Transcripts For CSPAN Capital News Today 20101123

and all that. media --ng the term news media or media? where are we getting information? jon stewart and "meet the press." at a certain point, as many nights as i have spent hollering at a member of the news media, a certain amount of the responsibility is out there. there is a lot of rubbernecking that goes on. do i really need to know what happened to lindsay lohan? >> let's take a break. >> there are only a few that want to watch a level of highbrow discussion. if you want to get 15 minutes of their life, there has to be something engaging about a bit. there needs to be -- i think the front page of "u.s. aid today" is a dramatic example of that. that is dramatic and it is compelling because it is his point of view. if that it simply had the publication date, people would not stop for 15 minutes out of your day to take a look at it. >> watching the interview, he asked a lot of questions about how the former president felt about things. how you feel about their not --ng w in the region wmd's how you feel about their not being wmd's. at the end of the day, they do not give you anything to use to improve the situation or get a better the next time. mark, you work with politicians and celebrities. is the line blurred between how we cover each, and from your perspective, in the last 10 or 20 years, how having shifted? >> radically, but it is the market. unless we want to be a soviet- style cultural force in this on people, the news response to what people want. just a couple of examples. a recent poll asked 19-20 years old who their most respected news source was? most answered jon word. we were doing some bi-partisan work talking about working together in a bipartisan solution to the problem. we cut the bread. aho said to me, the host turn to us and said, cut the bipartisan plan out and give us the red meat. the market is responding, too. a couple of non problems aren't popping up with serious journalism where people can get the news that they want. but we need to kept -- quit the trade about the notion that some of the networks saying that this is really is. what we bring in some of this stuff, unfair and unbalanced, and tell like it is, and then brand -- and i am saying that for all. i am not relating that to one side of the argument. >> you're not just talking about talks. >> know, all media. cnn is withering on the vine. some more news, but they should just call of whatever they want to college, editorial from the news perspective. [unintelligible] >> quit calling a news! >> is essentially dividing opinion from news. >> that is not necessarily the tradition of american journalism. their paper that identified with political parties. to me, there is often a false dichotomy between opinion and news. having worked for "mother jones" and "the nation," they have values but are still accurate. that is one of the things that the standards of the hardest to maintain. no one cares about up by us at fox -- a bias at fox or msn bcf the stories were accurate. -- or msnbc if the stories were accurate. dan, if you had clients who are struggling to get messages out sometimes in times of crisis. do you have more immediate choices now? is it harder to get a message out? >> for those that have always had to rely upon others to get their message out outlooks with much more opportunity. i talked to a lot of companies now, the employees have access to facebook and twitter to discuss the values of the companies. if they like where they are working, they will let people know. i think that there are more opportunities now for them when it comes to that. from a political standpoint, she is right. how the consumer, -- this oil reparation, we do not have to tune in at 10:00 a.m. on sunday morning. we can download it and consume it when we want. my. what i see is that those who are politically inclined are using this new found luxury to go to places that only reinforced their arguments, so if i have to go to a conservative-leaning side, or other and you have to run their ticket to talking points, and then you are armed with the points of the day because you have access to all the people who think just like you. and they can articulate a better the new. >> mark says that that is fair. you give people what they want. >> as we know from the ratings, they are going there. >> i think the consumer likes it. but for our politics, it contributes to the systemic partisanship that we're seeing. >> someone sent me a message from twitter and said, i never watch this, how did you have someone like that on meet the press? that as part of the reason not to watch the show because you disagree with someone's opinion. before, people would of from something that the tv set and never reached you. true.s just not >> the media has always been problematic. >> but the first televised debate -- you think people went on because they wanted to understand the difference between two presidential candidates? no, they went on for the what happens next factor? rarely did they tune into the debate because that would give a clear understanding of the process. i am telling you, they are waiting for the crash. go back to 1992. but it will win on at all. happy for people to walk away saying that this is some new crisis. it is not a new crisis. it is about our role is to ship between citizen and information. >> let us bring our ratings down for a second and ask joe. >> i always bring ratings down. judy and i always ask him about global warming. to my mind and a scientist, it is very serious. we're not doing anything about it. the last election put more climate deniers into congress than there were previously. looking at the media, think of it as an example of a serious issue, one that president bush agreed upon. i do not think that he did what he should have come but the bipartisanness about this serious issue, look at what the people focused on, the horserace or linsey lohan, what do you do in your office to work on that issue? >> part of the problem is that we're going have to redefine our terms. news used to be controlled by a few people for the public good. you could only turn four channels. remember, if you grew up in all -- if you were born in the last 20 years, it you did that had access to papers outside your home town. you might get the "new york times" or "the wall street journal." and now we have moved around -- away from this idea that a select few will make decisions for us. it is just content. politicians are just creating content the same way people do with the real housewife's of beverly hills. and you sit at home and you have amazing abilities to program your own information day. i won a little of this, i want all little of that. that is how you do it. >> look at global warming. it was an issue that no one paid attention to until someone figured out a way to make it interesting content, which was al gore's movie. the answer and in the translation is you go through these periods when it is not working. the way you will do it is the successful politician or advocates an activist are going to be those who create content that will give the impetus to supply the port or change. the global warming debate is an example. we have not build something to push that through. until we do, we will not get anywhere. >> being at "politico," you have been there for a while. we have been through the 2010 cycle. we're looking at the 2012 cycle. qc anything changing in terms of political media -- do you see anything changing in terms of political media? >> i think it is definitely change in the past couple of years. political news is captured in real time. the notion of news of news on your driveway is gone. i don't think it is unique to political news. fragmentation is happening, not just across media, but across everything in our society. choose your metaphor -- but you define what you will consume or listen to when you wanted. what people now have -- if they have gardening, they have a gardening or whether or sports. it is not just us, it is across the board. consumers have more power to get what it is that they want. this is well beyond that. >> let me ask you and mark about the issue of speed. one thing that depresses me is that information comes and goes rather quickly these days. stories break at 10:00 a.m., they are in cable within two hours, they are refrigerated by the nighttime, and the next day, it is like it was weeks ago. how many people followed twitter? every time you had somebody to your twitter feet, it makes her twitter feet go faster. -- your twitter feed go faster. and you tend to add. this was the political battle, to get things faster. i am old enough to remember the day when heat used to be able to think for a day or two about something before writing or reporting it. and for a week, sometimes long for the week, people were responding consider it. and then the next thing would happen, but now it seems everything is so compacted. >> it is a false choice, david. when it comes to breaking news, certainly it happens in real time and we consume over -- consume it and chew over an hour later. the sort of pieces that can penetrate and take weeks or months to put together, i just think that just because there is now a platform where you can get something real time, if you get that quality journalism is necessarily a thing of the past. think about some of the pieces that came out about the obama white house, and sort of the pre mortem before the election, all long, thorough reporting, 2000 words about the obama white house, the challenges of what they've done wrong, an hour with the president in the oval office. that peace had staying power and was referred to again and again and again. it was not a pop in the wind. i would dispute the notion that we're only in the world now of 300 words and then you work on. >> i just think there may be fewer than they used to pay and a transmission belt is getting faster and faster. >> i have had a spending debate with my wife of the last 24 hours about this. i think this proliferation of new media, while messy like democracy, it is starting to give us -- for people seeking information, campaigns are compelled to provide. deep information on policy because people can get to it. if you are responsible campaign you have an obligation to provide that. in a lot of ways, it had a lot of good impact. my wife feels strongly that you do not need information 30 times a day. and you do not have time to reflect or get any deep meaning unless you stand back and reflect on it. i think our families reflect the debate. >> it is interesting that it takes two to tango. . not just the press but people like dan and mark and me have a role to play in that. we have a conversation about our expectation in journalism. we want to flip the switch to get coverage whenever we do it. or do we become a stakeholder in the conversation? are we taking time when there is no coverage, to make sure that they have all the facts that we have? so that when we do engage and have to understand the context of something, they have a right. they cannot do it right themselves. we have a responsibility on our side to maintain that part of the relationship. >> you are compelled now, given the subtleties you're talking about, you post frequently throughout the day, and i remember you sitting down, you had the posted 10:00 a.m. and four or five times? you're compelled to do little bites, multiple times a day. does that allow you time to do long format investigation? >> absolutely. i had a blog for two years. i found times to do the longer pieces. i still blog occasionally now. it is not an either/or, mark. i also step back into a more comprehensive peace about some democratic friends you're seeing in politics. >> i think there are two sides to that issue. i agree with jonathan and mother jones, but we're totally schizophrenic. we have a bimonthly magazine in a 247 website. we have to do both at the same time i have some concern about the diversion of resources to the fierce urgency of nell. -- now. the other thing is the cacophony that the fierce urgency of now creates. it is not necessarily support the media to solve, but for people involved in policy debates and the citizens at large, how they absorb information and whether there is the need and the space in the time to ponder it in an effective way. i think the poor operation of hyper speed communications is making that were difficult. let me check on the time because there is no clock. i want to make sure we get to questions. it is 10 tel. time for questions! let's get some students, too. >> you talk a lot about -- >> no speeches, questions. you can preface your question with a short remark. to give you talked a lot about the vast amount of news and a global spectrum. what you did not talk about is the accountability, how much misinformation is there. how can restore accountability to what is out there? i didn't i was when ask you because you are the big market guide. >> i think it will take time what we are experiencing now are so much on government, we are increasingly getting that information in their consequences of that. amazingt amassing -- where we have stories that have a legitimate bylined but they're completely fabricated, whatever might be. i think that over time, people will get inoculated and began to demand accountability and they will look for sources that they know is honest and true, and over time, they will have multiple sources congregating into fewer. >> very optimistic. one view is that people just go to where they want. >> the danger of the blog mentality, that anyone can be ever -- a journalist, and you read in the new paper, someone else is looking at that. something it did is going on the television, there are people looking at the script making sure it is correct before you ever see it. that is gone in the block the sphere -- blogosphere. >> if you say you're locked in a room and you have to alternately watched msnbc or fox every other hour, you would go crazy. [laughter] and some of that, they cannot all be using correct, credible, verifiable information. they're telling a story that they know will appeal to people to make money. on the left and the right. and what we may get to, and this is where the promises, he mentioned espn being ahead of its time. they now have five channels. anything you want to watch. they will be smaller audiences for people who want it to% right or people that wanted verified. they want to see underneath. television footnotes. >> and by the way, for all the guff we take, we are giving readers something new, which is news. you can get opinion across the internet. but news, new information is oppressive asset -- is a precious asset in this environment. >> i can argue with you on news, you're giving content. we have to figure out how to process a better. the people used to process this for us are not around anymore. >> this is for another day or perhaps, but i have to say that when it comes to the easy to make equivalency argument between fox and msnbc, i would challenge that. i would challenge what anything glenn beck does, and anything equivalent on msnbc. >> about the questioners, i wanted to offer an alternative view about what could happen with all of the segmentation. and this is my own personal experience, and what i see in my class of students, one of the options with all of these different alternatives, but the cable and internet and everything else, is just to shut it off. i don't know of that is more or less dangerous than just choosing your news based on your political preferences. that is what i think younger people are choosing to do, to say, look, i cannot trust any of these outlaws. no one is accountable and so i am not one to watch, i'm not going to read, i am not going to vote, and i am not one to participate in this process. what he say to people that feel like they cannot trust anything that they hear or read? >> i think you make an interesting point. it is on a broader scale, actually. social media takeoff not because people costs up with their friends on a website. it is that traditional place that we go to to verify decisions, political, religion, all those pillars are now under assault in really -- in many respects. i think the news media is one of those pillars, just like politicians, they have all time low popularity themselves. they're just going to go as a friend, what are you doing? the social aspect is saying, i will go to people that i trust. i only have one facebook people that i trust. i will do what they do. it breaks down at the analysis and the research and all of that. i will go to people who are like-minded and have the same values. and whether it is the person i'm going to vote for, or the financial it bought from want to use, i'm going to go to people who would trust -- who i trust to give me good information in that regard. >> before we get terribly depressed about this. politics -- the extension span is pretty short. all of those things came together in 2008, with the youth were engaged in a campaign since not -- not since the civil rights movement and the vietnam war. we need the combination. we need people willing to tune in but we need leaders and the system where they can engage, and for better or worse, the obama presidency has not been able to engage in -- the way that the candidacy did. twoette let's ask the next questions so that we can try to get to the people on the back of a line. >> my favorite acre man growing up was walter cronkite and my favorite as an adult was tim russert. i miss them. from -- dearly. it is not afraid to challenge the person on the other side of the table from him. he was not afraid to ask a question and put them on the spot and make them uncomfortable. today what i find, instead of watching news, i am finding the what i am watching and hearing are talk shows and sound bites. one of the things i wanted to ask you is, because of the limited number of owners of media -- of one time, you could only own media -- if you own the newspaper, or television if you on television. now they own a lot of things and all of these companies, the big guys -- i am wondering how that is affecting investigating the investigative journalism? >> let's take the next question. >> i would ask a question from a global perspective on media. as the world's largest exporter of democratic ideals in media, to you think that turning public policy questions it to a spectacle more than a real discussion is going to change the way that emerging countries like india, china, and russia, and brazil in particular, approach allowing freedom of speech? >> betsy, if you want to talk about nbc news? if we are happy about that. the truth is, investigated reporting cost a lot of money. newspapers better under pressure and networks under pressure, the economic pressure find it increasingly difficult to spend that amount of money. as particularly when they do not think they're going to be big ratings or returns. it the 24/7, and getting news turned around quicker and quicker, investigative journalism, you have to spend a lot of time working on a piece. your editor is not win a seat you turning out story after story. -- is not going to see you turning out story after story. >> that is why you have places like a nonprofit organization doing investigative journalism. "mother jones" is another as well. it is hard in the profit world to justify the cost and expense. >> i think that the center for public integrity, the collective permission and will work with reporters and partner with them and help them along the way. they elect a research partner for the news organization, a cost-effective way of getting out investigative pieces. >> anyone with any thoughts on the global question? what might impact the emerging democracies? >> between 2007-and traveling the world, it is already been exported. they're just sensationalistic, if not more, and other parts of the war. if you just pick about it, just the difference between how the gulf war i was covered with no satellite television, and in 2003, and how that was in the region and around the world, whether it is able to be used here in certain countries, for them to say this is not what we want, a fascinating story. we're in a meeting with president clinton -- putin, and there were stories about steps he had taken with a premium. any has to bring a lot of complaints from india and others and this came up. president bush said, you gotta let them say what you want. gol dang it, just let them do it. >> and he said, don't you lecture me about the news. you fired that anchorman. you fired dan rather. you got him fired. you call the corporate headquarters in got him fired. and he said, if i had got him fired, i would have fired him a long time ago. i think that course is already out of the born. >> let's take two questions and keep them short. >> and young people are disillusioned with the media for many reasons discussed. since that comedians have come the new source for young people, and sat rigid satire has taken on a new town credibility. -- and satire is taken on a new- found credibility. >> where do you see the line being drawn between being an entertainer and a journalist? despite the fact that they're very popular, it's more about -- more than entertainment. it seems it's about jon ststuart. trying to bring them back to a more discourse in this country, and even though glenn beck markets itself as an entertainer, is that lange going to be blurred and do we decide where we define that line? >> it captures the rise of media figures as public personalities. getting on the field and playing in the game. think about big rallies in the past. they featured public figures. martin luther king at the time. now you're seeing the rise of media. the spokes are becoming -- i will say leaders, but their public figures of influence in the room right. media has become much more powerful and they're not just observers that are detached, but they are actual players in the game. that't know any politician could draw as many as those beck did to the mall. and look at sarah palin, someone who blurred the line between being a politician and a media figure. do you cover her as the president candidate, already beck figure? >> ordeal cover is a soap opera? -- or do you cover her as a soap opera? >> don't people getting their news or political information from the entertainment world is not new. there was a show calledlaugh-in" that became the first big source of the affirmation about the vietnam war. and the exceptions have been when they turned it upside down. that concept is not new. one of the differences is today when you journalist-turned- advocate, we're talking about specialty media or minority media. we have a huge right of minority media, which i think it's awesome. african-american leaders on radio, a lot of cities our rank traditional broadcast networks. major news outlets, but traditionally in the communities of color, the news has been brought to bear by abacuses leaders because they would be the ones that pulled it together, and that is what is happening today. >> let's get to more questions. >> why did think that comedy central has cornered the market on accountability? >> my question is about the rally also. our reaction was to is blatant attack on the media. young people are disenchanted with fox news, because part of that is that he epitomizes how we feel. >> one thing interesting about the two rallies were at the end of that day, they had no political content . we political theybeck, but then he made it sort of a religious rally. -- we thought that beck would, but then he made it sort of a religious rally. and then jon stuart's was mostly his show with a 10-minutes sermon at the end. he did not relate knowledge that there were some very significant real policy difference in how we should challenge our economic, our policy -- of foreign affairs, and we have had always trouble resolving these issues. i think that they are geniuses. they are mark twain-level of satire. but it is not their job. their job is indeed to entertain and may be engaged, but not to talk about how we deal with this conflict. at the end of the day, i thought it was an easy out for jon to make that broadside against the media. they're people on this panel and others who work hard and do care about issues and try to understand the debate. it is not always easy, and sometimes the public turns the channel. there is it npr, there is pbs, and they denied that the ratings that jon stewert gets. why is that? >> we're having a conversation here, smart people referring to jon stewert as a journalist, and he is not. colbert makes a fortune pretended to be someone else. maybe there is a future for that politics. [laughter] but you can say you get information from watching the daily show, but it is not a new show. maybe news it has to be redefined or thrown out, but the people who sit around in new york but that showed the gap -- together are very bright and funny and well informed. but they are not journalists. that and i gather news for the purpose of delivering news, they are trying to make you laugh. >> if you produce the number one sunday show -- how you feel when you hear that? i am not going to "meet the press," i am going to jon stewert. they do not feel the need to watch david gregory interviewing someone. ,hey're watching jon stewert and i assume -- tell me of fun wrong -- they feel like they're being informed by that. >> we have newspapers on campus, the new york times and others, and they go every day. they're gone. at the same time, we have the comedian who can filter out all the garbage that is a 24 hour news network. >> is he putting his own garbage on top of that? >> yes. >> you said it -- you watch this show to be entertained. you do not watch betsy's showed to be entertained. >> i do. >> as long as you're watching what is happening, you may not watch us now, but 10-year note, maybe you will. it to 10 years from now, maybe you will. >> i think that that is a positive thing. didn't that is the impact that he is having. where he is going back and forth across the line of irony for direct engagement as a news source, he is boring that line himself and what point does the end of the manual of trying to change the discourse? he is a media critic making -- playing media critic. it is interesting to watch. >> he is not controlling the debate. it is the only place you'll get your information, you have a real problem. if you are bringing texture and sometimes information, and that it is fine. as long as it is not the only place you're getting news. i get to go a lot of different places to piece together what is going on. you can do it in a customized weight, but it still requires work. to get let's take two more quick questions. >> we have talked about the rally a lot. i did not get a chance to go to it. i did not hear is anything in that. there were so many people. it was an incredible opportunity. unfortunately, what i sense -- did any of you attend the rally? were you able to get into the main area or were you outside? >>in the mosh pit? >> i manage to get access up front. >> i was not. i was just walking around talking to people. >> why did you go? >> why not? in what drew you there? did you want to be entertained? >> i went because i thought it was a good thing to do. [unintelligible] even going down, i have no idea what to expect. with a clutch of other members here, i went and met with the national organization. the thing is, the distinction that i feel, from what i was able to engage from being there, it was more an opportunity to debt issues that in so many other ways are modeled and clouded and not thoroughly discussed. like the d.c. vote -- washington, d.c. do not