in the finance committee, there has been more discussion. 've had a lot of meetings where we're talked about this. but the bill is not being written with republican input. republicans have not ever -- any republican input? >> republicans on the committee have never sat down and said, ok, here's what we believe about x, y, and z. we've had general conversations back and forth and democrats i think know full well what our views are. they may or may not take into account those bills. but we're not being asked to write the bill with them. the bill that the president -- that the chairman comes up with and says this is my mark, now let's amend it, will not be a bipartisan product. >> senator, just last week i was talking with some finance democrats and they insist that it will be a baucus-grassley mark meeting. the chairman and ranking member. and i'm wondering, though, are they just sort of grasping at straws here trying to grab gratsly here, maybe senator snow who sits on the finance panel and maybe a couple others? it doesn't think of me you're

the finance committee will be more moderate in the legislation it proposes. but as the chairman of the committee let slip the other day, max baucus, says this bill will be written in conference. that means that after the house has passed a bill in the senate has passed a bill, members of those committees will get together and they will decide what the bill is and will come, take-it-or-leave-it, to the house and senate. my guess is the answer to your question is it will be very liberal bill. the american people are going to have the ultimate say here. they are either going to say we do not like it, the president was right, you do it really fast or we don't know what's in it and we will like it. or, they realized they'd better get some republican, bipartisan input and then maybe we could have a bill that is bipartisan. >> i want to see if we could change topics. >> i will filibuster. >> that's exactly what i was going to ask you about. is there anything in judge sonia sotomayor's record, the nominee for supreme court, that you think would merit a filibuster on

we've done this in the finance committee. goodness knows, i don't know how many panels we have had, how many walk-throughs, how many slide presentations. boy, that's tough in the afternoon to turn lights off with senators trying to pay attention. and fact after fact after fact and suggestion after suggestion after suggestion and policy objective after policy objective on each day as we go through the legislative smock, if you will, to try to get there from here. our requests, again, i think -- i want to say it again, first, we should provide -- you should provide us with your detailed plan with enough time to read it, understand it, get feedback from our constituents back home, the people the bill will affect. the reason i said that twice is that every day we had one of these slide shows, every day we had a power point, every day we got more information, my office would send it back to the providers of health care in kansas, much in the same fashion as many members of the committee would send it to their people and say, hey, i

it was written by the finance committee and promulgated by the finance committee. i am not sure, i am not sure it went through the judiciary committee. well, two members here as well. >> mr. chairman, i just wanted to express my support for this amendment. if it were to come to a vote, i'd be strongly inclined to vote for it. i do think it's important that we accommodate our colleague senator kohl who has asked to be consulted before this whould go forward. i hope we could accomplish that in relatively short order. if it comes to the point where they can't get their arms around this in time for us. we may have to come back and vote on it. >> on an issue we would agree with. >> interoperablity and -- >> let's make that kwer. let me instruct staff to get ah i think we would all like to vote. >> mr. chairman? >> this doesn't really solve the issue of germaneness, and i do think it is important that the record show that germaneness does not apply in committee, and when i chaired this committee, we marked up the number of bills on which this issue was raised. this bill

and the same thing is true under the plan that is being talked about in the finance committee. there, a private entity is organized but again there is nothing that would prevent the private entity from, prevent the federal government from rationing care research by the private entity. the help committee creates what would-- what it calls the agency for health care research and quality in the department of health and human services. in the finance committee as i said it is a private entity but in neither case is the federal government prohibited from using this compared to the effectiveness research from rationing care and in addition to that the health committee bill establishes what is called a medical advisory council. the medical advisory council is specifically given the authority, a very broad authority to make recommendations on health benefits coverage. in other words what is covered by the federal government, and obviously when the federal government sets rules insurance companies frequently applied the same kinds of rules. you don't want the government rather than patie

clearly, these are areas that on the face would be the jurisdiction of the finance committee so if we're going to selectively choose which members get to participate in it, i think it's a little unfair to senator isakson. >> the lastx we return to live coverage here on c-span 3. >> you get a three option check in the state of georgia as to what you want end of life done and in many places, it has been established through a court precedent which is why the language in there refers to whether statutory or as recognized by the courts of the state. so i certainly, i'm trying to save a cost burden on medicare and improve the quality of life to the individual, not put a cost burden on the individual. >> that's exactly right. >> because of the 90 day -- i think i'm right. i stand to be corrected. but i think you're supposed to go in 90 days before your 65th birthday to register and that's at which time you get your package of information on part b and the other options, and then you enroll. >> but see, that takes me to my question. so you got your 90 day packet and then would medicare have a st

