put them into a good position for next year's race. the democratic committee has not been able to raise as much money. the republicans are out raising them. obama has gone to new jersey once. he will go back again. he has associated himself with the corzine camp. he thinks he will win. by contrast, creigh deeds said he is not an alabama democrat. -- not an obama democrats.

. he says that he has problems with what the democrats are doing in washington. >> an update on the virginia and new jersey governor's races. >> in a few moments, today's headlines and your phone calls, live on "washington journal." the senate finance committee continues to consider its version of a health care bill and may vote to recognize -- recommend a bill to the full senate. that is live at 10:00. the house is back for legislative business at 2:00 p.m., eastern. and we will look at unemployment

benefits with the representative from the representative laurie project. more from the health-care debate from the council for affordable health insurance and a princeton university professor and health- care economist. "washington journal" is next. .

host: before we get to your calls we will get started right away with one of the reporters following this issue. his robert schroeder, a reporter for market watch. what is the structure for today's meeting in the senate finance committee? guest: we get started at about 10:00 p.m. and senator max baucus will dabb gavel the meetg to order. you will see statements from nonmembers who will all want to say something with something as big before them coming up. chairman baucus probably wants

to hasten the vote. he believes he has the numbers. he needs at least 12 of the 23- member committee. host: the new times" reports that the questions might be allowed and what does it mean for the final vote? guest: republicans and many democrats have been concerned about the overall price tag. president obama wanted something that came in under $900 billion in 10 years. the cbo recently came of this it would be $829 billion. that still might be to rich for some.

republicans might want to question the committee about how the bill saves money and from where. they will want to know the nitty gritty details. there will probably ask if it can be whittle down even further. they argue that in the midst of the recession even though the signs look good this bill spends too much and still leaves about 25 million people without insurance. host: yet another photo in the paper today of senator olympia snowe. remind us of why she is so important? what might be going through her mind? guest: senator olympia snowe is thought to be the only republican voting for this bill. she was one of the gang of six among the few months ago with senator max baucus and five other bipartisan members.

she will be watching it closely today and everyone will watch her equally closely to see if she will say yea or nay. she has been considered moderate, someone willing to work with democrats. one interesting thing that might come out of her statement is which he thinks of so-called the trigger for the public option later down the road. it is something that came up during the committee's deliberation. the public plan got shot down. that she at one point had talked about using it in an emergency case for those who could not afford insurance otherwise. host: here is another big one

in the papers today, something that started to come up yesterday morning. headlines on this insurer story. "the financial times" calls of a fight on health care reform. what exactly happened yesterday with this 26-page report coming out? who put it out and why? guest: that is exactly right. it was released by american health insurance plans which is an industry trade group. it was prepared by price waterhouse coopers. it said that a family policy, the cost is a little more than

$12,000. it would jump up to almost $26,000 on average by 2019. the cost would go up more than the white house is saying. democrats say no, the tour for will bring down costs. so the white house will really push back saying that it did not take into account other provisions like tax credits and so on. characterizing it as open warfare, as you said. it came one day before this critical vote. what the result will be i am not sure. jay rockefeller who had had some reservations about this committee bill and was worrying

which his criticisms of it can not to say no, this report is misleading and harmful and represents corporate gain. it may not have had the desired effect that -- the effect that the insurance company wanted. the questions are not out there, at least among the democrats. host: thanks for the set up today. like 10:00 a.m. here on c-span will get started and have the afternoon part of the session on c-span 3. before get to calls, reaction to this report from senator rockefeller. the report is 26 pages, it cannot by price waterhouse, and released yesterday by america's health insurance plans. you can read it on our website, c-span.org.

rockefeller said the report was misleading and harmful and represented politicking for corporate gain at its worst. the first call this morning concerning the meeting, perhaps the final one, chicago, kathleen, a democrat. caller: good morning, i watched this whole thing from the very beginning. i watched every mark at the hearing. -- mark up hearing. it is really easy to tell whose hands in congress are in the pockets of the insurance companies. this isn't the report prove that we need a public option? my daughter is, works for a global company and her health care is with united healthcare. her premiums -- she was already told are going up, no doubt about it. my son has quit playing sports because he cannot be on our

insurance anymore. he does not have health coverage. what does it tell americans that someone is willing to pay a big mouth pig like rush limbaugh $400 million to do what he does, but we're quibbling about covering americans for health coverage? what does that tell us about our country? let's get our priorities straight. host: from arkansas, the next caller. caller: the first thing, no one party should ever the on anything, especially since they don't read the plan to start with. concerning illegal immigration -- according to a former federal

judge when he read the constitution it says that any federal plan that is passed for the benefit of the people includes all -- the key word there is "all," not saying that it will give preference to the illegals. until you let the attorney general penalize and put people like a lobbyist in jail -- because it is bribery, and it says in the dictionary that the word bribery means influencing. host: will move on to spokane, washington on the republican line. caller: i think it is a power

grab by the federal government to get more involved in our private lives. that is said and done. what appalls me is that most in congress have not even read what is in this bill. i'm sure there would not sign a contract to read a car or house unless they read the contract. host: there's a big push in congress to have a 72-hour layover. for people to read this before they vote on it. is that enough? caller: i don't know, but i called my congressional representative and two senators to volunteer my time to come to their office and read it. i am a disabled veteran. i have a lot of time on my hands. i said i would volunteer to come to their office to read it and highlight what i think they

ought to know. i have not heard back from them, but they need to read the bill. if it becomes law, no one knows what is in it. host: moving back to "the washington post" peace -- as panel votes today democrats look ahead. the second paragraph says that with few if any republicans expected to support the bill, democrats have already begun their own internal negotiations. the lead story in "usa today" has a similar theme. the health bill faces key votes in senate. it says the versions would still need reconciling.

they talk about the two specific bills in the senate, one iser t health committee. it will be very difficult, said former senate republican leader bob dole who has urged a bipartisan solution, said monday.

battle creek, mich., what are your thoughts? caller: cut bless america, god bless c-span. i am 40 years old from central michigan. my dad lived in detroit. when the charges came in there were $1.89 per minute for a call not even 80 miles away. there was a monopoly on the system. now the most recent bill from the same company is 10 cents per minute, almost 190% decrease. as they change those laws, the phone charges were drastically slashed and you can get telephone service for a fraction. host: make the connection to the health-care issue. caller: the basically give us more options to help drive down

the costs. the public option could do the same. you do the math, people. host: thanks for your thoughts, and thoughtsnashville. caller: there are already 1300 insurance companies. that was all about a government takeover. here is my biggest problem with this whole thing. this conversation has been dishonest from the beginning. not about health care reform. every single person in the u.s., including illegal aliens, can walk into any emergency center and get treatment for whatever ails them. that has always been the case since this debate started. the real question, never answered or addressed by the press, the government has run out of money. they have spent all the money we put into medicare and medicaid. they needed more money.

how will they do that without taxing? let's charge the insurance company and drive of the insurance costs. then we will be mad at the insurance company and not the government. host: thanks for your points, caller. and $829 billion plan over 10 years. we will watcher at here at 10:00 a.m. and if this bill into the afternoon hours we will switch to the over to c-span3. here is a message from twitter. and there is more here on this latest round of debate on the insurance industry's report.

this is from "the houston chronicle" where it says that interest companies aren't playing nice anymore.

again, you can read this report, 26 pages, by price waterhouse, put out by america's health insurance plans. back to the phone calls. connecticut, robin, a democrat. caller: good morning, i think there should be a public option, period. end of conversation on that. host: let's see what bill has to say from north carolina. what do you anticipate? caller: i think that olympia snowe should do like arlen specter and switch parties. wendy's make their rules of course there will put health insurance companies out of business. host: banks, new york city, ted,

a democrat. caller: the finance committee members take huge campaign contributions from the healthcare industry. i believe that any reform will benefit the healthcare industry, and it is amazing we have not turned the discussion about campaign finance reform. campaign contributions are the root of all evil. johnson said that elected officials commit economic treason. 7% of earned income of two $110,000 goes to medicare. medicare should probably be the public option. their criminal penalties for companies who rip off medicare and medicaid. lastly, cdp -- it is what the american people should be paying only. there should be no exclusions.

the healthcare industry should be paying your medical bills. host: banks, 9:00 a.m. our eastern we will talk with princeton university professor, reinhart, about trends in healthcare costs. lots of details about how things have risen over the years. then we will have another guest talking specifically about the pricewaterhousecoopers report that came out yesterday. there is this lead story in "the new york times" -- the congress put on a health-care tax on costly plans. it has touched off a fierce clash between the senate and house.

louisville, kentucky, you are up. good morning, mary, on the line for democrats. caller: i think this report justifies the public option or universal care. i am on medicare and have no problems with it. in fact, really, i'm getting better coverage with medicare than i did with kaiser. that is all i have to say. host: let's move on now to tupelo, mississippi. caller: good morning, i was just

listening to the woman from illinois. that she would rather have a public option. there are so many hidden things in the bill that will pass. we do not know what is in it. it won't put it on the internet. because they don't want us to know the truth. the public option is going to be in there. let me tell you this story. i have a retarded 42-year-old daughter. my husband is dying, ok? this is going to mean my daughter is going to die with this public option. my husband would have been dead three years ago if we have lived in canada. we would not have gotten the care we have now. i did not realize we had a problem with healthcare until obama took over.