have representation. the amount of creativity that people would normally apply was put to a really difficult and clever sound. it was really engaging and it was unique. what i wanted to ask you in relation to that -- you make this assumption that jon stewart is trying to dictate this message, it being this controlling -- >> i do not think that we did. not mediae they are bankers. they are entertainers. jon stewart, they do journalistic pieces were they interview people. it is interesting. it has a completely different take. >> and the question is? >> politicians do not -- i do not know what your opinion is about this. >> try to get to a question. >> howdy think that individuals like me and you could require individuals representing us in congress to answer the simple questions? >> there is a question behind this. as long as it jon stewart is jon stewart. did it all the talk about the potential benefits that this could bring in to the public debate. you have pseudo journalist so if you to talk about the financial benefits that nontraditional sources bring. >> astute candidates quickly. to what degree people -- yes, i guess. to what degree does the media impose a policy agenda on politicians? you have all worked with politicians. hardest think that i have never found is to get them off their talking. . you can see that on meet the press at every week, how hard tim would push. it was very difficult. what you tell them in the locker room? >> this is the free market element. when your issue is important for the majority of americans, that is when the politician will answer the question. and when the politician -- a journalist will ask a question. i'm not saying you are right or wrong, but a matter of how many are worried about that affected their quality of life, or getting a job, and making sure the root is not leaking at school? >> want candidates decided her -- one candidate decided her approach would be to enter questions when she was the senator. >> what we are telling them in the locker room is not go to hell. [laughter] >> this is the promise of this great new media. every politician in washington, almost to a person, it does not understand the new media but is definitely a parade of it. there is no better way to get run out of office than missing the next new thing. if this is the issue and you can get 15,000 people on face big bridge on facebook to send an e- mail, the congressional office will be devoted to figure out there position on cannabis. that is the power that they had 20 years ago. it is a mess right now trying to figure out how people are going to use this and where everything will settle. a lot of people, we had people come up in a row saying, i do not watch any of you people. jon stewart i just want to jon. that is a recognition -- i just want to watch jon stewart. >> and on that note, that we do not know, we have to finish. am sorry we did not get to the final question. please thank all the panelists. i think that they're great. >> in a few moments, today's white house briefing with robert gibbs. he was asked about new airport security screening. in about an hour, an american enterprise institute form on the future of the new health-care law. the discussion on the u.s. security interest in the middle east with former national security advisor is. and later, we will be air the pat on the role of journalism in reporting and politicians. several live events to tell you about tomorrow. the american association for budget and program analysis will look at how to balance the federal budget in the future of the budget process on c-span2 at 8:45 a.m. eastern. here on c-span, a panel on the future of social security and how the system has been affected by reforms implemented in the early 1980's. that is 2:00 p.m. eastern. >> from barack obama to george washington, learn more about the nation's presidents on line at the c-span video library. biography, interviews, historical perspectives, and more. searchable and all free. it is washington your way. here are some programs c-span is airing thursday, starting at 10:00 a.m. mr.. jeff bridges talks about his work to reduce youth hundred. jane goodall on her love of nature and animals. chief justice john roberts and the role of the supreme corporate leaders, lawyers discussed the impact of retired supreme court justice john paul stevens. in the medal awarded to tony blair. that is thursday on c-span. >> white house press secretary robert gibbs was asked questions today about new airport security screening procedures. also cover reports of a new north korean nuclear facility, the new nuclear treaty with russia, and the don't ask don't tell policy. this is a little less than an hour. >> mr. feller. >> on north korea, could you give us some detail about the president's thoughts on the revelation of this new enrichment facility? let's start with that. >> i am not going to get into intelligence or anything like that. i will to say that obviously their claims, if true, contradict the pledges and commitments that they have made repeatedly to the international community. as you know, ourepresentatives are traveling in the region right now to brief our partners and our allies and coordinating a policy response to their actions. >> you said, "if true." is is still in doubt? >> i'm not going to discuss intelligence. >> all the parties involved are trying to get north korea to resolve -- to comply to the six- party process, does the white house view that this is a threat -- that this threat is deepening? >> on a separate those. i think the six-party process -- the administration believes that the six-party process can play an important role if and when the north koreans take that six-party process to move toward need glue colorization -- denuclearization seriously. we do not wish to talk simply for the sake of talking. the north koreans have to be serious about living up to their obligations, and not having done so has put the sanctions regime in place that is the strongest the country has ever faced and has greatly increased the price of their noncompliance. of their noncompliance. i think the threat is always been serious. we have certainly taken it as such and will continue to do so. that is why we went to the u.n. to get stronger sanctions on their ability to move anything out of their country that could do others harm. >> one other topic, on the controversy that emerged about the security screening process at airports. does the white house have a view about the planned protests on wednesday at airports and how that might affect both security and travel? >> i think that our tsa and mr. ritter, mr. pistole, addressed that in some interviews this morning. i would point to what the president had to say on this saturday evening in lisbon, and that is, we put in place enhanced security measures for the simple reason that for more than two decades al al qaeda and terrorists have sought to do us harm and have focused in on aviation and airplanes. we've seen the christmas day attempt by mr. abdulmutallab to blow up an airplane using a device that, at the president said, would not have and was not picked up by a simple metal detector. just in the flat -- the past few weeks alone, we've seen an effort by al qaeda in the arabian peninsula to bring down an airplane is in explosives in cargo. we must do everything that we can to protect the public. the president, as you heard him say a few days ago, in meeting with secretary napolitano and administer the stolen -- and administer the stolen -- and pistole,re our goal must be to maximize protection and security and minimize inconvenience and invasiveness. he asked them then and continues to ask those that we do all we can to protect the public and do so in a way that is least inconvenient as possible. it is not an easy task. but we know from intelligence that al qaeda seeks to do harm through aviation security, through aviation security, through devices concealed on a body inside of a device that one might take onto an airplane or in luggage that's put on an airplane. so our charge is to do all we can to protect those that travel, but also to do so in a way that is minimally invasive. that is a balance that we will continue to search for. i think what is important -- this was a process based on intelligence and based on feedback and will continue to evolve and change. that is the nature of both the threat and the response to it. so i think that -- you have been asked, will you take into account some of people's concerns or complaints based on met conditions or how they feel personally about some of this. absolutely. we seek to maximize the security and protection and minimize that invasiveness. this is a -- these are procedures that will continue to evolve. again, the charge of the tsa is to ensure that when you or i or others get onto an airplane, that we can feel reasonably assured that we can travel safely. and i think that is what the president wants most of all president wants most of all around i think if you look at what the president's charge has been in a flexible and devolving security process., this is exactly what i just told ben. there is importance on protection and to do so in a way that is the least inconvenient for those that travel. again, the policies have to evolve. when we originally, and this was years ago, with the tsa screening, you did not have to take your shoes off. x-raying issues was something that was imported. -- x-raying shoes was something that was important. walking through a metal detector, it is not going to go off, so we went to advanced imaging technology, to provide security screeners with a better opportunity to detect whether or not somebody is trying to smuggle something either concealed on themselves or concealed in what would be a normal device or in their luggage. >> what about the concerns of the senator on this issue? a political disagreement? >> well, i think as the president said on saturday, we take everyone at their word that they will do all they can to protect the country. the president spoke with the senator last week. >> was that before or after? >> after. the vice president continues to speak with people on both sides of the aisle. look, if senator kyl has questions, we are happy to meet them. that is important thing to do in this process. i think it is important, if you look at the series in range of what we have heard over the course of the weekend, from the military, from those retired in the military, who have operational roles in our nuclear security, hearing from our allies in nato and particularly our allies in eastern europe, those closest to russia and the old soviet union, in saying clearly that the revocation of this treaty is in their best interests and our best interests, and getting it done quickly, that is i think a tremendously important endorsement for those efforts in curtailing the number of deployed nuclear weapons and insuring -- ensuring an inspection regime. >> when secretary clinton was asked yesterday on cbs, she laughed and said that she would not want to. how can you ask the rest of the public to follow through on these roles when a senior administration official laughs at them and says that she would not do it -- follow through on the rules? >> i think that she also says that, look, we would all like to live in a world and exist in a place where none of this is required, but as she said, we do not have that luxury, because i have said earlier, we have known for two decades that al qaeda and terrorists of the like have sought to do harm using an aircraft, inside the realm of aviation. to avoid something like that, one should go through that screening device to get on a plane, but i think what she was saying was that we live in a world where, of course, nobody would want to -- it would be nice to live in a world where that was not necessary, but, again, just less than one year ago, we know that somebody got on an airplane with the intent of blow me up, using a device that would not have been picked and thatmetal detector, e is cause for quite a bit of security concern. >> why did it take nearly one year to put this system in place? why did not happen in february, march come april? >> there have been a series of procedures that have been phased in. we have advanced imaging technology. those are the machines. those are at many airports throughout the country. there has been a process for the construction and procurement of those machines, but it was not going to happen overnight. and, look. as the security system involved in pat-downs has evolved, as i said earlier, this is not something that started one week ago. this has been phased in. >> various officials like secretary gates talked about in reaching uranium, but they did not know about the specific facilities. is that a failure of the piss security that it took the north koreans? >> we will not be discussing the intelligence. >> nearly half of the public says they're concerned about the health risks because of the new scanners or are unsure about the health risks. is it the position that there are no health risks? >> based on studies through the fda and others, the imaging technology provides so little in terms of -- the truth is, there is greater exposure sitting on the airplane than going through those machines. >> how has the a administration failed to convince so many members of the public that there are no health risks about these scanners? scanners? >> if you have another question, let me try to find this in my paper, and i think i have something i can talk to you about on that. >> the other question i have also about the tsa is that the public does care about security. but when there is an intrusion on privacy, they want it to be targeted in justified. you watch you to come and you of is the spending great deal of time watching cable. >> may be less than you will presume, but