>> 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 talompleted. 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 fea 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 cntry. sour systems are better. and it may be that our adversars are simply lying in wait and waing for another opportunitand they just havet seen a good point yet. >> rose:o they have sleepe lls in america, do you think? >> i think they have peopl in erica who follow and wis to part patriot in them, yes. and think one of the chief things we have to combat is a sense of complacency hey, this was a lo time ago. vernment will take care of this problem, let governmendo it, i've got to worry about a lot otherhings. granted, peoe have lots of things to concerne about,

buthe purpose of my speech today at the council onoreign relations is to say, look, we have to deal with this terrorism issue as a cstant in our lives now. we just have to assume that there a those out there who wish to do us ha. every indivial can be prepared and th you move outnd communities n prepare the federal governmentnd our international partners. sot four different levels we ourselves need to be better networked, better prered and ow better what we iend to do. >> rose: lete give you one smalexample or one lae examplof what people say is our vulnerality. that if there was an amic weapon the size of theeapon th was used in japan at nagasaki or hishima, it cou come into this country detected by the present detection technology. >> well, i think it cod. if it came in parcular way. and i think that our goal is to shut down those particular ways.

and then the issue , wel who would ing it, what ability would th haveto assemble it, e it, in a way to cse ssive damage. and e reason pointhat out is because that's not the type of a attack that's doneby a lo wolf. that kind an attack would require mebody with scientific knowledge, acces to certain pes of materia. at means you have a group. that mns you have planning. and thmore you have a group, the more you he planning, the re your intelligence has the ability to intercep and interdict. >> rose: what worries youhe most? >> well, nuclear certainly. i think as well biologil, chemal weapon of ms destruction used by a group that has the ability toave it

disperd in a broad fashion. those are the things tha we need to be constantly concerned abou alsoew threats in a changing enronment. the whol issue ofyber and the protecti of our cyber networ. not just fm hackers but from those who want to get into and use th cyber world to get to our critical infrastructe. >> re: and shut down our economy. >> and try toshut downur economy, yes. >>ose: you have hired a hacker, a prominent hacker, you said, to the council foreign relations. that seems like a smart ing to do. why did it takeo long? >> wel i don't know. 's actually a volunteer. he's on our spial adviso committee. but we have be in the cyber area hiring real experts from the privatesector to come to really let us be atthe forefront of this new battlefield. both in terms how we coordinate ang the federal gornment, but also, again,

with the private sector which owns 85% of our ctical infrastructure. >> rose: do you ha the resources too the job? >>verall, ye if you just lk nuts and bolts andhat sort of ing, yes. this department has bn well funded historically by e congress. the president himlf putn another increase this year even in t wake of where we are ecomically. the challenge for us is how do you makeure that everybody just simy doesn't assum that the federal government going to takcare of this. because if that's everybody's assumption, weill not be as safe as we ought t be. >> rose: one of t vulnerabilities, as you well ow because of 9/11 sdy commissions and othegroups have looked it into it was the lack of coopetion between all the agencies responsible for national security and national securi related issues. have we overcome that

vulnerability inerms of coopation, in terms of sharing ofnformation, in terms of everyby on the same page? >> orall, yes. and, again, i go backo the same analysi do we have better tel gathering and sharing and coordination and cooperation than before 9/? absolute. >> rose: c.i., f.i., everybody else. n.a.? >> c.a., absolutely. the whole alphabet soup. yoknow, episodically are there things thacould be done better? always. so the questionor me is is en i came in as the secrary of homeld security isell, what's our value added to that? why should the taxpayers pay f us to be involved in intelligence gathering and aring? and i thin our value added is really tha important linkage with stes, countie, cies, tribes, territoes. d so what we are working on now is to really make that a

very rost connectn. not just for exanging information, but also analysis ck and forth. and there's a lot ofork to do there. >> rose: new york city gets lots of credit inerms of the things that i read written by indendent journalists bu what they have done as a loc organization in terms of combating terrorism and the commission here, commissioner kelly sends pele all over the world. he sent peoplemmediately after mumbai to look into mumbai in order to provide se kind of information thathe city of new rk could benefitrom. >> that's right. >> rose: and you coordinate... it'sour responsibility to coordinate new yk city with deral agencies andhe like. >> that's right. and that' right. and neyork city occupies a uniqueole. it occupies a unique role as a potentl target, as a tget that already has been attacked. but so a unique role because