can anyone not see what he has already done? he is taking us down every day we live. host: the washington post reminds us of this vote today on the healthcare bill. we expect passage. 13 democrats to 10 republicans on the committee. senate majority leader, senator chris dodd, and finance chairman max baucus -- they point out there will combine the measure with the senate health committee's bill. to the left is this passage. in the senate's, negotiants are shifting from the public forum to more cloistered settings. the seating area in front of the marble fireplace of harry reid. after tuesday's vote, max baucus will retreat to his office --

reid's and continue to work on it. they do point out that many liberal democrats, however, the the panel's effort as too meek in key areas. that is at the senate's store. we'll tell you more about the house is part later. they have three separate bills there will try to bring together. halifax, pa., democrats. caller: first of all, i don't understand what is so new about health care costs rising. they have been rising rapidly in the last 10 years.

it seems like a lot of republican callers are considering me. it is all about "me." i don't understand what people don't seem to care about these horror stories you read where people who consider themselves better off dead financially because of their health care options. people being denied care, basically waiting to die. it doesn't make sense. a lot of these republicans claim to be christian. i don't see anything cushion of about not caring about those people. host: another tweet from one of

our viewers. here's a call from atlanta, mohammad, on the line for republicans. caller: the senate finance committee should call this legislation. they should pass the public option. a lot of people are calling in, talking about the health care, health insurance companies. i don't care about them. they are making billions. the ceos make exorbitant sums off of people's misery. one less thing, i want to disabuse people of the notion that you can go into any emergency room and get care. i came from new orleans. there is if you got shot, if you went to a regular hospital to the emergency room without

health insurance they would tell the ems to take you to a charity hospital. here in atlanta you can go to a certain hospital and unless you are shocked or have a knife sticking out of your back you will probably sit there for 24 hours before getting care. host: appreciate your calling. more of the preview of the fight on health care.

washington, d.c., john, a democrat. caller: fresh, in the beginning god created the heavens and earth, and then he created c- span. we need to get down to facts. americans need to realize the republican party at this point is really scared. anything this democratic party put on the board, anything barack obama brings to the board they will reject. they are scared. what is wrong? we're providing health care to someone who does not have the financial stability as working

folks to provide health care. host: a quick word -- the finish up. caller: the republican party is running scared. host: house democrats have spent weeks trying to bridge the divide between liberals concerned primarily about securing a public option, and rural conservatives who fear that doctors and hospitals in their districts would do poorly under that approach. there is still quite a ways to go on health-care legislation. we will be here to tell you all about it. one last call on the senate finance committee's meeting today and we think that final vote. a republican, what do you say? caller: simple, the democrat people calling in need to read the constitution.

the government does not owe anybody anything. we need to get our country back on track the way it should be. this is not a democrat- republican thing. this is an american thing. you can give people healthcare, but you will be taxed for it. we are taxed enough. we have troops in afghanistan who need back up. we're neglecting the troops. i have served 20 years. this is just ridiculous that you have a war with the fox news and everyone else and are just pushing along on health care. host: more on health care later in the program, but now we will shift gears to talk specifically about unemployment benefits. an effort underway in congress to extend them. our guest will be.

-- our guest will be chris king owens. --christine owens. e >> the british house of sessions as back -- british house of commons is back in session.

fall by statement of gordon brown, all live on c-span2. sunday, columnist and commentator, and the co-author -- why you're wrong about the right, the surprising truth about conservatives. "washington journal" continues. host: at the table now, christine owens. our topic now, the efforts in congress to possibly extend unemployment benefits. remind us of what has been in place the recent months. guest: a couple of programs, the emergency unemployment program entirely federally- funded, providing 33 weeks of benefits for long-term jobless workers in every state. we have also had a permanent extended benefits program providing either 13 or 20 weeks

of extended benefits for workers who exhaust the emergency benefits. host: how important have they been? guest: hugely helpful. we know from the last recession that people are more likely to fall into poverty if they do not have unemployment, more likely to have to foreclose, more likely to go hungry. it makes a huge difference to families to collect them and to the communities. host: what is running out? where the house and senate working so hard on this? guest: there are roughly 1.3 million long-term unemployed workers who by the end of this year will run out of every single benefit they have. all other state and federal emergency and extended benefits. they will have nothing to fall back on. unless congress acts quickly --

400,000 have already run out and 200,000 will run out this month. we will have well over 1 million by the end of the year unless congress acts quickly. host: jobless benefits are the topic. here are the phone numbers. if you are unemployed we want to hear by your situation. a quick reminder from congressional quarterly about unemployment extensions. the house bill provides an additional 13 weeks in high unemployment states -- what does that mean? guest: in states that have averaged 8.5% over a three-month period, those are considered high employment states -- there

are 26 of them. the house bill would provide additional 13 weeks. host: there has been a bit of a tussle in the senate as they try to craft their own bill. they think they have agreement on the democrat side of and added 14 weeks for all 50 states. the highest unemployment would get 20 weeks. how significant is that senate approach? guest: hugely significant. it does not make much difference to a long-term worker if they are in a state with 8.5% or rather 8.4% unemployment. every state has experienced significant increases. so, every state needs a program in place for these long-term

unemployed workers. the workers need it and so do their communities. host: what is the bigger story would jobs here in america? the papers today have headlines like this -- most economists see f reavery. but the sub-heading says that the rebound will be slow amid high joblessness. there is the idea again of "a jobless recovery." guest: we had a jobless recovery after the 2001 recovery. we did not start adding jobs until 2004. it is one reason we are in such a bad situation now. we had a weak jobs recovery over the past eight years and the economy had already entered recession at the end of december 2007. economists predict unemployment will rise to at least 10.5%,

that we will continue to lose jobs every month over the next year. it is not unusual for unemployment to rise after a recession has ended. it is fairly typical. what has been unusual for the last recession and what appears we're headed toward is that we will have a sustained period of rising unemployment and job loss which underscores how critical it is to have a strong safety net in place for those who run out of benefits. currently, if you only look at official numbers of the unemployed and job openings, there more than six unemployed for every single job opening in the country. is brutal out there for those looking for work. host: we get calls over the months asking if the government can afford these of bailout and health care. how long can the government afford to extend and plenum.

guest: it is not b people work for unemployment benefits. everyday you are at your job you earn wages going into the unemployment insurance trust fund. when you lose your job through no fault you are entitled to collect the insurance and just as if your house burned down. he would be entitled to collect on your homeowner's policy. it is not a bill. the bills in both the senate and house are paid for and it is relatively a modest amount of money. it will make a huge difference to workers and communities. host: what is the average weekly unemployment benefit? guest: around $350 -- not really enough to work on. host: the first call frofor our guest, bill, on the republican line. caller: the sad state is that 30 years ago the republicans and democrats together sold out the

american workers and our country. if they have not created tax incentives to go offshore, let the environmentalists, unions, and the list goes on -- to push legislation through lobbyists, we would still have a manufacturing base. until everyone on that list, and until we get a leader who will not succumb to the pressure of his or her unemployment groups -- until we have a leader to get everyone at the table to say 75% of something is better than nothing, we will never get our base back. i would rather have a protectionist and a decline in the economy and possibly a collapse for about three years until we would get back on our feet and said of this prolonged 20-year cycle.

guest: i agree that the manufacturing sector has been clobbered. there is no question. you see it in the midwest. i'm from southeastern virginia and know many in south carolina who have lost their jobs to trade and decline of the apparel industry. we need an industrial policy in this country. we need to rebuild our manufacturing core. that is right. i don't necessarily agree with the callers prescription for what we should do, but we do need an industrial policy and to revive manufacturing. host: we have allen live from phoenix. i understand that you are unemployed? what is your situation? caller: i had been fired or forced out of every job i have had since i have been of college and the military.

the only support troops until we come back, and then they pushed us to the wayside. so, i hope everything gets back on track. but i have been fired or forced every job. host: have you been getting the benefits each week or month? caller: no, i have never applied. host: why? caller: i am a college graduate and decorated war veteran and i do not see why i should have to. guest: this question raises an interesting point which is that fewer than half of unemployed workers actually collect unemployment benefits. fewer than 40%. part of the reason is rules that exclude people from coverage. part of the reason is that people assume they're not covered and do not apply. fault should at least apply. make sure if they are eligible

they can collect benefits. they have earned them. he has earned them. host: two points -- would exclude certain people? guest: if you are not an employee, but rather an independent contractor. if you have not met certain income earnings tests during the time of your employment, or if you have worked part-time and want to look for a part-time job because maybe you have child care responsibilities, some states will not allow coverage for those only looking for part- time work. host: prior to applying to see what happens, how can people learn about whether or not they qualify? guest: you can go to the website of your state or labor department website. you can phone the state agency. we have information on our website, www.nelp.org.

