>> rose: welcome to the broadcast. night, the secretary of homeland security, jat napotano, lays out the adnistration's plan on counterterrism, border control and natural disters. >> the tools that terrists can use are muc more sophisticated than they we prioro 9/11 where the terrorts tmselves are much more nworked io different types of information an they were prior to 9/11 and that requires us to think not justbout what they'rehinking now but what they could be thinng in the future. an we always need to be wary of the risk of terrorism, but also liveot in fear but knowing that we are constantly in a state of preparation. >> rose: and we continue with a

health care reform debate wi dr. howard dean and d bill frist, both doctors, both politicians. >> if you're not going toave a puic option, don't pretend you're doing health care reform. you kn,hat's what presidents oaf both parties le to do, ey like to sign a bill an they'vhad a big victory. itsn't going too anything. do the insance reform, take all the moy out of it and call it a day. >> i think i is fiscal suide r the united states of ameri toass a bill that all of sudden says 're going have $1.6 trillion into a systemow that is broken without doi ything to control the cost over time. and i think that's thesbills are. i'm for reform. i think a bill wi pass, should pass. and i think it needs to do the good things that wve talked about, vue driven outcomes based syem. >> rose: buthouldn't have a publ option. >> but consumer iven with markets to bend the cost curv instead ofhe government squeezing from above. >> rose: napolitano a health care next.

captioning sponred by rose commications from our studi in new yo city, this icharlie rose. >> re: janet napolitano is here, she is the secreta for homelandecurity, created after the 9/11 aacks, the deparent overse 22gencies ranging from the coast guard to the secret service. its wide mante i clouds

coterterrorism, borde control and naral disaste. since being confirmed,she has dealt wi the response to swine flu and violencat the u.s./mexico border today she outlinedhe administtion's approach to counterterrism at the council on forgn relations. >> so if/11 happened in a w 1.0 rld, terrorists are certainly in a web.0 world now. and many of the technologic tools that expedite communication today re in their infancy or didn't even exist in 2001. therefore, more than jt rdware, we need new thinking. when we ada prominent foer computer hacr to our homeland security advisor council-- as i just did-- it hel us undersnd our own weakness that cou bexploited byur adversaries. the job securing our nation against the threat of terrorism is a rge one and it m never be totalompleted.

but we have much larger cnce at success if westrengthen our own networks by enlisti the talentand energies of americans. >> rose: . napolitano was appoint... rmer governor a attoey general of arizona. i'm pleased to have her at thi table. welcome. >> thank you. >>ose: as you pointed out, the st time we were here you were talking about ththen governor of alaska. >> we re talking about state issues and t roles that governors playnd i guess each of us venezuela ha gone our own way. rose: ne of us has any id-- includger-- what her future would become. >> i think tt would be a correct statement. >>ose: it would be a rrect unrstatement. >> (ughs) absolutely. rose: talk about wt you just said tohe council on foreign relationin terms of countertrorism and terrorism 2.0 and what ur department has to do today, what its mandat and its imperative is. >> rose: thiepartment... >> this depament was founded

in the wakof 9/11 and our goal of o department is to reduce the risk of a 9/11 attack from ev again happeningn american soil. but also much broader thanhat. to prepare americans for disaers of all typ, whether terrorist caused o wheth caused by nature and to coordinate.. to beable to coordinate the response tohose things. so it's a broad, broad mandate. and we've focused today on counterterrorism in auch dierent environment where the tools that terrosts can use are much more sophisticatedhan th were prior to 9/11, where the terrorts themselves are much more networked int different types of information than they were prior t 9/11. and that reqres us t think not just abo what they're inking now but what they could be thinking in the fute and we always need to be wary of the risk of teorism but als live

not in fear but knowingthat we e constantly in state of preparation. >> rose: how safe are wetoday? >> you know, i think we e safer now than we were prior to 9/11. mu work has been done in a lot different environmen. buif you were to ask me n i guarantee at weave 100% eliminated t risks that any type o attack could occur i'd haveo say no. are we asafe as wean be? th is something that we are constantly strivingfor. >> rose: why hasn't there bn an attack since 9/11? >> a varty of reasons, perhaps. one is think that our intellence gathering is tter. it's more coordinated. more information is shared. i thin we've implemented me systems that have a better chance o cahing a potential terrorist before they can get into the coury.

my precessor mike chertoff gave a statent once that i think said something to e effect that if the sobodies we have now in place had been in place prior to 9/11,all but four of those terrorists would have been prevented from coming into the coury. so o systems areetter. and it maybe that our adversarieare simply lyingin wait and waiti for another opportunity d they just haven'seen a good point yet. >> rose: dthey have sleeper ces in america, do you think? i think they have people in amica whoollow and wish to part patriot in them, yes. and i ink one of the chief things we have to combat is a sense of complacency, hey, this was a long time ago. gornment will take care of this problem, let government it, i've got to worry about a lot ofther tngs. granted, peoplhave lots of things to be concerned about,