i will take th concept. >> is it justified? >> i will say this. we are used to be understanding of a profile that looks at a range of people, for instance, you know, 18 to 35. and yet, we have seen in just the past year, we know of people the past year, we know of people who have been arrested in this country for terrorism that would not fit into the range of those ages. all right? we know specifically that they were targeting somebody who does not have the characteristics of those previously that attempted to do us harm, that they shared. we know that they are continually looking for, and i think the cargo example is a very good one, of ways in which they can take something that looks normal or a situation that appears not out of the ordinary to augment that in a way that gets passed security. what we would normally think of as these are the characteristics of what might happen, understand that we have seen no about very specific efforts to find people outside of what security might normally be conditioned to. i do not think it is an i do not think it is an accident that this one person was seeking through concealing this device on him to get on to airplane, something that was not going to be with a mal detector, to be delivered by somebody who would not normally be seen with as associate with them in an effort to get around what you'd be set up normally to look for, and i think it is important, and i will go up again to what i said. this provides the foundation for the basis of how security the basis of how security screening has to evolve, because things will be different in three to six months, because they will be trying to find different ways around what has been set up, and i think this goes back again to what secretary of state clinton said. we would love, and the president said this, there are things that agree to us when going into buildings are getting -- or getting onto airplanes, and the was a time when that did not have to exist, but we have to continue to evolve. >> you are president -- you are a parent. the president is also. there are individuals with medical conditions of and forced into humiliating situations. is this evolution? >> i think it is important to understand anybody under 12 customs of the much more modified. i would say first and foremost if the tea is the administrator would review was here, he would say this to you. was all of this done perfectly? no. if somebody feels as if they have been unduly subjected to something that they find far more invasive than a convenience and security, they should speak to the tsa representative at the airport. again, without leaning too far into this, i do not think it is of the realm of possibility that those you wish to do people harm using airplane have looked at some of the ways to explosives and devise, luggage or and devise, luggage or themselves, that we know can get around and through security, and we have to be careful about that. we are trying, and the tsa is trying. this will evolve. and, again, the evolution of the security would be done with the input of those to go through the security. i think that is important. since the more stepped up process has taken place, approximately 34 million people have been through the tsa system. i did the figure that i have seen is about 1% of those in of gone to the process have gone through the overall screening process have gone through this more stepped up procedure. >> thanks, robert. during the period from when the administrator made the comments and later, making clear that there was quite enough to be some flexibility here, whether any conversations within by anybody at the white house? >> i am sure people of the white house speak with tsa and dhs constantly on security, redoing -- on security at. -- on security. they communicated that several weeks ago. >> i am talking about between the comments. >> do i assumed that people here have constantly been in touch with them? sure. sure. >> i am asking specifically that if somebody at the white house called him and said -- >> i do not know of the conversations that happens with every person here, but if you ask with people are constantly in touch and being talked to -- i am and knowledge in that i am sure the conversations have happened, yes -- i am acknowledging that i am sure that conversations have happened. >> i am reluctant to get graphic here, but everybody knows there are theoretical possibilities, way beyond body cavities and such. how are we respond specifically -- responding specifically when there are so many other ways out there? >> again, let's make this somewhat broader. again, i think you have seen this in screening at large. we all remember that you put your things on the things that go through the x-ray machine. ecb evolution of something that is going to detect something that is metal. if you look at the evolution of security, plots, and attempts, right now, you have got shoes, liquids, again based on specific attempt using various devices to do come, and -- to do harm, and an ait, which gives you the ability to detect something that might be on someone hoping to do you harm is maybe something that is not metal. >> use of the vice president is working the telephones. if the president or anybody at a high level in the organization doing that? >> look, well, i am sure the legislators and others are discussing issues like taxes that will be dealt with in a lame duck. the president has not, other than meeting last week. yes, ma'am? >> can i just do one more proof -- one more? the millionaire's tax. they do not want to extend it. is a patriotic -- is it patriotic to pay more taxes if you are a millionaire? >> i am not going to be the spokesperson for warren buffett. [laughter] yes, i know he is slightly above the millionaire threshold. i do not necessarily have anything to add on that except, look, i think you have seen or heard from, again, using mr. warren buffett as an example, mr. buffett is someone whose marginal tax rate based on where he drives his income is, i think he said before, pays a rate that is far lesser than that of presumably his spokesperson and the secretary, the kids he derives, again, a vast majority of its income from invtments rather than from his paycheck. rather than from his paycheck. >> steny hoyer -- in light of the election earlier this month, he said in his way in possible that congress is going to approve the money about the files of the guantanamo bay detainees. >> of indifferent was said last week. talking about al qaeda -- something different was said last week. we know they were using guantanamo bay as a recruiting effort to seek those participants who want to do us harm. we are not giving up on that goal. >> it is almost two years into the president's administration, and you have not been able to close it. are you willing to commit to closing it in 2011? any way you can put any possible time frame on it? >> i think i said last week that no one expects this to be easy, but i know that the president have not given up on the goal. >> my question is about the entire record. let me tell you about why i am asking that. a complete negotiation record of the treaties, discussions, classified briefings. >> the russian? >> the russian missile defense. this is according to foreign policy. a hole with an analysis -- a whole written analysis. the briefings of state, defense, and energy. what is the posture of the white house? will they be able to accommodate that? that? i will have to look at that. we would certainly provide the documentation to them. somebody like general cartwright, on missile defense, or others at a classified level, but those are conversations that are being had currently with senators right now, so i think if there is information that we have that can help answer those questions, we would be more than happy to provide that information, those briefings, that documentation to the senator a lecture anybody else in order to demonstrate. general cartwright would say it has no effect on our ability to conduct these activities, and i think a pretty good example of that is nato agreeing to the president's approach to protect president's approach to protect europe at a meeting that saw the russians ultimately participate in, and at the same time, they and nadel are arguing for ratification of the treaty. i do not know if the senator let's talk to anybody on the national security staff year, but i do not doubt that folks will be -- hear will reach up to it rather quickly to provide information. information. >> some of refused to turn over these negotiating records. >> i am happy to ask nsc as to whether that is the case. again, i think two or three of the spokes people -- our defense posture as relates to the street, the secretary of defense, the chairman of the joint chiefs of staff, and the vice chairman of the joint chiefs of staff, and that is general cartwright, and i think all of them are spokespeople, rather than the opposite. >> you mentioned that this is among the strongest that the country has ever faced. i their concerns that these sanctions have not been strong enough? >> without getting into the timing of the facility, the sanctions that were put on north korea and hampers the ability to move product outside of the country, the state back i think some time to mid november last year. year. and, again, that was in direct response to the testing of a long-range missile in late march, early a port. i forget the exact time. i think you go back many, many years to the north koreans walking away from their obligations and six-party talks, in discussions with their neighbors and allies and the flaunting of those international standards. >> but sanctions, the last couple of years? >> i am not going to get into that intelligence, but understanding that the sanctions, based off of what the u.n. did last year -- >> and, quickly, you guys said the midterms show that the americans want the democrats and republicans to work together. given that, why not be more direct in accusing senator kyl of playing politics. the president kiner sharron -- stayed away from that. >> normally, if one side wants to do something, then the other side does not. given who you have seen in terms of alligators and supporters, that does not fit the mold of what you normally see in the politics, and we do not think it should fit that, given to those supporters are. we think there are some that can and should get done, certainly before the end of the year. >> the deficit commission. there will be hair and eye balls all over the floor. all over the floor. this is concern that some will stand in the way. >> i think we have got a ways to go before we get to what the senator describes. this is an issue that we're going to have to deal with. going to have to deal with. i think his words were that we'll understand that we did not get into a debt crisis in the last year or two years. this is something that has built up for many, many years. we have to put ourselves back on the path towards some sort of fiscal stability. fiscal stability. you've got to understand -- let me give you two answers. one, i think it is fair to say that as the threat has evolved, our screening process has had to in has evolved. i feel he can understand why you and would not want to get into the intricacies of what would be detected and how and when and because we do know that those that want to get around those procedures watch what it is we do and what we say. >> finding something in a body cavity. >> the most up-to-date threats possible. we had instituted the very best in technology and in screening efforts in order to detect that threat. >> the israelis? >> i think there are two international airports. in tel aviv. we have 450. i have watched and read the stories of can you not jealous do -- understand the scale involved is infinitely different. different. >> a couple of questions. does the president of anything planned to pick up tomorrow where they leave off? >> next week's schedule, jonathan, and do not know the process. i can go back and check. >> senatorlugar has said if this gets to the floor, it will pass. what has been gone on between president obama and vice president biden and others? >> it was a topic that came up with staff, conversations directly with the majority leader. >> is it worse for u.s. international relations to see it go to the floor and failed and to see it not go to the floor at all? >> -- van to see it not go to the floor and opera -- than to see it not go to the floor at all? >> those countries, again, i made mention of this that represent that easternmost represent that easternmost border with russia believe this has to get done as urgently as we do, and i think that is an overwhelming endorsement for why delay on this does not make a lot of sense. >> thank you. the news of the irish bailout, the shorts in the financial markets. how concerned is the present about this? >> well, look. >> well, look. we welcome irand's intention to seek the assistance and for europe to deal with the crisis that affects those countries. i do not think there is any doubt of the impact of greece on our recovery and acting quickly to deal with these problems by europeans is good news. >> do you think thi will stem the tide of problems in the euro zone could >> i am not a euro zone expert. i think addressing these causes and concerns is good. and concerns is good. >> on wednesday, the president pardons another couple of turkeys. >> i will check with counsel to see the degree of what the process is for active partners in the administration. i think that is a gubernatorial issue. yes, ma'am? >> how closely is the president monitoring the irish situation there? >> it is a topic where there was an economic daily briefing today. this has come up in the past. it has been part of the briefing. >> discussion about portugal and spain? >> i would