we're going to start department of ag ag 200 new waste water and -- projects through the america. as you know, mr. president, these are big ticket items. most of these little towns can't afford this but it impacts on their quality of life. transportation we're going to begin work and rehabilitation on 90 airport, 1,500 highway locations throughout the country. that means we've authorized the money, mr. president, but now the contracts are let, shovels are going to be in the ground, people with hard hats are going to be working making a decent wage. at e.p.a., mr. president, we're going to accelerate the clean sites that exist on the national priority list. education, 135,000 education related jobs including teachers, principals, administrators, support staff we'll talk about in a minute. at labor 125,000 summer jobs. and the idea of these summer jobs, let's not make jobs we're going to put students in positions of jobs that they'll be able to turn around. lastly the defense department will initiate 2,300 rehabilitation construction projects on 359 military facility across the coun

and also how are you helping to bridge the differences with the ag ag committee? >> we will bring the bill to the floor when they are red yes, -- when they are ready. and i congratulate chairman waxman and mr. markey for the masterful job they did in passing the bill through the energy and commerce committee. other committees have their jurisdiction to weigh in on, and that's the process we're involved in. and when we're finished and when ready we'll go to the floor. >> madam speaker, there are bipartisan discussions in the senate about an i.b.m. creating privately run cooperatives instead of public option,. just wondering what you think of the concept. and given the concern about some of your moderate members about public options is this something you might be open to? >> not instead of a public option, no. in our caucus i think members have been -- i know that members have been very clear about what their concerns might be about a public option. and i agree. it should be actuarily sound. it should be administrative self-sufficient. it should be a real competitor

age. we were looking at 10 years, the average age, we kept it that way. the average age on the top has gone from 38 to the mid 80s down to 10 active wings. if the structure is half of what it was. the air force says we are striving to get between 15, and 20. another look at procurement of aircraft. on the top, we see the numbers of aircraft on the bottom half,

age of the child. >> what age do you write for. >> all ages. >> we write for all ages, with tremendous audacity. >> true. >> we write picture books, we might young adult novels and chapter books and middle grade readers, and, our latest is an anthology for all ages. poetry anthology, called the julie andrews collection of poems, songs and lullabies. >> and this is actually quite thick. so -- >> very thick. >> it is the first book with our lovely new plusher, little brown, part of the group, and, they actually came to us and said, would you consider doing an anthology, for us, and we said. >> had so much fun we're doing another one after this. >> yes, we are and it was enormous fun to compile and we obviously, it is our favorite poems well, have been fond of them all our lives, my father instilled in me a love of poetry and hopefully i instilled in my kids and we read to each other and give poems as gifts to each other, all our lives we have done that and suddenly here we are asked to put down our favorites and the first choices which were about 20 were really easy and then after that, we had the most wo

age of 65. it is called confessions of an original center which is a pretty good title. and as i told you, it was published at age 65. fort in an evil are ever thinking about writing an autobiography or even if you write something informally for your children, family, that's the time to write an autobiography. at the age of 65. not earlier and not later. but 20 years have passed since 1989, and i was compelled about three years ago to write, not to continue this but to write another book because i don't want to go into great details about this. just about the time 1989, my life considerably changed. it changed professionally. it started a more extensive writing career. it involved my native country, hungary, because it's a coincidence. it in 1989 that the russian rule, the soviet rule, the communist rule in eastern europe fell apart. and not for the first time, since 1989 i have been able to go back every year, even though i have no relatives left now, to my native country. and this is not so much the result of a patriotic pole. because something happened since 1989 that i would have never believed would happen, even in the change of the regime, it even within the communism, that i must say i foresaw long before important people in the cia foresaw at all. but we must understand we live in a world wher

in favor and support of these brave iranians, average age in tehran is 33 years of age, in their request for the fundamentals of freedom and democracy that we have enjoyed for more than a couple of centuries. mr. president, today and -- i and all america pays tribute to a brave young woman who was trying to exorcise her fundamental human rights and was killed on the streets of tehran. all americans are with her and our thoughts and prayers are with her, her family, and her country. >> senator mccain will join us on tomorrow's "washington journal along with bob schieffer of cbs news. on thursday, tom ridge is our guest. "washington journal" begins each morning at 7:00 a.m. eastern.

over the decade of 2010 to 2020 the number of individuals over age 40 who experience blindness, low vision or age-related eye disease such as age-related mack lar degeneration, glaucoma, and cataract will grow from today's level of 38 million cases to 50 million cases. as a result, the national eye institute's leadership in directing vital vision research over the next decade will be more important than ever. i have been pleased to work on this resolution with my co-author, mr. sessions of texas, and he has been a terrific co-author and worked very hard with me to bring this matter to the floor and to the attention of this congress. i commend this resolution to my colleagues and would reserve the balance of my time. the speaker pro tempore: the gentlewoman from wisconsin reserves the balance of her time. the gentleman from texas. mr. sessions: thank you, mr. speaker. mr. speaker, i rise in support of the gentlewoman's amendment and i want to thank tammie baldwin from wisconsin for not only working with me but also other members of my conference, republican conference, on important issues related to eye and retinal health and i

it goes from ages 0 to age 99. the light different kinds of books, religious books, nonfiction, self-help, literary, mass market, it is a huge variety. that spectrum that we have in publishing also means that it is slower to change radically as the music industry did. the audience changed very rapidly and they could reinforce themselves without audience more easily. the second reason that books are different, and this is not a subtle reason, the reading of books on devices is want to be a slow transition over many years. it has not even started in other countries. that is because there are a lot of devices that cause eyestrain that is more significant than a normal page. many reading devices have very low eyestrain but not the same kind of contrast, so you need decent like to read it in. people like to have books. it is a very sticky medium. you have seen it this way since the 15th or 16th centuries. there are a lot of psychological reasons for that. i find books are the intellectual for richer of your life. when y

age of the child. >> what age? >> we right for all ages with tremendous audacity and have to say. in the right picture books, we write young adult novels, we read chapter books and middle grade readers. and her latest book is an anthology for all ages, a poetry anthology all the julie andrews bombs. >> this one is actually quite thick. >> very thick. >> it is the first book with our loving you publisher brown and they actually came to us and said it would you consider doing an anthology for us and we have so much fun. >> we are doing another one. >> yes we are. it was enormous fun. we obviously, they are our favorite poems. my father instilled in the love of poetry and i hopefully instill that in my kids. we read to each other, we give poems read together, all our lives we have done that and here we are asked to put down our favorites. the first choices which were about 20 were really easy and then after that we have the most wonderful journey of discovery in finding what we really loved. >> digging back into our memories of family anthologies. >> we essentially came down to nine s

age -- dunkirk, maryland, age of 22. then another lefty. southpaw, ross detwiler, still looking for another major league win. nats are winless in his starts, six of them. we'll get you going at 6:30, johnny holliday and phil wood, "nats xtra". >> rob: i've been told cecil went to dematha high school in the area. >> bob: home to one of the greatest basketball programs to the long time brilliance of morton wooten. dirk hayhurst. >> rob: now pitching, dirk hayhurst. >> bob: did you do any p. a. announcing? you sound like you have. >> rob: only in the shower. >> bob: no singing? >> rob: now getting into the shower, rob dibble, dibble getting into the shower. >> bob: ah, look at that. i love seeing families at the ballpark. is she adorable? >> rob: yep. >> bob: wow. here we go, bottom seven. top of the order. guzman has been first-pitch swinging all night. he takes one a foot high. >> rob: just a little late with the feeding one time and see how quiet that baby is. [ laughter ] >> bob: babies are just like managers. they just want be to be on ti

it goes from age 0 to age 99 through every kind of walk of life. they like different kinds of books, some religious books, nonfiction, self-help, literary, mass market, etc. there's just a huge variety which means that spectrum that we have in publishing also means that it's somewhat slower to change radically as the music business did which had more or less a single cohort, let's call it 15-25-year-olds. and so the audience changed, and the tastes changed fairly rapidly, and trends could reinforce themselves fairly easily. second reason that books are different and this is, also, not a subtle reason is that the reading of books on devices is going to be a kind of slow transition over many, many years in this country and other countries. hasn't really started in other countries. and that is because as, you know, as i've certainly heard a lot of times there are a lot of devices when you read on them, it's like looking into a flash light, you'll get some eye strain that's more significant than the eye strain from a normal page which has almost optima

age. we were looking at 10 years, the average age, we kept it that way. the average age on the top has gone from 38 to the mid 80s down to 10 active wings. if the structure is half of what it was. the air force says we are striving to get between 15, and 20. another look at procurement of aircraft. on the top, we see the numbers of aircraft on the bottom half, it costs $1. billions of dollars on the bottom, the reagan administration, we spend between $6 billion, and $8 billion. how do you do this? the cost is on the bottom, almost the same amount of money that we had spent for 20 airplanes a year, we were buying 200 some just 20 years ago. >> is so much more capable. >> of course. >> there's a big argument about f-22s, which is costing an arm and a leg to operate. the air force ones to buy more, $200 million a coffeepot. we are also counting on the joint fighter to save us. this is a look at what this program is going to cost. we are looking at 3 different independent estimates of the underfunding of this program. we need $5 billion more, that is near term, $33 billion m