of the fact that it has built s own intellince ghering apparatus and has organized a hugeounterterrorism efrt in neyork city and in the w york cy region. we don't hav thosehings all over the country t we do have ces all over the untry. you may have seen, fo example, thathere were arrests a couple ofeeks ago in minnesota. there wer arres ry this week in north carina. so we have.... >> rose: tl us about those cause that's interesting stories. the arrest in north carona in terms of cal... how wou you characterize it? >> parcipation? knowledge? lack of knowledge? well, to be frank, i really don'want to talk about that because that's an open criminal investigion. but i think it's fair to say that ts was a gup that was a terrorist-related oup or

purported to be terrorist related grp. >> rose: all americans. >> all america. and the key point, reay, for those watching this show is hogrown. inther words, american citizens who had bome radicalized. and so en we look to prent terrism, we have to be thinking not just of those who wharerom another country who would sohow get into the uned states to do us hm, but the who have actually become radilized on our own so. and we've had cidents since 01, as indeed we hadncidents ior 2001. so the issue is havee done a better job and are organized better to capture those things bere any harm occurs? the aner is yes. t do we have to contue to lean forward? do we have tcontinue to think in new ways tha the attackers cod attack, doe have to coinue to be concerned about terrorm and allof its

itations, the answer is absolutely. and one of the key challenges i have as the secretary is,gain is notion of, wellthe fedel government will take care of it. or complacency. every citizen has aole tolay here. >> rose: let me talabout the swine flu. you spoke about thatn the counl on foreign relations. what oug we know and wha are you doing and what's the... wh is homeland security findg swine flu under its jurisdiction? >> well, because there's actually a predential order knn as h.s.p.d. 5 wch gives the presidenthe power to appoint the secretary of homeland security ashe principal feral official in any major nural... any disaster of any type. and that gives the power or really theuthority to coordinate to ma sure.... >> rose: so somethi like katrina orwine flu would come unr that just diion? >> yes >> rose: that executive order? >> absolutely. so this st happened to be the

h1n1, the ine flu. and there are lots othings that need toe cooinated. obviouy the department of health and human services th the c.d.c. is partf at, has the le on all the health-relat issues, the vaccinissues and the like. but there are lots of other issues. education, for example. we alreadyaw what impact flu can haven school closures. and then when you close school what impact that has on the department olabor and how you handle worr-related issues. and so even though that outbreak of h1 has reced from the publ mind, the pla fact of the matters people have been getting th fonstantly over the course o this summer. as of june, i think, we had well over a million americans had already had h1n1 flu. and those are just the reported cases. >> rose: h worried should the be if they have it? >> well, again, it has exhibited about the same rate of lethality as seasol flu. andhe difference. the key

difference being that it attacks a much younger population overall. so now wre getting ready for the fall, scho is about to start. school-aged chdren plus community college university age studentsrime targetfor the h1n1 flu. so a lot of planning needso go into effect. we need to be leaning forwd. what happens if and when this flu circles bac around from the southern hemisphere back up here in aore severe form. >> rose: are we prepared? >> yes. we are ppared. >> rose: we havenough vaccine? >> we don't ve vaccine we are prepared in the sse that a lot of these issues that i've just described which sound dry and techcal until you actually have to dl with them like for example if a worker shows upt the workplace an he or she has the flu can or should an employer direct that they go

home >> rose: what's e answer to that? >> well, thenswer is going to be is up tothe employer if it's a private employer. but our whole goal here is obviously going to be to reduce the rate of infection, to rede the rate of transmission to keep those who are ck at home. so we're gng to be aing employers to be sympathetic and understanding. and also to be thinking aad about how much work can done by telecommutingnd the lik >>h 2h rose: could it=d >>ook, here... the way i look at it is preparation is e opposite fear and the more we prepare, the ls fearfulwe need to be, becausthe more we prepare, the more know we can respond to wtever level of whatever happens to come. so we rely on scienceto tell us at it is likely to happen ev though that's a changing environment and in the meantime we wor to anticipate the issues

that will ariseto make sure that the pla are in place, at if we have timetoctually practice those things so that we know that, look, mother nature's going to hapn, we can't prevent that, but what we can d is prepare for it. >> rose: when you look at e range of things tt you do a number of arties i read about you and about the departnt said ts thing: homela security needs a full articution of its missio because a lot of people don't understand its mission. do you agree th that? >> oh, i think that' right. i think there's a lot of educatn.... >> rose: a how would you define it yond what we've said already? >> y know, i would tak this department 22 some-odd agencies and 0,000 pluspeople-- and i would sawe haveive major missions. one is the fight against terrorm.

