but the underlying issue remains the a.m.a. ow represents fewer than half of american practicing physicians. and increasingly physicians that identify themselves not just as doctors but as cardiologist, family practitioners, and that's the vehicles through which they participate in the political process. host: and what's your view on that? do they have too much power, enough power? guest: i think -- i think on economic issues they behave exactly like every other recipient of -- professional recipient of government payment. i any over the last decade or so the government has both in the congress and in the executive branch has done a much better job of engaging physicians in decisionmaking and those areas where you most need physicians and where the process could most benefit from them in making decisions about ways to improve the quality of health care, increasing patient safety, developing new technologies, which ones ought to be paid for and which ones shouldn't and so on and so forth. i think there's an indispenseable role fo

but the underlying issue remains the a.m.a. presents fewer than half of american practicing physicians. and increasingly physicians that identify themselves not just as doctors but as cardiologist, family practitioners, and that's the vehicles through which they participate in the political process. host: and what's your view on that? do they have too much power, enough power? guest: i think -- i think on economic issues they behave exactly like every other recipient of -- professional recipient of government payment. i any over the last decade or so the government has both in the congress and in the executive branch has done a much better job of engaging physicians in decisionmaking and those areas where you most need physicians and where the process could most benefit from them in making decisions about ways to improve the quality of health care, increasing patient safety, developing new technologies, which ones ought to be paid for and which ones shouldn't and so on and so forth. i think there's an indispenseable role for phy

. >> the a.m.a. says doctors don't benefit that much. medicare's reimbursement for an amputation, $750 to $1,500. it says the entire cost of the amputation, including hospitalization, and these ya and other fees could come to $30,000, bret. bret: what about the president's promise that healthcare reforms won't add to the budget deficit. >> it is extremely difficult to project the cost of government programs out over a long period of time. medicare, for example, 25 years after congress created it, was costing ten times the original projection. administration officials say we will simply have to live within the budget for whatever healthcare reform plan is adopted. take the prescription drug benefit former president bush signed into law in 2003. two years later, it had doubled the rate of increase in medicare's overall cost and is so popular congress won't trim it. bret: wendell, we will continue to fact check. thank you very much. he has already admitted to an adult are russ affair and now john edwards is ready to come clean on a related s

the a.m.a. has endorsed the house health reform legislation but in many cases they have not. the nurses association is onboard and the pharmaceutical industry is still onboard but it will basically cancel that support, bret, if the white house takes back a deal limiting reductions in future benefits through drugmakers to $80 billion. if that changes, the deal is off. bret: and doctors and nurses say that those groups don't represent every doctor and nurse out there. >> not in every case, certainly not. bret: thank you, major. the g.o.p. senator trying to work with democrats on healthcare reform didn't get much encouragement today during his town hall session. carl cameron is live in ewe dam, iowa where senator chuck ghastly is holding his second meeting today. >> is the third meeting of the day and it has been overflow crowds an agitated iowans. they have all come to talk to chuck ghastly because he is the top republican among three, the lone republicans still negotiating with democrats to pass some sort of healthcare reform. >> how am i going to trust you people to do the ri

but the underlying issue remains the a.m.a. w represents fewer than half of american practicing physicians. and increasingly physicians that identify themselves not just as doctors but as cardiologist, family practitioners, and that's the vehicles through which they participate in the political process. host: and what's your view on that? do they have too much power, enough power? guest: i think -- i think on economic issues they behave exactly like every other recipient of -- professional recipient of government payment. i any over the last decade or so the government has both in the congress and in the executive branch has done a much better job of engaging physicians in decisionmaking and those areas where you most need physicians and where the process could most benefit from them in making decisions about ways to improve the quality of health care, increasing patient safety, developing new technologies, which ones ought to be paid for and which ones shouldn't and so on and so forth. i think there's an indispenseable role for

i think the a.m.a. found that 94% of metro areas face the same problem where the private health insurance market is dominated by one insurer that doesn't allow that choice in competition. >> president mubarak. can you say you how the president raised human rights? >> i didn't talk to dennis and those guys about the other topics. >> do you think that there is a perception among some dissidents and human rights groups that this administration has downplayed that side of the relationship in pursuit of broader issues? >> i would not not agree with the premise that we have somehow swept under the rug in either this relationship or in relationships with other countries, the notion of human rights or greater democracy dem in the world. those are important foreign policy goals that are in the national interests of this country. and we will continue to pursue those as well as issues relating to comprehensive middle east peace. >> in one of the factors that judges have september -- accepted the luckabee defendant