of focusing on health care reform working under chairman baucus and ranking member grassley on the finance committee. i know other senators have been working hard at this as well. senator kennedy and senator enzi on th the "help" committee and i want to urge us to keep working very hard to work through all the complexities and moving parts of this very challenging problem. but i also want to say that i think how we discuss health care reform is very important but i'm also concerned that some voices are greeted with derision or even implicit threats that suggest they better keep quiet if they know what's good for them. tremendous amount of work has gone into the series of three finance committee roundtables and walk throughs but i'm disturbed by some reports that perhaps senators and certainly staff have urged key stakeholders in the health care reform debate to keep their mouth shut. mr. president, every american citizen has a right to petition their government. this is a right every american citizen has. and no american should be told to keep quiet on the subject of health care reform, in

committee -- this is finance, not help, not the one i'm talking about, but the finance committee and i have the privilege of serving on both -- their overhaul proposal is $1.5 trillion over 10 years. according to several sources, a typical news story, the committee's timeline to redees and markup the legislation could slip open the news and senate finance committee chairman baucus said the numbers are on a bill that is two weeks old and the bill has evolved since then. the chairman indicated it is unlikely he will release it wednesday as previously estimated -- that's tomorrow -- the high score could add more credence to an insurance co-op proposal offered by senate budget committee chairman conrad as an alternative. so we don't know, is it $1.5 trillion? is it $1 trillion? we don't know. in an offhand comment that may or may not be private, but i don't think anymore anything should be private in regard to health care reform, the chairman said it was a response to senator snowe, how can we vote for this bill in committee if we don't know how much it will cost and how it will merg

let's all keep in mind that on the finance side, we have a provision in the finance bill that would provide up to $200 a year tax credits per employee for wellness and prevention programs. that's incentives. again, reducing premiums that could be an incentive. but i have a small company in des moines, iowa, employs about 200-plus people. the owner of it didn't start reducing premiums. he found that didn't work that well. he wasn't getting that much reduction. but what he did is he just built a gym on to his workplace. and he hired a full-time trainer/nutritionist. he went to iowa state. i don't know why i wanted to add that. but then, he said to his employees, okay, this is all voluntary. i want to get you all into a smoking cessation program. and i may be a little off here. i can't remember it. but like if you sign up with our less absenteeism. he runs two shifts a day, two eight-hour shifts. it used to be that, boy, when the first shift finished for the last half hour you didn't get any work. people rushing for the doors. now he said people hang around. they take care of their equipment.

what i would say, the finance committee under senator baucus has been putting forward white papers that provide indications of where they are intending to go. for those who are interested in the major condor's of reform, i would refer you to those white papers with regard to the finance committee, but you are right that the next month or 2 is going to be where you are going to see the reform packages coming together. >> alice? >> peter, as you know, there is a long history of congressional resistance to doing things like competitive bidding on durable medical the claimant or things that medpac recommended have gone nowhere. is there a new mood on capitol hill, a different understanding of the necessity of doing some of these cost savings things? >> yes. let me answer that in 2 ways. yes, there's widespread appreciation that the reform must be at least deficit neutral and contain costs savings and there is a surprising recognition, a significant recognition that a change in the process would be beneficial. senator baucus has spoken about the fact that he doesn't feel, both because of und

ranking member on the health, education, labor and pensions committee and in my service on the senate finance committee and in my service on the budget committee i have been working to facilitate a constructive dialogue with my colleagues on both committees. i've also met with the president and administration officials on numerous occasions so we could chair ideas on how to best craft a strong, bipartisan bill. as the debate on health care reform proceeds i top to stand ready to work on this critical issue. this is likely to be the most important legislation that we will ever work on as members of the senate. no matter how terms we serve. how well we handle this crucial issue will have an impact not just today but for many tomorrows and countless years to come. if we fail to provide the change that's needed, it may be a long time before the senate will ever try to do this again. i'm convinced we have a perfect storm before us as we face this issue. the time is right. the political winds are with us. and we have the support and encouragement of the current administration and the people of the

the speakers include senate finance committee chairman max baucus and white house budget director peter orszag. from the brookings institution this is about an hour. >> [inaudible conversations] >> good morning everyone, i would like to welcome new to this brookings institute this morning, im mark mcclellan, director of the engelberg center for health care reform at brookings and on behalf of bob and the hamilton project we would like to welcome you to today's events on one of the key issues of health care reform. implementing comparative effectiveness research here and we're delighted to have such distinguished participants to discuss this issue and that, of course, includes all of you here, in the overflow room and i know we have a lot of participants, as well. comparative effectiveness research has vaulted to the front lines of the health care reform debate and as you'll hear from some of our upcoming speakers it could even be a game changer come a key part of bending the health care cost curve and comparative americaness research is moving toward. the american recovery and reinvestm