point you more particularly to their governments on not. most of the briefings that i think the president has got are focused primarily on ireland and portugal. that is the extent that i can recall. recall. >> just one other thing. will the president bill the -- be speaking at the chamber of commerce and the next few months? >> in terms of the second part, i would certainly point you to india and the invitations from the chamber obviously. we continue to be interested in speaking with them and their members, and we will see if the schedule allows for that in the beginning of the year. they have an event that i think has been rescheduled for sometime in january. >> no response, the president learning several weeks ago and raising concerns in portugal. and the second question, -- >> horsley, i think i have been through an iat -- personally, i think i have been through an ait. i have travelled to and from atlanta a few weeks ago. >> i guess i am wondering if this is a way of showing some love to chrysler. >> this is a particular plant in kokomo that because of some of the restructuring and some of the funding for retooling and modernization is a transmission plant that was able to retain more than 1000 workers rather than seeing its plants shuttered, so we have been two and continue will go to chrysler, gm, even ford facilities, a company that did not have to receive restructuring help, but, look, i think if you look at some of these places and plants that are located throughout the country, particularly in the u.s., you'll see that kokomo is a pretty good example that is pretty dependent on those types of jobs for its economic livelihood. that is important, and we are proud of our efforts. there were more than a million people throughout the country whose jobs were saved as part of that restructuring. another part of the restriction was about making some difficult choices. we know there are some corporate restructurings, particularly, to give both of these companies pointed in the right direction. >> what specifically in terms of stimulus can the president still get out of t lame-duck congress? issue were to do list for the lame duck session getting shorter and shorter? there is less time left. >> again, we talked about about this last week. i do not think many people believe that the week it became , and we knew that this was largely held off for thanksgiving, and then we will be back again one week from today. i do not think that many people believe that many thought that this would be a time when much legislative business would be gone through. there is an organizing process on both sides of the aisle. we have got new members and senators coming in. senators coming in. >> a lot of this is focused toward january. >> i think if i am not mistaken, this is going on a week from now. this does not stymie our legislature. this is not a totally exhaustive list. my memory is not what it used to be, even from this morning. but i think there is no doubt, as you have heard said, we have issues around taxes. we're going to have to deal with issues around unemployment insurance and compensation, as well. you have heard the president make mention of starch. that is something that is crucially important to our national security. there are issues around do not ask do not tell that i think are best dealt with through a legislative process and not through a legal system. there are priorities such as the dream act. there are several things. again, i am probably be no more than i am mentioning. there is no doubt that we of plenty of work left. >> asking the pentagon to hurry up. >> i think you original date was december 1. there were some informal hearings on the survey and its results. if i am not mistaken, that started on the first. we can do this legislatively. the senate can do this. providing an avenue with which to implement the policy. it is not likely to provide the pentagon and others with a pathway for doing this. i think in order to do this in a way that the president wants to see, that is the best way to do this. >> robert, on two separate >> robert, on two separate issues, using the airlines, but what about this country's rail system? in the subway system in major cities? >> with doug getting into a lot of detail, let me say this. i think that to presume that only aviation security is a priority is not the case. there is passenger rail and cargo real. -- rail. there are many ways where we know terror can be brought into this country. this country. i think if i am recalling correctly that one plot had dealt specifically with some aspects of transportation beyond airports. we have known for quite a long period of time that this has been a focused. been a focused. >> amtrak. passenger rail. is this an administration working with amtrak to work something out? >> i do not have a lot of this stuff in front of me. we can contact both dhs and others for the regional transcontinental things. >> the midterms are over. are we expecting to hear some names to be removed? will you stand at that podium much longer? >> i will be here to answer a few more questions. i think i called on you just last week. lester? let me answer the question that has been posed to me. april. in terms of the reorganization, that is something that the chief of staff, the president, and others are continuing to work on. i do not know when any of those announcements will be made. i have spent very little time working on that. >> about one week ago, a freshman republican congressman from maryland stood up apparently in a benefit session in the house and complained about the time it would take. about the time it would take. some progressive groups have called for house members to renounce their health insurance. >> i think there is an understanding of the role health insurance place in the security of families, regardless of their economic situation. i am not going to make a blanket statement about what a congressman-elect harris would do. i think it is probably a pretty good demonstration of the fact that the rhetoric of what people say threat of political debates or in campaigns and the reality of us something like but it is is apparently quite different just in this example alone. i think he is going to have to reconcile and himself the notion of health care that is subsidized by the american people and what surrounds the. i think it presents a fairly interesting dilemma for those who have castigated that in the past. past. i would agree with you that you think that it is. >> the remaining service chiefs are on record. does the president anticipate that they will be on board once the report comes out? >> i think the service chiefs, as i understand it, are coming out in order to discuss this. the president has not yet seen this. so i do not want to presume that that would change their opinion or not. and i think it is best not to get your 04 down the road in commenting on that until we get a chance. and the president says he once military leaders to get on board. what is the purpose of this reported not to get that? >> i think the original question you asked me is will that report change their mind. i have not seen this report. this is not to say that it will not. not. this is not to say whether or not you left anonymous agreement. people of stood on this policy as long as people of wanted to. it will be important to view the attitudes, to use those attitudes to craft a pathway to implement a change of legislative process. that is what the president has advocated through this process. we may have a better sense of the to get a chance -- when we get a chance to look at that. i know the president has spoken previously with the service chiefs on this subject, and i expect that as this report is finalized and released that they will have the opportunity with the vice chair in the service chiefs as this process moves forward. thanks. [captions copyright national cable satellite corp. 2010] [captioning performed by national captioning institute] >> president obama will be touring a chrysler plant. in a few moments, an american enterprise institute on the new health-care law. in a little more than an hour, a discussion on u.s. security interests in the middle east with former national security advisers. then, a look of the role of journalism. on "washington journal" tomorrow morning, a group of republican economists opposed to the federal reserve plan to buy $600 billion of new treasury bonds. other guests include the u.s. ambassador in nato. also, a look at the contest -- "washington journal" every day at 7:00 a.m. eastern. >> this year's student camera video documentary competition is in full swing. make a five-minute to at 8- minute video. upload your video to c-span before the deadline of january 20 for your chance to win the grand prize of $5,000. for information on how to upload your video, go to the website. >> now, a forum on the future of the new health-care law in congress next year. this is a little more than one hour, hosted by the american enterprise group. >> good morning, everyone. good morning. i am arthur brooks, the president of the american enterprise institute, and we are welcome note -- welcoming you to this. good friendsby our at the national review institute, who is headed bykate, kate, and we are looking forward to a lively discussion, which i will tell you about in a minute. the discussion has obviously mandated sweeping change. the question is, what exactly is that change, and how do we execute change? it is completely obvious that change is what people ask for in the exit polls after the selection, according to the work done but edison research, and that my colleagues have analyzed here at aei, 57% said that the number one issue for the next congress was either cutting spending or lowering taxes, wrote and 3% said they were enthusiastic. 21% were satisfied. 74% of voters said they were either dissatisfied or openly angry with what was going on in the federal government. that certainly sounds like change is in order. what kind of change? people in the business community, academics, journalists are asking, what kind of change do we need? republicans and democrats to dedicated themselves to some sort of change, how do they respond to what voters wanted? what might even satisfy voters, that policy makers heard what the voters said? we are talking about three different areas. we have a panel on health care and the economy. kirsten up is a panel in tunnels health-care reform. -- entitled health-care reform. kate will be chairing. we have several guests, including one from "national review." after about one hour, we will take a break, and kate will be mistress of ceremonies today. the second one will be the economy and spending, growing and cutting, and we have panelists from aei and first trust advisers, and then to wear around out today, -- round out today, some politicians said if they would be elected, they would be guided in all actions by the u.s. constitution. what does that mean they today? what does that mean and we are talking about the budget or regulation or about taxes? frankly speaking, is that an achievable goal? panel 3 today is the constitution, and our panelists include those foraei, -- from aei and others. i should note that we have a moderator from the national review for our second panel. we hope it will be a lively discussion. thank you for coming, and i turn it over now to kate. >> thank you. we are pleased to be joining with aei to talk about these crucial issues. it is time for the policy community to make recommendations for an agenda that delivers on the promises made during the campaign. this addresses three central policy challenges. we think the primary issue is health-care reform. many believe that this imposes an unprecedented federal dictates on citizens. it is fundamental to tackling the bloated budget, entitlement reform, and we need to begin reestablishing limits on the federal government. so health-care reform is central. eight months ago tomorrow, president obama signed in nation protection and affordable care act. eight months ago, there was a motion to appeal it. the new majority in the house is expected to attempt that appeal, but there is apparently no majority appeal in the senate, and a veto would be likely. president obama noted that he was not the first president to take up the cause under sweeping health-care reform, but he was determined to be the last. they look forward to a president to will realize the cause to repeal 2013. why has the law met with such opposition? and what options are available to its critics, short of a repeal that remains unlikely? this panel will address these questions and then entertain yours. jim is going to go first. he is a public policy center here at washington. he worked of the office of management and budget from 2001 until 2004. and he presides over an indispensable website, which implementation.s following his remarks, we will hear from a practicing physician who is a fellow here-- aei. finally, ramesh ponnuru, the senior editor for "national review." is been a contributor to "times" and "of the washington post." is extremely talented. i will turned the first over to you. >> of pleasure to be here this morning. an important time to talk about what we do now but before we get to that it is important to spend a few minutes on the health care bill once more to lead the predicate for why, i would say, there is no oil avoiding the need to repeal it. and replace it with a genuine reform. the "wall street journal" wrote an editorial called "bob worst bill ever." is worth going back to that. i suspect that that is basically right or it is in the running. it is worth going back to why it is so important for the new congress to keep focus on this issue, why they cannot let what past stand, why they must muster all the effort they can, despite obvious obstacles, to