. >> backing the president's plans are the unions, drug companies, hospitals, and doctors, the a.m.a.what does health insurance reform really mean? quality affordable care you can count on. >> former republican speaker newt gingrich. >> the president is not proud to have all these big lobbyists supporting his campaign. >> you will have government bureaucrat taking away your choices. >> not true, says barack obama. >> because we are getting close, the fight is very fierce. >> the president is out in front today in the fight for hearts and minds with health care. >> he holds another town hall tomorrow in colorado. president obama's goal is to convince americans that health care reform is both urgent and do-able. and to counter critics' calls to slow down. nbc news washington. >> governor martin o'malley's public call to cut spending was answered by people all across maryland and the governor released those responses yesterday. here's a sample -- one person says eliminate the use ever front license plates. close state buildings on fridays. put a fat tax on cakes, cannedies, red meat. leg

well, the fact is, and the president said to the a.m.a., cancer, heart disease, stroke, diabetes beatevent all. so many are linked to unknown causes. 5% of patients need 50% of health care resources and, sean, that is not go to go change as long as we look after the sick. and that's what families really have to be aware of. and these bills, these are health care for the healthy. but when you're sick, it's not going to be there. sean: when you need it. i was very impressed, ladies and gentlemen, unlike your congressman or senator, someone actually read a bill before it happens. this is a nightmare and calling it "universal nightmare." thanks for being with us. we have a final update on our two patients and how the outcome of their cases would have differed in an obama-stylehat dt most for headaches. for arthritis pain... in your hands... knees... and back. for little bodies with fevers.. and big bodies on high blood pressure medicine. tylenol works with your body... in a way other pain relievers don't... so you feel better... knowing doctors recommend tylenol... more than any other bra

president's plans are some strange bed fellows, a big union, drug companies, hospitals, and doctors, the a.m.a this new ad -- >> what does health care mean? quality affordable health care you can count on. >> newt gingrich. >> i think the president who campaigned so aggressively against lobbyists is so proud to have lobbyists supporting his program. >> you will put up with government bureaucrats getting between you and your doctor. >> not true, says barack obama. >> because we are getting delose, the fight is getting fierce -- close, the fice is getting fierce. >> the president out in front for the heart and minds of health care reform. president obama's goal is to convince americans that health care reform is both urnlent and do-able and to counter critics' calls to slow down. steve handelsman. >> governor o'malley called for responses to cut the budget. here's examples -- eliminate the use of the front license plate. put a "fat tax" on cakes, candies, and red meat. set up a lottery ticket that channels funds to the state retirement system and put in a toll at the i-83 maryland-pennsylvania l

well, the fact is, and the president said to the a.m.a., cancer, heart disease, stroke, diabetes beate all prevent all. so many are linked to unknown causes. 5% of patients need 50% of health care resources and, sean, that is not go to go change as long as we look after the sick. and that's what families really have to be aware of. and these bills, these are health care for the healthy. but when you're sick, it's not going to be there. sean: when you need it. i was very impressed, ladies and gentlemen, unlike your congressman or senator, someone actually read a bill before it happens. this is a nightmare and calling it "universal nightmare." thanks for being with us. we have a final update on our two patients and how the outcome of their cases would have of their cases would have differed in an obama-style grill: holy moly!!! what just hap...whoa! grill: i mean...wow! hey! that looks great. grill: and there's no need to discuss it further. in fact, you can buff most of that out. just give it a once-over with a wet paper towel...hee, hee grill: ok, good talking to you... anncr: acciden

the a.m.a., which was opposed to medicare back in 1965. this time, it's on board in support of this legislation. and if you look at some of the other hate media people are seeing on television, you see people on board. at the same time, you've got a lot of misinformation coming out of far right wing radio, talk radio, and other outlets. we need to make sure we get the message out there. and we're confident that the american people will support this legislation, and we're doing to make sure that health care reform cousin not get swift voted in the month of august. >> i would only add that i was counting on you all. i was hoping that you you, as supporters of the truth would put out the story and dispel the myth scaring seniors when the aarp is supporting the legislation. if you're a senior, you are helped by this bill, by closing the doughnut holes of prescription drugs and making medicare stronger. and if you are a small business, if you are a small business, you will receive tax credit to provide coverage for your employers. and employees.