age of 6, selling ice-cold coca-cola and chewing gum door-to-door in depression-era omaha. that is age 6, by stages he added other businesses to his strain, he sold retrieved golf balls in bulk to the club pro shop. he sifteded the discarded racetrack betting tickets in bulk, searching for winners, accidentally thrown away. he set up a mass production newspaper delivery operation in which he personally could deliver 1500 papers. he rented pinball machines to barber shops and split the take 50/50. and this is all before warren was 15. from the age of 13 he supported himself completely. and by age 18, he had the present-day equivalent of 100 grand in the bank. when the wharton business school turned him down for admission. [laughter]. >> schools don't even hint at the existence of some a road to self-sufficiency. imagine if 60 million trapped schoolchildren were set to actively imaginening personal ways to add value to the general community. just like buffett did at their age. suppose from kindergarten boys and girls were needed with examples of how opportunity can be developed and managed. wouldn't our country be crowded with buffetts and ventures and fannings and wassermans, even mozarts, isn't that what this nation needs, not more zom buy, not more parasites, it isn't wild speculation, what is done is to carry your imagination back to the colonial days in ben franklin's america, where the possibilities were not created by task force of experts but by everybody getting a chance at a term, just as soon as they felt able. in an

age groups. as the aging population we know the baby boomers are come, we talk about them in terms of social security, but the fact is we know as we are aging and needing more health services, it is in-- it is very, very important for us to have access to primary care providers. let me also talk about the fact that one of the reasons we need primary care providers, all of us, but particularly those with chronic conditions, we think about needing health care when we get sick, an episodic experience where we need to go to the hospital, might end up in the emergency room, but for many people, they have chronic conditions. and they need to have an ongoing relationship with health care providers. so that they can get the kind of care they need, get the kind of advice, get the right prescriptions and be able to work with their medical practitioners to be able to comply with that advice and be able to make sure that they are healthy. the number out there is 50% of americans who get health care comply with recommended health care they're told to comply with. so obviously we need some work here. this is not only the responsibility of those who pay f

aging because i would see in local communities, senator isakson, something that our committee has jurisdiction over are the office on aging. that's where so many of the old-timers often go for advice and counsel and information and so on. so let's get it quick and take it back up, okay? >> i appreciate the consideration. >> you told me you had an amendment that was -- you're ready with your amendment? >> yes, sir. >> why don't you let us know which one it is. i'll distribute it. >> number one, sir. >> it's roberts number one? >> yeah, roberts number one. it's the one that you were going to take, you can just take it right now and you won't have to listen to me. >> is this in alphabetical order? >> page 20. >> this just says that cer can't be used exclusively for cost containment, et cetera, et cetera. if you wish, mr. chairman, i can begin and just -- >> yes, please do. >> first, let me say that i don't know whose glasses these are, but they were lying down right there, and it looks to me like they would be a pair of women's glasses. i don't know whether they belong to somebody on that side. if they do, i'm not sure i could -- i want to give them the glasses. >> are they rose colored glasses? >> no, they're more like cbo glasses. >> rather opaque then, i presume. >> they are sort of bent up and they are -- but at any rate, i don't know whose glasses these are. it might belong to some camera person or whatever. and so i'm going to -- i can't hand it to anybody. i'm just going to leave them right here and proceed. >> thank you, senator. whoever these are, you can see your way clear to support my amendment, that would be great. this amendment in my view protects patient choice and physician independence in making treatment decisions when, as we all know, we all support when a loved one gets sick or when we get sick. you want to be sure that you and your doctor are in charge of making decisions and not somebody else here in washington. or somebody else in some regional office. the amendment is identical to senator kyl's. stick with me. the preserving access to targeted individualized and effective new treatments and services act. now the reason that all that was stuck together is because, as you know, everything has to be an acronym in washington and that is called the p.a.t.i.e.n.t.s. bill. so after that explanation, the bill is endorsed by the american medical association, and i am an original co-sponsor. it ensures that patients and doctors remain in charge of making treatment decisions by prohibiting the federal government from using the results of comparative effectiveness research, i.e., cer, to deny coverage under medicare or any other federal health program. in addition, it requires that cer conducted account for differences in the treatment responses and preferences of individual patients. these prohibitions are required because current law does not prohibit the government from using the $1.1 billion awarded to cer in the stimulus package for cost containment and to achieve cost savings. along with other goals. neither do the cer provisions in the bill before us today. now we have all heard the horror stories of the united kingdom's national institute for health and clinical excellence. the acronym for that is n.i.c.e., and it's not very nice. delaying or denying access to cancer drugs and requiring seniors to go blind in one eye before approving treatment to access for macular degeneration, this is a real thing, it actually happens. we need this, it seems to me, to safeguard, to guarantee that this scenario will not happen in american medicine. i want to make it very clear this amendment does not prohibit cer. would never do that. i would never stand against medical innovation and advancement. we need cer. it does not interfere with the fda's ability to rule a medical treatment to be unsafe. i would never prevent. i don't think any member here would prevent he fda from fulfilling its mission of ensuring the safety of our medical products. it simply prohibits the federal government from rationing health care based on this research. so it is to protect patients and to protect seniors. i would ask that people would support this amendment. i might add something here from personal experience. and i apologize for going on. i said before that i've had the privilege of public service for a long time. and i've said before that health care seems to be -- i don't know how it ends up under my jurisdiction. at least in terms of a committee or working for a previous member or wherever in my career. but that's been the case, and i've also expressed considerable frustration and angst dating clear back as i indicated to the chairman to joe kalifano and h.e.w. and h2 s, cms. and i do have a little blood pressure. i have not been down to the agency recently. i would like to pay a visit, just indicate to them that i am -- i'm not exactly a total critic of what they do because they do have a very important job. but i can remember that we were in the midst about two or three years ago of several big time problems when we were trying to cut costs in health care. and i know that there's a lot of concern about greed and sour apples in the barrel and a lot of things that doctors may or may not do to make up for the lack of what they think is a proper reimbursement that should not be done. having said that, there was almost a revolution out there. the rural health care delivery system. tom arkadose is the co-chair of the world health care coalition. i'm the other co-chair. i thank him for his contribution. and the one that really got me was this competitive bidding business with home health care. and i know this is sort of -- this is not directly on the subject, but it is. because one of the first regions was kansas city. in kansas city, that region included parts of missouri, parts of kansas that were not metropolitan areas by any means. it was supposed to be a metropolitan area. there were 428 home health care entities or businesses in this region in kansas. of the 428, i know at least two-thirds never even knew that they were in a competitive bidding process. didn't even know that that directive had come down and that they had "x" number of days to respond. but i did hear from some of the bigger ones who said, whoa, wait a minute. this is not the way to do business. we can't do this. and so there was a lot of back and forth on that. finally, cms came down and recognized 24 in the bidding process. that were eligible for medicare. my question is if you have 428 people involved in home health care you recognize 24 eligible for medicare, what happens to the other 404? and that's where we were. so if you have an elderly person who relies on home health care and, number one, they didn't even know about it but once they did they were trying to catch up and to catch up was impossible because the 1-800 number was always busy. when it wasn't, when someone couldn't answer the question. so it was just a real problem with 404 of these entities out there that couldn't get medicare anymore by this edict that came down from cms. so i wasn't happy with that. about that time they had nominated a gentleman by the name of kerry wiens to be the director of cms. i thought i'll take the bull by the horns and put a hold on him and made it public and so he naturally came in to see me. he was a nice fellow. he's from new mexico. he went to harvard but couldn't help that. and so we basically sat down and visited about it. and i prepared him a list of five questions that i had received primarily from doctors and hospital administrators and home health care people, clinical labs, pharmacists, et cetera. mainly on reimbursement and basically on all the regulations. he thanked me for it and said he'd get back to me immediately. he sent me back a five-page single spaced response that, quite frankly, i thought was cms gobbledy gook. i called him back and said i can't understand this. nobody on my staff can understand it. you can understand why a senator wouldn't understand it, but not staff. so he came back and looked at it and said you're right. i signed this letter or somebody signed it and i can't read it either. and that's the signal right there i'm trying to get and the point i'm trying to make of what happens here when we turn things over to people. and then they are not even aware of what happens. so he sent back about a two-page later that made a lot of sense and promised he'd watch carefully for these reglaer to overkills and things driving our people nuts out there. and so i voted yes and hoped for the best with cms. i saw him later on an airplane flight. he had a ball cap. i didn't recognize him. i said for goodness sakes, kerry. then i thought to myself, am i going to have to sit on the airplane and talk about cms this whole flight. he probably thought the same thing. and the problem was that everything that he promised in those five different areas, nothing happened except the things we didn't want to happen. and i told him that. i said you promised me. he even got on the telephone and i recommended five people for him to call. he sat there for two hours in my office and talked to people that were on the receiving end of this regulatory overkill. n yet we had the same problems. so it seems to me if we're going to protect that patient/doctor relationship and make cer do exactly what it's supposed to, do and it has atremendously important mission, we ought to at least put this patient's bill in here to protect us so we won't have that kind of problem i experienced with mr. weems who did the best job he can probably try to do. it's just that we have folks over there that have some pretty crazy ideas. you know, when they come and visit with you, mr. chairman, they bring a lot of staff. one staff member indicated. well, one way we can cut costs -- i was asking them other ways to cut costs rather than cost containment in regards to how it works today. and he said by age. i said oh, by age. senator mikulski, your better listen to this. i used a fig are that was below both of us. i used a figure that was below both of us. what about these folks. should they get a knee replacement, hip replacement and that person said well maybe not. now that sounds like that can't happen in the system we're trying to construct today, but i'm telling you, it can. that's why i've introduced the bill. i've gone on way to long. i appreciate the patience and indulgence of my colleague. >> thank you, senator. senator mikulski. >> first of all, let me just say that this amendment offered by the senator from kansas is unnecessary. if you go -- because we get into this cost. we get into this repetitive word and it goes over very well with focus groups, but it has no rationale here. if you go to page 323 of the actual bill, where it says incorporation, we absolutely prohibit that this -- anything related to the center for health outcomes, otherwise known as comparative effective

