Transcripts For CSPAN Tonight From Washington 20090820

>> coming up tonight and c- span, three cabinet secretaries issued guidelines for businesses for dealing with an outbreak of h1n1 swine flu. then gene taylor holds a town hall meeting in moss point, mississippi. and didn't reporter's question press secretary robert gibbs about health care. . >> this is 25 minutes. >> thank you all for joining us. the secretary of health and human services, kathleen sebelius, and janet napolitano and spent months on the forefront to combat the h1n1 swine flu virus. i am glad they joined us today to unveil this fall's guidance to help businesses and employers prepare for what many experts believe to be an active flu season. we're also joined by a doctor from the center for disease control, and the department of labour deputy secretary. they will be on hand to answer questions at the conclusion of our presentations. as all of you know, h1n1 is more than just a significant health issue. it has the potential to affect virtually every aspect of our lives, from our economy to national security, to our educational system. as such, it will take americans from every walk of life, all of us, pulling together and doing our part to mount an effective response. as i have travelled the country the last few months, i have learned the businesses across the country, from mom and pop businesses to fortune 500, are counting on the federal government to convey accurate, reasons information in a timely way. we already face much economic uncertainty. a flu outbreak is a very scary prospect. and president obama has mobilized the entire federal government to get america prepared. and the interagency effort you see here is further evidence of that cooperation. but government cannot do it alone. for this effort to be successful, we need the business community to do its part. businesses play a key role in protecting employees health and safety as well as limiting the negative impact to the economy and society, whether in regular flu season or during an outbreak of the h1n1. here is what businesses can do to help. first, the can set the right tone within their companies. the starts with letting their employees know that if the employee is exhibit flu-like symptoms, they should not come to work. and if an employee shows symptoms during the workday, the cdc recommends that that employee be asked to go home. in america, we love to praise the puritan work ethic, and with reason. but this fall, it would serve the country better to fit -- a phrase common sense and responsibility. if an employee stays home sick, businesses need to drive the point that it is not only the best thing for the employees' health but also for the health of his or her co-workers and of the productivity of the committee. second, employers will be able to develop smarter health policies for their employees by staying in touch with local health apartments. and aligning their guidelines accordingly. that could mean anything from the basics, encouraging employees to frequently washed their hands to cover either mouse and a cough and sneeze, to considering alternative work environments for employees at higher risk for complications from the h1n1 flu. developing sick leave policies that are flexible and non- punitive also makes sense. some businesses now require workers to provide doctors notes are other paperwork to prove that they or their loved ones had to miss work because of illness. that is a requirement that employers should consider dropping. it has the potential to overload the health care system that will likely be stressed during this year's flu season. the third thing that is absolutely essential for american businesses is thorough preparation. even if precautions are taken, some employees will likely get sick. and parents may have to stay home with a sick child, are even healthy children if a particular school is closed down. that is why companies need to plan for continuity of operations with the depleted work force. plans should be put in place now to allow for working telephone and staggered shares. employees should be cross trained to cover essential functions. if the flu outbreak becomes severe, companies need to take steps to reduce face-to-face meetings or to curtail non- essential travel to reduce the possibility of h1n1 flu transmission. hopefully companies never have to take these steps. but a little planning now will help ensure that our economy withstand whatever the h1n1 virus throes at best this fall. and of companies need more information on how to prepare, they can give to the federal web site, www.flu.gov. that i flu.gov. you can get a tool kit on how to prepare and plan for and prevent an outbreak of the h1n1 virus from drastically affecting your business operations. now like to invite secretary of hhs, kathleen sebelius, to come up and talk about the steps that american businesses can take to prevent their employees from ever getting sick in the first place. secretary sebelius. >> well, thank you, secretary locke. it is good to have a chance to join you today and be with my colleagues in the flu-fight, secretary napolitano. welcome to the others here with us today. i am pleased to be here at commerce to talk about the role of the private sector can play in preparation and mitigation of the flu outbreak. this is a shared responsibility. so the federal government, as the secretary said, is doing our part, working across agencies, working with our state and local partners to get ready for flu season. but we really rely on the private sector to also work with us to make sure that americans are safe and secure as much as possible. in terms of the steps that employers can take, secretary locke also already talked about the employee policies that need to be reexamined in terms of getting ready for the flu. but i want to talk for a little bit about the strategy is for mitigation. certainly, the for