but e purpose of my speech today at theouncil on feign relations is to say, look, we ve to deal with this terrorism issue as a conant in our lives now. we just have to assume that there are those out there who wish to do us harm every individu can be prepared and thenou move out a communities caprepare the federal government a our ternational partners. so afour different levels we ourselves need to be better networke betterrepared and know better what we intend to do. >> rose:et me give you one small ample or one larg example what people say is our vulnerabity. that if there was an atoc apon the size of the wpon thatas used inapan at nagasaki or hiroima, it could me into thisountry untected by the present tection technology. >> well, i think it coul if it came in a partilar way. and i think thatur goal iso

shut down those particular ways. and then the issue is, well, who would brg it, what ability would theyave assemble it, use it, in aay to cause massive damage. d the reason i point that out is becau that's no the type an attack that's done by a loan wolf. that kind of an attk would reque somebody with scientific knowledge, aess to certain types of matials. that means you have a group. th means you have planning. anthe more you have a group, the more y have planng, the more your intelligence has the ability to intercept and interdict. >> rose: what worries you t most? >> well, nuclear certainly. i think as well biologica chemic weapon of mas destruction used by a group that has the ability to he it

dispersein a broad fashion. those are the things that we needo be constantly concerned about. also n threats in a changing envinment. the whole issue of cer and the protectionf our cyber networks not just fro hackers but from those who wantto get into and use the cyber world to get in our critical infrastructur >> ros and shut down our economy. >> and try to ut down o economy, yes. >> re: you have hired a hacker, a prominent hacker, you said, to thecouncil on foreign relations. that seems like a smart thg to do. why did it take s long? >> well, don't know. he actually a volunteer. he's on our specl advisory committee. but we have been in the cyber ea hiring real experts from the private ctor to come in to really let us be at e forefront of this new battlefield. both in terms of how we coordinate amo the federal govement, but also, again

with the private sector which ow 85% of our critical infrastructu. >> rose: do yohave the resourceto do the job? overall,yes. if you just look at nuts and bolts and that sort of thing, yes. this department s been well funded historically by the congress. the presidenimself put in another increase this year even the wake of where we a economically. the challenge for us is how do you ke sure that everybody justimply doesn't aume that the federal governnt's going toake care of this. becausif that's everybody's assumptionwe will not be as safe as we oug to be. >> rose: one of the lnerabilities, as you well kn because of 9/11 stu commissions and other oups ve looked itnto it was the lack of cooperaon between all the agencies responsibleor national security an natiol serity related isss.

have we overcome that vulnerability in tms of cooperion, in terms of sharing of iormation, in terms of everybodon the same page? >> ovell, yes. and, again, i go back t the same analysis, do we have better inl gathering and sharing and coordination and cooperation than before 9/11 absolutely >> rose: c.i.a, f.b., everybody else. n.s.? >> c.i., absolutely. the whole alphabet soup. you ow, episodically are there things that uld be done better? always. so the question f me is is wh i came in as the secrety homelansecurity is wl, at's our value addedto that? why should the taxpayers pay for us to be involved in intelligence gathering and shing? and i think our valuedded is really that important linkage with stas, counties, cits, tribes, territori. anso what we are working on

now is to really make that a very robu connectio not just for exchging formation, but also analysis ba and forth. and there's a lot of wk to do there. >>ose: new york city gets lots of credit in tms of the things that i read written by indepeent journalists but what they have done as a local organization in terms of combating terrorismand the commissionerere, commissioner kelly sends people allver the world. he sent people iediately after mbai to look intoumbai in order to provide som kind of information that t city of new yo could benefit fm. >> that's right. >> rose: and you coordinate... it's yr responsibility to coordinate new yorcity with feral agencies and t like. >> that's right. and that's right. and new rk city occupies a unique re. occupies a unique role as a potentia target as a tart that already has been attacked.

but al a unique role because of the fact that it has built itown intelligee gatring apparatus and itas organized a huge cnterterrorism effon new rk city and in the ne york citregion. we don't have those tngs all over the country. buwe do have cas all over the cotry. you may have seen, for example, that tre were arrests a couple of wks ago ininnesota. there were arrest rel this week in north carola. so we have.... >> rose: telus about those beuse that's interesting stories. the arrest in north caroli in terms of lol... how would you characterize it? >> partipation? knowledge? lack of knowledge? well, to be frank, i really don't nt to talk about that because that's an open criminal investigatn. but i thinkt's fair to say that thi was a gro that was a

terrorist-related grp or purported to be a terrorist related grou >> rose: allmericans. >> all americans and the key point, reall, for those watching this show is homeown. in oer words, american citizens who had bece radicalized. and so wh we look to prevt terrorm, we have to be inking not just of thoseho who e fm another countrywho would somew get intohe unit states to do us har, but thoswho have actually become radicazed on our own soil and we'vehad indentsince 20, as indeed we had iidents prr to 2001. so the issue is have w done a better job and are we organized better to capture those things befo any harm occurs? the answ is yes. budo we have to contin to lean forward? do we have to ntinue to think new ways that the attackers coul attack, do w have to contue to be concerned about

terrorisand all its iterions, the answer is absolutely. and one of the key challenges i have as the secretaryis, ain, th notion of, well, e federagovernment will take care of it. or complacency. ery citizen has a re to py re. rose: let me talk out the swine flu. you spoke about that o the councion foreign relations. what oughte know and what are you doing and what's the... why is homelandecurity findin swine flu under its jurisdiction? >> well, because there's actually a presintial order knowas h.s.p.d. whi gives the president e power to appoint the secretary of homeland security as t principal fedel official in any major natal... any disaster of any type. andhat gives the power or really the ahority to coordinate to make sure.... >> rose: so something like katrina or sne flu would come unde that just dictn? >> yes. >> rose: thatxecutive order? >>absolutely.