people at the age of four come at the age of seven he goes receding and voice from fdr with fairly substantial requests from the transportation of u.s. supplies across tibet in world war ii at age of 11 he was surrounded by a civil war in lhasa and in the age of 15 when most are thinking about our first prom or first date he was made for political leader and up against the leaders of the world's largest nation. and i think it's that in part that has intensified the national debate national pragmatism which means that in my experience it deals with obstructions or wishful solutions. he's always very much looking out will work at the here and now. i remember once i went in to see him and he said you know i'm addicted and i was surprised. i felt what possibly could the dali lama be addicted to, compassion, certainly that, and permanence probably come emptiness i'm sure but he said no, i'm addicted to the bbc world service and every day when i do my four hours of meditation from 4:30 a.m. to 7:30 a.m. when he's traveling to places like washington and can't listen to the bbc service that he feels as if something significant is missing from his day and i think he follows the news muc

age and need a kidney transplant, you just don't get it. if you need by pass surgery, if you're a -- bypass surgery, if you're a certain age, you get on a list but you never get off the list, you just die. if you need medications, you're denied those. if you need cancer treatment, you just don't get those. we in this country, with the health care that we as physicians can give, we've made marked strides since i graduated from the medical college of georgia in how people survive various forms of cancers. back, in fact i think dr. roe will talk about breast cancer, because he talks about that frequently, but our breast cancer survival rates in this country are extremely good. in other countries where they have socialized medicine, people die of that disease. heart disease, diabetes, you go down the list of all these chronic diseases. in socialized health care systems, as this administration and the leadership in this house, in the senate across the way, want to take us, it's going to take away people's choices. they're not going to be able to get the care that they desperately need to stay alive and it's just the wrong thing to do and dr. beginning --, -- and, dr. gingrey, i appreciate your being one of the co-chairmen of the doctors' caucus and helping the american people to understand the direction that we're being led by this leadership, the liberal leadership in this house and this senate because the not going to be in the best interest of the american public and it's actually going to create a financial collapse as dr. fleming was talking about. it's going to be exasperated -- exacerbated and people are going to be exacerbated because of this rationing of care, taking away their choices and some federal government bureaucrat in washington, d.c., is going to make those health decisions for them and it's not going to be their doctor, it's not going to be their family, it's not going to be the patient and the wrong thing to do and i thank you for yielding. mr. gingrey: reclaiming my time and i thank the gentleman before yielding to our colleague from tennessee, dr. roe, fellow ob-gyn physician, just want to say to my colleagues on both sides of the aisle, mr. speaker, madam speaker, that what we are about is trying to work in a cooperative way on both sides of the aisle and offer our expertise to say to our colleagues and there's some health care practitioners on the majority side as well and we have reached out to them and made ourselves available. we want to be at the table. unfortunately, madam speaker, we are not at the table, we haven't been enjoined, if you will, but we still hope, we still have hope that that can occur because we do have some ideas, i think some very good ideas in regard to bringing down the cost of health care, making it more accessible, making it more portable, making it available to everybody and that would include people who are currently considered high-risk, maybe even considered uninsurable or if they can get insurance, it's because they can afford to pay three or four times the normal standard rate, which many, many cannot. so we want to talk about some of those things tonight and we'll get back to that. at this point i yield to my colleague from tennessee, representative roe. mr. roe: thank you, dr. gingrey, and also, madam speaker. it's good to be here tonight to discuss a very important and, i believe, dr. gingrey, and madam speaker, probably from a social standpoint, the most important issue that we'll discuss and probably this health care debate's the most important one since the mid 1960's when medicare was voted on of the judgment to give -- just to give you a little bit background, i'm a native tennessean. i practiced in johnson, tennessee, and saw a tremendous change in the health care delivery system from 1970 when i graduated from medical school until the current and i really marvel myself at the miracles that have occurred. i recall when i was in medical school when st. jude's children hospital had just opened, hadn't been there long and the death rate among childhood cancers was 80%-plus and today over 80% of those children survive and live. . and thrive. . we are having a debate and i will share with you some things we learned in tennessee about a public and a private system. what i hear when i'm out talking to people is that number one, they're worried about the cost of care. they are worried about the availability of it. and there is another whole discussion we haven't had which is accessibility. as we age, as the medical population ages, there is going to be a huge problem of accessibility in this country and we are seeing in our own communities. where in the next seven years, we need one million registered nurses. next eight to 10 years, there will be more physicians retiring and dying. you cannot maintain the quality of care that we have grown to expect and the medical advances we have grown to expect without practitioners. and that is an entirely different issue which is part of this debate. in tennessee, about 14, 15 years ago, we had medicaid. we got a waiver to try a managed care system back in the 1980's and 1990's. managed care is how we were going to control the escalating costs. it was a wonderful idea to provide coverage to as low a cost as we could. we put a plan together, as we're doing right here in this congress. we are going to put -- the most astounding thing i ever heard of, in less than 60 days, we're going to vote on a health care plan that affects every american ci

age of capitalism. that golden age led not only to unprecedented and relatively egalitarian growth but also the introduction of welfare state measures. keynes and white were perfectly well that free capital movement and speculation inhibit these options. professional economics literature points out, which should be obvious, that the free flow of capital creates what they sometime call a virtual senate of lenders and investors who carry out a moment by moment referendum on government policies and if they find that they're irrational, meaning they help people instead of profits, then they vote against them by capital flight, by tax on the country and so on. so the democratic governments have a dual constituency, their own population and the virtual senate who typically prevail. and for the poor, that means regular disaster. in fact, one of the differences between -- one of the reasons for the radical difference between latin america and east asia in the last half century is that latin america didn't control capital flight. in fact, in general, the rich in latin america don't have responsibilities. capital flight approximated the crushing debt. in contrast, during south korea's remarkable growth period, capital flight was not only banned but could bring the death penalty. one of many factors that led to the surprising divergence latin america has much richer resources you'd expect it to be far more advanced than east asia but it had the disadvantaged of being imperialist wings. from the 1970s, the golden age faded. when neoliberal rules were observed insofar as they've been observed, economic reform deteriorated and social democratic programs have been substantially weakened. we see that right here. the united states partially accepted these rules and for the past 30 years, real wages for the majority of the population have stagnated up till then, they essentially tracked growth. work hours have increased. now well beyond europe. benefits which have always lagged have declined. social indicators kind of general measure of the health of the society, they also attracted growth until the mid-1970s when they began to decline reaching the 1960 level by the end of the millennium. there has been economic growth but it's finding its way into very few pockets. increasingly, into the financial industries, which have grown enormously while productive industry has significantly declined. we're seeing it right now. and with the decline of productive industry, of course, that means a decline in living

age. and i said, by age? center mikulski -- senator mikulski, you need to listen to this. i use to figure it was below both of us. i said, what about these folks, should they get a knee replacement? that person said, maybe not. that sounds like that cannot happen in the system that we are trying to construct. i am telling you, it can. that is why i introduced this bill. i have run on way too long. i appreciate the indulgence of the chairman and my colleagues. >> thank you. senator mikulski. >> first of all, let me just say that this amendment offered by the senator from kansas -- if you go -- we get into this repetitive wording. it goes well with focus groups, but it has no rationale here. if you go to page 323 of the actual bill, where it says in corp. -- incorporation, it prohibits anything related to the center for health outcomes, otherwise known as comparative and effectiveness. there shall not be construed as mandates for payments coverage for treatment. it is in the bill. this is page 323, line five through seven. please, take a look at it. tell me about that. we sa

ages. that was the dark ages of the 60s and 70s and then you remember that being homosexual in america wasime until recently and interesting a homosexual in america until 1974 was to be crazy, according to the american psychiatric association. what changed that? well, the activism of harvey milk and many like him who stood up and in the film this what you see. he stood up and was knocked down herm stood up and was knocked down. he stood up again and was shot. that's why it's a film worth supporting because we see there the power of activism. we life in a very different world. it's not the gl rights aren't doing being debated. but it's true. that what we see in milk is we see the role of an activist and the role of a movement of activists. people are vague, everything isn't just right. things aren't that good. let's change things for the the better and shifting the metaphor from crazy crimes to human beings with human rights. that's -- >> guest: can i add -- you may have already said this before i die here. so stop me. i think another great example, midwest example. illinois example, the mo

