back at my years, and we had public health to begin with, then we had medicare, and we also have a va program. if you look at public health, they have gone bust. if you look at the va, they put in a billion dollar computer system which was supposed to help of the veterans. well, since they put that in, it cost the veterans a ton of money because now they charge you for different types of health care and stuff. guest: can i jump in here? ernest, we have a factual disagreement. i think the facts show that both the cases you raised are quite the opposite as you have betrayed them, with respect. health care in the va has constantly been cited as one of the most efficient, effective forms of health care provision in the nation, if not, the world. this is a model program. secondly, public health care -- if you are talking about medicare, if you compare overhead and you compare efficiency and compare how much of $1 of spending in that program goes to direct health care provision to patients verses the private sector, both of those programs come out way, way on top. it is one of the motivations for h

dissemination of materials in conjunction with this media program through all of the other agencies that have anything to do with health care, va, dod, medicare and medicaid programs. the second component of this allows t secretary through the directors for centers for disease control and prevention enter into a kral contract with a qualified entity for the development and operation of a federal internet website for personalized prevention planning tools. okay? so it's much like you can go right now to the mayo clinic or google. we make this available and we put it out there. so we have this personal prevention site that you can go get on. we're going all the promotion, doing all the education through this media, and this paperwork trail where we're making the information available to the agencies if they want use it and we establish an internet portal that people can go on, and we actually put together the information, we send it out, we measure it, and we give them a way to evaluate themselves. and the way we fund it, we don't bring any increase in funding. what we say is d cdc, with all your other prevention programs, this a

vas thing. unfortunately, mr. president, the underlying bill, h.r. 1256, contains no cessation program. even though the bill requires the manufacturers to pay up t to $700 million a year, it contains no cessation program. again, how can you call this a public health bill? how can you suggest that this is going to reduce the death or disease. how can you make the claim that you're going to reduce youth usage when there's no commitment, no requirement to cessation? secondly, our amendment assists current smokers who are unable and unwilling to quit by acknowledging a continuum of risk of tobacco products. exactly what i showed you here. more specifically our amendment does not preclude reduced products from entering the marketplace. this piece here, they like this end, we pull this, the 90%, to less harmful products. because the objective in this bill should be to reduce death an disease. -- and disease. there's a great debate under way in the academic world on tobacco control. some advocate abolishment of tobacco. straight abolishment is hard to achieve and can bring many unintended cons

country by and large are very supportive of the va system which is run far more cost-effectively by the way that most other hospital and medical programs you have medicare. does medicare have problems? it sure does, but the administrative costs of medicare are a fraction of what private health insurance costs are. it runs more smoothly. i think that's the goal we have is to create a simplified system, because the complexity of the current system has to do with insurance companies among other things, cherry picking saint we want to cover you because you just won the marathon and a you're 20 years of age and we are quite sure that you're not going to get sick. you're a good guy to cover. on the other hand, if you are 50 years of age and had a cancer operation, we really don't want to cover you at all because we're going to lose money on you. it becomes a very complicated process to cover you, not cover them. but we have got to say we are all in this together, we are all going to get coverage and we are going to do that delivery system in the most cost-effective way. we're going to put more money in disease prevention. were going to put m

va. on democrats line. caller: thank you very much for your leadership, governor dean. the question that i wanted to ask -- i'm always hearing the people on the right saying that medicare is a cheap program, but the reason it is cheap is the cost is paid by the government. i'm wondering, when you come up with those figures showing that medicare is less expensive than other plans, has the cost paid by the government been included? guest: absolutely, yes. who cares if the cost is paid by the government or the private sector? it is cheaper. is the argument of the republic is that we should allow it in the fishing industry to drive us into economic oblivion. we should not get around to having the government running health care because the private sector knows everything -- that is their argument. the private sector knows everything, how come our economy is not better? let's look at the best way to run health care. let's not be against the government or the private sector. the conservative or republican view is ideological. i do not care about the ideology. i just want a choice. the president does not say the private sector is bad so we have to have a government plan, or that the public secto