so this ju happened to be the h1n1, the swe flu. and there are lots of ings that need to b coordated. obviouslthe department of health and human services wi e c.d.c. is part o th, has the leadn all t health-related issues, the vaccine sues and the like. but there are lots of other issues. education, for example. we already s what impact flu can have o school closure and then when you close schools, what impact that hason the department of bor and how you handle workerelatedssues. and so even though that outbreak of h1nhas receded from the publicind, the plain fact of the matter i people have been getting the flu cstantly over the course of this summer. as of june, ithink,we had well over a million americans had already had h1 flu. and those are just the reported ses. >> rose: how worried should they be if they have it? >> well, again, it has exhibited about the same ratef lethality as seasona flu.

d t difference..the key difference being that it attacks a much younger population overall. so now we' getting ready for the fall, schoolis about to start. school-aged chilen plus community collegeniversity age students pme targets r the h1n1 flu. so a lot of planning needs t go into effect. we need to beeaning forwar what happens if and when this flu circles back around from the southern hemisphere back up here in a me severe form. rose: are we prepared? >> yes. we are prered. rose: we have ough vaccine? >> we don't ha vaccine. we are prepared in the sen that a lot ofthese issues that i've just described which sound dry and technil until you actually have to dea with them like forxample if a worker shows up athe workplace and he or she has the flu can or should

an employer direct that they go home. >> rose: what's th answer to that? >> well, the awer is going to be it' up to e employer if it's a private employer. but our whole goalere is obviously going to be to reduce the rate of infection, to reduc the rate of transmission to keep those who are si at home. so we're goi to be askg employers to be sympathetic and understanding. and also to be thinking ahe about how much work can be done by telecommuting a the like. >>h 2h0ñose: could it=d >> lk, here... the way iook at it isreparation is th posite of fear and theore we prepare, the les fearful need to be, because e more we prepare, the more wenow wean respond to whaver level of atever happens to come. so we rely on science tell us wh it is likely to happen even though that's a changing vironment and in the meantime we work to anticipate the issues

that will arise, make sure that the plansre in place, th if we have time aually actice those things so that we know that, look, mother nature's going to happe we can't prevent that, buthat we can do is prepare for it. >> rose: when you look at th range of things tha you do, a number of articl i read about you and about the departme said thi thing: homeland security needs a full articulaon of its mission. because a lot of people don't understand its mission. do you agree wi that? >> oh, ihink that's right. i think there's a lot of educatio... >> rose: andow would you define it bend what we've said already? >> younow, i would take this department-- 22 some-odd encies and 20000 plus ople-- and i would say have fe major missions. one is thefight against

terroris one is securing our bords. and that means a and sea a well as la. one is enforcent of our nation immigration laws. one is preparing for and making re we have the ability to respd to natural disasters. and the fth is to eate a one departnt out of many that peopleome toely upon and have confidenc in moving forward. >> rose:peaking of the border, your local hometown newspaper the "washinonost"... >> i'm starting to think ofhat as my local home... it's hard to think of it as my hometownpaper but i'll giveo that you right now. >> rose: ty were talking about peacand president caeron and his efrts to do something about narco teorism which is a rder issue. is he going to be successl? should we lp him? are we helpinhim?

what'she responsibility of the united states? >> well, first, would say it's more than border issue because those.... >> ros it's fail state. well, i think it's fa from being a failedtate. but these drug cartels that a erating outside of mexico are stributing drugs throhout the united states. there is virtually no community of any size in this country that their fingerso not get into. so it' not just t border issue. is he cceeding? right now is what iould call a valnt strugg and we need help. >> rose: bause the outcome is t certain. >> and the outcome is not certain. >> rose: and he's der some criticism for the sategies that he's employed. >> yes. and.... >>ose: on both sides. not enoughr too muc >> right. which probab means he's doing it enough. but in an event wre working very cloly with him. i amworking very closely with my counterpart in mexico.

other members of e cabinet a working closely th their counterparts. >> re: and what are youoing? >> it's a t of diffent things. opationally. for exple, we're moving and have med hundreds of agents to the southwestorder. we've moved canine teams and chnology. have instited southbound chks to see if we can impede the flow of cash a gs into these ug cartels. there are many othe things happening at many other different levelsn coordinati withur mexican cnterparts. but i'll tel you, i've worked this borr for a lg time. i mean, was the s. attorney ing back to993, th a.g., the governorf a border state and this is such a unique windo for us because the feral government of mexico is fully enengaged in this an so shame on us wre not ther as a full-fledged partner in part because the demand for these drugand the dage....