move forward on building the coalition to move health care in a different direction. why is the bill so in need of repeal? it will have a devastating impact on the american economy, on this policy, on the quality of american healthcare, and on help the political discourse in the united states. we will take it from the top. the economy. so much has been said about the bill, on its insurance coverage aspect, on the new rules regarding what is covered by insurance and pre-existing conditions, etc. lost in the shuffle of the debate is it is a giant tax and spending bill. over the next decade, according to the cbo numbers, it will raise taxes by about $700 billion. this was not just an insurance regulation bill, it was a massive, massive tax hike on the american economy. it will pose a huge tax on capital income, on wages, on all manner of health sector industries. the effect will be slower growth, lower unemployment -- lower employment, and higher health care costs. it is bad for the american economy. employers will have a strong incentive to avoid hiring particularly low wage workers. if they hire low-wage worker in may and up in the subsidized system of health insurance, that will pay a fine. not so they hire of higher wage worker. this is a huge in dissented -- dissented -- disincentive. the primary problem in the federal budget is entitlements, and this would open ocean of cason that raging fire. it expands medicaid by 60 million people. medicaid is already stretched to the limit, and it is not serving the 50 million on the program very well. the network of doctors and hospitals that take care of medicaid patients is very strange. this program and this new law will put a huge number of people in the program without an ility to take care of them. the second entitlement is everyone between the income of 133,000 -- just above the poverty line and is entitled to premium discounts if they get their insurance through the exchanges. this is a huge number of people. the number people but to win this percentage is about 111 million people below the age of 65. potentially this is a massive new entitlement expansion. the cbo official estimate is en route terms 20 million, but got -- but that could be off of a magnitude of two or three. that is if the employer-based system stays intact. this would create huge in equities. we would have a massive new entitlement in the exchanges, and lots of similar workers with the same wages getting on the order of $6,000 less in federal support for their health care. you've got a huge to set librium their rigid disequilibrium their -- you have got a huge disequilibrium theiere. if that is the case, just in the first 10 years, not counting the long run, we would add $1 trillion more to the cost estimate of the bill. watch out for the headline of your to from now, cost estimate explodes. i think most americans would not be very surprised. in the state of massachusetts, what is it going to do to american healthcare, they are already going down this road. lots of costs above projections and the state is grappling with huge deficits. well, they impose caps and trade control. that is really the next up in the process. it was supposedly going to reform american healthcare to improve efficiency in the delivery system. that is really not the case. what is happening in the bill and in massachusetts, across the board price cuts. they cut every doctor, every hospital, every clinic exactly the same. there is no distinction on quality. they just cut everyone the same. that is how they save money to hit budget targets. in effect of that is quite predictable. it drives willing suppliers out of the marketplace. that is what happens in most other countries. it will happen here. it is already happening. that means an access problem. the damage it has on the american health-care system will be quite significant. and finally, the bill will have a huge impact on the nature of american political discourse. the real point of the bill, when you strip the ball away, is to bring the american middle class in the full dependence on the federal government for their health care. there will be millions of more people looking to the federal government over ton for the financing and delivery of their health services. this will change -- if that succeeds -- very dramatically how people view government. it will change the balance of power between the government and the citizenry, where people feel depended on the federal government's power to deliver health care for them. uriel up -- you have a real shift that has occurred in other countries here in the united states. i think that would be very damaging over the long run for a healthy functioning democracy. kate's observation about what we will do about this, and i want to laid the predicate for why we need to do something, but i will leave most of this to the others. beyond the strait repeal, which should be done as soon as possible, there are lots of things that can be done to a dance and continue to build coalitions to move -- to advance and continue to build coalitions to move this. just a couple of ideas from the very beginning, why is it not the case that people can i keep the health plan they have today if they like it? that was the president's promise. i can see an amendment offered to allow people to do that in reality, not just a waiver issued by hhs. i can see provisions to delay some of the really damaging cuts in medicare advantage, and a commensurate del in the startup of the new program based on the fact that these cuts really were not the way to do this bill. there are a lot of things that the new congress can do along these lines to continue to build momentum toward moving health care in a very different direction. thank you. >> thank you, jim. mr. gottlieb. >> of wanted to touch on a few things. i wanted to talk about repeal and what will happen between now and the time that we can do anything in terms of new legislation. what can be done over the next couple of years. it is unlikely that this legislation will be repealed as long as the obama administration remains in power. the president will veto any attempt to repeal the core elements of this bill. remarkable article in the "new york times" this sunday, about consolidating local providers in accountable care associations. this was creating a local control of provisioned with communities by the hospital. under the auspices of the new organization, which no one has seen yet. it's like unicorns, you do not know what it is until you have seen it. what is remarkable ball about the article, is that the liberal left war against -- they have been listening to the administration and were surprised to find out that they would handle the monopolies with a hospital communities. i think the left can take solace in knowing that this is a prelude to a true single payer system. what you have the health care systems controlling the provision of health care in communities, contrasting with the federal government, it is such as medicare but the exchanges, you are very close to a single payer structure. we're evolving toward that very rapidly. this is very important to watch. these things are happening very quickly in this country. by next year, more than 6% of all doctors will be working for hospitals. these mergers are happening very fast. the health plans are trying to get in on the action. there's integration and they can i get them. most of the big ones are hooked up with hospitals already. the implications of this -- the ability of consumers to exercise choice in their health care -- the market structure has evolved so quickly that any attempt to repeal legislation in 2013 will probably be met by resistance by the provider community by those who have invested. 2013 is too late to do anything about this legislation. the will be a large constituency of what have laid out billions of dollars in new arrangements in anticipation of this legislation and these exchanges going into effect. the problems with the accountable care organizations are manifold. i talked about the fact that these are handing global monopolies for care to hospitals within local communities. it did not have to be this way. the concept of allowing doctors to assume our arrangements for providing care to patients, that is a fine premise, there's nothing inherently wrong with that. what is wrong with that in the obama health care plan is that the legislation itself puts the raged in the hands of hospital. it is the wrong vehicle for inspiring innovation in the delivery of care. hospitals have never innovative. all the real innovations are delivered by hospice care, outpatient dialysis, home health-care rehab -- all the creative innovations' were designed to take patients out of the hospital and move them into cost cutting settings. none of them came out of hospitals. it will be impossible for anyone other than hospitals to form these accountable care organizations. they have not been able to get the capital. these plants are out there and they are floating around venture capital firms. they are not being funded. that will take advantage of new incentives and the legislation, they aren't at the hospital. that is what is playing out in the market. it will have a couple of implications for patients. first of all, it increases to -- decreases choice. if you are a medicare patient, it decreases choice to go outside the local community. but the more for an implication is that the administration does not just to envision this, but going on to the exchanges on 2014 and being an option for consumers in the exchanges. they are writing rules that would favor the aco's. there's certain provisions and kickbacks to give them a leg up in the exchanges. these rules are being written right now by the administration. the cms at had a meeting to discuss this very fact. the advantage will give them a leg up. with the goal of cutting out the insurance companies altogether, which create a competitive environment for the pricing of health care, which you cut out that mechanism in the marketplace, and you believe they are just middlemen, anyou turn all the provision of care over to the aco's, you're close to a single payer system where people are getting their care from captive provider networks in contract with the government. it is a very short leash. the real rules that are going to favor these aco's in the marketplace. there's nothing inherently wrong with them. it is the fact that the legislation and regulation so heavily tells the market in favor of these local monopolies. it was the creatioof these monopolies, as if someone just discovered that this was in the bill. turning to the second. bank just recent -- just briefly, what to do of the next couple of years. i believe that these market structures, as they continue to take hold, and you see medicare advantage plans consolidated, you can see doctors consolidated these local markets. quickly around hospitals and becoming salaried employees. as the solidified, the bill itself will become self sustaining. i would try to stall and head off some of these regulations that will in favoritism to certainly preferred market actors like hospitals to form these aco's and other entities like that. a lot of this action will play out in the states. we wrote about this that the american enterprise institute. tom miller and i wrote on a piece. we will continue to work on this piece. we need to put instructor's the challenge the core element of the obama health care plan. by creating a ruling from worse within the states that may not comply with federal regulations but offer consumers a more attractive alternative. we want to set up a fundamental choice on whether people want to continue down the path of this legislation or look for something fundamentally different. thanks a lot. >> to build on your left point, could you briefly explain what is already happening in the state's, light utah and california? >> jim is more an expert on this to me. the states have to pass legislation to set up a framework for how they will set up and make the changes. they can either pass legislation to try to set the framework for how they will create these exchanges, or they can default and not do it, refused to do it, and put it in the hands of the federal government. republican governors were talking about refusing to implement the obama health care plan and let it fall back on the hhs, thinking that it cannot do that, it would encumber the federal government that they could not go forward with the plan. the more creative choices for the governments to put forward things that are truly transformative and not compliant with the federal rules. the challenge of the federal government to withhold the subsidies to the state exchanges. a more market-based type of exchange. what california is doing is creating a government-run exchange where on appointed boards will dictate what can and cannot go into the exchange. this is just one idea -- create a structure where any willing plan can offer a plan on the exchanges. noncompliance, not the ones that meet the federal rules in the obama health care plan, which is a one-size-fits-all plant for everywhere. it is not a choice. it is one plan. it allows true competition in these exchanges and then allows the subsidies to flow into it. you cannot repeal the subsidies. it will start flowing in 2014 unless you repeal the legislation. you needed a new president in 2012. but create a market-based framework. some are looking at changes only confined in certain health care plans. it would critics changes in the marketplace and creates a real choice for a lot variety of health plans. >> thank you, scott, so much for the discussion. we need to look get options available to congress, and it is important to broaden the discussion to options available to the states. it's helpful but you and jim have done that