age, but the dreams of all ages. so intense was the cooperation between our nations that when winston churchill regularly asked to see strategists who were planning d-day he never knew until they arrived whether the officer would be british, canadian, or american. and so next to omaha beach, we join president obama to pay tribute to the american soldiers who gave their lives on omaha beach for people they never knew, and yet people who have lived in freedom thanks to their sacrifice and valor. and i know that the whole of britain will be proud that jack woods is today decorated by president sarkozy, and alongside brave and fearless canadians, he landed on juneo beach and with his comrades went on to capture five bridges. and the hand that will today receive the legion of honor from the president of france is the hand that liberated one of the first french villages to be freed. and there is an unbroken line from what happened here to the battle of the bulk to the crossesing of the rine to the fall of the third rike to the eend of europe's enslavement. on d-day the sons of liberation will head right across europe, all over france resistance fighters began to below up bridges and railroad lines. and in amterdam a young girl ann franks was inspired to write of the news of d-day as too wonderful, almost too like a fairy tale. and for her even at the age of 14 it was an affirmation that humanity can triumph in the face of carnage. she wrote, i still believe that people are good at heart. and these words written before her short life ended in a diary she thought nobody would ever reach. are perhaps the greatest eeptaff of those grages men and women, that people are good at heart is an inspiration for another generation of courageous men and women in our armed forces whose goodness today is to work for peace in every corner of the world. we salute the devotion of our armed forces, our gratitude to them and our families must always be equal to what they give. above all else, for you, if remaining few, the veterans who have outlived that day, that battle, and that war, who gather here today with your families and with your children, so our children and our children's children will gather here year after year to honor you long after you are gone. and far beyond these moments of reflection and remembrance the threads of your lives and your

age and your children get to a certain age you probably do not need certain insurance so it is better to reinvest that money into something like stocks and bonds. but the other is to keep a certain term policy in the fact then use the balance of what you would have four insurance to put into stocks and bonds. i think annuities work while in relation to certain classes of people but generally speaking with your money you cannot get it if you need it. and they have a big load going in with most annuities to pay so you are paying for their work to sell you the policy. it is difficult to know what to do. people are facing a mortgage when do you buy or not? i have a chapter in this book called love nest or money pat. [laughter] you can determine people always ask me is it time to buy? i say sometimes it is and sometimes it is not it depends on the house or your circumstance or what kind of good deal is out there and what kind of financing is available. the other thing that people are asking right now is it time to finance? there are rules in the book ride on the money is the formula is when it is inappropriate to refinance and when is inappropriate to hold what you have got? people ask me these questions on television and they keep asking them sit-down and worked out the equation if i will live in this house five more years and it cost me so much money to refinance its if i have a savings and interest of so much, what will be left? many times is nothing the other is it is a lot and it is a good deal. a person has to determine their own situation in regard to real-estate. i strongly recommended against buying real-estate three or four years ago. i knew it was overpriced come overvalued and lo and behold the prices have dropped 40 or 50%. people who jump in four or five years ago said this is a great investment have lost half of their money and furthermore they cannot get out. we have nobody that will buy them that is a very unpleasant feeling. but this is why one must me cautious in terms of real estate but again in terms of refinancing real-estate cbn is on our crew be said i lowered my monthly expenses by $800 to refinance the mortgage and got an extraordinarily good rate and a nice package that worked well for him. he is not going anywhere for the rest of his life he will not sell the house and for him it is wonderful. if somebody is going to move in one month or one year or two years and may not be a good deal. all of this is here in the book "right on the money" and some of the chapters i would like to read to you just to show you what is here but first it says why aren't i rich. [laughter] and the second one says why do i run out of money and the one says where do i get credit where credit is due? what's my score? what is my road map to 12? what is my engine to 12? what if i don't like risks? mutual funds and exchange traded fund options and futures? will i be a homeowner should prepay my mortgagor refi my mortgage? how do i prepare for winter and what can make old age more secure and how do i bring on the pieces together? and how do i pay for care in my old age? i have something in here having to do with insurance and one of the best insurance policies that is extremely important from a catastrophic care on the one hand but if somebody is concerned about long-term care, i think they are relatively cheap policies and long-term care is very important for somebody as you move along than your put in a nursing home and who will pay for it? you have a policy that is not too expensive for something like that but there are other tips of how you balance your investments, real estate, you balance your retirement it is all here. i will turn the gathering over to the doctor if you have some questions [applause] >> sino for me i am already thinking about plastic surgery in a new way. [laughter] we do not want to make sure your racket -- raise your hands we can recognize you we have one write-up front. >> and previous periods of our nation's economy with increas

age of admiral mullen -- around the age that admiral mullen that described, and how we communicate better with them? how do we get reactions from them to things they are doing? how do we get better plug dint with what they're thinking? also, in terms of this strategic communications, that is the age is not younger of many of the people around the world we're trying to reach, and how we reach them in a way that they understand. this department i think is way behind the power curve in this and is an area that needs a lot of improvement. >> has anyone been stepping up your communication with the chinese, south koreans, japanese about interdicting north korean ships? if so, are you sensing more of a willingness particularly on the part of the chinese to monitor and interdict north korean ships? >> i will just say when i was in singapore, i had bilateral meetings with both my south korean and japanese counterparts, and then we had the first ever tri-bilateral meeting of the defense ministers of the three countries. our focus was on how we improve our defensive capabilities together in response to what is going on in north korea. i am not aware, i certainly have not had any communications with the chinese in terms of north korea. >> i have not, although i know admiral keating has engag

american people should speak out in favor and support of these brave iranians, average age in tehran is 33 years of age, in their request for the fundamentals of freedom and democracy that we have enjoyed for more than a couple of centuries. mr. president, today and -- i and all america pays tribute to a brave young woman who was trying to exorcise her fundamental human rights and was killed on the streets of tehran. all americans are with her and our thoughts and prayers are with her, her family, and her country. >> senator mccain will join us on tomorrow's "washington journal along with bob schieffer of cbs news. on thursday, tom ridge is our guest. "washington journal" begins each morning at 7:00 a.m. eastern. more about iran's election from the state department. this briefing is about 13 minutes. >> at the friday sermon by the ayatollah, did that set back the prospects for meaningful engagement with the regime that seemed strident and hostile to the west? >> you all know our policy about engagement and keeping iran from obtaining nuclear weight -- obtaining nuclear weapons. this is not about us, th

age of 60, but not during the time in between. time in between they retire until the age of 60 is referred to as the gay area. they are reserve component retirees under the age of 60 with more than 20 years of faithful service who have qualified retirement at age 60. the legislation fills in that gray area to ensure that these men and women have health care coverage and provides access to the care they deserve. this legislation is important because currently around 50% of those serving in iraq and afghanistan are reservists and national guard. and this option for purchasing tricare standard will serve as an incentive for those guardsmen and reservists to continue to serve. i thank the armed services committee chairman and ranking member for including this important legislation in the national defense authorization act for fiscal year 2010. and i yield back. thank you very much. the chair: the gentleman from missouri. rereserves his time. the gentleman from california. mr. mckeon: i yield such time as he may consume to mr. austria from ohio for the purpose of a col key. the chair: the gentleman is recognized. mr. austria: i appreciate you and chairman skelton

in the course of their life will experience a mental disorder will experience it by the age of 14. 75% by the age of 23. and that the average lifetime between first having symptoms and interim chair is nine years. in the united states of america. so the understanding, for example, of how untreated mental depression can interrupt the mom's ability to turn on those receptors in the baby's brain that are critical to developing the relationships and how that can leave later on to behavioral problems and a conduct disorder, you know, which we understand the scientific link there. the report just out from the iom about prevention, and the report just out about depression in young people and their adults, boy, is this tough time at. so the question though of how we make the sale to, and i really like the metaphor of poking our car to that train. what our message is, in this community, we're going to have to get a little bit clearer about, but i think a message about prevention and wellness and the centrality of the surgeon general said mental health is essential to overall health. that have to be what w

age. there was a coming ice age that was published in some of the major publications and it was inest tabble that the earth was going to cool and people were going to have to migrate to south texas. and it's a fact that at least one, and probably more than one, although scientists were certain we were going to undergo this ice age, are now on the side of the argument that the earth is going to get warmer and get warmer fast and then anything that's a weather anomaly is going to be the result of global warming. if you remember, we had a few hurricanes as a result of global warming. last year, hurricanes were way last year, hurricanes were way off.

age of 11 he joined the local game and found himself in the better part of his life in and out of jail cells. her mother was sent to kindergarten just like maria put by the age of seven in second grade she dropped out of school. she found herself at home helping her mother make sure everyone else had clean clothes, enough to eat and at the age of 15 she made a bad decision. she got pregnant. by the age of 20 she had three little babies, a one-bedroom apartment and a husband in and out of jail and like so many women in the audience she was proud. she didn't want government assistance or pity so she worked. and as many of you can imagine what the second grade education her options were limited. so her first job maria would watch her mom get up at the crack of dawn to go clean these big beautiful homes. homes and communities just like this. holmes maria realized at the age of five or two expensive and they would never force. then she would watch her mom, home, change clothes and go off and scrub toilets and fancy hotels. once again, hotels marie realize that the age of five we are never going to afford. and her third job maria but watch her mother changed her clothes again and go to sweatshops to solve these beautiful outfits and beautiful clothes she realized even at the age of 5i am never going to wear and we will never affo

american people should speak out in favor and in support of these brave iranians, average age in tehran is 33 years of age, and their quest for the fundamentals of freedom and democracy that we have enjoyed for more than a couple of centuries. so, mr. president, today i, and all america, pays tribute to a brave young woman who was trying to exercise her fundamental human rights and was killed on the streets of tehran. all americans are with her. our thoughts and our prayers for her, her family, and her countrymen. now, mr. president, i'd like to talk a bit about health care since that seems to be a -- a major issue also of concern to all americans. today's june 22, 2009. millions of americans still lack health insurance coverage and we need to pass reforms that help them get coverage. yet, more time has gone by with no plan from the majority. while we wait, how many more people will forego needed care today? how many emergency rooms will have to care for americans who could have received care yerlier and -- earlier and at a lower cost from a medical professional if they had insurance? mr. president, the m