>>ose: comes from here. >> well, the demand comes fro here and the damage these drugs do hur all of our communities. >> rose: oy. but w do we c a fullledged partner? what is it we'reoing and not doing in order to become a full-fledged ptner? well, one of th tngs we're doing is labeled the merd initiative. this is a bill congre passed. it provides substantial funding to provide equipnt, train civilian law enforcement, supporthe federal government of mexico in these effor. we're strengthening our own efforts at the southst borr to impede their affic. and we're also strengthening our efforts on the sea. because what happens iyou starclosing off the land border, some of the roes go by sea. that's the coast guard, at's thdepartment of homelan serity as well. so all those efforts under way and that'sust smart of what wee doing. >> rose:s you know, eve flynn has writtea whole number of articles, m sure you've read some of t>>e:ose'er hhes es >> rose: here'she question steve ynn raised in the

may/june twine issue is homeland securitytill on the nation's radar reen? one can be excused for wondering. after all we' heading forhe eighth anniversary of 9/11 attackand so far al qaeda r has yet to strikeousgain. th technicolor national threat level has beenrozen and the w sectary of homelan security janet napolitanhas mused ald that maybet should be abandoned a together. the issue missing in action during the marathon 282008 presidenti campaign. the transition camend went without the ama administration publicly olining its plans fo the homeland security missio and there was no expressions of outrage or disy from etorial pages oredia pundits. indeed, the only media srk napolitano has managed t generate during e early days of h ture arose for something she dn't do,he omted the word terrorism from her prepared testiny before congress on february 25, 200 >> yeah, i think he's... ais i say, it's being distributive not critical. >> re: exactly. >> and myesponse is that it's

ve consistent with what i'm saying now which is that complacency a danger and if... we need to move forward and needo beonsistently and constantly looki at our adversaries and one of the purposes of my speech this morning was rlly the first speech of this station laying out our plans on counterterrori. poinng out thatt can just be o agency, the federal government,hat there are invidual les, a by tt i also inclu the private sector. there are community, state, local,tribal law enrcementing other agencies in the feral gornment and our international alli all have to be employed. we have to be creating a curity network in that regard. so that visions out there now. and the way we do it is under e priorities i already outlined for you. it's the fight against terrism it's securinthe bders, it'

effective enforcement of o immigratiolaws and it's constantly prepari for any kind of disaster should it happen. so that's the way we're going t get at it. we have advantages wdidn't have befor9/11. we have grter use or greater ability of science a technology tossist usn these forts. partnehips at different lels have already begunnd in some places are quite robust. so we have some aantages there we didn't have befor buthose are the effts, that's the strategy d that's the sion. >> rose:f someone in europe and the intelligence arena, a high-standg, would discovern al qda or some other terrorist oups effort ongoing planwith perhaps connections the united states to exete the an and they wanted to art the unit stas governnt, would e call go to you? >> it mht. itould go to several places.

the key thing is thatthe person who gets theall, do they understand who else th need to call immediate. >> rose: okay, answer that question. do you think they clearly do and wasn't that rt of the problem bere 9/11? >> yes. it was pt of the problem and, yes, thers been great prress the. it's what we cl the connecting the dots iue. the dots wer there but nobody knew how to connect the dots. i think we're much bter at that now and the iormation sharing environment isuch stronger thait was then. but wean't slide bac into the old ways. those old silos d't match the that environment that we exist in now so it's my responsibity, it's thdirector of c.i.a.'s reonsibility, it's if dector the f.b.i.'s responsibili to maksure that we don'tust lk about that sharing in washington, d.c. but that our agents, our fos in the field kn that that's what w expect

of them as well. >> rose: thank you. >> tha you. >> rose: jet napolitano form gornor of arizona, rmer distct attorney of arizona, former lawyer in arizona directorf homelandecurity. back in a moment. stay wh us. >> rose: tight we continue our coverage of the dete about health care refo. we're joinedy two people w ow the issue of health care from my perspectives. howard dean had been a esidential candidate, bornof vermont and chrman of the democric national committee. before that he was known as . dean when heracticed medicine for more th a decade. bill frist was republan senate majority leader for four years until 2007. prior to entering polics he s a heart and lung transplant surgeo while the twof them rresent different parts of the politic spectrum, they agree that the nation's health ca system needs major changes. i am pleased to haveoth of em bacon this program. welcome. >>ood to be with you.

>> tnks. rose: here's my sta. wh should the debe be about fothe politicis who vote, fothe people in washington who care, and formericans who want better health care what ought to be the debate? >> i think there's two parts to the debate. first of all, how do you get your ecomy going? i'convinced the health care system is one of the reasons america is boming a second-class power i terms of our ability to compete with her countries. and, two,what do you do about the ct thatt's a scandal that a six of our population has no health insunce? you fithose two this then you'veixed health care. >> and i would.... >> rose: if u fix the economy, you fix health care? >> in order to fix the enomy, you've got to fix heah care. you' got to f the incredible incrsing costs of health care. >> rose:nd if you fix the economy, you can better fix alth care? >> thas right. and i would take the economy macro and shrink it down to your viewersonight and theda 300 llion people out there that what they're sayin is that th