gretchen: what's striking to me is that the a.m.a. came out in favor of this health care reform. ? that's the association of doctors. but we haven't heard a lot from actual physicians. we hear from you. but why have we not heard more from how the doctors really feel about this? >> i think that's a great point. i want to make the point that the a.m.a. only represents 17% of doctors. i'm not even sure they represent those 17%. the a.m.a. is a lobbying group. it goes to washington. it has its own agenda. i'm not sure why practicing physicians aren't speaking out more. maybe they're afraid that the i.r.s. will come after them. maybe they're too busy taking care of patients. brian: how about this? are you comfortable with the insurance company deciding what kind of care you give your patient? i know you're not. >> i'm not comfortable with that either. that's another thing. i don't like the idea that we're demonizing everything. we're demonizing insurance companies. the government doesn't do a much better job with that. i don't like dealing with the insurance companies, but at least the

and i think the a.m.a. is -- actually years ago sort of crossed the line. >> jim coal, a month or two back, president obama had some hospital executives in and they broadcast that they were going to save $155 billion. what was your reaction to that? >> well, as i said, i think it's achievable, frankly. but it's got to be done in a responsible way where those hospitals that had done a good job of controlling costs and providing high caught resident penalized and that we do deal with a geographic variation and cost. the dartmouth atlas i think has dramatically documented that there are significant variation but we need to be focused on reducing the costs in the high cost areas and promoting incentives and trying to learn from the areas that have low costs and good quality. >> next call for the two guests. lois, medical professor. please go ahead. caller: good morning. i have a 73-year-old, still practicing physician in the central valley of california and i have two points. one is, i know this is a personal qu

the a.m.a. will be upset about something. the pharmaceutical industry will be upset about something. the insurance industry will not like this or that. it's, you know, a lot of money is made in this country off of sick people. and then you'll start seeing a lot more of the behind-the- scenes attacks on this legislation, in an attempt to kill it. the status quo is what would work best for these industries. >> moyers: in other words, if the industry is able to kill reform, or the democrats and the republicans can't agree on a proposal, that's what the industry really wants. >> exactly. and it happened in '93 and '94. and just about every time there has been significant legislation before congress, the industry has been able to kill it. yeah, the status quo works for them. they don't like to have any regulation forced on them or laws forced on them. they don't want to have any competition from the federal government, or any additional regulation from the federal government. they say they will accept it. but the behavior is that t

the hospitals support it, the a.m.a.upports it, big pharma sports it because they're all big-time players. sean: let me ask you -- >> it's a genuine public revolt that's taking it down. sean: are you saying that you think these grandmothers and these stay at home moms and these veterans showing up at these town halls, you're saying this isn't genuine? this isn't real? because i'm going to tell you something, we watch our ratings, we watch our web hits, you watch radio, you watch the passion, i'm telling you it's real. are you suggesting that this is orchestrated by outside forces? because if you believe that you're dead on wrong. >> no, absolutely. part of it is orchestrated by outside forces. there is lobbying group that's put together funneled money -- >> democrats have a lobbying group now. >> yes, but initially when there were folks going out there, they were going out there with talking points. now there's a groundswell -- you're laughing at this but you're part of a conservative movement that helps draft these talk

long-term costs under control, that in fact this will help address the problem of rising costs, and if the a.m.a and the nursing associations are also on board, then i think you'll have reassurance that you've got two important groups in the health care equation saying, "we don't think that our relationship with our patients is going to be hurt by that or our ability to do our job." i'm going to look for those four signals that they've got a good piece of legislation. and i think if you've got those four signals, much of the details can fall to the side because you've got a lot of reassurance going out to the public that it's not as scary as the extremes on either side would argue. >> moyers: drew altman, kathleen hall jamieson, thank you for being with me on the journal. >> thank you, bill. >> you're welcome. >> i want everybody to be as courteous and as civil to everybody else as possible. >> we won't go, we won't go! angry mob! angry mob! >> moyers: i was looking at the website newmajority.com the other day and was stopped by the question: what if we win the health care fight? what happens th