age and the beginning of the digital age. there are a lot of benefits that millions of american consumers are beginning to enjoy today. i think that we will find that this is good for consumers and good for the country. the transition is far from over. we are in the midst of it. there will be some dislocation as we have said over the period of the past several months. we are hard at work what teams in the field. we have a call center. it is a lifeline for consumers that are experiencing problems. we will keep moving ahead and make this transition complete. everybody should be read scanning their television sets. >> -- should be scanning the television sets again >> things went about as smoothly as we could have hoped. it looked more like y2k then the bay of pigs. we have been getting a lot of attention on this. we are not done. we have a long way to go before this is over. this is because we had a delay. if we had not have the delay, this might have proved to be a disaster but we got the time that we needed and we got the resources that we needed to address the many concerns that we got from members of the public and now the public is and a position to benefit from the digital age. they get better quality picture, better quality of sound and more channels for free over the air. maybe this is the time to cut the cord and stop paying for tv and enjoy the benefits of digital television that looks more like pay television than anything else. you get more channels, you get a program guide, so why pay for television when you have this wonderful digital television available for free over the air. we have a ways to go. we have a major operation in the field. calls are pouring into the call center. we are now in a position to answer all of the concerns that we are getting from the public. we have people in the field that can help them in their homes and answer questions. we are ready. we are getting a large response and we are now able to handle it. that is why things went as smoothly as we could hope. >> i had robert mcdowell, commissioner of the fcc. now, the fcc moves into its search and rescue mode. we need to find those that have been left behind and we need to rem

age of 30. perhaps, even under the age of 25. so this is an extraordinarily young country. and i was moved to write about this young generation because i had moved to iran as a young reporter for "time" magazine. and not only was i charged with covering iran politically and trying to understand american readers what the political situation was like, what sort of changes the country was going through, but also i sort of saw that these young people were so critical to that whole debate about where iran was headed. because at that time, there was a moderate in power, president mohammed khatami and there was a particular set of power that he would be transforming iran to a more democratic and a more open society. as i was living in iran at that time and i was in my early 20s, and these young people were my friends and my relatives, and i grew quite fascinated with their political attitudes and behavior. and i felt that i couldn't really capture what they were striving for in these short 600-word news stories. and so i wrote -- i decided to write a book about them to portray how they were going about trying to transform their society. many of you may have read that book but i'll quickly because i think it's important to talking about what iran is going through today remember what young people were dealing with back at that time, in the years sort of early 2000/2001. i described their culture of as-if pretending all the rules in place, what people could wear, how they could behave and read and watch, they pretended these rules did not exist. young women started to flout the dress code and wear brighter colors. they were wear tighter coats and push their veils back to show a little bit of pair. young people would hold hands in the street and watch band movies and videos, perhaps depending, of course, on their taste, drink alcohol at home. there was an underground music scene. young people would start rock bands and hold private concerts. they were very much determined as i saw it to change their society through daily life. and their individual behavior rather than through the political process because it seemed to them at the time and that was certainly my sense disillusioned with the prospect of being able to change things politically and so that was the young generation that i wrote about and grew to know in that time. and i left iran at the end of 2001, and went on to move to beirut and cover other developments, of course, the war in iraq and the aftermath of that, which sort of played out across the region. and was based in beirut when 2005 rolled around. and in 2005, iranians went to the polls in may of that year to elect their president. i flew to tehran to cover that election and it resulted of the victory of someone whose name we struggle to pronounce, president mahmoud ahmadinejad, who won that election. and it came as something of a shock and certainly my editors at "time" were a bit flummoxed as well and they called me up you've reported on iran for so many years of this country of a secular young people who are open to the west and very sophisticated and very -- in ways affectionate towards the united states, how have they gone and elected such a radicalb and so at that time it was fascinating to me also as a reporter to go back and report on that election. and to try and chronicle how it had come to pass that iranians had chosen a man that ended up being a very defiant and vitriolic leader, certainly not what they had expected.xv and i moved back to iran at the time and in the course of reporting how it had come to be and i'll quickly just -- and i'll quickly mention my reading of all that, which was that president mahmoud ahmadinejad, who was unknown before that election virtually even in the preceding weeks, no one had really taken him seriously as a contender emerged at the last moment as a proponent of change. and i think in this country we've recently had an election in which a candidate has run on a platform of change and we can relate to how appealing that can sound during a time of deep disillusionment, and that's certainly what president mahmoud ahmadinejad -- or at that time candidate mahmoud ahmadinejad attempted to do. people in "lipstick jihad" they were no longer in their entire 20s, they were in their late 20s. they were still interested in political freedom and social freedom and they certainly still did want to be able to hold hands in the street without being stopped by the morality police but their needs and their attitudes had also evolved because they were approaching their late 20s and were starting to think about marriage. and so other issues began to also become a priority. like can i afford an apartment? can i find a job where i can be able to support a family? these were questions that were urgent at the time because the iranian economy was bad before the global collapse acquainted everybody, especially in the west about what a bad economy could really mean. iranians were dealing with this all the way along. and so young people also were attracted to his message. he promised to battle corruption. he promised to bring the country's oil wealth to people's dinner's table and this was certainly appealing to a young generation who was starting to think very seriously about whether or not they could afford and sustain decent married adult life back in iran. my move back to iran was occurred with a change in my life. given the title of my book, i met someone who would later become my husband, and when i moved back so that we could start our life together and go forward, i began to experience and sort of firsthand witness all of the things that iranian young people were dealing with when it came to marriage and moving on in life beyond simply being single and young. this all started for me in the course of planning our wedding and there's a chapter in mygcw k devoted to this and it's called "the persian bride's handbook." it looks at weddings in iran and, of course, i being the woman, the one who was planning the wedding, and was quite astonished by the world that i encountered in iran, the world of weddings and what a middle class dream it had become to have an extravagant, beautiful, over the top wedding. being from california, i was very familiar with, of course, this culture of extravagance of a wedding. and i didn't expect to find it in iran and the middle class who could certainly not afford these kinds of lavish spectacles. it all started for me when i started looking for wedding coordinators to help me plan our wedding.!í ask my friends and i started to go around with my fiance at the time to meet them and was quite amazed -- they were sort of characters out of a hollywood film and would run these empires, these g& wedding-coordinating empires and we would be ushered in and be taken into a room that was devoted to the food that would be served at the wedding and there would be a+ñ powerpoint presentation and the7+÷ wedding coordinator would be sitting there in this immaculate suit looking like clark kent or a calvin model saying we could 13 courses or 18 courses and i was sitting there quite amazed by all of this. and i remember asking, well, could we have two or three? and he was mortified by my suggestion and said, absolutely not. my reputation would be demolished no one would come to me again to plan a wedding. these are your options. and we sort of silently sort of not and went along with the next step in that wedding empire of that coordinator which was photography. and we were handeds&÷ a big boof photos to show us, you know, if we went with this wedding coordinator what could we have in terms of wedding photography. i started to go through these albums and it was quite astonishing. there were photos of young couples galloping off onto horses in the desert and frolicking in the ocean waves and finding each other dressed, of course, in a tuxedo and ball gown on a grand estate and we were told, of course, this could all be set to music and we could have a dvd made of it. that our friends and family would, of course, then have to suffer through repeatedlyt because it was very expensive and, of course, what would then, of course, the point that everyone would have to watch it all the time. [laughter] >> and so this was of course our introduction to this world of lavish weddings. and there was also a security element to all this. many of the wedding coordinators also offered security packages because in iran, if you're going to have a wedding in public, at a public reception hall men and women have to be separated because, of course, the islamic regulations of the government hold that men and women can't listen to music or dance or sort of cavort in each other's presence in public. and so if you want to have a public reception, men and women have to be separated and i attended one of these segregated weddings once and it was a rather grim affair. and i didn't certainly want to have that be my wedding. 500 women on one side of a ballroom and 500 men on the other side of the ballroom and the war on terrorism could talk amongst themselves as women do but 500 men alone didn't quite know what to do and my husband and i were texting each other throughout the whole thing and i discovered that that sided a stand-up comedian. so this is what people had to to either have this -- of course i wanted to mention, very traditional and pious families would still would have a segregated weddings but for majority middle class secular city-dwelling sort of spectrum of iran, that was not something that would certainly have any appeal. and so if you wanted to have many young couples chose to have their wedding parties at home. their receptions at home so that men and women could be together and, of course, this would be conspicuous at a certain point because there would be many cars outside and there would be loud music and inevitably, the police would come knocking at the door and usually there would be someone who had been charged with having a bribe ready to give to the police so the wedding wouldn't raided. they had security packages as well. you could have different types of security guards attired variously. you could have them dressed up as guests and not as guests. this was part of the world of weddings that iranian people were inhabiting. these were all the things that they had to consider when planning this very transforming moment in their lives. >> the middle class in iran, although, very sophisticated and educated is not financially or materially very well off. their standard of living could be compared very much to the lower middle class in the west that are in this country and so it was really a strain for couples and their families to have these kind of weddings but it had become such a social standard; it had become such a way for couples and families to exhibit their status within their community that it was just what young people aspired to, whether or not their parents would have to go into debt, for example, to afford this for them. and the government was concerned because in an islamic country marriage is the cornerstone of society. it was very important to the iranian government to uphold the institution of marriage and to encourage young people to get married at a younger aged they would hand out marriage loans to sort of help with this but what they would give out in the loan, of course, could barely even cover a fraction of the type of weddings that young people wanted and so the government started to pursue this moderation scheme to promote moderation in weddings and also in wedding contracts because in iran, in the modern iranian wedding contract also in the old prerevolutionary marriage contracts there's a line that there's a financial sum that the couple agrees upon before marriage and it's basically the woman is entitled to collect that sum upon divorce. and in my mother's generation, very often this was symbolic because they felt that women -- a woman's worth could not be determined by a sum of money and very often my mother had a symbolic line. it was some sugar crystals and a book the poetry, you know, these very kind of idealistic kind of things but in the very status-conscious and in a calculating iran today young women were putting in things l