clearly, these are areas that on the face would be the jurisdiction of the finance committee so if we're going to selectively choose which members get to participate in it, i think it's a little unfair to senator isakson. >> the last let's take a braque -- let's take a break and we will come back to it. >> there has to be made somewhere near here. -- there has to be somewhere near here. let me turn to my colleague from georgia for any comments on this latest proposal. >> mr. chairman, as i understand it, there has been a proposal to move this consideration to the long term care section in the legislation, which i was in the walk-through when we were going through that provision the other day, and that is an opt out position. i have some interesting numbers for you. medicare estimates that 44% of americans do not have an advance directive and 37% have never considered it. if you take those numbers, those are pretty large numbers. i get to go into medicare this year and sign up, and during the process of that, you have options on a and b and d. it seems like to me that this is a way of ens

. >> this is with the finance committee. this is a representation of what the president said, i want to make certain that this means that the president is there for the questioning and the benefits. >> the leader of the finance committee said, yesterday, he considers this a good option, to provide the financing that may not currently exist. and he said in public yesterday, this is an issue that has been revealed in a briefing. >> he also said this one week ago and i was asked about that then. >> your information may be better than mine on this. >> iran for the presidency a few years ago, and was not a member of many committees, this is a process that you saw, the letter that was based on the principles, it would like to see health care reform and he will watch what is happening on capitol hill. >> i want to make sure if he is interpreting the president's position on this issue? >> this will be answered in the preceding week's from this podium. the president will watch what happens and we will know as soon as this is closer to

the finance committee has spent many hours, many days, weeks, months laying the groundwork. you have 12 hearings last year all day summit at the library of congress we held three round table discussions outlining options for reform. totally inclusive, totally bipartisan. i've never participated in a more inclusive endeavor in my life. we can to one funnel agreement that something must be done. in 2008 america spent 2.4 trillion in healthcare. that's one-sixth of our economy. yet we ranked last in major industrial nations on the health systems performance which ranks the number of deaths that could be prevented before age 75 through effective healthcare. last, the united states ranked last. some analysts estimate that as much as 30% of our spending is for ineffective redundant or inappropriate care. that's care that does nothing to improve the health of americans. our system leaves nearly 50 million americans without health insurance, 25 million more with inadequate coverage and most bankruptciess in america are related to medical costs. our system needs reform. if we fail to

with backing from the treasury, talf provides loans to investors to finance chair purchases of highly rated asset backed securities with the securities themselves as collateral for the loans. and backing was from the treasury, so the tarp funding was instrumental in our ability to be able to do that. as conditions evolved, we modified the facility along multiple dimensions, even before it began its operations in the beginning of april. the first markets targeted by the facility were those for securities backed by relatively simple assets. the securities were familiar to market participants and their pricing was relatively straightforward. then we moved onto more complex and long-lived instruments. initially the only eligible securities were those backed by newly and recently activated auto credit card and student loans and small business loans guaranteed by the small business administration. in april other securities were made eligible, backed by servicing advances, leases of business equipment or vehicle this month eligibility was broadened to commercial mortgage-backed securities. w

several members on the finance committee, including myself, are working on a proposal that will empower patients and consumers, and not the government. it will not get between doctors and patients. it will not rely on denying or delaying access to care in order to keep costs down. we believe that innovation is one of the things that's made health care in america among the greatest in the world, and that's why we believe that we need to retain and protect and nurture that innovation and that quality health care and to empower patients to use a market that plays by the rules to help lower their costs. i've seen that as recently as a few weeks ago in austin, texas, when i visited with a number of employees of the whole foods company that's headquartered in austin, a grocery company, where these workers have health savings accounts, or high deductible insurance. they actually call them wellness accounts. i was told that 80% of the employees at whole foods don't have to pay any money out of pocket for health care. but since they have wellness accounts, or money that they control, they have b