vaccine is available, before a vaccine becomes ready to go, there are a couple of steps that are critically important. one is encouraging target populations to get their seasonal flu shots. seasonal flu vaccine will be ready. it is ready at some places rain now. it is going to be widely available in september. so encouraging employees to get the shot and get it out of the way is a good first step. as the secretary said, the two as mitigation strategies involve hands and home. so keep your hands clean, which is frequent hand washing, frequent use of hand sanitizer, but also, covering a sneezes our profs with a sleeve or an elbow, not your hand. and cleanliness, we know, will stop transmission of germs and go home or stay home. that is the other critical piece of this puzzle because we know that those are two important ways to stop the transmission of the virus. now vaccine we know is one of the best strategy is to immunize the population against this brand new flu strain. so getting employees prepared to receive the vaccine is important. the target population has been identified in, and we hope that employers do some personal of reach to the target population might be in their employment. pregnant women are particularly susceptible to the h1n1 virus and should be strongly encouraged to be ready to get a vaccination once it becomes available. adults under 65 who have an underlying health condition including asthma are in the kind of respiratory distress, are in the target population we want to make sure are ready to be vaccinated. if employers have younger workers, the target population includes those who are six months of two age 24. i am hoping no one has children working in their shops on a regular basis, but certainly, the 16 to 24-year-old to may be working full-time or part-time our target population. again, i think lawyers can go along way to encourage those people to get vaccinated. health-care workers are critical target population. a lot of the private sector employers deal with health care workers, either on a full-time or part-time basis. parents or guardians of infants under 6 months old, vaccinations is not appropriate for babies, but the guardians of those kids may stay vaccinated and that will help protect the baby. we have to get the message out to those critical population so that they're ready to get vaccinated. we're working closely with scientists at the national institutes of health, the cdc, the fda, working actively to make sure that an h1n1 vaccine is safe and effective as possible. we know that the health departments will be the best information source for regular information, and we anticipate the same kind of outbreak that we saw in the spring, which is that, in some areas, there may be a lot of flu, and and in some areas, there is really little. it is hard to predict in advance with that will look like. so staying in touch of local health departments, as an employer, is a way to make sure can monitor responses carefully. flu conditions change rapidly. what we saw this spring is that day-to-date changes are quite dramatic. so local public health officials have the best pulse on the situation. human-resources and leave policies definitely need to be as flexible as possible. hopefully will follow public guidance. so letting employees stay home and the cdc guidance is 24 hours after the fever ceases is the time to stay home. that will vary from person to person. some people may have a two to three they operate. others may have a long verse series. after 24 hours with no fever, it is safe to come back to work and we engage. and finally, keeping workplaces as clean as possible. again, we know germs are transmitted, often through hand contact. frequent wiping down of services which people are likely to touch, having a protocol in place some of the cleaning is done on a regular basis, and hand sanitizers and opportunities to clean your hands on a regular basis will minimize this flu. again, the website, www.flu.ogv, has information and a regular updates. we hope people take a look at it. now i would like to turn the podium over to secretary of homeland's security, janet napolitano. >> well, thank you. thank you, secretaries. i do not have too much to add to the comments that you have already heard. but i would like to emphasize a few things. one, protection from the flu is a shared responsibility. in all likelihood, the flu virus will be back on our shores. it has never really left. but we are now going to see it reenergize at the beginning of the school year. that means, from a business perspective, that planning is essential. what is being released today is a systems floor plan. maybe you are busy dealing with a very, very tough economy rain now in business, and you may not have taken time to think through the heavy flu season means. but that is why we're issuing some plans, some assistance for businesses so they do not have to start from scratch. you can take that document that is on flu.gov. it is on line. think through this. it is not just seasonal flu which will happen. it does every year. as the secretary sebelius said, those shots are available or soon will be. encouraging your employees to get their seasonal flu vaccine, but preparing for absenteeism for the h1n1 virus. particularly in this time we're in now where we're in an flu season for h1n1 but for the vaccine will become available. let's not just play wait and see. let's be proactive. we are being proactive that the level that we're at, but we're now asking the business community to be proactive and do some planning, too. let me emphasize one part, and that is, business is the control critical infrastructure. to make sure that those operations continue, even if you're absent get, you have to be ready. monday was down in the gulf coast meeting with leaders in the oil and gas industry. a number of issues, but a key part of our meeting was to guarantee and make sure