age. >> guest: we're exactly the same age. c-span: do you know him? >> guest: oh, yes, sure. c-span: you quote him in the book. >> guest: oh, yes. we're in the same racket. we've been doing this for a long time. c-span: he said he got interested because there are lots of american soldiers in his village of taunton. how did you get interested in this subject? >> guest: i was a civil war historian, and in 1964 i got a telephone call from general eisenhower, who asked if i would be interested in writing his biography. he had read a couple of my civil war books. "yes, sir," said i, and it got started there. i mean, you can't do eisenhower's biography and not be interested in d-day. c-span: do you remember the first time you met him? >> guest: certainly. it was in his office in gettysburg. we talked for a whole afternoon about what access i would have, what papers would be available to me, what would be involved in doing this work. at the end of that conversation, he said, "i notice you're teaching in new orleans. did you ever know andrew higgins?" "no, sir," i said. i knew who he

the same age who'd been elected to the illinois legislature at exactly the same age, with not much national, if any -- no national experience, then became elected to the u.s. senate at the same age that rod blagojevich was when he elected to become the governor and guess what? he's our president. [laughter] >> it wasn't that unrealistic. >> no, it really wasn't. if you look back at the first inauguration -- first inaugural speech that rod blagojevich gave, it was a wonderful, stirring, uplifting, you know -- this is a new -- a dawn of a new era in illinois. the politics of old is over. this new era of cooperation, getting things done. it was an amazing moment. i don't know if you were in springfield for that. you certainly saw it and reviewed it. but it was really quite a moment when blagojevich took office and a lot of people thought that he had a ton of promise to do just what you're talking about. >> absolutely, you have to remember it was 25 years since democrats held the office -- they controlled both the legislature, both branches of the legislature and governor and you remember the governor that he followed, you know, george ryan, was in a bit of trouble. he hadn't been i

ages and he has seen shifts in pensions. i am not one that fears of the aging problem. actually, ron is more where china was 15 years ago where you have this much larger than normal share of your relatively working age and you do not have a lot of children that our dependencants. turning to the credit capitalism issues, i would not call it crony capitalism, i would call it crony stateism. maybe the rhetoric was one way, but it has not been the other way that is an area which is best addressed by just opening up competition and i think that is where the government made quite a bit of progress. it has to do with where the president took a large step back. the of focused on people with connections and they had huge transfers of wealth in terms of under market loans and most of those loans have gone to corporations. the rational monetary policy would give people incentive to save and would do more about corruption. in terms of subsidies, the world bank and the finance minister under the old version, this is such an extraordinary waste of money. the value of having young iranians being able to drive up and down at high speeds and getting stuck in traffic jams provides very little utility to the populatio

aging country. hawaii has one of the fastest-aging populations in the entire country. so the issue of health care coverage and how we're going to do it is very much on people's minds. when you talk about, you know, how are people supposed to take care of their long-term care needs? that is a huge, huge concern in our country. and so, what we should be also talking about is, how are we going to help our elders age in place as opposed to having to be institutionalized where the costs are so much greater? so there are so many choices that we can be making that truly enables the people of our clint to sleep soundly at night knowing their needs will be cared for. ms. woozesee: one of the things we're going to -- ms. woolsey: one thing we'll hear is we can't make the insurance companies compete with a public plan. it won't be fair to the insurance companies. excuse me, the insurance companies have a huge marketing budget. they have overhead that's so much more than the public medicare program. ms. schakowsky: i've heard their c.e.o.'s get paid pretty well. ms. woolsey: and their c.e.o.'s get paid so much. if they can't compete with the public plan, too bad. they'll either, you know, plus up and get better and pay their c.e.o.'s so much, or more people will go on the public plan. if we have a good public plan, over the years, and i don't know how long it will be, it can lead to a single, universal co