one is securing our boers. and that meansir and seas well as nd. one is enforment of our nati's immigration laws. one is preparing for and making sure we have the ability to reond to natural disasters. and theifth is tocreate a one depament out of many that peop come to rely upon and have confidee in moving forward. >> rose: speaking of theborder, your local hometown newspape the "washgton post"... >> i'm starting to think of that as my local home... it's hard to think of it as my hometown paper but i'll give to that you right now. rose:hey were talki about pee and president lderon and his forts t do something about narco rrorism which is a border issue. is he going to be succeful? should whelp him? are we helpg him? what the responsibility of the

united states? >> well, first i would say it's more thaa border issue because those.... >> re: it's fail state. >> well, i think it's r from being a failed state. but these drug cartels thatre operating outside of mexico are distributing drugs thughout the united states. there is virtually no community of any size in this country that their finger do not get into. so is not justhe border issue. is hesucceeding? right not's what i would call a viant strule and we need to help. >> rose:ecause the outcome is not certain. >> and the outcome is not certain. >> rose: and he'sunder some criticism for the straties that he'smployed. >> yes. and.... >> ros on both sides. not enough or o much. >> right. which probably mns he's doing it enough. but in anyvent we're working very closelyith him. iam woing very closely with myounterpart in mexico. other members of the cabinet are

working closely withheir counterparts. >>ose: and what are you doing? >> it's alot of dierent things. erationally. for ample, we're moving and haveoved hundreds of agents to the southwest border. we've moved canine teams and techlogy. we have institutedouthbound checkso see if we can impede the flow of cash and guns into these drugartels. there are many other things happening at many other different levels in coordination with our mexican countparts. but i'll tell you, i've worked this bder for aong time. i meani was theu.s. attorney going back to 1993, e a.g., the govern of a border state and this is such a unique winw for us because the deral government of mexico i fully enengaged in this d s shame on uife're not the as a full-fledged partner in pa because the demand fo these drs and the mage.... rose: comes from here.

>> wl, the demand comes fm here and the damage thes drugs do hts all of our communities. >> rose:kay. but how do we can a full-fleed partner? wh is it we're doi and not ing in order to become a full-fledged partn? >> wl, one of the things we're doing is labeled the merda initiative. this is a bill congress passed. it provides sstantial funding to provide equipment,rain civilian law enforcement, support thfederal government of mexico in these efforts. wee strengthening o own efforts athe southwest border to impede their trafc. and we'relso strengthening our efforts on the sea. because what happens is yo start cling off the land boer, some of the routeso by a. that's the coast guardthat's e department of homeld curity as well. so all those efforts und way and that's just smart of what we're ing. >> rose: as u know, stev flynn has written awhole number of articles, i'm re you've read some of them at lea. >> i have. >> rose: here's the question steve flynraised in the may/june tne issue.

isomeland security sti on the nation's rar scre? one can be excused for wondering. after all we're heading for the eighth anniversary of 9/11 attacks ansoar al qaeda has yet to strikeous aga. the technicolor nationalhreat level has been fron and the new secreta of homeland security janet napolitano ha mused aloudhat maybe it should be abandoned all together. the issue missing in action during the rathon 200828 presidential cpaign. the ansition came and went without the obamadministration publicly outlingts plans for thhomeland security mission and there was no expressions of outrage or dismay om editoal pages or med pundits. indeed, the only media spark napolitano has managed to generate during the rly days of her tenur arose for something she didn do, she omitte the word trorism from herrepared testimony before congress on february 25, 2009. >> yeah, i tnk he's... as is i say, it's being distributive not itical. >> rose:xactly. >> and my resnse is that it's

very csistent with what i'm saying now which is that complacency is a danger and if... weeed to move forward and need to constently and constantly looking a our adrsaries and one of the purposes of my sech this morning was reall the first speech of this station ling out our plans o counterterrorism. pointingut that it can't jt be one agency, the federal government, thathere are indivial role, andby that i also include t privateector. there are community, state, local, tral law enforcenting other agencies in the federa governnt and our international allies a have to be employed. we have to be creating a secuty network in that regard. so that vision is out thereow. and the way we do it is uer the priorities i already ouined for you. 's the fight against terrori it's securing th borde, it's effective eorcement of our