cost of health care for them is going up three and a half mes faster thanheir wag or inflatn together. and thathey have a fear that they'rnot going to be able to afford it they're gointo ve to drop their insurance coverage. so the cost of health car affecting the security of family i what they care most abt. and thenhe second issue i'll ree. we've got 46 million people in is country who are uninsured. we can kind of go through that later. about 20illion are really hard core uninsured. you know, 12, 15 milli already have a plan out the, 10 or 12 million ma more than $75,000 and could pay for . ten million are not u.s. citizens but would say the million people who a uninsured coupled with the ct issue fo everybody are the two issues th we should address and today. >> rose: where do y see the health ce proposal of the administration that' making its way through the house anthe senate and theenate finance

coittee and wt's happeni over on e house side? where is it today and has it lostomentum? >> you kw, first of all, is impoant for people to understand-- and howard d i were talking abouttarlier-- there are three committees in the house d two in the senate so far we've n seen the hlth care plan reallyhat it's going to be. so anythinwe say, the principles areut there. that's cgress, and thas where the action is. the president ishe cheerleader. i'm not minimizing it,ut in truth the prident can't control what thi body... e unit states senate, is doing. >> ros should the president have prented a plan he wantd? >>t would have made a big diffence but he looked back to 1993 andaid listen, the mistake of the first lady hillary clinton and president clinton s that they-- a -equal branch of gernment-- imsed on the senate andhe house a detaile plan and basically that was the downfl. so smartly, initially, i would argue should have gotten involved a nth ago, he basically said "ese are the principles, you go write it." well, the "you g write itpart

is whe we are now. >> rose: and it will have what conseqnces, do you think? >> well, first of all it is very importante address ese two sues. we've got to address it. >> ros cost and aess? >> the costissue to the indidual and the access to peopleho simply can't get alth care. ople say you eventually get alth care... if you'r uninsured you do die sooner today. you get less preveative care, you eventually canet into the emgency room but it's more the heart attack or heart transplant instead of tating the blood pressure. so hing insurance matters. so thosetwo. right now, i would argue that none othe plans that are o theretoday adequatelyddress the first, t cost issue. in fact, mt of them add cost. and instd of cost being lot now and goinup three tes what premiums... it's goingo actual push them up even higher. to me that's got to be fixed. >> rose: didn'the congressional budget oice say the proposal making its way through was decit neutral. >>o. . in fact, the knedy health care plan ends up costing abo... thiss incomplete. it costs $700 to $800 billion.

ovall cost in its deficit. but that's not reallyfair because the revenues co in. and the house pl, the last c.b.o. estate of the wman plan, the onlyomplete plan in the houshas a deficit... createa deficit $2 billion. now today there's a lot talk that we've taken care ofthat. but the only pns that have been writtenthat have been costedut today that are publicly available all increase theeficit. >>ose: speakto both the politicaltatus as well as the cost issue. >> i thin.. well, i dagree with senator fristbout the debt. i think that ultimaty... first of all, let me just se this in contex our prate health insurance system doesn't work. it's collapsed over theast 15 years. it treats bot doctors a patients like dirt. i think one the reasons the majori of american primary care people doctors fav single peyser because they hate the insurance companies much. and the insuranceompany... my wife is tread worse by public surance companies.. private insurance coanies than she is

by medicare. when i was practicing, that wasn the case. medicare w a bigger probl. so this not st about cost and lack of insurance, this is about how people are treated. you know, ere's folks out thersaying if there's a government map will, they'll put bureaucrat between u and your docto there already is a bureaucrat between you d your doctor, it's a private insurance industry. so this is about howe're going to shape this stem and make it work right. i don't think you can contro cost unless the governme has a bigger rol i doot think so. medicare'sost have gone u.. they've gone utoo much because they've gone up less than private insurance has. there's a lot of reasons for that. some of it is cost shiftug medicareoesn't have to pay for g salaries for executives. ey don't have to payfor return on equy to their shareholders. they don't have to pay for advertisin medicare also accts all comers. they d't kick people o once they've t.... >> ros why not just extend medica. >> well, that's a good idea >> it's going bankrupt. >> it's not going bankrupt. >> it's going bankrupt ifwe don't do anything but were going to do somhing. >> but what you're going to do cut iteven further.

you troposal is goingo cut about $400 billion, according to the president, out o medicare and th may say 's not goin bankrupt but that means physicians getaid less, hospits get paid less, he health care people getpaid less and if you pay them less, timately they won't particate in the system. >> there's a lot of fraud i the health care... >> i agr. an we'll agreehat of overall spenng, 18% of our economy, probably 20% to 30% is efficiency. uff you can wring out o the syst and i think the real questi question is do any ese plans wring iout of the system. and some good thin but some not so good this. but i think the answer on medire is impornt because medicareas fled. it's a gat system and plan and i agree. administtive costs are less and it's good. it's pdominantly a fee-for-servicsystem that dres up the health care sts today because it means y do morerocedures. and is... you y say it's not, but the actuaries tell u it's goingankrupt in eit years.