we also have another website for unemployed workers with general information. search the web and look for your state's rules. host: our guest is christine owens. she was part with the falco. ohio, on the line for democrats. caller: i would like to know the difference between unemployment benefits. if these people do not get them they end up on welfare. which is cheaper? you get medical care then. what you get on unemployment? guest: normally those on unemployment get a weekly benefit which varies by state, but averages just over $350 per week. right now unemployed workers are

also eligible to have their cobra payments subsidize. it was part of the recovery act. normally an unemployed worker would not automatically have a cover a subsidy. it is in the long run more cost- effective to provide unemployment benefits then for them to resolve to public benefits programs like welfare and medicaid. host: you mention the roughly 350 per week -- is that taxable? guest: not right now. as part of the recovery at the first $2,400 of benefits in 2009 is tax-free. host: and if you are working part-time you like them? guest: it depends on the state. some states will allow it, particularly if there is a employer has cut hours to save jobs.

but not every state, by any means. host: the next call. from lawrence, mich.. caller: i have been unemployed long enough that i am not eligible for unemployment welfare. i would take one of those so- called jobs that we do not want as americans. i have tried to go out and pick apples. they will not hire me because they say that i will bruise the fruit. i have tried to get work. i have been in construction for many years. you go on a construction site nowadays and is all illegals. so, the unemployment is useless for a lot of us americans because we are not eligible for it. host: with the think you will do?

caller: right now i'm picking up cans in the ditches and scrap metal from different places. we will probably lose our property this year. we will not be a will to for the property tax. our house has been paid for for 15 years. now we're probably going to lose it do to property-tax is. host: days, don, from michigan there. it has one of the highest unemployment rates there in michigan. guest: yes, his situation underscores the importance of congress moving ahead with extending emergency unemployment benefits. he makes a good point in terms of losing his house over property taxes. think about all the ways or even a modest amount coming in every month makes a difference in people's be nimble to hold onto homes and cars, continue to look

for work, provide mobility. once that is cut off people are struggling. host: pa., josh, on the independent line. caller: yes, i have a question for mrs. owens. i apologize -- christine. caller: i ran out of my benefits, at euc. i had to go look for work. i had to fill out applications. it was a seven-week thing. i call the unemployment office and they said i was eligible for an extension. i believe -- let me see here -- in this hr3548 -- the that passed congress jet?

guest: i think what you are talking about is the permanent extended benefits program. it does require that one engaged in job search while collecting benefits. it is not the emergency program that has different requirements. the house has passed a bill and the senate is poised to consider one this week, but we do not yet have another extension. host: the next call, houston. caller: thank you. i have a son who has been trying to get a job. the employment is not too bad, but lots of people having a hard time.

my son has been working little jobs here and there. they say he has not been working at one place long enough all these little part-time jobs hardly have the benefits. that's the state a case that? it is really, really hard out there. could you tell me on that, please? guest: it is very hard, and unfortunately it does sound like given the way that you describe his job history that he probably has not met the minimum requirements the state imposes in terms of how long he has been in a job and how much he has earned over the course of what is called a base period. we talked about the rules that

exclude people from coverage, this is the kind of role that excludes someone if they have moved to a variety of temporary jobs and has fairly and lower earnings. in many states the person will not qualify. host: how did the states generally operate in this area? what kind of rules, approached do the states take? guest: they have rules that basically requires someone has worked for a certain amount of time and earned a certain amount of money. it is called a base period. until the last 10 or 15 years the most states use the formula to determine earnings that would not consider an individual's most recent earnings. its effect was to exclude a lot of low-paid workers, new entrants to the work force.

we work on something called an alternative base. which allows states to look at a different way to count somhow mh someone has turned into include the most recent earnings to determine eligibility. many rules were originally set at the toime when record-keeping was not done by computer. the states have not updated their systems to take into account. host: remind us of the scope of your organization. guest: we do a lot of work on unemployment insurance, but a lot related to worker protections, generally. the right to earn a decent minimum wage, get overtime pay. the right of workers in the midwest to get trade adjustment assistance and access to

programs. emigrant workers to be treated fairly on the job, and those who have prior records to have a fair chance for re-of plymouth. host: let's hear from cedar rapids, from john. caller: i have another two weeks and then it will be one year since i have been laid off. i was working in a factory for the last four years. i was in the building trade for four years before that. i'm pretty used to this unemployment. i hear everyday people telling me they're not eligible for unemployment. their bosses will not pay it. i know i've worked for one contractor who always told everyone they will not get my money. the money that goes from his pocket into that fund only sits there for a certain amount of time.

after it is there for a while it falls off and to the general fund. anyone told they're not eligible because they quit their job or got fired, or whatever -- they are eligible for that unemployment benefit. they will just have to wait a little longer than others. it is a shame that i hear those who have never applied for it. because someone has told them they are not eligible. it is a shame that people don't know what is going on. guest: that is absolutely right. people become discouraged either by their employers, or thinking they are not eligible, or think

there is some stigma. people should apply for unemployment benefits. it is not the case that in every state the rules are the same. in some states you can qualify even if you quit, but not in other states. people who have become unemployed through no fault of their own should definitely apply for unemployment benefits. host: have you think congress will work things out and in how many weeks? guest: i believe we will have legislation that covers every state. we think the senate bill that both senators reid and max baucus and others have come up with is very good and provides a good amount of coverage for workers in every state. i believe there will be bipartisan support for it. there have been republican senators who have expressed a view that every state needs relief.

we think once the senate acts which we hope will be within a couple days that it will move back to the house and move quickly. host: here is a question by twitter. guest: i think it is premature to answer that question. we know that we need a jobs policy. we need to create jobs because people want to work, not collect unemployment benefits. we need to address the crisis we face now in terms of 1.3 million people falling off a cliff at the end of the year. to build a jobs policy and in the future if those two solutions are not adequate, look at what we do next. host: indiana, larry. caller: i would like to address

a subject not talked about. that is the temporary services jobs. about two years ago i worked through temporary service at a small factory in about half the employees were temporary. some of them up to five years as a temporary. the hired workers were making good, livable wages, but the temporary service people were not. i would like to see laws put into place that these companies who use of temporary services will have to hire people after a certain time. guest: there are tests under current laws that determine whether an employer can legitimately consider folks who they might classify people truly

as temporary, or if in effect they basically become employees. but is a hole in the law would make sense to address. i thought he was going after a different issue. sometimes employers will outsource work forces to get a lower insurance rating for their unemployment insurance coverage. that ends up hurting a lot of workers as well as the state funds. but i think his point is basically right. host: we go to ohio for the last caller, republican. caller: we have something like 12 million illegals and each year we bring in something like 2.4 million. every 12 months that is 200,000 jobs just to stay level.

plus, the automation number. in order to create one job and you have to give be on the number and it should be recognized. if someone does not collect a check they are not counted in the unemployed. we have some really screwy numbers out there. guest: in terms of who was counted among the unemployed, that number which is over 15 million now is based on the labor department's survey done every month. it is not based on who collects an unemployment check. host: christine owens is executive and director of the national unemployment law project. thank you for your time. we will take a short time on and get back to the health-care debate, particularly the

insurance report that came out yesterday. our guest will be roy ramthun of the council for affordable health insurance. in the meantime, here's an update. >> president obama is working at the white house today, meeting with the president of spain mid- day, later he and vice president joe biden said down with robert gates as the strategy in afghanistan continues to be considered. "the washington post" says the white house has authorized and the pentagon is deploying 13 delta more troops to afghanistan. they primarily support forces. more this morning on president obama's efforts for peace in the middle east. a document accusing the u.s. of failing to set a new agenda for peace talks is circulating among members of abba's' look a party

saying that any hopes have evaporated. hillary clinton i is in russia. they're discussing issues including the nuclear ambitions of iran. it is said that neither country has us the other of anything to deal with iran and would be silly to do so because of our positions, said. meanwhile, the pentagon is speeding up delivery of a bomb designed to destroy hidden weapons bunkers sheldon underground. this follows the recent disclosure of the nuclear site in a run deep inside a mountain near the city of kolm. . .

host: our guest is ramthun, a resident fellow at the council for affordable health insurance. guest: we are a trade organization for insurance companies. we have been around since around the formation of the last healthcare debate. host: here is "the washington post" story about this insurance industry report. they write --

and as far as some of the details, the talk about this report done by price waterhouse coopers, and some of the details, among other things -- does your group supports the report that came out yesterday? guest: in content, yes. we have been saying we believe cost of insurance will be less affordable under these proposals then maybe it is under current law, and that is because we do not address the problems of group health care cost

increases. host: members of congress are pushing back as well when the report came out. some of the details in the piece -- guest: i think that is true. they did not look at the provisions of the bill, so there are a right to push back. the difference with the studies is everything had been a moving target. the details matter, and now we finally have the details but it is difficult to commission a study in the coming weeks. host: you can read this 26-page report at our website, c- span.org.

roy ramthun will be here to take your phone calls. he is a resident fellow for the council for affordable health insurance. republicans, 202-737-0001. democrats, 202-737-0002. independents, 202-628-0205. more reactions from the newspapers. jay rockefeller on finance said the report was -- guest: i would expect nothing less from him. we have to keep in mind when he would like is for all of us to be enrolled in a program similar to medicare. this is somewhat the opposite end of the spectrum, and he believes we should be looking at the government providing more health care, and he believes they would do a better job controlling the cost. that would be a major change for

most americans. most of us get private insurance, do not want the government to provide insurance for us. so i am not surprised at all that he made those comments. host: what is a level of the insurance industry? guest: first, making sure that it is an option, and making sure that it is affordable one thing i hear a lot is that congress has tried to lessen the penalties for people who fear they will be required to buy insurance. at some point, those penalties become someone worth less in terms of guaranteeing that people would have coverage. so the more people go without coverage, the more expensive and will be for the rest of us because we are all ii assumed those who need the coverage the most are absolutely going to buy

it, but we need as many people in the risk pools as possible. people who may not have health conditions today, but could in the future. insurance is in a way of cross- subsidizing those needs. host: first phone call with joe from west virginia. please turn down the sound on your television. caller: and i wonder why they chose the public option in the bill. you said that people would not be able to afford that. the second thing is, is it going to be mandated for everyone to have insurance, even if they cannot afford it?