conclude, i would like to say a few words about the current process of the health care reform in the senate finance committee. i said at the outset i'm committed toward working toward bipartisan health care reform. as a member of the finance committee, i've witnessed and been a part of at least foundations of such reform. there are many hurdles that remain but i want to thank chairman baucus and ranking member grassley for their very hard work on this extremely complex, difficult issue. we've never had an issue that involved as many people in this country. 100% of the people. and it's important that we get it right, take the time to get it right. member grassley has been very cooperative on it and chairman baucus has been open on it, and that's been extremely helpful. we've spent hours upon hours in that committee receiving inputs and options from both sides on how to reform our nation's health care system. it stands in great contrast to the partisan process that was unfortunately unfolded in the health, education, labor, and pensions committee that we've been tediously working through. there's bee

under the bill written by the finance committee, that is not true either. even though you may like the insurance you have today and say that the federal government cannot tell me what care i get, it will not be too much longer before that will not be true. if you will have the government insurance and it will tell me what kind of care it can give you. when we talk about the fact that we are eager for adults reform, we're talking about people being able to keep their current coverage. it is portable when you leave one job and go to another job. to make sure that you cannot be denied care because you have a pre-existing condition. if you need financial help to find a way of providing the financial help, we believe that those are better solutions to making sure that everyone is insured and providing a public auction. it is a little bit like the government taking over general motors. it is one thing if the people running general motors make a mistake. it is usually not going to be a life or death situation. it is a whole new ball game if the government decides t

some of that is also in the finance committee. so it's -- it's clinical. it's schools, it's workplace and it's communities. the trust for americans' health did a great study and they came out with it last year showing that small investments in community wellness programs had an immediate payback, an immediate payback in the first and second years afterward. you didn't have to wait 10 or 20 years. they had immediate paybacks and so we had to think about the whole spectrum from early childhood through schools and workplaces through communities and clinical basis for settings and prevention and wellness. when i say that i might also mention that we can't forget about two other aspects of this. one is oral healthcare and making sure that our kids have good preventive health care in terms of oral health. we all remember the story, barbara, the young boy in your state that because he didn't get oral care got an infection and died from it simply for the lack of preventive care for a young boy on oral health care, and then the other great one is mental health. we h

prevention, better quality, information technology and rooting out ways, fraud and abuse and of the financeommittee has ever to do another part and will get to that and we will all get to that but this bill to the law to reduce costs and the way that we can on our jurisdiction. secondly is affordable health choice and preserves a choice. if you like you're doctor in your health insurance company you can keep its. if you don't like it and don't have insurance is our obligation to help. it. thirdly, the affordable health choice act ensures quality, affordable care. we know the numbers. by one estimate by 2025 at our system will cost us $7 trillion from where and is now at about two and half are close to two and have. next we're going to build on the system have, no reason to dismantle the system we have but we do have to build it. senator brown's and we have to fix what is broken in keeping works. we will protect the doctor patient relationship. and we will at long last for tricia urban and other people cover pre-existing conditions. unfortunately for her it is far too late because of her los

the senate finance committee will do that. the ways and means committee will have to weigh in as well. host: the story in "the wall street journal" looking at payment for these kinds of things, looking at benefits and whether they will be taxed or not. guest: we all talk about the public plan and how controversial that is. this is another hugely controversial topic, taxing health benefits. max baucus, the senate finance committee chairman, sees it as the largest pot of money that congress can go to to fund a health-care overhaul. but it will stiff -- but it will face stiff opposition from unions to do not want to see health benefits taxed. they see their members as taking a big hit. the president campaigned against this, so it puts him in a sticky position politically. a lot of land mines there. but with max baucus being so -- he is almost an unequivocal when he talks about it that i think we should expect to see some form of benefits being taxed, at least coming out of his committee. host: you talk about amendments to these bi

so, we hear that the finance committee, as i mentioned, is in such disarray over the cost in policies in their bill, they postponed their consideration until after the 4th of july break. they obviously don't have their policies together enough to move forward. it appears to me from service on the health committee that it does not either. i think the only reasonable thing to do is to go back to the drawing board. let's go back to the beginning. let's sit down together and work out a reasonable proposal that we can go to the american people that says that we will provide them with affordable and available health care. every american knows that costs are out of control. everybody knows there needs to be reform. but we will do so without a government takeover of america's health care system. madam president, i yield the floor. the presiding officer: the senator from iowa. the clerk will call the roll. quorum call: the presiding officer: the senator from iowa. mr. harkin: madam president, i ask further proceedings under the quorum call be dispensed with. the presiding officer: without obje