age of 35. many are insureable. college-age kids up to 35. they tend to be more insureable than much of the rest of the population. i believe we do have suggestions and proposals of ways to cover that population, get them into an affordable catastrophic coverage they need in the event something dramatic happens in their life. that's another statistic i don't think we talk enough about. also, there are a large number of people uninsured who are eligible for program, whether medicaid or the children's health insurance program. mr. murphy: many of the younger folks consider themselves inas a rule nearbies, they don't need insurance, they don't get sick. what happens is if they do get sick, they do end up in emergency rooms, we pay for it. it is important we provide every incentive to purchase the insurance that many times an employer does offer. mr. kirk: we ought to allow small businesses, for example the libertyville state insurance health plan, right now prohibited under law. we know half of all americans work for small businesses and many don't have a plan through their employer that will be included in our legislation. mr. dent: that's an important point. there are so many people out there who need coverage. you mentioned allowing employers to reach across state lines but the other issue to help the uninsured is you know employers receive federal tax rebates, that's beneficial to helping them provide health care coverage to their employees. that's a good thing. we want to protect that. it's about $-- about 16 a 5 million americans have insurance through their employers. what we should do is give the individual who lacks insurance, his employer cannot provide it or if they're un-- self-employed or on their own, give them the same kind of favorable tax treatment as an individual that we give to business. that would do a lot to help cover, particularly that younger population. mr. murphy: in addition it has to do with how they purchase. the federal government recognizes if we allow people of low income to pool together, the v.a. does this all the time, they combine the purchasing power of the v.a. to purchase for veterans across the nation. yet we don't let individual do that we don't let a small business with only 20 employees do this. that wall placed by insurance companies and by the government leads to higher costs. we ought to allow business to do the same thing the federal government does and use that as a mechanism to drive down costs substantially. mr. kent: -- mr. kirk: one thing you mentioned is the need for public health. that puts forward a critical point missing in the debate. we know of the uninsured, 44.7 million, of the uninsured, 14.7 million are already eligible for public coverage. as we have found -- mr. dent: that's medicaid and schip. mr. kirk: that's right. as we found in the state of massachusetts, when a mandate that everyone has to buy health insurance is put forward, what they have generally found is that a technical and legal solution is not adequate. they thought by putting a health insurance signup machine at the entrance of every emergency room at the state would register and collect the required number of people who hadn't yet signed up for public assistance that they were eligible for. what they found is, for a small percentage of the most difficult parktes, either because of alcohol, drug abuse, or law enforcement problems, these patients were not registering under similar names, not registering under similar addresses and were failing to report for appointments and other preventive care. meaning for that small percentage of american we need to provide an open public clinic. it's the most more -- it's the much more appropriate health delivery system. for this small percentage of americans, we have different names, different addresses, but we want to provide care. you need to do it through a public health clinic. mr. murphy: as you describe, it brings the thought, too, of how people having this hodgepodge of a disjointed and difficult system that does not allow individuals to purchase insurance we look on other solutions and say, they're not purchasing it for other reasons, we artificially keep those things high and keep a system that incentivizes lots of tests and is dysfunctional. i bring my colleagues -- my colleague's attention to a study that said this nation wastes about $700 billion a year. all these inefficiencies have to deal with care delivery, beyond that of what we're talking here with the insurance. mr. kirk: one of the things i want to make sure is sometimes in this debate, when you hear about the uninsured, you have the impression the federal government doesn't spend money already providing health care to low income and needy americans. as this chart now somewhat outdated from 2004 shows, it's a total of almost $35 billion in assistance given to cover the uninsured but one of the problems has been that some of the patients directly eligible for these government programs don't sign up. mr. dent: the gentleman pointed out an interesting point, he mentioned the massachusetts health care experiment. they had a universal mandate for coverage duh but did not do anything to deal with the cost issue. what happened in massachusetts is why -- while the number of those provided coverage through the programs, the costs rose. but the ability of the taxpayers to meet the rising costs was limited. what does the government do? it restricts care. it denies treatments. it denies service. it rations care. that's sort of a microcome. that's what happens in massachusetts and perhaps other western european countries or canada. i'm not here to either praise or condemn those systems. in western europe, the united kingdom, or anywhere else. they're different systems. people need to understand that. what happens in those systems when the costs continue to rise for health care and there aren't the tax dollars to meet the costs they deny care. i think we all know that -- we know that people are concerned about cures, not treatments. they want to be treated like human beings, not numbers. unfortunately, that can happen in those systems when off single payer system, take a number, wait for dialysis, wait for hip replacement if you can wait that long. if you're canadian, if you have the money, come across the border and get the care you need when you need it. i think we have to have this sober discussion. mr. kirk: the gentleman points out canada, a country with a two-tyre health care system, the canadian health care system, then when you're denied care, especially prevalent when you need imagery, we come to the -- they come to the united states. some doctors call it fargoing a patient. when care is going to be denied, they'll refer that patient to fargo, north dakota, where they immediately get care under the u.s. system. the concern i have is, if we have the government take over health care, where will we be able to drive? where will we be able to go? that's why in our legislation we'll be outlining on tuesday, it includes the medical rights act. it says this. we guarantee the right of patients to carry out the decisions of their doctor out without delay or denial of care by the government. the legislation protects the right of each american to receive medical services as deemed appropriate by the doctor. i yield to the gentleman. mr. murphy: that's a great base to be moving from. there does need to be the basic rights outlined, because we have a system that stands with huge barriers between doctors and patients. much of that barrier is the government. the government handles, through medicare and medicaid, for example, handles cost controls by delaying care, denying care and denying or diminishing payment. physicians and hospitals paid 30% or 40% less or saying you're not allowed to do these other tests, we're not going to pay for it, end up promoting a situation more based on quality than quantity that increases many kansases and increases the chances for fraud and abuse. in pennsylvania today there was news in the paper of millions of dollars, again, of abuse in the system. what is so important is if you have the patient and the doctor in charge of their care, you incentivize quality, make sure the doctor has the timely information through electronic medical records. those are things we are not doing. look at other clinic the mayo clinic, university of pittsburgh medical center, ones that are focused on we're going to change the quality of care you see the costs go down. that's part after the -- part of the focus we need to have. with that, i yield back to my colleague. mr. kirk: i want to talk about some solutions we're going to put forward. what's lost in the debate is we agree with the president we should lower cost. we agree we should expand health care. we think we have a better way. many times in the partisan debate, people can say we have no alternative. so we've spent about 90% of our time coming up with that alternative. we want to make sure that we guarantee the rights of each patient in the doctor-patient relationship so you or a loved one in your family is allowed to carry out the decisions made by you and your doctor, and not be interfered with by a government entity. also we're focusing on lowering the cost of insurance. through alliances, through equalizing the tax benefit for individuals, so they get the same benefit employers get when they buy health insurance, and obviously what we've talked about here, lawsuit reform. i yield to the gentleman. mr. dent: that's a point i made about equalizing the tax treatment. the 165 million american, 60% of our population, has insurance through their employers. but those individuals who cannot afford insurance, and there are a lot of them out there, cannot afford their insurance but get no favorable tax treatment themselves. their employer receives i but the me, the self-employed individual should get the same favorable treatment. that's a way to help, particularly the younger population, some of whom have the capacity to purchase health insurance, may be relatively health iy but decide not to purchase it. we can help that population afford a reasonable comprehensive plan. that's one of the major parts of the reform you and i worked on. i think there are plenty of people in this room who on both sides of the aisle would be willing to vote for this type of common sense reform that's going to help people get access to care and coverage. mr. kirk: we want to equalize benefits so if you buy your own insurance you get the same benefits an employer does. there are ideas building in strength in the congress and downtown that talk about cutting the tax benefit that employers get for providing health insurance to their employees. one study by the lieu well in-- lieu well lynn group says luolen group is cut, 100 million americans will lose their health insurance. a health reform bill will cut the number of american who was their own insurance from 170 million to 70 million. our bill, our positive alternative goes in exactly the opposite direction. we're enhancing employer-provided coverage and making sure it's more available. i yield to the gentleman. . mr. dent:00 when you talk about 100 million americans losing their health care where will they go to get it? that employer exclusion, that favorable tax treatment is essential to making sure many americans are able to maintain their coverage. that's the first thing we have to protect in this whole discussion. we have to protect that first. and some of the proposals clote floating around this capitol as you pointed out would either eliminate that exclusion or severely limit it as a way to finance whatever kind of program they are advancing. this is big money. so i just wanted to share that with the american people. make sure they understand that seems to be the primary funding mechanism that many are looking at to finance whatever kind of health care system we propose. whether it's a government option or some other proposal, single payer. mr. kirk: they are talking about maybe a $1 trillion cost of a government plan. so the most obvious response with such a cost is a huge income tax increase. we know most americans oppose that. some including emanuel, one of the heads of the president's advisory committee, has talked about a national sales tax on p of the other tax. but i think there's significant opposition to that. so they have talked about cutting back on the tax benefit that employers get when they provide health care to their employees. by this estimate it could cost over 100 million americans their health insurance. mr. murphy: when you look at the government running a plan a cost of $1 trillion. that's several hundred more than the pentagon. i'm not sure the people would say for the pentagon, of all the pride we have for our sole soldiers, airmen, marines, i doubt people would say that's the model of economic efficiency. would they say the social security run by the federal government is the best investment system? would they -- pick pic a system the federal government runs and it's hardly seen as the best. we know we have a lot of dedicated employees there, oftentimes they are saddled and handcuffed by regulations. we have a system that is still after all these years, medicaid that has been around since 1960's, so fraught with inefficiency it invites waste, fraud, and abuse. it has not been revamped. an article that appeared in the "the new england journal of medicine" a couple weeks ago was saying, we've got to fix these systems first, otherwise, i go back to the art youicle, providing health care is like building a house. the task requires experts, expensive equipment and materials and a huge amount of coordination. imagine instead of paying a contractor to pull a team together and keep them on track, you paid an electrician and carpenterer for every cabinet. would you be surprised if you got a house with 1,000 outlets, faucets, and cabinets at three times the cost and the whole thing fell apart? that's where we are with the health care system. it must be focused on quality and an outcome. i worry if we have a government-run system and this bureaucracy created, it's going to be a matter, it's going to be between you and your doctor to get anything done it's going to take an act of congress. all of people who say it's going to be less involved with regard to administrative costs, don't see how that is possible given the track record we have. mr. kirk: we also not only see other examples of the government poorly running the bureaucracy that's already taken over, recently the government took over the largest bond dealer, bear stearns. the government has taken over the largest insurance company, the american international group. and the government has taken over the largest consider manufacturer, g.m. i don't think anyone would argue the government is running it better in their current states. i yield. mr. dent: if the gentleman would yield. to follow up on that point you were making about government ownership and autos and financial services and elsewhere, let's talk more about health care. there is an idea being floated about called a government option which needs to be i think fully understood, invented before the public. but that government option many fear may become the only option for insurance because a government option coverage will perhaps -- would be able to offer a much lower cost than any kind of private sector insurance product. and the fear is that you would have a backdoor government takeover of our health system through this government option. very real concern. and again -- i just don't think we should lose sight of the fact that if -- this turns into a backdoor single payer system or government takeover of health care what, will soon follow will be rationed care. that is waiting lines, delays, denials of care. mr. kirk: i would emphasize the point the gentleman raised. not only if we create a government health care program will it compete and maybe the lowest cost option because it has a taxpayer subsidy, but that taxpayer subsidy may be paid for by ending some of the tax break that employers have in providing health care to their employees. mr. dent: the 165 million americans. mr. kirk: employers seeing they don't get a tax break anymore for giving health care will cancel your health insurance plan and the government will be your only option. mr. murphy: i believe government does have a role in turms terms of pro-- terms of providing regulation, standards ever excellence, and pushing companies towards this. provide the oversight that says if you are going to spend the taxpayers' money on medicaid, medicare, v.a., we want to see quality measures. if the federal government is going to put up money for electronic medical records we need to see you driving towards intelligence systems, integrated systems, towards one that is are highly interactive with the physician, the federal government can play a role in pushing people towards higher quality. i worry if the federal government is the prime owner of this will the federal government itself push things towards that? that's where i have trouble recognizing that. mr. kirk: i want to keep this on the positive side because what we are doing is we are putting together a positive alternative. one of the other reforms that we will be outlining is to dramatically expand the number of americans who can have a health savings account. very much like an i.r.a. so that they can save, especially in their younger, more healthier years, in a tax deferred account, that they will use to make up for their deductible expenses in their health insurance. over time as with our i.r.a.'s, an account balance will build up. and then if each of us reaches the age ever medicare at 65 with a balance in that account, that account can either become part of our retirement plan or eventually a part of our estate to our children. this is a much more flexible way of providing health care. more importantly it's owned by you. not by a government bureaucracy. i yield. mr. dent: well said. i think we should focus on solutions. we talked a lot about the challenges and the problems and the costs. but it does come down to solutions. i think to sum up what we have been talking about tonight in terms of our solutions, you congressman kirk, have been a great leader on the medical rights act and make sure that that sacred relationship between doctor and patient is not violated. you have to protect that principle and that notion must be protected up front. as we lower the cost of insurance we talked about some ideas about making sure that businesses can reach across state lines. that they can reach across state lines, realize greater discounts, so they can provid

age in 16, about one in 16 served during the war. in the civil war, about one american male of military age in 10 served. and in world war ii, it was about one in 75 american men of military age. of those who fought and died, on the american side, about one in four who bore arms, at least in the continental army. about 100,000 men serve in the cottonelle army. and we are pretty certain that 25000 of those 100,000 perished. about one in four regular soldiers died during the revolutionary war. in a civil war if you combined union and confederate casualties and look at the regular soldiers gets about one and five which perished. and in world war ii, about one in 40 american 40 american serv. at greatest single cause for death of american servicemen in the revolutionary war was a disease. this was a time period before anesthesia have been developed, before modern antibiotics have been developed. it was a time period, in fact, when most people hardly traveled from their place of birth, probably not more than 40 or 50 miles if they went that far from their place of birth, and suddenly they were thrown into army camps with men from all around the country. and oftentimes they were ma