guest: the public option was not included in the senate finance bill because it was in the judgment of the chairman that there were not enough votes to include a public option. they replaced it with something called healthcare co-ops. we will have to see if that remains in the bill as it moves through the senate. in regard to your second question, yes, everyone would be required to purchase insurance in the future. there are some exceptions and all proposals with individuals who may not be able to afford that, but the government has provided subsidies that would make insurance more affordable if it does not appear to be affordable up front. after one looks at the cost of insurance and some cities, there would still be counties in place for individuals who choose to go without, but yes, everyone

would be required to have it. the concept of the co-op is rather interesting because if it has been hard to get details on what the finance committee actually mean by that. we are working with a couple of states where a collection of the employers have brought together and pooled their workers into a cooperative run by the workers themselves. there are others in washington state where they contract and become not only the health insurer, but also the health care provider. they set up a health-maintenance organization, they employ the doctors and hospitals. host: louisiana. emily, on the line for democrats. caller: good morning.

i wanted to ask your guest, he is a senior fellow where? host: the council for affordable health insurance. caller: is that an insurance company? guest: we do work with a consortium of insurance companies. caller: my mother is on medicare. how would this non-public option impact her? my husband has a pre-existing condition. he had a triple bypass. he has to pay his own insurance because he is self-employed. how would that affect him also? i would appreciate if you could help me here. i am worried about both of these issues.

those are my two primary questions. thank you so much. guest: seniors on medicare or anyone about to enroll, will continue to enroll in the medicare program. not much will change in terms of how your health insurance is delivered. except for those individuals who are on a private alternative to medicare, medicare advantage, there could be some changes that would reduce the number of those plans available to you in the future. the details will be worked out in the coming months as congress finishes its work, but by and large, little changed for you. your husband, with a pre- existing condition, he will no longer be able to be turned down, if the bills pass, because

there will not be an opportunity to deny people coverage because of a pre-existing condition. because he is self-employed, people have to buy his insurance through the health insurance exchange. you can think of that as i should -- supermarket for health insurance, where you could go and collect one of the policies offered to individuals who are self-employed, unemployed, who work for small businesses and may not be getting coverage today. those will be the choices available to him in the future. the intention is to become more tauruses, kind of like state and federal workers. it does not matter which agency they work for, but they have maybe 20, 30 choices they can choose from. your husband would select health insurance plan he wants, and the

tax treatment of that in turn would be roughly the same as today. host: here is the "financial times" in all of this. they talk about the report that came down yesterday from the insurance group. the report estimated premiums would rise much faster under the proposed reform then there would have otherwise -- take us back to the beginning of this process. the insurance industry was broad in early in the process. what was likthat like?

guest: everyone said, let's get the people around the table who were some of the biggest detractors, and critics of the health care reform debate in the last time around, and let's talk to them from the beginning. everyone is playing nice, trying to stay focused on supporting common goals, and the question was how long was i going to last? at some point, there are decisions that need to be made on how this would actually work that might cause problems for both employers and the insurance industry. i think we have now reached that point. it has been a long time coming. there were not many details available earlier this year, so it was hard for the industry to criticize the proposals, but now we have a proposal similar to

the senate finance committee, which people believe has the best chance of getting through to the president, those details matter. we can question the timing of the report. had it come down several weeks ago, people may not have questioned the timing. if it came out some of weeks from now, people would have said it is too late to make a difference. host: more reaction from senator rockefeller --

guest: not much has changed, even though we are here 16 years later. a lot of the demonizing of the industry has gone on, primarily from liberals, so they see this as an attack on the planned date are trying to pass. in is getting very political by now. -- it is getting very political right now. the industry has to do what it can to defend themselves. you could look at the industry and it is not a high margin profit business people tend to focus on individual companies, individual characteristics of companies who are not good actors in the health-care debate, not contributing anything positive to health care in this country. but most of us are satisfied

with the plans we have, so they must be providing some kind of value, or we would not continue to do it. host: next phone call. drawn from new jersey. independenct line. -- john from new jersey. guest: why is it that the health care that congress has, why is that not good enough for everyone in the country? guest: it might be, but the question is, who is going to pay for it? federal employees, which i used to be, those costs are subsidized by the taxpayer, on average, 72% of the premium paid by the government.

they do not get that money, except from the taxpayers, so it is important to keep that in mind. would you like the insurance plans that members of congress have? that is quite likely because there are a lot to choose from, and hopefully you can find a plan that fits your needs. the question is, would those be the only ones that would fit your needs, would there be others that you could find more affordable? most of us would like those plans if they were subsidized, but the cost of those plans are much higher than those which employers provide today. host: next phone call. oklahoma city. caller: i have a question.

suppose we pay for health care by a national health care sales tax, only for health care. it would be collected by everyone, of course. everyone would pay into the system. it would not the employer-based insurance company-run method of providing health care. the providers come with representatives of the public, both set prices and have their pay consist of both a fee-for- service and performance so that they can be reimbursed for their services. the question is, how much will

and an average family of four pay in sales tax over 1 months time compared to what they would pay in premiums to the insurance companies? guest: i'm not sure that is an easy question to answer. i do not have that sort of data in front of me. it is important to note, the british health-care system is essentially that. they use any value added tax. for all of its shortcomings, many of us would think that that vat tax is not high enough, but also, no one had been supporting raising the tax, and there is a certain reticence

among the british people to change the system dramatically. we have to look at any system that did that, and understand who the potential winners and losers are in that type of system. then we get into a system where the care it is essentially free at the point of service and everybody starts whining of to get their share of the care because they have paid their taxes, and nothing they are entitled to as much care as they can get. we also have the british system where individuals are rationed based on their ages in some cases, prospects for improved health outcomes. to me, that is a system that this country would not likely embrace any time soon. it would be easy to say, let's finance the health care differently, and for all of us to choose our own health

insurance might be an improvement over the current system, but it is more foreign of the concept to us. all discussions of those types of flat tax is dedicated to health care have not gone anywhere yet, politically. host: here is the next question from twitter. guest: that must open up a new world of choices. as people have discovered they can buy plans across state lines, almost anything other than health insurance, across state lines. when a state makes the cost of insurance prohibitively expensive, it would give the opportunity for individuals to look across the border and say, maybe there is a more affordable

policy over there for me. the finance committee does take time steps to move in that direction. it is not as far as republicans would like to go. they would like it to be more free market, but it does take some of those steps. host: the lead paragraph in the "new york times" reads -- and then at the bottom of the "washington post" story, they predict these new fees on these policies would be passed on to consumers.

they go on -- reaction to those comments? guest: yes, you would think if there is a tax imposed on high dollar plans, there would be fewer of planned in the future. the question is, for those individuals enrolled in the high dollar plans, to they have the option available so that they can switch their plan and avoid that tax? i agree that the talks would likely be passed on to the individuals who chose the premiums, so to say that we will

charge a windfall tax to insurance companies, that is a little bit of a false impression. would it get plans to lower their premiums over all? i think there would be enough flexibility in the bills to allow that to occur. the question is, will people want the policies they used to have, even though they are taxed, or when they want to switch to a lower-cost plan that does not have a tax imposed on it? host: sheila on the democrat woline. go ahead. caller: i have a question. volume on corporate insurance -- and i havi have cobra insurance.

after this year, it will go to $757 a month. if this passes, is this going to help us at all? guest: no, it is not going to change those premiums. the premium you are paying is your share that used to be paid by your employer. since you are not employed by the company anymore, the company is not paying a portion of the premium, which is why you will see the premium goes from 200 to 2 $5 a month to -- $265 a month to $700 a month. i do not know, in these bills, whether the subsidy currently

provided by the federal government will be available to you after that point. i believe it will be replaced by other forms of subsidies that will try to make insurance plan more affordable to you in the future. depending on the details of how the health reform legislation and upcoming out, some of those funds may not be available to you for a few years. host: time for a couple of more phone calls. clint on the independent line. caller: i am someone who has multiple college degrees, have marked several temp jobs, factory jobs. i never made enough money for unemployment benefits. i never successfully insured

myself. i only had coverage when i was in school. i have donated money for those kids who do not have insurance. some people cannot take care of their kids through the hospital, so they go through the church or family contacts. if you are really for free choice, i have never really been covered by your system. i'm would never choose -- i would probably choose the public option. if you opened up the borders, i might go to vermont or canada.

i do not want to help a company that does not help these kids. guest: everybody wants good choices. the main concern of the insurance industry is that a choice with a public auction would not be a true choice, the power of the federal government would come in and take away the choices they had. we want to make sure the government is going to be willing to pay doctors and hospitals adequate reimbursement for services they provide. doctors are concerned about the fees they are paid under medicare today, so we want to make sure they are still amount to take care of everyone in the future and make sure the government does not use its power to destroy the market angeles is available. host: daytona beach, florida.

