dr. redlener: out of kindness and respect. i am just saying that if you can't define it, how can you find it. in a sense, we're definitionally challenged and that is a big problem. let's put that aside and say that is lingering out there and something that at some level we have to deal with. i will give you the five top concerns, or five of my top concerns. first is unfortunately the federalist system that we live under in the united states. in many ways the system serves our country and its people very well. the point is that decisions affecting the lives of citizens are to the extent possible decentralized and by design, government decisions are made by levels of government as close as possible to the people being served. that is the point. if a fundamental tenet of our society and on the whole it is good. the problem is it doesn't work for disaster planning. federalism and disaster planning are essentially incompatible. because federalism doesn't allow us to create an enforceable coordinated master plan to -- or even the ab

redlener: hard to stop. >> dr. mckinney from chicago talked about coordinating activity at the local and state level and unfortunately i don't think that that is a model that has been used very effectively and other communities. at the end of the day, unless you've got everybody at the table, a small group of people at the table and then you exercise and rehearse those plans, you will end up in the same situation as you did post sandy. we have experience with those lessons. with katrina, there were lessons, but most of those were lost and not applied with sandy. so the rudimentary notion of that after each disaster you have a debrief, what has transpired, what was effective not effective, and you maintain observations from that. >> i took your point about the decision-making process to be directed, not so much at the way we operate in a crisis, but before the crisis, the government's ability to look ahead, prioritize it one threat over another, one value over another, you said education versus preparing for bioterr

dr. redlener. grande max prepared. what we are hearing here right now is we have the space of the need for innovation and the challenge status quo. we need the private sector involvement in this space in a big way, and we need to -- we need the proper incentives for the private sector to be involved in this space but we also need innovative ways to actually we make something to be able to get to the population quickly and in time. and even the postal system doesn't sound like innovation it is in this regard. we also have imposed on all of us in this whole system whether in the program in government or whether you're in the private sector trying to serve the public good in this space. you have federal acquisition regulations that inhibit private-sector collaboration and actually it becomes very risk averse to the business model of medical countermeasures development. and we need all this to be able we need innovation to drive change. we need that collaboration. do we need for any of the panel is, do we need a manhattan

redlener. this is one hour. >> thank you for accommodating our request to keep everything under schedule. we have quite a bit of ground to cover. our speaker is dr. erwin redletter. he is a professor of health policy and management at columbia university. he is also director of the national center for disaster preparedness. we will invite erwin to share -- we will invite irwin to share his thoughts with us. a pleasure of working with erwin since my days in the white house. dr. redletter, please get us the benefit of your thinking. if you would, please. i expect you can be prepared to get quite a few questions from the panel. >> looking forward to it. thank you very much. i appreciate the opportunity to be here. i have known many people in this room for quite some time. we have been through a lot of issues and struggles to gather -- struggles together, and i feel privileged to speak to all of you on the blue-ribbon studies panel. i am going to try to keep my remarks pointed and specific as i can. part of the introduction should have been that i am a person with that half into glass -- with a half empty glass. as opposed to have full. full disclos