before putting another trillion dollars into ityou wa to fix the system. >> rose: let me make sure understand this, too. do you... where do you think the politics are? it, for example, thereby bill but a lot of people who re for public optio, thing like you, are going to be hugely disappointed? that's theolitical reality? >> i don't thi so. i honestl believe republicans don't want a bil because i think demint reall spoke for the republican party more than they'd admit. i think you're going to get a decent bill in the house. the blue dogs havemade an agement. i think it improvedhe bill and the two committees have passed it, now waxman will ps it and we'll get a dect bill in the house with the public option. but the public option will be... look more like a... it will be more competitive. they won't have an unfair advaage, they'll payoctors better and i think that's probably an imprement in the bill. in the senate, honestly think the finance committee is ing to implode and there won't be bill and therefore iwill go to conciliation. >> rose:ou should know, senate

majority leader. poor harry re. he having a tough time. rst of all, we wi see aill before november. and the bill will pass and president obamawill sign it. >> rose: will it he republican support? >> i don'tnow, because what howard says,t's going to reconciliation. and once you that, you're basically saying we're cramming th thing through with 50 votes. so by definition you'r excluding republics. and if iasically said "i'm not gog to talk about the debate" you're probably going to ve against it no matter what it is. so i don't know. and i woulncourage... the reconciltion for the viers means instead of using a -vote threshold the senate which forces bipartisanship, force the discussio once you send sial... and the majorit leader does it. harry reid now with oba basically sayingo it. you're going to ler it t 50 vote. and when you do that, itakes away all chae of people working together. >> that's how sh's tax cuts

were passed. >> that's right, but i d the same thing with e medicare modernizion act six years ago, a $400 billion, big bill, prescription drugsnd i refused to use the0-vote threshold. i' just comment quick. think the house will write the bill, pa the bill for sur i think it will be a bad bill. rose: bad bill because it will havehat? >> becauset won't slow the grow of cost over time. basicall howard, this is where we disagre he thinks th government cos in and squeezes and controls it and i believe fundamentally that markets ll work if we ha better data,ore transparency, more accountability. knowing wh you're getting when you're going to see a docr, which people don't kw, and u're using some ofour money to buy it. and that'she difference, i thk, mainly between us. >> rose: and you believe public option is necessy in order to make insurance companies more coetitive? >> thensurance mpanies are terrible to the people who get their insunce policies, many of them. not all of them. if you worfor i.b.m. or microsoft, you've got great insurance policy. it is a little tough on i.b.m. and microsoft beuse the cost is going muchaster up than

your competirs in gmany and francend soforth. but if you're in the indidual market, the kind of abuses that tients have to go through, it's a testiny in the house about thre weeks ago that the three largest heal insurce compans in the country have cut 0,000 peoe off their rolls using thnicalities in order to bring $300 million profit down to their bottom line. that's not heah insurance, th's just doing what's going on in wall street for the lt 15 years. you can't have that kind of stuff. what t public plan does is guaraned community rating, w administrave costs,available wherever you are whether you have a job or not. it forces th private insance compies to compete. ani think that's good and they can't keep tating eir consumers li that if there's another option that'she purpose of the plic plan. >> rose: is e public an a problem for you? the public option? >> fir of all, i for rerm. it important for you to know

we'll both get pigeon holed a little bit overall. and i think onef the good things in all the ama bills is reform of the iurance industry. i think it's one of the mos positive things d that is to eliminate cher picking. to elinate if people lose their job being thrown off in the les to the vultures out there. so guaranteed issue, pre-existing illnessall that kind of reform is good stuff. and it's in these bills. the probm is you've got all this other stuff in e bill. so the iurance has to be refo. i automatically agree the public plan boils down to this. i didn do in the 2003, $400 biion bill for prescriptio drugs and all and wdidn't need a public plan. we did have a pubc plan as a backup if you could not rulate e insance mart and it endeup there were plans for all 40 miion peoe. thus what i uld do if i were the senate-- and i think the senate can write a good bill ca is say yes, you may need a public plan a backup if the private sectordoesn't work. that public plan can be three kinds.

it can be thenationalized sort of single payer medicare like plan. the american peopl probably aren't going ttake that, but some people will like it and the houswill probably pass that. a state-run...n admistrative type plan or it can b something local which is much mo of a collaborative cooperate which is really hot right now inthe senate. i think if you get a lally run not ationalized plan thats a cooperative as backup, you can have aublic plan there. and it can accomplh everything that the democrats opresident obama wants >> i don't think s i thi that's... tha approac has been ted in the past and bill gave an example where he thought itad worked and i do think the health care plan y passed, therug plan, worked much better th the docrats thought it was goingnd iive u that. but it also hn't worked in other areas what i thinks, younow, medicare's pretty popular right now and it works pretty well. why not let peoe sign up for medicare if they're under 65 yes old. why? >> rose: the predent cotantly refers to that we're

not going to... if you want t maintainour presentystem, yocan. nothinwe're going to do.. >> exactly >> rose: ds that get lost in the debate? and the fear of pubc option is that somow it means that the way you, an individual, go out getting medical care wil be dramatically fferent? >> well, that's t insurance mpany shtick god knows we're going to hav socialized medicine wee had socialized medicine r 44 years. medicare. >> rose: >> socializededicine is not medicare. socializededicine is you o the hospitals, yoown the doctors. it's singl payer. the v.a. is. the v.a. iocialized. >> so we've had socialid medicine. >> dyou want to go tohe v.a. where you're limited in terms of the drugs yo have, the prix procedures enough? the v.a. is a great system and the qlity compared to when y and i arted is unbelievably good. theyave electronic health records. but why do republicans keep talkg about socialized mecine if medicare is not socialized medicine.