immigration la and it's constantly preparing f any kind of disaster should i happen. sohat's the way we're going to get at it. we have advantages we di't have before 9/. we have greate use or greater ability of science and chnology to asst us in these effos. partnershi at different level have already begun and inome places are quite robust. so we have some advanges there we didn't have before. but the are the efforts that's the strategy and that's the visi. >> rose: if meone in europe and the intelligence arena, a high-staing, would discover an alaeda or some other terrorist groups effort ongoing pla with perhaps connectionin the united states to ecute the plan and they wanted tolert the uned stes govement, woulthe call go to you? >> itight. could go to several places. the key thing i that the person

who ge the call, do they understand who else ey need to call immedialy. >> rose: oka answer that question. do you think they clearly do and wasn't thapart of the problem fore 9/11? >> yes. it wasart of the problem and, yes, the's been great ogress ere. it's what weall the connecting the dotsssue. the dots we 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 them bacon this program. welcome. >>ood to be with you. >> tnks.

rose: here's my sta. wh should the debe be about for the 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? >> that's right. and i would take the economy macro and shrink it down to your viewersonight and the 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 dany 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? thv.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-sponsor get no x advantage whatsoever. we feed to equalize that. so what i dohink is that we ought to tax the very rich pns out herend make them a part of wages themsves, whether you pick up $100 billi or $150

biion, take that, have fundable tax credits to empower indidual choice in the individual mket instead of a nationalized medicare like single pay public pl. >> well, first of all, i think that's very dangerou at's exactly why think the obama plan is better an what the republican plan is because at would drive pele out of the employ-based system. and i thin we probably agree that the employer-based system prably hurts the economy in the lo run. t in the short run, most people like th employer-sed systemnd most ployers, much to my astonishment, likethe employer-based system. i think it's a mistake t drive them out of the employer-based system. you're afrai they'd leave voluntarily, i afraid the governnt will push them out if we adopt a plan y suggested. whatever we do, we can't do it too fast. this is a country ha doesn't. ey say they like more change than they want. and you n't push them too fast. d that's the geniu ofbama's plan is we will get reform if you have a public option because the american people will chse the rate athich that change takeplace by making individual

decions. >> rose: oneast question on politics. there is no publi option in the democrat plan, willhe left of the demoatic party rebel against the prident? >> hope soecause it ouldn't be passed. it's a waste of money >> rose: in other words,he public optning... without public option u should not have health careeform. >> you should have insurance form. there is nhealth care reform witht a public option. the gure is not 1.6. i think c.b.o. scores one bl at $60 billion and e bill $800 billion. it's a helof a lotf money. and i n't think you ought to pour $0 billion into the present privathealth insurance system you'reust giving more mon to the peopleho screwed it up in the pirs place. if you're gog to giv americans a real choice an let them choose rerm, then it's okay. but if you're not, hers what you ought to do. you oughto pass community rating abill was talking abt, we all ree with that. do the insurance reform. we did this 15ears ago in vermont. >> agree with that. >> it doest cost anything t do with that. >> tha goodness. >> so if you're not gng to have a public option, don't

prend you're doing health care reform at's what presidents of both parties like to do, theylike to si a bill and say theve had a bivictory. isn't going todo anything. do the insurance reform, take thmoney out of it and call it a day. you've made an imovement in pele's lives, we'll do it another day. >> and the psident will take that as a victory. >> i'm oimistic, i tnk we'll pass theill with the public plan. >> re: thank you, you have to host t keith bermann show and i thank yo for spping by. are you going run for prident again? >> i think it's unlikely but never say never in politics and i think senator frist.... >> rose: i was going to ask you the same questn. >> i out for good. i'm not running for any elective office, governor or psident or cabinet position i'm out of politics for good. >> but we keel keep worki. this is imrtant stuff. rose: thank you. i have in front of me howard dean's "prescription for real health care reform, how we can achieve affdable medal ce" i suspect some of theideas in books you have just heard.

>> and it's in english. >> re: thank you for joini us see you xt time. captioning sponsored rose communicatns captied by edia access group at wgbh access.wgbh.org