going through what needed to take place in the absence of this, on top of the financing difficulties. this will be smaller. throughout the entire time of distress, we have been thinking about the spillover effect, where the state and local governments are impacted not through the fault of their own, but because of financing that puts them at unnecessary risk, to the extent of something -- that something more orderly could be engineered, through a transition period this has been the goal. >> this goes back to the national forum. bernanke made a statement about fiscal discipline. and the role that the deficits may play in the future in terms of inflation. a warning shot to congress to thing beyond the current recession. there are many questions about how badly the current deficit problems could influence the inflation pressure, how much will they complicate the job at the federal reserve, and what will be the interaction. what will be the issue of monitoring against fiscal stimulus? this is not just your strategy, but the fiscal strategy as well. >> this is a difficult time for everybod

the finance committee is talking about a smaller expansion of coverage. so imagine a senator going home to the state of tennessee -- won't be me because i've already had the privilege of being governor. but say if one went back to be governor of tennessee, what would we find if we passed the kennedy bill as it's now proposed? we would find a bill by 2015 of $1.2 billion in today's dollars, and where would the governor get the money? well, when one governor proposed a 4% state income tax in tennessee in 2004, a 4% income tax would bring in 400 million new dollars. we need $1.2 billion under the kennedy bill to pay for the expansion of medicaid. so to raise nearly $1.2 billion, a new state income tax of more than 10% would be needed if all other services were held flat. and the governor has already said that most state functions will see a decrease in funding after the stimulus money goes away. this same problem would be true for all states, madam president. the national governors association says that if we assumed that all individuals under 150% of poverty

is it justified the chairman of the finance committee described it as being on life-support speech to a discussion, of course, about the trades. a call. an idea being floated in the house. payroll tax to help fund this. also the session, primarily, on capping. right now they don't play any tax. and it's that is a lot of lost federal income. so the senate has been looking at that, but that brews coupled with union groups and democrats. would you picked relates to how much you can get, and it would be a big change on how employees get their health care. they could set the exclusion fairly high, but over time as health insurance costs increase the have to look at that. that is one of the most controversial elements. >>host: will congress be able to keep up with the time line? >>guest: you have covered capitol hill. max baucus said previously that the bill would come out this week. mark up would be next week. he said earlier in the week we will have them marked which they are ready. they can say how much that bill will cost. trying very, very hard to get the public to support that panel.

we will take the conceptual bill out of the finance committee in the legislative product interactive. >> there is some question as to what the floor processes. >> i agree. is a said earlier, i can't think of another piece of legislation that any of us are going to work on our have worked on as important as this, so this is one where i think is going to be important that every member of this body feels as though they have got more they fear an ample opportunity to be heard. to make sure that we represent a quarter of the united states senate around this table, and i want to make sure everybody feels, whatever the outcome is to get to this process they felt they had a fair opportunity to be heard on this committee. i know senator committee would want that in his place i'm going to try to achieve that goal as well. >> mr. chairman? kristoff i appreciate your willingness to be flexible, relative to the way these amendments are brought forward. i do have to liability-- i don't wish to waive the right. at fae wischer i would get a shot at it on the floor i would say that is a good place to

the chairman of the finance committee indicated that his bill would be paid for, but on the health and education committee on which i serve, that's not the case. the bill's not even finished yet, and already as the senator from new hampshire pointed out, in the 5th through the 14th year -- 10 years -- it would cost $2.interest, taking the federal debt up -- it would cost $$2 trillion. let me mention an aspect of cost which is often overlooked. federal debt is certainly a problem, but as a former governor, i care about the state debt and state taxes. the states don't have printing presses. they have to balance their budgets. so if we do something up here that puts a cost on states down there, they have to raise taxes or cut some program. we know the programs they have to cut -- education, health care -- programs that are important to people in illinois and people in tennessee. well, the medicaid program in the kennedy bill that we're considering would increase medicaid by to 150% of the federal poverty level, which sounds real good until you take a look at the cost. in tennessee alone,

the senate finance committee is trying to bring the cost of the bill down to a trillion dollars or less and i understand the white house supports that as well. are you willing to make the trade-offs needed specifically in order to bring the cost down, forget about the pay force but to bring the cost down you're going to turn back the benefit package, turn back the number of people who qualify for the number of the subsidies, that's how would you bring the costs down. is that a trade-off that you are willing to make? >> i think we continue to watch what is going on as the finance committee works through this process. i would mention that the president has put a think last count of $950 billion on the table, as you're shaking your head, it's actually 950 -- >> that's not relevant to my question. my question is and how you pay for it, the you need to pay for it. >> but you did talk about a force and if you are going to talk about trimming the cost down to petroleum and i'm willing to tell you 950 billion is put on the table i think 950 billion, the trillion is a relevant part of the conver