>> you don't hear me talking about it. >> you don't. but the public plan, i think it's worth thinkingbout and the house willrobably pass it and yore right, grassley and baucus wilnot because is not ere the american peopl are. >> i think where's they e. 7% of themould like the choic including 50% of the publicans. choices the key word. >> w doesn't grassley and max baucus, airman of the fince committee and th minority member go alon with that ide if they think e public is there. >> 72%of the public want the chce. >> rose: why don't they go along withhat? >> i'd like tonow that mylf. >> the pubc plan is... this where the republicans are and i've told you wher i am. you have a system out there that gives a lot of tax advantage to the employer-snsored private health plan. you have 26 million people who are outhere who don't have insurance. you set up a public plan, these people can choose fr the private or pubc plan. the prlem is the publ plan is a nationalized singe payer system. it will pay doctors 20% les than these private peoplare paying. >> not according to the house. noaccording to the blue ds

amendment. >> l me finish. >> okay. >>o you're paying hospita 20% ss, hospice 20% less home care. that's where medica is today. medicaid is even les than that as we bo will agree and so what happens the, you're offering e same benefits to these people, their choice, for 20% less, really the same thing. now people say that's good because that causes mpetition. ese 160 million people over here whore in employer sponsored pls, the employe e going to say "list, for a little bit of money i ca dump my patients t whereof they're tting this choice into this public plan because it's cheaper for me." and therefore instead of being tenillion people, it grows to 20 million people to 30 to 40. the 16 millionpeople outere who have choice in prite plans dot have that choice. so oe you get stuck in t public plan, y really have no choice. you can't goack. >> that'sot so. i'm saying... >> that's not so. that's nothat the bill says. the bill says...he house bill says you can't get out of your employer-bed plan.

that's a... you don'tave a choice about tha >> unls you're in a small business >> after five years the whole system goes away. i'm not saying it's goingto happen. >> c.o. sayst's not going to happen. >> c.b.o. says they don't think. t the fear is asou go into this large public plan, the big bad private insurance indusy disappears, they get smallut then when you're in the public plan, evybody is being paid less andith that you're lked into it so you have less choice and there less innovation d less techlogy and there's more-- and'll use the b word that predent obama did-- tioning. >> that unfair to tk about that. >> i'm saying it's a rational. >> they may be t rationale. we spent more our g.n.p.than anybody in the world. we're at 17%. canada and britain is 10%. so the's 1770% you can squeeze out. >> i would say 30%.

>> sendly, what the bi says and the blue dogs just negotiated is you caot pay the dicareate. now it'soing to be pt of the house bill you cannot pay dtors medice rates. >> so you y them... first of l, medicare is here,private insurance isere, but you can't pay medicare so you pay medicare plus a few percent? >> sure. >> but still you'r going to have the flow of pele coming into it. probably >> wel it may result i having insurance premiums that wou go down. which have gone up 2.5 times the inflation. >> igree. so so maybe is not bad to have squeezing down. >> is it yourope... met me say one mor thing. >> where do you nt to go with this? >> let me fish one last thi. every countrin the world tha s so-called socialid medicine or atever you want to call it, you say it' not socialized medicine, okay. every couny in the world in the western indtrialized world also has privatensurance. evenn britain whi iseally soalized medicine, 15% of all the health ca dlasre private doars. so the idea at we're going to

squeeze out public insuranceis never going to be choice again i thinis wrong. ere's no evidence of that what is over. >> butt may go from 100%f employer-sponsor market down to 30% with all of that going into the public an. you say that good because the public plan has less administration cts. i say it's d because it's less innovation and ls choice. i would like to see a publi plan co-existing with e private plans. i think the prive plans will treat patientsetter, treat doctors better and if people think the public plan is efficient, they'll move back into private plan. >> look, the heah insurance industry is not run a bunch of dumbos. you may not ke them, but they're smart and th can make money any wathey can by filling niches. medicare is a one size fits all program. d there are people who don't liket, a lot of people do. so there's going to bother insurance you can t and most peopleho have medicare have supplemental insurance tt pays for pharmaceuticals. >> rose: this ma be aarent t if, in fact, all the doctors in america could vote for the kind of health ce rerm they want, what would they want?