caller: good morning. i am 69 years old. i am on medicare. why do the insurance companies have people, when they are the most vulnerable part of their life, all these people are paying in the end of a lot of people are not even getting the benefits of these private insurance companies? guest: 9 not sure what problems you are referring to. most people do get a benefit from their insurance. it is a small fraction of people who do not. most of us are healthy enough at younger ages where we do not use a lot of our health insurance but we pay a lot in premiums. we have to keep in mind, insurance is meant to protect us

in case something horrible happened to us, protect us from going into bankruptcy. today, there are a lot of choices that will determine what type of premium you are willing to pay for the coverage you think meet your needs. we would think that those choices would not be taken away from anyone in the future, and we would expect insurance to pay for things that it truly should pay for, but i think your assertion may not be based on facts. host: we know there is still a ways to go on the debate. what is your industry's priorities? guest: we are trying to make sure there are lots of insurance options available to people, that they are affordable, and that we address some of the inequities in the current system today.

number one, not everyone gets the same favorable tax benefits for the health insurance they purchase. number two, people are locked into the situations of how they get insurance today. we believe that could be opened up by telling people to purchase across state lines. we agree with some of the insurance changes that they have talked about such as getting rid of pre-existing conditions but we do not believe it is a good idea to force everyone to pay the same premiums for those insurance policies because that means a lot of people who have low income will not be able to afford them. we believe the experience in the state has shown that. so we do not want to repeat those mistakes. we want to look at the positive things that can be done and improve the system for everyone. host: our guest is a former

health care policy adviser to george bush. roy ramthun is a current senior fellow at the council for affordable health insurance. thank you for your time. we will be right back after a short break. >> a final vote is likely in the senate finance committee as they finish discussions on health care. live coverage of the committee markup session thereafter -- right after "washington journal ." then television coverage moved over to c-span 3 as the house

moves in. 15 things on the agenda today. likely, later this week, spending bills for the homeland security and interior department. live coverage beginning at 12:30 eastern time. at 3:00, they resume spending for science programs. host: more about health care later in the program at 9:00 with uwe reinhart from princeton university. the house and senate coming back into session today. we found this piece in the financial -- the financial time"the financial times" and it

says obama must start punching harder. the author writes - let's get your thoughts on that

headline. above it is a cartoon. here are the phone numbers on the bottom of the screen. republicans, 202-737-0001. democrats, 202-737-0002. independents, 202-628-0205. he goes on to write --

ballpark, tennessee. floyd, what do you think? go ahead with your comments. caller: i am a republican. as i said before --

hello? i apologize. host: we will give you a chance to call back. the convention is not great. phoenix, michael on the independent line. caller: i think he is doing the right thing with the public option. i think he needs to punch harder. about the nobel peace prize, although i am glad that he got it, and all they are trying to do is separate us. he did not really do anything at that time to get the nobel peace prize, but i am glad that he got it.

host: chantilly, and virginia -- , virginia. caller: the american people voted for barack obama for a reason. he keeps on giving a speech after speech. we need some action. sometimes it works, sometimes it does not work. but giving us a false speak all the time does not help anybody. we know we have a problem. we need action, that is why we voted for him. you are in a politician, do what you need to do for the american people. the democrats have the majority in the congress and senate. if we do not do anything about these issues -- how they need to

wake up and smell the coffee. host: in the "financial times" they write -- next phone call.

ned from florida, republican line. caller: i think this shows that president obama is in its. -- is inexperienced. we are relying on a president who does not have any financial backing. this is a multi-trillion economy and he doesn't have the experience to back it.. host: studio city, california. "obama must punch harder" is the headline. caller: one of the main things i wanted to say was president obama has been rather wimpy

about everything. he abandoned the public option, is putting more troops in afghanistan. what happened to usama bin laden? he is not doing anything. i think he needs to come out as they said and stuff currying favor with republicans who are hanging him out to dry. host: gideon rockman goes on to write -

harrisburg, pennsylvania. caller: the financial times is just -- "the financial times" is just another republican rag. i think president obama this plain people like rahm emanuel and others around him like a fiddle.

the far left, they need to relax. i think he is playing the media. he is taking on fox news now. i think if people blacks, -- relax, let them do their thing. host: austin, texas. norma on the republican line. caller: our president does seem to be trying to be exceedingly kind to us republicans. the point of the matter is, on health care, if he cannot get it the way that he wants, he should

regulate health care so severely, so instead of them putting all these commercials against health care, we needed to us that the. everything the republicans say they want, going across state lines, we have that in texas. tort reform, we have that in texas. we republicans have not done -- have not brought down the price of health care in texas. unfortunately, the president does not point that count. when he says the insurance companies are gearing up to cut down health care -- i hate to say it as a republican, but we have helped the interim committee stay in business, turned up rangers rates -- a

charge of greatest rates, because the republican party support the industry. host: next phone call from pennsylvania. mickey on the independent line. caller: i think "the financial times" is being a bit in winter. if you want to invite this into a real political debate, this is not the place. it does not really matter what they know about obama. i do not want this country, the congress looking like a third world nation having a fight. the only way that is going to happen is if periodicals like "the financial times" comes up

with better analogy is to world dominance, foreign relations. i highly disagree with the idea that the usa always needs to be the dominant country. it is just unrealistic. there are plenty of other people and other ideas in the world. it does not mean that the usa is the only continent on the globe. host: thank you. we will read the wrap-up of gideon rachman's piece -

hostmiami, joseph, democrat lin. caller: obama is well grounded in his strategy is good because the studies his problems with full attention. when he does his job, he does it well. i do not have a problem with the president. i am glad how he is handling the situation.

he is going to do what he has to do to fix the problem. host: here is the lead story in "the washington post" --

louisiana, back to the question about the president. david, should the president be punching harder? caller: i think so. i cannot think anything he has done has been thought through. each of his policies have failed so far, from the housing industry to the automotive industry, to health care. because of that, he is not getting any support, at least not in a bipartisan way. host: atlanta, dwayne, independent line. caller: i believe president

obama is punching as well as muhammed ali. first of all, he will last all 12 rounds. the people who are saying that he is failing, they say that he is fighting like a girl come on but that is an insult. he is not a failure. if you look at the work he is doing around the world, you will see that he is prevailing. congratulations, president obama on your nobel peace prize. host: next phone call. caller: i think president obama need to come out with the gloves on.

enough of the republicans trying to derail him. of course, he has only been in office nine months. gave him the opportunity to lead the country. host: the business section of "the new york times" talked about clamps tightening on credit. the lead says -- lead story, "wall street journal" --

david cho writes - "washington post" there. winston, south carolina.

what is your opinion? caller: obama does not have been in him to pledge any harder. some of these people calling on the republican line need to be calling on the democratic line. he is at a gay rights activism thing -- that is not even important. he is a disgrace to the country, he is a socialist. he is trying to take over health care. you have people being interviewed in detroit, michigan saying that there are just there for the money, trying to get obama's money. these people do not even know what they voted for. they have no idea what they are in our goal -- when they are going to get. host: here is one more message from twitterr --

houston, texas. caller: good morning. the president is the most powerful men in the world. he has the u.s. armed forces behind him. he can punch if he wants to. second, it is impossible for a president to win when the other party is not helping. it is not fair for the american people. nothing that he does will be ok for the republican, otherwise, he will stay in power. third, if you go to texas and you find out how they passed certain laws, the governor

perry, it gives insurance companies the ability to set up networks to reduce the cost for workers. that was a republican who signed that into law. the republicans love the insurance companies. they do not love the people. host: a house is coming back into legislative session today. a bill on iran sanctions. and a reminder, the senate finance committee, 10:00 eastern time. right after the program, we will go there and expect them to finish their remarks on health care bill and take a final vote. chairman baucus says he does not have enough votes to pass the

bill. morning session on c-span, and then on and c-span 3. tallahassee, donald. caller: i just want all the republicans out there to know what mohammad ali did to george foreman. i love with president obama is doing. he is going to get new drug and then he is going to mug you. this is what you have to do. thank you very much. host: ohio on the republican line. what do you make of that had donheadline?

caller: one year ago we selected a man who did not have much experience in this is his training. for the things that he has inherited, you have to give him credit for what he is trying to do. he is going to get better at it, the lead. host: columbus, ohio. caller: i just wanted to say, with respect to picking winners and losers in this debate, it is not the right thing. we need to be listening to everybody, as opposed to fighting everyone on the side. when we do that, the american public loses. we elected obama's so that we could get something through for the american people.

now we are fighting tooth and nail on everything he is trying to dupe. i think we all need to take a deep breath and look at the facts and make sound decisions for all americans. host: iran topped the agenda for clinton in moscow, talking about the secretary of state. "the philadelphia inquirer" has this.