we need a similar approach in the, as we prepare to mark up in the finance committee the health care bill to go along with areas and work in the help committee. i strongly agree with senator balk and senator grassley, we need a bipartisan bill. many democrats and republicans, we need a bipartisan bill. my fear is if we don't have a bipartisan bill we will not be successful. while there's -- most of the media coverage of the health care debate is focusing on the conflict, should we have a public plan or not? tax exclusion? what portion of our benefits should be excluded from taxation? should there be employer mandate? setting that aside, but there is huge agreement on a bunch of things that are important that are going to save money, save lives, reduce costs and provide better health care. make it possible for businesses, large and small, but especially small businesses, to get interest a purchasing pool to be able to take advantage of lower rates and better choices of benefits for their folks. moving toward chronic care. to make sure we're -- people who have diets do not have to wait

the baucus bill, we are told -- according to press results -- in the finance committee may cost $1.5 trillion over the next ten years. an independent study released yesterday says the kennedy bill may mean $4 trillion. the national government association says that medicaid itself will add a half trillion dollars to the state costs -- to the state costs over the next 10 years if reimbursement rates are increased, as they are proposed to be increased. this is on top of what the "washington post" said earlier this week is a set of proposals by the obama administration that would add nearly three times as much to the national debt over the next 10 years as we spent in all of world war ii. and this bill, mr. president, i'm sorry to say, is absolutely not a bipartisan bill. we're having a bipartisan discussion. we're all very friendly and civil to one another. chris dodd is doing a tremendous job of sitting in for senator kennedy. we all like him. but we know what a bipartisan bill is. it's when 15 or 20 of us from different sides of the aisle sit around a table and start from scratch and t

there is the financing costs which themselves are a function of the interest rate you get. if you're not deemed credit worthy, you can get a loan guarantee. you're paying top dollar for the money you are borrowing. your generation cost is going to reflect a very big chunk of financing cost. by contrast, if you have a long delay, even if you have low interest rates, your overall financing costs are also going to be quite high because you want to realize any revenue in the timeframe you would have realized without a delay. finally, there's the overall question of what the capital costs are themselves. there's a lot of unknowns here because if you don't have recent data point on what it costs to build a plant in this country with the labor force that we have today, you don't know. there's a lot of speculation and a lot of estimating s. been going on. but what is clear is that in the middle of her recession when factory costs and everything have fallen, land, labor imager, those dollars are going down. as an opportunist may look on sort of a capital, dollar to capital bases, pu

. >> [unintelligible] >> i think the finance committee is making progress. there are other committees on capitol hill that are getting comprehensive health-care reform to the floor and botin both thee and house. >> there is a lot of inaccurate information out there. >> i think you still see some that oppose taking strong action. one, they say this will hurt jobs, not produce jobs. as you saw in the president's statement today and as you have seen in the investments we have made in cleaning -- -- in clean energy to the recovery act, creating a marketplace for clean energy will create jobs. we are going to have to figure in this country -- those jobs are going to be created. there were a number of windmill's producing energy in a clean way in germany. the question is, are we going to produce those jobs that create those blades and build those turbines or are we going to import them from somewhere else? secondly, i think many opponents have used inaccurate information or make up numbers on how much a piece of legislation like this would cost the amped -- the ave

the next big example is the finance case. the court did not decide the citizens united case about hillary the movie, which was not very complimentary. it was revealing to me to note she was the antichrist. these folks wanted to publish a movie that was harshly critical of hillary clinton and wanted to distribute it and ask for it in the run-up to an electoral cycle, and the question is, should we treat that as a campaign act, but it was put on the table. the profound question of whether it should overrule prior preference filling with corporate speech in the run-up to the election, so i think the court will decide as with a couple of terms ago when john roberts nearly decided the finance question but said the table for more aggressive steps. next to there are five or six highly congressional questions were the court will continue to move to the right. i think this court can afford to be quite patient on the questions on which it is moving along, because it is very unlikely there will be any opportunity to. the court membership

we have increased this and added to the financing bank, and this is an effort to reduce some of the financing costs which, as this project continues to get more expensive, anything that will facilitate this will be important. >> what about the use of natural gas for transportation? >> absolutely. if you think about the options when it comes to, how we move the vehicles, this is only a matter of time before we find out how to get off of oil. natural gas is clearly one of the ways to do this. if we have this resource, why would we not move in this direction. >> i have one technical issue, are you going to support the zero discharge drilling, on the future lease, because there is the concern about the of the release, just talking about the future exports. more broadly, he said he wanted to consider this on the floor of the senate, and he has continued to say that he wants to conserve energy. can you tell us about the nature of this, do you understand the provision and the disparity? >> quickly on the discharge, the devil is in the details, in terms of how this is defined. this may be a very diff