doctors? >> it would be. >> the's controversy about that >> i think it's a good queion. i've ner answered it. >> and don't think eher one of us know it is answer because i don't think anybody know its answer. i do thk... one ofhe things... anthis is where the obama approach, movingtowards value is very good. first of all the information technology is great stf. i think moving toward vae instead volume reimrsement, the more procedures you do, the more medicines you prescribe, the more hea tnsplants you do, for t more clinic visits you do, the more imang you do, th's the way our system is fee foservice. and when things g tight and you n't payoctors very much, i'm not sayinghey do it, i know the preside got in trouble for implyinghat, but at the e of the day instead of seeing a pient every two years you can see them twice overthat peod of time. soe have a... we' a volume driven system today cause of fee for service instead ofn out come rests oriented condition driven system for reimbursent. so we need to reimburse people

for value stead of just volume. >> re: one question about the potics of it. if understand where you are, you would like to see the demoaticarty push through and use whater reconciliation orhatever they need to do, be damned the republicans.. >>ecause i don't think tre's >> rose: but damn the repuicans, get health care reform as you would ke to have it. >> just like medicare. >> rose: just le medicareith a public option d get it passed and that woulbe the way to go. that what you would like to see. stop ting to tisfy the republicans with their objectns. >> who don'tant to be satiied. >> rose: fai enough. >> if i thght the republica were sincere, i wouldn't te this position. rose: fair enough. you belie that if, inact, they do that and go to the country in 20 and in a congressional election yr they'll get, what? killed? >> i think it goes back to with what howar opened with. i thinit's fiscal suicide for the united states ofmerica to pass a billhat all of a sudden says we' going to have $1.6

illion into a system no that is broken witut doing anying to control the cost over time. d i think that'shat these bills ar i'm for reform. i thina bill will pass, should pass. and i think it needs to do the good things that we've taed about, a value driven outcome based system thais csumer driven, driven witharkets to bend that costurve insteaof the government squeezi from above. >> rose: should benefits be taxed? >> and a public option as a backup thais lally ru and not run by the feral government. >> rose: shouldbenefits be taxed? >> well, the iue there again for r viewers, is the employ-sponsored a a free ride that is very regssive. ri people get a huge tax benefit who are worki for an emoyer and the individual markets out there, the millions of people out there whoon't get employer-sponsoredet no taadvantage whatsoever. we feed to equalize that. what i do tnk is that we ought to tax the very rich pla out here a make them part of wages themsels, whether you pick up $100 billion or $150

billn, take that, have rendable tax credits to empower indivial choice in the individual mart instead of a nationalized medicare like single payer public plan well, first of all, i think that's very dangerous. th's exactly why i think the ama plan is better th what the republican plan is because th would drive peop out of the employerased system. and i thinke probably agree that the employer-based system probly hurts the economy in the longun. buin the short run, most people like the employer-bad system a most emoyers, much to my astonishment, like e employer-based system. i think it's a mistake to drive them out of the employer-based system. you're aaid they'd leav voluntaril i'm afraid the gornment will push them outf we adopt a plan you suggest. whatever we do, can't do it too fast. this is a country ha doe't... they say they like me change than they want. and u can't push the too fast. and that's the gius of obama's plan is we will get reform if you have a public optn because the american people willchoose the rate at which that change

kes place by making individual cisions. >> rose:ne last question on politics. if there is no plic option in the demoatic plan, will the left of the mocratic party rebel against thpresident? >> i hopeso because it shldn't be passed. 's a waste of money. >> rose: in other words, t public optiong... without public optn you should not have health care reform. >> you should ha insurae reform. there no health care refo thout a public option. the figure is not 1.6 i think c.b.o. scores o bill at600 billion and one bill at $800 billion. it's aell of a lot of money. ani don't think you oughto pour $800 billion into the present prate health insurce syem. yore just giving moreoney to the pele who screwed iup in the pirs place. if you'rgoing toive americans a real choicand let them choosreform, then it's okay. but if you're notere's what you ought to do. you ought pass community rating as ll was talking abou we all age with that. do the insurance reform. did this 15 yrs ago in vermont. >> i agreeith that. >> it doesn' cost anything to with that. >> thank goodness.

>> so if you're not goi to have a public option, don't pretd you're doing health care reform. th's what presidents of both rties like to do, they ke to sign bill and say they' had a big ctory. itsn't going to anything. do the insurancereform, take the ney out of itnd call it a day. u've made an imprement in peop's lives, we'll do it another day. >> and the predent will take at as a victory. >> i'm optistic, i thi we'll pass the bl with the public plan. >> ros thank you, you have to host theeith olrmann show and i thank you for stoing by. are you going to run for present again? >> i think it's unliky but never say never politics and i think senatorrist.... rose: i was going tosk you the same questio >> i'm out for good. i'm not running for any elective office, governor or predentr cabinet position. i'm out of politics for good. >> but we keel keep wking. this iimportant stuff. >> rose: thank you. i have in front ofe howar dean's "prescripti for real health carreform, how we can achieve afforble medic car i suspect some of the eas in

oks you have just heard. >> andt's in english. >> ros thank you for joining us. see you ne time. captioning sponsored by rose communicatio caption by mia access group at wgbh access.wgbh.org

martha jane frh values her indepdence. i always wted to be my own boss. so i started two home businees which enable me to stahome and take care of aunt rginia. who's almost 9years old. martha jane'generosity extends beyond her family. fe is more than work. life a value. and i think 's important for me to ve to the generations th come after me. anthat's why a gift to public television is so important. and if i can do a small ing to perpetuate this, tn it will ntinue for generations to com. that's why marthjane included her publ television station in her will. televisi to span generations.