revolution has entered its second age, ever since the election of ahmadinejad in 2005. this new age has several trades characteristic -- the growing assertiveness of the once timid supreme leader, the immensely important and economic rise of the revolutionary guards and previously very important key power centers, including clerical once. the coal states had to rebuild ties in the 1990's. and the rejection of popular legitimacy. we have to understand something -- here we see iran -- we look back to 1979 and we see a very bumpy road. factionalism playing at. controlled chaos, competing power centers. this is not how most gulf leaders see iran. i would argue most arab leaders. kasey continuity. they see linearity. they see the revolution as having a profound motive -- consistency -- that is not well- understood and the west. -- in the west. we want to see the nuances where they see a purpose-driven system that is expansionists and hegemonic. what is the assessment about this new iran? not much has changed in the formal structure of power. the reality of power is very different. the as

age of 2043% of them are underrepresented minorities. -- under the age of 20, 43 percent of them are underrepresented minorities. the dearth of minorities in the nation's health workforces is a major fat contributed to help disparities. achieving greater racial and ethnic diversity of the nation's health professionals has distinct benefits. first, minority physicians are more likely to practice in medical and underserved areas and care for patients regardless of their ability to pay. a number of studies, beginning in 1996, have shown this data. secondly, minority physicians are more likely to choose primary care practices, and minority registered nurses are more likely to be employed in nursing and work full time, thus improving the care of vulnerable populations. finally, a diverse work force encourages a greater number of minorities to enroll in clinical trials designed to the immediate health disparities. the united states also has evidence that the elect shall -- that -- is enhanced by all learning in an ethnically and racially diverse education and permit -- environment. then serving culturally and linguistically culturally diverse individuals increases the number of initial visits to hospitals, to clinics, or physicians' offices. it results in higher utilization of care, enhances high-quality counters, lowers medical errors, and reduces emergency room admissions. with the prospects for health reform on the nation's stock it, we have the challenge and the opportunity to develop a successful model to eliminate health disparities, by addressing the central issue, and that is the health care work force. the administration and congress can lead this effort for needed changes in our health-care system. such an effort must not only address the lack of health insurance or underinsurance of more than 47 million of our citizens, as well as the high cost of care, it must also focus on the current and increasing shortage and maldistribution of forces and the need for greater diversity. all of these factors have is an advocate impact on access to healthcare, of protecting and improving the health of americans, and eliminating disparities in the health status of the nation's racial and ethnic minorities. i think you for this opportunity to present these opportunity -- to present these facts. i appreciate your comments as well as your leadership and support in these efforts. to achieve our goal of eliminating disparities in health status and access to healthcare for all of our citizens. thank you. >> thank you for letting me to address this civil-rights council. this is to improve the health of several through the developmental policies and programs that would help eliminate health disparities. we are located in the office of secretary within the office of health and science within the department of health and human services, and we advise the secretary, the assistant secretary, and others on programs that impact ethnic and racial minorities including efforts that address minority health issues. first, in terms of what we talk about when we say health disparities, health disparities can be defined as significant gaps and differences in the overall rate of these incidences prevalent, morbidity, or survival rates in the population as compared to the health status of the general population. the institute of medicine defines this crisis as racial or ethnic and the equality -- clinical the patient preferences are in need. -- are needed. there is a report in 2002 that served as a significant datapoint in terms of tracking and analyzing issues related to health disparities. the overall health status in the u.s. has improved significantly as demonstrated by an increase in life expectancy for the majority of the population. however, despite many improvements in health over several decades, significant gaps still exist. these gaps may be related in part to demographic changes in the united states, but according to the 2000 census data, the population of the u.s. grew by 13% over the last decade but has increased dramatically in diversity at a greater rate. ethnic and racial minorities are fast-growing in this country, comprising 34% of the total u.s. population, and is projected that by 2030, 40% of the u.s. population will be comprised of minority populations at large. consequently, the u.s. is not on experiencing greater diversity, but they are experiencing greater cost with health care, and diseases are presented challenges across the board. while this is increasing, minorities tend to die sooner for many acute and chronic conditions. racial and ethnic minorities receive a lower quality of care across a wide range of diagnostic and therapeutic services. these conditions in health care can be to continuing differences in the burden of illness and disease. for example, an estimated 15.8 million people in the united states are living with coronary artery disease, but more than 5.7 million have felt the effects of stroke, which is the second leading cause of death across the board. african-americans continue to experience a higher risk of stroke, have even more severe strokes, and continue to be more than twice as likely to die of stroke as the general population this is among the serious public health problems. 70 million americans fall into the newly listed risk categories of pre-hypertension or are in danger of developing hypertension. hypertension, as you well know, leads to half of all heart attacks, strokes, and part failures in the united states. this is a major risk factor for coronary artery disease, kidney disease, and heart failure, and it is 40% greater in african- americans compared to the general population. mexican-americans, also experienced an even higher rate of hypertension, and we seek similar numbers in the african- american community. black non-hispanic between certain ages are more than twice that for white non-hispanic. african-americans are 30% more likely to develop cancer and 30% more likely to die from cancer compared to the general population's. hispanics in the u.s. are 50% and more likely than whites to suffer from diabetes and incidences of diabetes, and with native americans, that number come as welcome is twice that. they are much more likely to suffer from hepatitis b and liver cancer, as compared to the general population, so we have seen over the past many, many decades of health disparities and the emergence and we confirming of data in terms of the impact of disease prevalent, morbidity, and mortality on minority populations across the board. i want to mention that one of the significant challenges that we face in documented health disparities are data gaps when we look at specific populations, so we face the challenges in collecting data on native american and specific pacific islanders and the populations as well as some specific hispa

age. >> nothing -- >> you might ask me some other question about age... >> i saw you in the movie, in the documentary and you were on that treadmill. how many saw the documentary, "iron ladies of liberia" when i saw you on the treadmill i was like i think need to get myself together... because you're on that treadmill, wok out and do you still keep the regimen up. >> i try, not as disciplined as i should be. i used to like to swim every morning and i can't do a lot of that anymore. but, yeah, i still like the treadmill. my sister jenny who is here is much more religious when it comes to that. hour, hour-and-a-half of exercise, is her thing. most times iav

age. the older you get, even though the treatment may cost less, if you are less likely to get it because of your age. think about that. if something costs $20,000 in united states and you are 65 years of age and they decide they cannot afford to pay for it, is that what the united states of america is all about? should the government have the right to say that based upon the research that we have done, you cannot have that treatment? if you say that that cannot happen in the united states, i say that it can. it is happening in great britain and canada. what is the harm in adopting our legislation? that is the question that i would ask with anyone who says that it is not necessary. what harm does it do to say that this research cannot be used by the federal government to deny or delayed treatment? i hope that my colleagues will appreciate that healthcare is the most important thing to all of us for our families. whatever else we may think needs to be done to reform health care, where we can agree on is that it should not result in rationing of health care for americans. our legislation is one step in that process. it does not preclude rationing of health care in other ways. it says that yo

mentioned it doesn't exist and these are the two things que, the minority age initiative and issue of health disparities. on the minority age initiative, i met with the national minority counsel a few months ago and expressed that the initiatives funding hasn't been reached in the grassroots organizations. it's being redirected to other priorities within hhs or being directed or redirected to other priorities to larger hiv/aids organizations that don't focus on minority community tease but the white depopulation and not the intention of the m ar . this year the funding was open for competition to the for-profit organizations for the first time and this puts a lot of pressure on the organization's and the local community organizations. understanding this and the possibility of the pressure on the organization's what faults do you have about that process? are you thinking of changing that or is it your opinion that it's a fair process that everybody is on even playing ground? and would you also can it to meet with the national minority aids council so they can also express themselves for themselves the way that we see the iss

age 4 in tee ball. i hit my first homerun at age 32 also in tee ball. >> rob: how do you hit a homerun in tee ball?fence? it is ante at home plate. -- it is on a tee at home plate. >> johnny: you have a lot of young kids in the outfield that can't run and can't catch the ball and thing bring the ball in. i guess. >> rob: anyway, adam's got to be good -- [audio indiscernible]. >> johnny: imposing figure at 6'6"290. but i don't think you will meet a nicer guy on this ball club than adam dunn. 2-0 fastball. gonzalez at 1st base. adam's numbers for his career. .347, 295 homeruns and 716 driven in. in three of these years in cincinnati, over a hundred rbis in 2004 and 5 and 2007. rob, when you think about 46, 40, 40, 40, 32, his homerun years -- >> rob: in arizona it was 40 last year. so, he has five straight seasons with 40 or more homeruns and he is tied with only babe ruth for the most consecutive years. if he gets 40 this year he is all by himself. >> johnny: and he draws a lot of walks and he has one there. >> rob: lifetime on base percentage this year of .381 which is very impressive. >> johnny: l

age when he killed someone or a group of people. there is enothinthere's nothinge constitution that says that. they found some foreign law to make an argument about what the constitution says about what age a state can set for a death penalty. i know we can disagree on what the age should be, but it's a legislative matter. the court in that case said it was looking to -- quote -- "evolving standard of decency that marked the progress of a maturing society" -- close quote. what kind of standard is that for a law? where do you find what the maturing society now believes? do you check with china? do you check with iran? or maybe france? i mean, where do we do this? how do they define what this all is? the court concluded that the death penalty violated the eighth amendment, which prohibits cruel and unusual punishment when there are at least six or more references in the constitution itself. the capital crimes, to not taking life without due process, it's always been contemplated in the constitution that the death penalty is not cruel and unusual. that was for drawing such matters as@@@@@@@ h @ @ @ @ @ t is the authority and power will be diminished. yet this is precisely what was advocated by judge sotomayor who says those that do this will bring together by laws