the bottom up approach and i know the finance committee is going to allow that to the tax provisionsith but i think there is any value in in a top down trading the structures and the opportunity for those things to occur. also is important and it's on awful lot to expect people to make those choices when they don't know what the choices are. it is not directly related so i want to be careful about drawing to tide and analogy and one of my daughters is a very serious food allergy to the point where they are not life-threatening, sir, reading labels is something i never imagined i would do a lot of. i read every label. it is hard because a lot of it is pharmacology. there are 11 different descriptions of milk and try to understand what she can and can't have. that is not everybody in the population but it is unfortunately growing number of people to be able to have that information so she will be safe. where we got to eat, anything she does, plates and so forth very conscious. i think the idea of making sure that people can have it the possible information on the opportunity is in the

senator baucus, it is your strong leadership with the finance committee and your creativity that led o the development of this unique solution. we also support you and look forward to the next up with optimism. the bottom line, without you, we would not be here today. we offer all of our thanks to you. >> when the president issued his call for all parties to come together to address the issues of health care reform, aarp, representing over 40 million members was proud to be one of the first to step forward. when today's announcement means that struggling americans looking for help in their pocketbook just to stay healthy, to say -- who say that one of the single largest drivers of their health care cost is prescription drugs. today, americans in medicare, the doughnut hole, the gap in coverage will have their brand name drug costs cut in half. a 50% reduction in drug costs, a 50% reduction. to many americans fall into this coverage gap. they stopped taking their medications, because they cannot afford it. now they will have a new opportunity to lead a healthier life. every american wh

in this committee that has not been done and in the finance committee it has not been done. at least senator baucus has said, whoa, stop, slow down. don't think we can get to the mark up that quickly. i think that's progress. if we can slow down, maybe we can get more bipartisan support. it was my hope that by receiving this information we could better participate in the quest to ensure this every american has meaningful access to health care. because changes to the health care system, as everybody knows, has the potential to impact every single american citizen. we must ensure that we protect the best of its features when we consider changes to shore up its deficiencies. careful consideration is required. that is why we asked for more details and more time to date our request for more information have not been met. i know there are problems in trying to do that in terms of staff and trying to put that together. there's always problems. but this bill is enormous. absolutely enormous. and it's incomplete with the most controversial items being left out until tomorrow's delayed

guest: we have put hundreds of billions of dollars into the finance industry in b.c. the same greedy behavior the have always exhibited. everyone knows that greed is good, but in recent years we have seen the problems with that. to make sure that these companies are overseen -- those with exceptional assistance from the government, to make sure that they comply with what people want is what mr. feinberg will take care of. host: will he oversee all love executive pay? guest: especially those that have come back to the trough a couple of times will be under more intense scrutiny. he will take a close look and either approve or disapprove, request changes. now for other companies who have received tarp funds, they will face restrictions, probably on their top 25 earners. barack obama administration has been trying -- it is a delicate balance to marry these two various proposals to make sure that we oversee host: them is there any precedent? guest: you have seen the government step in before, but it is a step beyond what we have seen in the past with the finance industry.

the way i like to think of single payer is the most radical reform on the financing of health care while keeping the 19th century horse and buggy delivery system that riyal that is not a tenable long term strategy. one of the fundamental things we need to do with american healthcare and litmus test rican news how do they reform the financing system but also how did they reform the delivery system to make sure we control costs and improve the quality of care? one of the major problems is they keep the old payment system fee-for-service and do not encourage quality of care. fee-for-service encourages doctors to do more things, more test, more procedures, and not necessarily paid them better for quality. if you want quality and steady around the world whether the mayo clinic or cleveland clinic you will see they have coordinated care. they coordinate the doctors with the hospitals with the home health-care agencies, first pharmacies center signals that cannot be done on a fee-for-service basis that facilitates exactly against that bird but it seems to be one of the fundamental things you ne

we have to get a bill law the finance committee. we have to make sure the senate votes on this legislation, this year. frankly, this summer. not late in the fall, not in the winter, not in 2010 -- right now is the time for action. and the president, president obama, has led us on this. he has attached the same sense of urgency to this issue that i know the american people feel. now what is it about? well, it's about an act that a lot of americans are just hearing about. which goes by a very simple name, the affordable health choices act, that's the act that is presently before our committee. and it does a couple of things. it focuses on fundamentals to get at that change that should come to the status quo. first of all, it reduces costs by way of prevention. very important. we know that can reduce costs substantially. and it reduces costs by better quality in information technology. that is still hard to believe when other industries like banking and insurance and other parts of our economy have moved into the new era of technology,