san louis. tony, democrat. caller: i do not know how you can consider him being weak. diplomacy takes time. you have to talk to this person, that person, make sure these people are doing what they say they are going to. it is ridiculous to think that he is some kind of weaseling man who does not get anything done. host: where do you think the president is strong? caller: internationally, he is doing a wonderful job with our allies, talking to people

again, getting people to come to the table. that has not happened in a while. the only place he is having trouble is here at home. he is getting in from some republicans, from the blue dog democrats, from the gyas. -- the gays. don't worry, he will take care of you. i know it is hard coming from a black man to say, have patience, but it takes time. .

caller: there will be losers in the way that democrats would to reorganize healthcare. i think he is fighting as hard as he can. host: this piece today, the british plan to raise money including selling its stake in a rail tunnel -- their right that gordon brown is selling a range of government-owned assets. it includes this which connects london to the continent to raise money to help plug the country's huge budget deficit. new jersey, on the independent

line. caller: punch harder? the biggest problem is a lack of jobs. i say this because i bought a reese's peanut butter cup and when you looked at it is no longer made in pennsylvania, but in mexico. obama put through the bailout of general motors. the american public should be aware that not one job was lost in either mexico or canada. all the jobs lost were in north america. this morning mexico just announced they had a 9% increase in their border exports. host: one of the lead items in "the washington times" today -- israelis might stay home to avoid arrest.

it says that israel is seriously considering restricting air travel to europe by senior officials and military officials fearing they might be arrested in the wake of the disputed u.n. report that accuses the jewish state of targeting civilians in its gaza war earlier this year. one last call on the headline, the opinion piece from "the financial times" saying that obama must punch harder. massachusetts, on the line for democrats. caller: thanks, i think all hold punching carter team is the wrong thing. obama needs to punch more intelligently. -- will hthe whole punching harr theme is the wrong thing.

i am personally speaking to my own representatives -- we need you. as a single dad i'm very lucky, able to cover my kids and ex- wife. but i know many out there who need this. they want to have affordable health care. the companies are ripping us off blind. what we need more people. it is not just obama who is doing this. it is for all of us. host: i appreciate thoughts. more about health care in this final hour after this short break and update. >> with attention focused on today's bubble the on health- care legislation in the senate committee, an overhaul of the nation's financial loss is being considered. politico reports that the top ranking republican on the committee is looking more like he is ready to compromise. he is backing of what house

proposal to deal with the resolution of 40 to wind down financial and institutions rather than bailing them out. it has endorsed the federal crackdown on bond-rating agencies. an update on afghanistan -- karzai spoke earlier from kabul on "good morning america" acknowledges a regular varies in the recent election, while arguing that it was generally good and fair and worthy of praise, not scorn. preliminary results show that he won with 55% of the vote, but a pending recount lower the numbers and force a run-off. in pakistan jets have been targeting bombers were more militant attacks are being planned. this is amid speculation that a new ground offensive is imminent and the remote mountainous region along the afghan border. and the last few hours the romanian government has fallen

in a confidence vote in parliament. lawmakers voted by 258 to 176 to oust the centralist government. it is the first time that parliament has dismissed the government since communism ended in 1989. >> the british house of commons is back in session in prague minister's questions live. it is followed by a talk by gordon brown at 7:30 a.m. eastern. >> sunday, columnist and commentator with this book, the surprising truth about conservatives. sunday night on c-span. "washington journal" continues. host: in the last hour of news we will turn our attention to the rising cost of health care

for the last four years. joining us is a health-care economist and professor at princeton university. let's begin with what we have seen in total health care expenditures over the last four years. in 1960 it was about $27.5 billion. in 2007 rose to $2.20 trillion. what is the main reason for this rising cost? >> there are several reasons. within each country healthcare costs are rising because activity gains are harder to get there than in sectors like electronics. there is a natural law and economics when one sector's output is produced with less productivity growth than another, the lows productivity sectors price will rise. it is true for her cats, lawyers, and university teaching as well. but in the u.s. we spend roughly

double what they spend in canada. for elective surgery they will cue up there, but almost anyone who has looked at it will find out that the canadians longevity, any metric used to measure the output is better there than here. the reason we could go into the reasons why -- why it is more expensive here than in other places, and perhaps you want to do that. guesthost: let's do that. over the last four yearsthegdp -- 5% in 1960, and now in 200716%. >> one reason why health spending in the u.s. desire is because we are a richer country

in terms of gdp per capita. if you plot on a graph on a vertical access health spending in international dollars you can compare among nations. and on the horizontal axis you put gross domestic product per capita, you get a cluster of points that cluster narrowly around st. line. that line tells you that international differences in health spending per capita can be explained to the tune of about 90% by just knowing the gdp per capita. it would be natural to expect that we spend more than canada does. the gdp of canada is about 75% that of ours. one would expect us to spend more. the same is true of other countries. however, if we were on that line

-- at the difference between us and others were only gdp per capita, we would be spending $2,000 per capita less than we do. so, we economists say taking in come out, what can explain that extra $2,000? what do we get for it? there what we buy in america, an enormous amount of administrative services which are basically and frankly, in my view, worthless. it is so because we have a hugely splintered insurance industry, private and public, each with their own rules, each with their own nomenclature. so, when a physician deals with 20 different managed care companies which have different rules, which somehow he or she has to learn -- usually they have computers to help.

for one insurance co. you must call to do and mri, another you do not. that is mindless. it could make anything very expensive. so a lot of insurance is still process by paper. there is no other country that does that. canada, taiwan, germany -- it is all electronic. we invented computers and software, but we do not use it. the germans and canadians do. secondly, we spend an enormous amount on very high tech equipment which is expensive. sometimes useful, sometimes a waste. finally, we spend a lot of money on fighting debt. other countries tend to view death as a natural phenomenon. -- we spend a lot of money on death.

we view it as an option, not inevitable. host: look of a breakdown of cost. according here to assist as for medicare and medicaid services, hospitals make up about 31% of the nation's health care dollars. talk about this pie chart and what it means. guest: obviously, and any health system you have a different -- you have different providers of care. there are some surprises. for example, most americans look down on the drug companies and said the cause of the spinning. but overall it is only 11% of the pie, half of what is spent on physicians, and much less than spent on hospitals. it used to be that we spent 38%

on hospitals, but over time we have learned to treat people outside the hospital. so, it has shrunk. outpatient treatment now makes up a huge chunk of health spending. it is interesting that this breakdown among sectors various across nations. it suggests there's a lot of flexibility on how to deliver health care. generally, the europeans use mixes that are cheaper. host: let's talk about going back to the rising cost of the last 40 years. if you look at it per-capita which is something you touched on earlier, in 1960 it was about $140 per capita. it reached over $7,000 in 2007. what are predictions for future

costs if the system stays as it is? guest: if you had a couple of beers and still wanted to be an actuary for medicare, just remember this rule -- every 10 years healthcare spending in american doubles. you do not have to be sober to be an actuary. that is an easy forecast. if you look at what the center for medicare and medicaid policy services predicts for the next decade, it is essentially a doubling of health care spending. we are now in total spending about $2.70 trillion. the forecast is $5.20 trillion 10 years from now. host: we are speaking with uwe reinhardt from princeton university today about health care costs. let's turn to our first phone call from new caller: hampshire

yes, thank you. i have two questions. -- new hampshire. caller: i know we first try opening the government pulls for insurance that they use for their workers? just open it up for ordinary americans. the other thing would be the discrepancy between what the hospitals charge insurance companies for procedures and what they charge people who do not have insurance. my sister had a knee replacement done for $3,300. she got a bill for $22,000. they said the deal with the insurance companies' was for $3,300. they add one priced at the

hospital for everybody -- maybe we would not in need insurance. -- maybe we would not need insurance. guest: let me begin with the last question first. to my mind that is quite a dubious approach of the hospital sector. they have what they called the charge master which in the auto industry would be called the list price. usually it can be up to double of what usually gets negotiated with large insurance companies. smaller companies then pay higher charges. the uninsured are often billed full charges. when an insurance carrier negotiates charges they do it in terms of discounts off the charge master. every hospital can set its own charge master, but they keep it is secretisecret.

if you are uninsured you have no market power. you are at the mercy of hospitals. if you are very poor they might give you voluntarily a discount. but if you are middle-class, making $80,000, many hospitals will show no mercy. then they will try to collect. in new jersey i took a car service and the driver was uninjured. i asked him what happens when he is sick. he said his little boy had pus coming out of his eyes. he took him to the emergency of a local hospital and said it was an allergy and build him 12 under dollars. i moved someone on the board and got it fixed so that at the end the bill was only $80 which was probably what this was worth, but then i persuaded the governor through a commission that the chair to pass a law in new jersey that makes it illegal to charge uninsured people more

than medicare, plus 15%. i have tried to persuade the white house and the max baucus committee, henry waxman -- all of them i have told and pleaded with them to make that a national law. we shall see. i believe in the max baucus bill there is something that puts a lid on what hospitals can charge the uninsured. i personally am surprised that the hospital industry would do that because all it does is smear their image. "the wall street journal" had a series of articles on that. i don't understand why an industry ruin their reputation. if you would tell that to any foreigner from asia or europe with these hospitals do, they simply would not believe it. host: next phone call, new jersey.