and we will talk about it in more detail. -- the courts may play a role. we will cover the courts potential role. >> at this i am actually the moderate on this panel. it's an unaccustomed role for me. i do not think that obama care is the worst bill ever. i think that prohibition and slave laws were worst. but it is right up there on the list. in addition to all the defects that jim and scott have mentioned, one area that i think that is the received enough attention is the very height implicit marginal tax rates that the subsidy creates for millions of americans of low and middle incomes. effectively, to for every dollar of a race that they did, they will only keep 30 cents of that. i think that the time when for many years we have been increasingly worried about the decline in social mobility in this country, this is not a step in the right direction. and i agree with all the other things that they mentioned. it is striking, the difference between spending cuts and spending increases in the bill, that difference being that this bending cut their fate and these other are real. it is still expensive way to die. it is also i completely agree that there cannot be, notwithstanding the recent election, the revival of a constitutional limits of government or individual responsibility if this law becomes an accepted part of public policy landscape. i think that it is impossible that we're going to have a system in which americans could look to washington, d.c. for the maintenance of their very health care and yet retain the kind of jealous regard for individual liberty that the constitutional design envisions. and finally, i do not believe that this legislation for variety of reasons can really be tinkered with or improved. i'm sure there are improvements that can be made at the margin with this legislation, but the more fundamental choices are -- are we going that had this legislation are not? as long as they're not a chance of repeal, that is what conservative should be focusing on. and i think there is a non- trivial chance for repeal. i think that that is being underestimated. in fact, and because so far to say that if there is a republican senate and a republican president in 2013, repeal is more likely than not. and i would say that the one thing we have not talked about, there is a very strong case that this individual mandate in the bill, required to make the thing work, is too weak to actually do the job it was intended to do. it will cause of massive amount of back-firing, cutting because in the number of people with insurance in the country to drop rather than rise. i do not see any possible congressional majority double want to stiffen the penalties. we just had the most lopsided little liberal congress that we will have been some time, and they're good reasons why could not make those penalties particularly high. i am not as much of the pessimists as a lot of my friends on the right. i do not think that this plan will go into effect as it was designed or that it will stay in effect for very long. when you start talking about this issue with conservatives, particularly those active in electoral politics, the most important thing that you run up against it is this concern -- well, the law bans insurers from discriminating on the base on pre-existing conditions. that is extremely popular. what are we going to do about it? maybe we should therefore not take on this legislation. the paradox of the politics of this issue is that, yes, banning insurers from looking a pre- existing conditions is very popular, but none of the things that you have to do in order to do that are popular. for example, if you're going to prohibit insurers from making those sorts of decisions, it then becomes totally irrational for people to buy health insurance, which is why you have to force them to do it. if i were to say, for all the complications, it can be boiled down to two steps. it transforms insurance into a product that could never survive on the free-market, and then force everyone to buy it. then the question becomes -- the political question -- which of these defects preminate? is the -- is the popularity outweighed by the unpopularity of everything that is inevitably attach to it? so far any reasonable reading of the political landscape over the last year-and-a-half, the unpopular provisions are more politically important. particularly since the ban on of pre-existing conditions is not implemented for a couple of years, i see it -- i do not see why that does not remain the case. those who oppose the legislation, we must explain that there are other ways of dealing with the i problem of pre-existing conditions, and we're not going to ignored. this is something that opponents have not done a good job of. i think you could make a strong case that the existence of this problem in the first place, the pre-existing conditions problem, is an artifact of our dysfunctional public policies. that we have a more integrated, less fragmented health insurance market with the possibility of renewable individual policies, but the possibility of buying health status insurance, if we did not have this tax code preference for employer based health insurance which has the consequence that sometimes when people lose their jobs, and there is a gap in their insurance, they have this problem that they are already sick and people do not want to -- insurance companies, it becomes a rational for them to offer insurance, certainly not at the same rate for everyone else. if republicans and conservative democrats who oppose this legislation will say, we have a problem here. there are market-oriented solutions. we can move gradually toward a more robust individual market. that is the trash and this -- we could have a better funded risk pool for people in the situation. we can address the problem without threatening everything at -- that everyone likes about their health care arrangements, in overturning the existing system from washington, d.c. for everyone else. i think that as a winning message. it will continue to be a winning message through 2012, likely beyond. with had repeated predictions on the parts of proponents of the sludge is less and the popularity will be just around the corner for this legislation. after the town halls of 2009, when the president ways end in september, but the president hardly gave that speech. in the debate in congress, people will see all the elements. it does not seem to have happen. once it is enacted, people will read it with flowers. -- greet it with flowers. all those folks who say that things are going to change, i would not be so sure of that. to sum up on the politics of this, but those who were expecting something to change, remember that in the long run we are all dead. i just hope that this legislation does the speed that up in reality. thanks. >> ramesh, ask you to the attention -- a dress court challenges to the mandates. >> i would caution opponents, but not the state's. it seems to me that if the political campaign against this health care law fizzles, for example, republicans acquiesced to t continuation of obamacare and conservatives allow that to happen, then the challenges to obamacare will not succeed in the courts. if the on the other hand, that political campaign continues, and gathers force, and then there is a shot at succeeding in the courts. i just think that perhaps i am too cynical about the way that contemporary american courts work, but i think choices that justice is maker. to be significantly affected by what they see as mainstream political opinions. and to the extent obamacare extent is part of the landscape, they are not going to want to act against it. >> i have a few follow-up questions before we go to the audience. ramesh, on the politics of health care reform, conventional wisdom holds that it was a problem for the white house and the majority party to spend two years talking about health care so prominently when voters were so in kirk -- worried about the economy and jobs. it seemed they were engaged in health care reform at the cost of the economy and jobs. does the new majority who pledged to repeal the health care reform and to be doing things short of repeal, did they run the same risk of appearing to be ignoring the economy and jobs? >> i think there is a chance to integrate these messages. what you would argue, i think correctly, is that at a time where we're projected to have labor markets -- weak labor markets as far as the eye to see, that is not the time for an increase in the minimum wage. at time when we are worried about fiscal conditions of this country, we should not be living on new entitlements. there is a possibility that this thing is displayed, but there is no reason for the opponents of the legislation not to put the economic implications of this legislation for the center and everything that they talk about. >> dr. gottlieb thank you. -- thank you. dr. gottlieb, these concerns are shared shared by some many doctors. if the ama endorse this, giving the impression that it enjoyed support from doctors. theyw they're saying supported the bill but they did not endorse it. that is what i was told by an ama official about four days ago. this is an example of what -- they have become captive to date mechanisms under which they aren't reimbursed and the medicare. that is the single thing they will lobby for to the exclusion of all else. the risk here in this legislation is that the business community -- they have become a constituency in support of this legislation. he talked about various people underestimating the possibility of repeal. none of these people are thinking that it does go away and they are making significant investments in it. it is very true that he talked about the popularity of the legislation and any potential for it to become more popular over time. everything they will happen between now and 2012 is good news for the president when it comes to the health-care market. consumers will find themselves in increasingly tight networks. the rising cost, the way to deal with it is not to raise premium but to tighten the network that the patients are in. they get less coverage in their plans. there are fewer plants in the marketplace. especially in the individual markets. you might to start see that in a large group as well. it is very clearly going up. and number of insurers have gone up quite dramatically and will continue to go because of this legislation. a lot of small businesses are making the calculation that they do not have the -- they can wait until 2014 and put their employees on the exchanges. the cost will be higher in that is what is anticipated. it will not be very attractive. >> thank you, scott. scott made the point, jim, that it will be terribly important, given what is already helping it in the health-care market, for congress to attempt to install regulations that favor the creation of those kinds of monopolist. how does congress began to do that? how was that possible? >> are two ways to do it. one would be to stop it there is some legislative action. you can pass. this is an appropriation measures to say you cannot spend money to implement this. you have to get to the senate and pass the president or override the president. hist it is not out of the question. there are some aspects where there are enough democratic senators were watching what happens three weeks ago and also up again in 2012 who are already worried that the bill was too ambitious, too costly, to regulatory -- there are possibilities for coalitions to form, bipartisan coalitions to do some of the things scott mentioned to slow down, particularly bad ideas, put them off until the voters have a chance in 2012 to decide which direction they want to go. also said that the way to slow down regulation is probably through a lot of oversight. the first thing to do is bring the oversight committees of hhs and mapped out for the public what exactly they are planning to do and have already done and what they are planning to do. but it absolutely clear that a lot of these regulations will restrict their choice, drive up their calls, and impose a lot of burdens on the sector. doing that is probably the most important step, highlighting that in an oversight >> that will be important to get that embedded. >> defenders of the build benefit from the fact that there's so many moving parts. it will make it extremely difficult for the public to understand which are the most crucial, which are the most damaging. that poses a real challenge for politicians to explain. >> on this point, i did think how republicans play their hand by talking about repeal of the spill to the detriment of focusing on other aspects of important issues to the voters, i think the voters actually connect health care to the economy. what they thought in a common- sense way it was that the economy was -- what is needed most now is priva sector. but growth, more dynamism and the private economy, more investment, more entrepreneurialism to create new companies, hire more people -- that is what they see in most of need in happening over the next couple of years. they rightly viewed the health care bill imposing a massive redistribution and burden on the ability to get that going. very much in the public's mind is that we want our politicians to focus on the economy and job growth, and we do not like health care. they're connecting health care as being a negative in that equation. that is one reason why health care will remain important issues. >> one fruitful topic we're hearing -- you may remember few weeks ago, secretary sibelius' sent out of letter that could be fairly characterized as threatening regulatory reprisal against insurers who were told their customers the premiums will rise in large part because of this legislation. i think that is something where the secretary and some of these industry