it has to be merged with the finance committee bill, and it's my understanding that on the process on that they are not going to take one bill or the other for fear it would look like they were favoring one kennedy over the other committee but there would be the merging of the bill and then there is i think will 44 that allows it to come to the floor and this might be an even bigger reason for not taking one bill or the other. there are no points of order against that no matter what committees are infringed or bothered with i think we ought to go ahead and solve and they would have an opportunity on the floor to make any comments to try to make any changes the same as anybody else but it's really something critical to this piece of the bill, and i would even be willing to do the medical liability. [laughter] which public has more jurisdiction of the committee but this 1i see as being kind of intricate to be able to do the halls of i.t. peace. >> and health information technology is the very foundation to what we want to do on quality. senator coburn and i are absolutely on agreement.

the federal government according to the finance committee of my pay for all that i remember a pays about there is one plan 6 million to increase so then pay for all that for the first three or four of five years. sounds good. let's said that. if we pay medicaid providers 110% and pay doctors at the rate of it as another $600 million in tennessee. remember that medicated doctors get paid about 70% of what medicare pays doctors, that is nationally and medicare nationally pays about 80 percent of what private people pay so you can imagine doctors aren't overly enthusiastic about those programs so i'm now that tennessee costs up to one plan to billion dollars and that is 3.3 but then the finance committee says we will gradually quote shift back those cost of the states so here comes the fun governor of tennessee in 2015 a great big $1.2 billion cost that i didn't have before. and where i get the money? it for% increase would have raised $400 billion. that is why i say the $1.2 million cost just for the expansion of medicaid isn't in this trillion dollar estimate that we got in the congressio

there are the financing costs that are a function of the interest rate that you get. the hue are not deemed creditworthy, -- if you are not deemed creditworthy, it costs top dollar. by contrast, if you have a long delay even with low interest rates, the overall interest rates will be high because you will not realize revenue they would have without the delay. there is the overall question of what the capital costs are themselves. there are a lot of unknowns. if you do not have recent data. on what it costs to build a plant in this country with the labour force today, you do not know. there is a lot of speculation. there is a lot of estimating that has been going on. what is clear is that in the middle of a recession when the costs of everything have fallen, those numbers are going down as inopportune as it may look on the dollar to capital dollar basis, by contrast, nuclear power might beat $5,000 per kilowatt. -- might be $5,000 per kilowatt. your cost could be cheaper, especially if the fuel costs go up more for the other sources. >> we have got to compare the theor

you see a lot of capital going into the finance system. >> you were in china recently. i wonder, how worried are they about their debt in america? you mentioned that you were hoping to see that the 3% of gdp. they did not think that would be possible. >> i think that the chinese have a very sophisticated understanding of the strategy we are embarked on. they have a lot of confidence in the u.s. i think that they understand that faced with the crisis we were faced by the beginning of this year, it was necessary for us to take extraordinary action. the results were a temporary increase in borrowing as we try to get the economy back on track. that was going to be the best path to getting us to the point where our budget deficits are more sustainable and we can get out of the extraordinary interventions in the financial sector. when faced with a crisis, the conservative response is to be aggressive. that is the best way to get yourself back to where you can put your fiscal house in order. i think they recognize that. they recognize that their economic fate is very closely ti

gavel the last couple of weeks that the rules of our committee, this committee are different than the finance rules committees. the rules of this committee in order to have a markup you must have a product down one week in advance of the markup, the finance committee has no such role. thick and syrupy markup and put something down and so i was trying to get moving so we have

chairman, i just want to comment on the financing aspects. we think that everybody needs to participate in this. and we believe that there's enough money in the system to pay for health reform and to cover everybody. but those people who want to say we have to pay for reform solely out of money in the system we think are just chasing fool's gold. it is not possible to do this without additional monies. we believe we have to look outside the healthcare system to do it. even though over time the system reforms will reap substantial advantage. and additionally, and finally, this really is a way to undermine the political and the public support for reform for reasons that have been discussed here earlier. thank you. >> welcome to the committee. your microphone. >> i want to thank you for being here this afternoon. i'm here -- vice chairman and general counsel of wagman food markets. as i had the opportunity to travel around the country on behalf of the u.s. chamber of commerce, my number one issue was the accessibility of healthcare and as i would