the lawyers will give you the mfn if you wrote this way, the a.m.a. u money if they wrote this way. that's the problem. steve: obviously you feel passionate about it and you were in the healing business. we're going to show a little bit of congressman frank. i thought some of his responses to some of the questions were rude. let's listen to 20 seconds of it. >> trying to have a conversation with you would be like have trying to argue with a dining room table. i have no interest in doing it. >> i thought you were thoughtful people here to have a conversation. >> are you incapable of a conversation in which you talk and i talk? you have to interrupt? >> you say you don't believe it you came here believing what you want to believe. nothing i say is going have any influence. steve: ok. so, mary, there's barney yelling at the people who put him into office. do you feel that he regarded that town hall as just a joke? >> yes. yes. because when i made my point, i was walking away. and immediately he said, "we need medicare and medicaid." i said, "no, we don't.

we will have the head of the a.m.a., aarp. one of the top republicans richard shelby. know what you deal in, but we are going to deal in facts. steve: check your local listings for show times. thank you, chris wallace. brian: now for headlines. pentagon saying no timetable for the war in afghanistan. robert gates says it will take a minimum of a few years to defeat the taliban and he says it will take a lot longer than that to turn afghanistan into a stable society. as for when the u.s. troops will be needed he left that open but admitted resources are getting strained. alisyn: secretary of state clinton wrapping up her trip to africa right now finishing up a meeting with the prime minister of cape verde. yesterday she met withly bernie leaders and discussed democracy. >> there are no magic wands or i would have brought one for all of you. there are no quick fixes for countries making the transition from violent conflict to lasting peace and stability. alisyn: she toured seven african nangss to bolster diplomat ties. sdwloo the woman who tried to assassinate president

the a.m.a., which was opposed to medicare back in 1965 this time is on board in support of this legislationand i think if you look at some of the other hate media that people -- paid media, you see people are on board. you have a lot of misinformation coming out of far right-wing radio, talk radio, and other outlets, and we need to make sure we get the message out there through our members as well as threw these allied organizations that support health care reform. we are confident the american people will support the bill. we want to make sure it doesn't get swift-voted during the month of augment >> i was counting on you all. i was hoping that you as reporters of the truth would put out the story and dispel the myth, scaring seniors, as the aarp is doing. if you are a senior, you are helped by this bill, making medicare more solven and stronger. if you have a small business, you will receive tax credits to provide coverage for your employees, and this in a way that recognizes the needs of small business. if you are a person who becomes sick, many families could escape bankruptcy each year

>> i would inform you to what the president talked about in front of the a.m.a. >> it's a little hard speech. [inaudible] >> voila. that seems to be good business these days. again, i think there's at least a healthy amount of evidence that in many states that have seen caps like this you haven't necessarily seen decreases in insurance costs. bless you. i think, again, president is willing to consider any number of approaches but there have to be people on the other side of the table to respond to -- to respond to those gestures. i'm concerned i think a lot of us are, that the people in those chairs seem to be leaving more rapidly than the american people want them to. yes, ma'am. >> if you put health care aside for a minute, are there bright spots on the legislative calendar that the white house is looking forward? how is the climate change bill going from the white house's perspective right now and anything else that you've flagged? >> in all honesty i haven't heard an update on where energy legislation is in the senate. you know, obviously we've, i think, a very important date comi

scott gotleib is a doctor, a fellow at the american enterprise institute and former a.m.a. deputy commissioner and top medicare official in the last bush administration. dr. gotleib, good to see you again. welcome. >> thank you for having me. >> what does the president have wrong about this? do we expect a president to be talking about medicine? >> the achilles heel of this house bill right now is that it is congress starting to step into the regulation of the practice of medicine in a way it hasn't before. traditionally the regulation of medical practice has been left to the state to localities to mediate and this is really congress starting to regulate medical practice issues. eric: in those states an locale tizz, the board of medical examiners are exempt. it is physicians guiding other physicians towards best practices. >> that's exactly right. even if you look at end-of-life provisions that have been talked about a lot, a lot of states have laws on the books that the doctor needs to discuss end-of-life issues with patients. a lot of hospitals have rules in place requirin