officials could use fully be asked to shed some light on the corrupting potential of this legislation, and what it says about casual relationships between the insurance industry and washington, d.c. as it is deepening in this legislation. >> he asked about what congress can do right now in terms of oversight to get a handle on the regulations on what is most central. clearly the creation of these expenses and the blowing of the substance is a core element of this plan. there is not a lot you can do about that short of slowing down the creation of the reaction -- the regulations. and it becomes easier to repeal it. i think the regulations that congress could address, are the ones where they have unilaterally made decisions to make it less competitive. the unilaterally made a decision that health care plans that offer more than two plants within the state, or as for the country, need to what led them. if you are at the -- if you are aetna, you can only offer to part the plant. they had to basically shut down a lot of their lines of business. these are the kinds of things that are happening all over. if you talk to people in the health-care community, it is making the health care market much less competitive. it will be harder to try to superimpose it 2012 or 2014 a market-based reform if you do not have much of a market-based industry left. >> what is the most important living part? the most important element of the bill is subsidizing people only through a heavily regulated, beverly-run exchange process where the government will have control over everything. -- federal e-would exchange process. then they captured everyone for the process. the key issue of finance couple of years is that they have 29 republican governors. it is an idle threat that hhs will go into 29 states and run health care. they need those states and those governors. if those 29 governors can get together around a pro-market, less regulated, more consumer- directed system and say, this is how we need to move. it puts hhs and the obama administration and a very difficult position. >> speaking of those governors, jim, and state officials, a growing number of them are howling over the mandated expenses in medicaid coverage. that is would be extremely costly to the states. what would you recommend that these reform-minded governors with respect to the medicaid restrictions placed on them question -- they need to go back that the system is already on the brink of collapse, and piling up much more americans into aystem that is not delivering to the people currently in it, that is the solution. the bill is trained to the private market and put it under federal control and captured. they should be listening medicaid and making it more consumer directed, more of up next entitlement, more control. you could almost put them into the exchange as opposed to the private marketplace. i would start from that end of the spectrum and say, we need to take medicaid and move it into a private exchange. what we start with the people in the medicaid that is already not working? to usurp your role. is there a 10% sun opt-out of medicaid altogether? >> i have not examined it carefully. i read the story and we're heard about some states looking at it. i think the state should think long and hard about doing that. the consequences politically are pretty severe. i do not have a strong view yet, but my information is that it might be more something to rattle the cage with than actually to do. >> you talk about the opportunity for a new majority to have votes on the more unpopular aspects of the bill. one of those they could be looking at on the medicare cuts that the bill pass. fiscal conservatives may have been taken about to say a fellow fiscal conservative arguing against medicare cuts, and yet they were and are. what are we to make of the cut opponents? >> there is a right way and a wrong way to cut medicare. the right way as though what paul ryan wants to do it, moving toward a premium support system, where the government cannot find a price regulate the health sector. it is really the source of tremendous dysfunction in the health-care marketplace. it is a -- it imposes prices on the marketplace. it says, take-it-or-leave-it. that distorts all kinds of things in the marketplace. it is really a huge problem. they'd double the moment the old model. they go with more price cuts, more across-the-board reductions. that does not benefit -- that makes the problem is much worse. on paper you could say, it looks like it will save money. i don't think it actually will. we have done this many times in the past. look at where we are. we have been priced controlling medicare for basically 40 years and it does not work. the alternative model is to put more consumer -- more control on the hand of consumers, give them more of the biggest entitlement of poland, and secure the choices available. they become more export cost- conscious, and that is the way to get control of the medicare program. that is the way to solve that over the long run. they're going exactly the opposite direction. >> the reason the price controls do not work utilization will go up and there's nothing that the government can do about that. >> folks to try to make the case of this is fiscally irresponsible legislation. they make a big deal about the advisory board on medicare. what people do not pay attention to is that this board is statutory always supposed to not suggest changes to the structure of the entitlement that actually matter, not suggest increase call sherry. it is only basically allowed to suggest tighter price controls. the idea that this opens the door to a tidal bore fruit -- it toddling reform, it actually slams it shut one last question before we turn to the audits. a political question. you have addressed alternative visions for health care reform. there such fundamentally different approaches. with the prior. it was the prior administration a missed opportunity to have had this debate with the advantage of the old white house? >> i would say yes and no. i think you have a right that had conservatives spent more time on health care and been more knowledgeable about it, it would prepare the ground for the last two years better, both in public opinion and getting republican congressman prepared for this debate. i don't think we should overestimate how much conservatives could have accomplished under previous congresses. do not forget that previous attempts to perform medical malpractice laws to make it possible to breed associated health plans were successfully filibustered. republicans never had the power in washington, d.c. that the democrats have had i find it extremely impossible that any more and bishop conservative free-market health care reforms, a real big bang change in the tax treatment of health insurance, could possibly have been successful. it does mean that should not have tried and to highlight the issues, educate the public, educate republicans, and shift the debate a little bit, but let's be realistic. people save republicans never reform health insurance. they tried to make little forms and they were not allowed to do that. >> with that, we're going to turn to our patient audience here. we have initial questions in the second row. and a microphone headed your way. identify yourself, and that particular panelists you would like to address your question, let us now. to get my name is peter, and i feel that i am daniel and the lions then because i think that contrary to many panels that have been presented by aei, which i enjoys a trade lawyer, when the head issue of trade law that is going to be discussed, they have a few variations of points of view. here you have a monolithic point of view without any opposing consideration. i think that that is not a way that the public policy forums such as aei ought to run its business. two issues with health care that have not been discussed here. the notion that there is a requirement for insurance and a government poll for covering the uninsured is not so novel in this country. we require everyone who drives a car to have insurance. if they do not get insurance, there are uninsured motorist pools to cover the consequences of a lack of insurance, so i do not find that there's a big our rage about that big -- a big outrage about that program. more directly with regard to health care, i just been three days in the hospital two weeks ago for a slight heart attack, which i was very quickly rehabilitated tempered by three nations in the hospital, the bill was $83,000 without a doctor's bill. that is a vw hospital for going to the emergency room, for intensive care treatment for three days. that is just beyond the range of most people's capability of being paid. it's a vicious number because it will not be -- it is a fictitious number because it will not be paid by anybody. the medicare for which i am eligible and the military service benefits for which i am eligible, i will not pay hardly anything. i think the real problem is that most democracies have recognized that health care is such a universal need, that a single payer system in some way that is a reasonable way of addressing that issue is the only way that if democracy can deal with that issue. and having the fictitious kind of programs that we now have is not working either, and to suggest is some -- it is desirable is irresponsible. we're delighted that you're well enough to be with us. and of ably made the case for the other side. if we were having a debate of the merits, we ask our panel is to discuss is, given the promises on the campaign trail, what the options for the majority in the house? anyone have a general comment in response? >> a couple of observations. i think if you are right that on the middle of the debate in this country is how to allocate resources in the health sector. what this is is a question of what process will be put in place to more efficiently allocate resources in the health-care sector, and a key objective is to improve quality in the health sector. if you're going to try to lower the cost to make the system more for over time, not rise astronomically faster than income, if you have to get more help for the dollar spent. what process is going to lead to higher productivity in the health system? that is the tunnel question. the bill answers -- the government can do that. i think that is not true. i think that is false. i think actually that a market mechanism will work much better. the government should be providing oversight. i think it deserves more oversight then the other industries because of the questions. but fundamentally, resource allocation decision should be left to patients and consumers' driving the market place. if the government tries to do it for everyone in the united states, there will be a lot more equity but it will be a worse system. >> on the car insurance, you are right that states do have that requirement. i think there are a couple of reasons why the health insurance mandate has attracted more opposition. it is done at the federal rather than at the state level. you have not had the federal government to require that everyone purchase a particular product. second, car insurance mandates is a condition of driving. which is very important. but the health insurance mandate is a condition of being a citizen of the country, or a condition to breathing. i think it is qualitatively different. interesting about the car insurance parallel, car insurance mandate does not get you to 100% compliance or anywhere close to it. the project that out to something they will likely be more expensive. some of the costs of the likelihood of this mandate to work are a lot more significantly negative. my last point would be, i think it is a mistake to suggest that because health care is a universal need, therefore single payer is reasonable. if we did that, if that was sound logic, we would have to agree to a single payer provision for food, which is also universal need. it's more important that something is, the less likely that we want there to be a government monopoly or quasi- monopoly on its provisions. >> another question? we have one in the back. my name is howard smith and i am a doctor. public to congratulate the panel. this is the first time that i have heard any discussion about the state -- the systemic things that concern me the most. the issue of the care organizations is a very destructive concept. in actuality, it has been tried before. in the mid-1990s, they were all paid by capitation. as the capitation was conceived of, of the risks could never be of -- prepared by the amount of money was spent, the was allocated. these caused tremendous parochial interest of former in the organization's project to 4 in the organization's -- tremendous parochial interests to form. they were forced into situations where they would lead to a group or that would be instituting the type of care that was cheaper, less effective, and more risky so that no one can make money. this is the future of what accountable care organization -- it is a formula for a much more risky madison. -- madison. -- medicine. there will be deadly medicine, should we go bankrupt, as did the tso's. in the bill, they are already built in. these organizations have been deemed too big to fail. >> you make an alarming. may. do you have a question for scott gottlieb? >> my real point is that, most people do not understand these things. they have been bombarded with how costly and damaging it will be to the economy. the real issue is that it will be as damaging to the health of every american, and i think that people who are in a position where they can get the word out, need to get that word out more than anything else. >> thank you. >> you make a good point that this is been changed before. this is been changed before.

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