caller: i totally agree with the first caller. we should have catastrophic health coverage for all. other medical expenses should be paid out of pocket as you buy concert tickets or tires for your car. the immense fraud in medicare is caused by providers building for services not performed. another thing is for the profit of the provider they do services absolutely not require. the canadian plan, the va, and medicare are all great until you get sick. people spend time in a hospital and medicare like myself would rate medicare as highly unsatisfactory. i am also patient in the va. irate that even more unsatisfactory. the va should be closed and

vouchers should be given to the individual veteran. bowsher should be given to the people and then they should go to the hospital who will take care of them. here in new jersey where i live hospitals -- charge -- double- charge for ambulance care. the cost is due to the lack of ethics. government is far too big. taxes are far too high. we need to change -- for example, doctors have so much money. my wife and i go many times. one doctor said to me two years ago what should we do? i said how about loving your neighbor the way you love yourself? we need a return to basic ethics.

in new jersey which should make a good decision on november 3 and put in someone who is ethical and honest. guest: that was certainly quite a multi-faceted story here. let me begin with the va. our son is in it, too. even the staunchest republicans defend the va system which is purely socialized medicine. it turns out that this system was pretty bad in the early 1990's. president clinton threatened to voucherize the system as the gentleman suggests, and then ken kaiser took the helm of the va entirely changed. it is not generally recognized to be the most sophisticated user of i.t.

there may still be individual hospitals not of to snuff, but the system gets high marks. the second problem that this gentleman alluded to which is everyone should have a catastrophic policy, but there should be a deductible of say, $5,000 that they should budget for out of pocket. that is sort of what will come out of this max baucus bill. if you mandate people to buy insurance you cannot buy them to -- you cannot mandate them to buy a cadillac plan. particularly for young people, the policies mandated would be the kind the gentleman suggests. but let me warn him and everyone else on this.

for any large cohort of people, whether it is all of general motors workers, all elderly, all new jersey residents, whatever -- you'll find 20% of the cohort causes a% of all the health spending. so, when you have these high deductibles of cost sharing you should budget for, you are really shooting at about 20%. even if you make advances their the hospitals and doctors will recover its in the catastrophic piece when people are really sick. then all things go. there is some virtue in paying up front, particularly if you relate that to income. for a waitress $5,000 is a huge hit. four princeton professor is peanuts. for us you could require $15,000

for a deductible and we could budget that. the real issue is that this is very hard to cram down people's throats. people want first-dollar coverage and most employers give it. host: in 1960 the private-public equation of medicare and medicaid and other public programs -- what are the main reasons for the rising cost of medicare and medicaid? guest: first of all, if you plot this out, and you can see that in the congressional budget

office report, they grow at roughly the same rate. over time the private insurance system bit by bit has in some way dumped into the government's lap all the complicated cases. the elderly are very expensive and do not have the money to cover the premiums that would cost in a commercial insurance market. therefore, the government is left to pick up pieces. medicaid does not just covered children and their mothers who are poor. it also covers the blind and disabled. that is an extremely expensive clientele. is it also covers the poor elderly. medicaid does not cover all the spending of the elderly, for example, nursing homes.

medicaid picks up the rest. the government was the catch basin for all the expensive, relatively poor people. that is why they have very high per-capita spending. it is not that the government is sloppy. on the contrary, they end up looking after the more complicated, most expensive cases. that is why buy now pretty much have of all the spending on health care in america is from government. in fact, it is more than what the british government spends on its citizens. host: next phone call, on the line for democrats. caller: good morning, professor, i have some food for thought on pain for the cost of medicare. i have called several times to my congressmen's office.

i went to a town hall meeting in got no results there. i have been to the office here locally. i spoke with someone, but have still not gotten information. i have some ideas. the government wants the people to tighten our belts and see how we can cut costs. i am 80 years old. i have to cut costs all the time to live on the fixed-income. three years ago i got some information. it cost $35,000 per hour every time airforce want went up in the air. 100 hours would be over $3 million. i must believe that would cover a lot of children with health insurance. i don't understand why they can't cut down on some of their expenses. that is just one plane.

there are planes from washington that taxpayers are paying for every day, every hour. i don't they cut down on some of their vacations and put the money toward health care? my other concern is, taxpayers pay for security for i believe, nine ex-presidents and their wives. i have been tried to figure out how much that costs. the claim is privileged information. i'm a citizen and have been all my life. i believe i'm entitled to know what i am paying for that. why is there life any more important than mine? i retired as a schoolteacher and i don't have security on my life. host: we will leave it there and

get a response. guest: there are symbolic expenditures that irritate the taxpayer, but if you express them as a percentage of anything they get very small. take for example of the security of these presidents. i think they get something like $400 and dollars in pension per year and maybe security costs another $1 million. we don't have that many, so maybe the entire amount is $10 million. but that will not buy you much health care. as a percentage of health spending there are so many zeros that it will blow your mind. what is the case that president bush had ordered many new helicopters to take him from the white house to andrews air force? there were billions of dollars.

i don't know why. he canceled them precisely over the symbolic issue. he said he can fly with the old ones. because it irritates in the middle of recession to spend that much. he did respond a little bit. now this lady believes we're all the same in america. i would say that is something they teach in high school, but surely no one in america believes that we are all equal. take any corporate executives. if you looked at their health care plan and how they're pampered by their shareholders compared to the janitor you would be utterly shocked. i could send you an article from "the wall street journal" where shows that many corporate executives have all of their out-of-pocket spending reimbursed by the corporation. because it is a taxable event to

them the corporation even "grosses it up" -- gives them the taxes they need to cover that benefit. our entire corporate and government elite is an aristocracy. you must understand that. we're not equal to them. the kids have better access to schools including princeton, have better justice, better health care. very often they do not pay a dime. that is the american way. i am always hurts when people, particularly in the middle of the country, believe that we are all equal. it is just not true. we're not all equal. host: profs reinhardt as city the healthcare industry for more than two decades. we have about 30 minutes left. let's take a look at prescription drugs. in the national journal, the

latest addition, according to centers for medicaid and medicare, drug spending has increased by more than 250% $236 billion. guest: a lot of new, blockbuster drugs were developed. those drugs are great. one which is a powerful, like- saving antibiotic. that came on line and they were under patent. therefore, the companies could charge much higher prices than for generic drugs. second, many illnesses that previously did not get treated now are. if you have high blood pressure you might be on more than one

blood pressure medicine. the doctors group to get it down. many children are now on drugs that 20 years ago there were none for. aspirin and antibiotics were all the children got. now you have drugs for attention deficit disorder, zillions of drugs. it varies across country, but a lot of american kids eat a lot of drugs. that is part of it. but i don't think there is any malfeasance by anyone. we do cents in some areas -- for example, in the southern states much more ritalin is eaten than in the north. you wonder if the doctors are overdoing it. but it is partly because many of these pharmaceutical products are very good. they are brand new, beautiful

drugs for mental illness that make people capable of working who could not before. so, i don't think i would want to do without. if you give americans a choice to have a health system with a drug regimen of the 1970's and the same lower-cost, or you could have a health system with the drugs that we now have although they are more expensive -- i did most americans would opt for the latter. host: 0 role do generics play? guest: generic drugs have generally sold in fiercely competitive markets and are therefore cheaper. they usually give the farm system bigger profit margin. when the bush administration came in and passed the drug bill for the elderly, one of their strategies was to persuade the

elderly to switch from expensive brand names to generics. they were successful. it has kept drug prices, spending under better control than people think. this will continue. in 2011 the industry runs into a patent cliff, meaning a lot of patents run out. then the generic companies will use the science and produce these generic pills. that will give the research- oriented companies a bitter pill to swallow. they are running out of new products in the pipeline. ironically, the drug industry is in economic peril at this time. host: the next phone call is from kansas. caller: are really a appreciate

your opinion that you stated about equality in america. i don't think it does exist here and we're leaning towards an aristocracy. i spent time in your. i think the main reason we don't have single-payer is because hospitals and churches were not systematically bombed . by i have been watching nearly every mark up meeting i can. i have kept an eye on the debate for a long time. honestly, i am not encouraged at all, but the question and concern i have -- this is something that will come -- it has to do with rationing. when i say that i don't mean a death panel or ignorant red meat like that -- the insurance

companies already have death panels to speak of that. where i am concerned about rationing is the massive shortage of doctors and nurses we are about to experience in the next 10 years. guest: yes, there is no question. we are rationing health care now. usually we do it by price and ability to pay. for example, for an uninsured person health spending is about half of what it is for a similarly injured person. there has to be rationing there. we already do it. the gentleman is right. we are cruising into a world with a shortage particularly of primary-care physicians, but also of certain specialties. the age of physicians and of the nurse population is alarmingly high -- in the 50's.

i don't know why this country has not build more medical schools. we have kept the match capacity for 30 years. since 1967 they have been at the same level placement. the country is growing. how can we fill the gap? we imported physicians trained from other countries, robbing them of their physicians. our entire health care work force policy has been less than smart -- i don't to say stupid which is a little brash, but less than smart. it has also been unfair to other countries because we are robbing them of nurses and doctors. maybe now we are expanding medical school capacity, but it is rather late in the game. yes, there will be rationing. massachusetts is one of the most over-doctored states. you cannot even get a primary-

care physician even if you are rich. i think that rationing will take other means in coming years. for example, in germany and in other countries there is a system called reference pricing for drugs. the group all the drugs that detect a certain illness like blood pressure, all into one therapeutic group. the insurance company says that we will pay a low cost drug fully. if you want a more expensive brand-name drag you pay the whole difference out of your own pocket. you could do this to hospitals. the insurance company could say every time a patient goes there is very expensive. this other one is much cheaper. we will cover you fully if you go to the cheap hospital. you can do this with doctors.

you can see how overtime you could use this reference price system to support, for you we have these low-cost hospitals, doctors, drugs. if you wanted disneyland you pay for it out of pocket. that is also a form of rationing. it is well-suited to our aristocracy. i'm quite serious that america has evolved into something of an aristocracy with corporate elite who completely divorced from the rest of american life and experience. they never take a subway, never even take a taxi cab. the never taken airplane that is not theirs. they have lost touch with american people. host: tim joins us on republican line from washington, d.c. caller: this has been a great

discussion. i was curious, dr. reinhardt, trending if you look at various cohorts. what is the trend on health care providers to individuals incarcerated? federal prisons, county jails? is there a mechanism where our government appropriates federal funds these individuals would be eligible for? it must be extremely expensive to provide care to them. host: professor? guest: yes, this is the irony. a professor in pennsylvania ran on that and run on the slogan that prisoners are entitled to health care, but the working americans are not.

that really struck people. this is true. prison health care used to be very good 20 years ago, but because of limited budgets, particularly in california one does read that over time it has deteriorated. every once in a while a judge gets mad and orders the state to upgrade the health care foreign in may. many inmates bring all kinds of chronic disease, often mental disease, and aids. so, these are not cheap. with the rising prison population, and many are aging -- this is now a big-ticket item for state government. i believe we have now the highest prison population per capita in the world. it used to be russia and us.

but i think we're now the leader. as they age it will need all kinds of care. coronary bypasses, and so on. host: what is the trend when it comes to chronic care expenses in the u.s.? guest: chronic care now accounts for more than half of all national health spending in a given year. and it is the fastest-growing component as the population ages, but also when you look of the obesity in this country which is basically the platform for all kinds of illnesses -- diabetes been one of them. many other diseases are triggered by of the city. then, we have an epidemic.

there is a wonderful website cdcobesity -- u.s. doublyou'll n some statistics. you will see slides with the statistics. it was a dark brown with the heaviest incident and then you see the very light map from the 1960's getting darker where now 30% of americans meet the definition of obesity. particularly alarming, among children the incident is very high. i tell my students at princeton, you guys are having a mortgage written that you will have to pay. not my generation.

there have been estimates that account for about 25% in the growth of national health spending. that is one factor that i forgot to mention earlier. obesity, chronic illness that follows from it, is a big growth factor in health spending. host: if you compare it among adults in the u.s. to other nations, the u.s. is about 34% compared to singapore, 3% -- and so on. guest: yes, even canada has such a much lower rate. i don't understand why we have this difference. but if you look at the map you will see that the north, the wheat states all the way to

oregon having much less of the city than in the sunbelt. it is regional even inside the u.s. we are leaders in obesity. unfortunately, of the city is growing in every other country, even in china. because of the one child policy children there are pampered. when i go there as i do often i'm amazed. i see these fat kids. 10 years ago you would never see an overweight chinese kid, but now you do. host: this creed, south carolina on the line for democrats. caller: thank you, professor. i like to know from the pie charts what percentage of that was all profit? also, is it true that in 1972 that richard nixon began the first for-profit hospital?

precisely how much difference in the cost has happened from 1972? from then until 1980? host: please stay on the line, michael. guest: interesting question. first, a friend of mine recently did this. he gave me this slide. total profit in the system, drug companies, for-profit hospitals, pharmacies, insurance companies -- their call was $127 billion. but out of the total of $2.70 trillion. profits per se are not that big of an atom. for the big companies they range between 3 cents to 5 cents of the premium.

for medicaid is 2% to three%. i once met michael moore and told him that he is a have the shooter, but always shooting at the wrong target. profit is not really the problem. waste, particularly in durable medical equipment -- they're really asking you want to buy this stuff. you don't have to pay. if you have to we will cover your cost -- it is pretty heavy leaning and people to buy this stuff. that is where there is more music. i would not shoot at profits. if you did away with all profits you would not release a ball that much health spending. don't ever forget, most non- profit hospitals are totally profit-gear. i have served on both boards and i find no difference in their behavior. they are all bottom line focus even if you don't have shareholders to whom to give the

profits to. take academic health centers. they will just plow it right back into expanding capacity. caller: wouldn't it be cheaper for the garment to set up the county hospitals and have them based on strictly non-profits for people of lower income brackets and for the poor? rather than paying all these other companies to do this we do with ourselves. guest: yeah, the experience there has been very. the va is fairly cost-effective. it is a government-run hospital system. at a hospital in dallas, highly regarded as a flagship public hospital in the u.s. -- but then there were others i don't to mention on tv and scare people, but it is well-known that there

were other public hospital systems that became patronage. the vernacular is, the politicians can park their idiot nephews. you know what i'm talking about. i had a former student who became a hospital administrator of such a hospital. she told me she has far more personal, more carpenters' then she needs, but every time the government changes they put in more people i'm supposed to hire. you have a highly havebag. some excellent public hospitals. san francisco general is a superb one. then there are others depending on local culture that are really misused and highly inefficient. again, you would not save all that much. you really need leaders who are passionately committed to running a cost-effective shop.

host: i want to show viewers a graphic of medicare spending. it varies across different regions. looking at public hospitals that vary in quality, but there is also -- dear friend regions have different costs when it comes to medicare. why is that? guest: it is a great mystery. it shows what medicare spend per elderly. they were statistically adjusted to be the same gender and age. in miami in 1992 it was a thousand, but only 5000 for the rest of the country. since then if you look at the 2006 numbers, it has grown to 16,000 while for the rest of the country the 5000 has grown only to 8000. one certainly can look at the

physicians and hospital executives in miami. can you defend spending twice as much per elderly as is now spent in san francisco? can you defend that? when you ask you get stunned silence. i once asked it to the senate finance committee, how can you justify that to me as a taxpayer that you write twice as much in tax to miami and then to the mayo clinic? and i got stunned silence. we do not really know. the group does the research, the dartmouth group, they , makes the difference to the outcome, patient satisfaction, or anything they can measure. others feel they can defend it.

the burden of proof is really on the medical establishment of miami to defend what they need that much money to look after the elderly when they're well taken care for half as much in san francisco. host: or again, on the republican line -- oregon. caller: hi, i would like you to address something that has been undermining medicare for more than one-third of the century now as well as undermining social security and pension plans. they said this hospital plan would be gone by 2017.

it looks like it will be closer than that because of higher unemployment diminishing payroll tax receipts. we want to read what is left of it to launch the healthcare plan. you may remember in the late 1990's we were discussing social security. that it was going broke. the politicians said they're going to be so many aging baby boomers and their living so long, and not enough young workers. they stop short of saying there will not be enough young workers because of last have quarter of a century we have eliminated one quarter of them.

that is by abortion. even though abortion may or may not be mentioned in the healthcare plan, the public option would set up an unelected board of people under the president who would define what procedures would be covered. guest: yes, first of all, this idea of medicare going bankrupt, etc. -- it does not impress me all that much. for example, take social security. it was in the late 1990's all this noise about social security going bankrupt. however, if we have not passed the two tax cuts in 2001 and 2003 social security would have been secure forever. the money we spend on the tax cuts would have been more than enough to shore up social

security for the next 100 years. so, if we're so worried about social security going broke, why do we give the tax cuts in 2001 and 2003 which the citizenry never asked for. president bush just gave it. secondly, if the country is aging and a higher proportion of the population is over 65 and on medicare, it should be a natural thought that you would have to raise the tax for medicare because there is now more mouths to feed. you can make anything go bankrupt. i could make the pentagon go bankrupt by simply saying the pentagon budget cannot go up by more than gdp. then in about five years we have a broken down tanks and airplanes. i can make anything grow just by

freezing the revenue. americans have to learn that with a population that is sizable alder then in the 1960's, the higher fraction of the gdp will go to the elderly. it means given the way we finance health care, raising payroll taxes. you can do it partly by broadening the base on which it is finance. i'm not so worried about medicare going broke. it will be fixed. how? there are many opportunities. but we will not neglect the elderly and put them on an ice flow. i always tease my students that because of global warming the will not even be an ice flow to put them on, so you will have to work harder and pay for them. but there are gains on a sub. the gdp per capita is now

40,000, but with only 1.5% productivity gain which is lower than the 2% we have had. there will be $70,000 in 2015, almost double what we have. if you with a doubling cannot look after your overly then, shame on you. host: professor, we will have to leave it there as we're running out of time. we want to thank you for joining us today on "washington journal." guest: thank you for having me. it was great fun. host: we turn now to your phone calls on the senate finance committee and before the final vote before sending the bill for further negotiations. the two bills have to be melded

together. people are starting to come into the senate finance committee. we'll take your phone calls as that gets under way. then we will take you there live. louisiana, on the independent line. caller: thank you. i was so hoping to get on with mr. reinhardt with his candid remarks that should reach the ears of every american and average them. yes, we are a drugged down country and have more children on drugs than any time before. yes, we are present state and have more in jail now than ever before. but the one thing he said that should be a call to arms for everue