that they have thought through what needs to have been so their critical employees have back up. cross training has occurred. telecommuting has been explored. whatever needs to be done so that there is a continuation of operations of the critical business level, at the supply chain level, and the like. the department of homeland security will continue over the bank's weeks with that sort of our reach into the private sector, as we have been doing, all over the summer. again, this is a shared responsibility from individuals washing their hands, coughing correctly, and the like. two, encouragement to get seasonal flu vaccines. especially if you're in the targeted category for that. so that stressor on the health care system is taken care of or is mitigated before the full effect of h1n1 arrives. three is to have a plan for absenteeism and be responsible and understanding about the absenteeism that needs to occur with this new strain of the flu. and then number four, we will continue to work on the dhs aspect with critical infrastructure businesses, in particular. because the country needs to be prepared, but it also needs to be resilient. thank you very much. >> i think some questions are in order. the go-ahead and stand over here. any questions? yes, sir? say who you are and which one you'd like to grill. >> i am from bloomberg news. if the flu spreads despite these measures, are you prepared to put out more drastic guidelines such as encouraging businesses to close down certain branches to stop the spread of flu in that area? >> well, the key is for every business to put in place plans on how they would continue to operate with perhaps severely reduced work force. so that is going to be up to every business on a case-by-case basis. it will have to decide for themselves when it is most economical to shut down a shaft or assembly line. each company, each business, each industry varies. it is impossible to come up was such a blanket statement. but the key is to come up with the flexible work policies and leave policies to plan for cross training, higher absenteeism, and to develop policies that encourage employees to go home upon the first symptoms of the flu. and to reduce the impact on the public health system, perhaps waiving policies that require notes and verification for medical personnel because the medical community will be inundated, attending to those who are sick and then having to issue notes and the verification that someone is sick or someone else in the home is sick merely compounds the problem. >> what we know also is that this will change on a regular basis. so this cdc is prepared and ready to issue of dated guidance as situations change. again, we anticipate the variants in local of breaks. so what may be happening in atlanta is not likely to be having in seattle. local health department officials will be the best guy. but the guidance from cdc is based on what we are seeing right now under the recommendations for preparation of getting ready. but we anticipate, as the flu season unfolds in a more outbreaks occur, that they guidance will be updated regularly, and we will keep people posted as we did this spring as more of bricks occurred and there were some school closures in areas and other missions were taken. we anticipate that that could change as the fall flu season unfolds. >> i have a question for secretary sebelius. first, as i am sure you have seen, there have been reports about the only a fraction of doses were ordered for h1n1 and will make it here by november. wondering how concerned you are about that and know how you fill in the gap. second, you have put up guidelines related to schools. i wonder if that applies this and to colleges and universities verses primary schools, and if not, i your address the difference? >> well, the school guidance for k-12 has been released. later this week, there will be school guidance available for higher education. and it is somewhat different. stay tuned. that is in preparation right now, in the final stages. i would like to have steve from the cdc answer the specific vexing question. why 30,000 foot view is that we are very much on target. we're working with five different manufacturers. they are preparing, as we sit, for target date of about mid 0- october for the production lines to begin. we never anticipated that all the vaccine would be available day one. it would be on a rollout basis. but i would like to call on the admiral to give you specific update on the vaccine. >> thank you, madame secretary. our intention was really to reiterate that this is something that is evolving, and to be as open as possible with what the actual situation is at this moment. there are efforts underway as we speak to increase the number of doses that are available to address this situation, but i think the one thing we ought to expect is as this process goes forward, there will be fluctuations in those numbers. in terms of the impact on the date that vaccine will be available, there are only so many people you can vaccinate at once, so i think that as we go forward, the total number of doses is going to be the same. there may not be any difference at all in terms of actual number people like to be vaccinated in those first weeks in october. >> any other questions? >> i had a question for the admiral. i wondered if you could address for us the military dimensions of this, whether in fact h1n1 poses any kind of national security threat, and specifically, whether you are aware of any mobilizations by any branches specific to this threat in the recent days have passed or that are to come. >> i think in terms of the mobilization, it is more at level of iterations and coordinations. we are working with the department of defense. there certainly issues that are different in the military than the civilian population. those are being coordinated across the departments. in terms of a specific national security threat, i think we are taking the measures to protect the health of the public. i think that kind of answers that question, that we are doing everything we can to minimize the health impact and the other impacts that this illness will cause. >> right, thank you all very much. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> on c-span tonight, congressman gene taylor holds a town hall meeting in moss point, mississippi. reporter's question one house press secretary robert gibbs about health care, and the center for immigration studies hosted discussion about the effect of immigrants on health care system. tomorrow morning, a journal of health policy called hell of paris hosts a conference looking at the government's role in health care. you can watch live -- beginning at 8:30 a.m. eastern with remarks from c. everett coop. >> as the health care conversation continues, she spends healthcare hub is a key resource. go online and all the latest week's, video s, and links. keep up-to-date with health care events like town hall meetings, house and senate debates, and even upload your opinion about health care with a citizen video. the c-span healthcare hub at c- span.org/healthcare. >> mississippi rep gene taylor host a town hall meeting. due to technical problems, we join the meeting in progress. from the pelican landing conference center in moscow, mississippi, this is an hour and 10 minutes. >> everyone is entitled to their own opinion, but these are the facts. the fact of the matter is that the debt has been growing belote in my lifetime, and we have to get a handle on it. [inaudible] >> shut up and listen to the man. [applause] >> what i think everybody needs to remember is that a little over eight years ago, we were running annual operating surpluses. they were small. we still had an accumulated debt, but when george bush took office, we had a small annual operating surplus. president bush, if you recall, when we had an opportunity to start paying the debt down, president bush said it does not make sense to pay down the debt prematurely, and therefore, we have to pay a premium on the debt that to prepay. we have calculated the amount of debt that the nation can pay off over 10 years and that is two trillion dollars. the national debt doubled during those eight years between a combination of katrina, the wars in iraq, but also the first president that i know of to cut taxes during a war. most other generation said let's pay our bills now, and not stick our kids with our bills. [applause] some people have asked about the fair tax, or the so-called fair tax. back up. one more. a fair tax -- [shouting] >> we will get to your questions. the fair tax is billed as a 23% tax on everything. i would also remind you that there is still going to be a 7% tax for the state of mississippi, because that is how the state gets over half of its revenue, and how the city gets 1% to help run the city. oh, i hope it came to listen, and i will listen to your questions. [applause] it is really a 30% tax, because if the after-tax cost is $100 and the item, 7 $7, with $23 in taxes, a $23 tax on $77 is a 30% tax. a 30% tax would not raise enough revenue to replace the current system. it would have to be at least 34%, even if there was no tax evasion. the bush treasury department said the rate may have to be as high as 40% very how would this affect the typical mississippi family? if you are a married couple making $39,000, very modest, the current federal taxes are $5,600. under the fair tax, you would be taxed $14,000. you get a rebate of $6,000, leaving you with a fair tax - 3 date of seven dozen dollars. the $6,000 rebate, the fair tax- entitlement, $18,000. if you make $99,000 -- again, this came from the bush treasury department. [booing] >> are you still there? kenya regression more became you hear me? health care expenditures in america, hospital care -- this is total national spending on health care. our nation already spends $746 billion on health care, $508 billion on physician services. that is a lot of money. national health spending my source. again, for those people who don't think we do much, actually we do quite a bit. these are where your tax dollars go for health care right now under the existing plants. where does the money come from? medicare revenues. what does mississippi get already? again, this is huge. as i mentioned, we have one of the most favorable ratios of federal dollars to stay dollars for medicaid. for every 19 cents the state puts up, the federal government matches it with 81 cents. that means the federal government is putting up $2.5 billion to the takes -- to the state's 508 $5 million. what is the other factor we have to keep in mind? in addition to the cost of existing situation, we as a nation are getting old. when my dad was teenager, there were 20 working people for everyone retiree. right now there are three working people for every retiree. if i live to retirement age, there will be only two working people for every retiree, demographically, it does not any easier to pay these bills, it gets harder. that is why we need to think wisely right now without running up the tab. in 1960, their only 1 million americans over 85. right now, it is close to 5 million people, and they are projecting a 2030 there will be close to 9 million americans over 85. it is this a simple, sad fact of life, as we get up in age, we will have higher bills. the last thing, again, because these are commonly asked questions, and then will vote your questions. i see my friend pat right now who is trying to build a hurricane proof house. he is probably paying enormous bills on that hurricane proof house. we are still working to have the federal government let you buy when insurance as an option to your flood insurance. a great many of you came to my town hall meeting shortly after the storm and said i got screwed by my insurance company. they did not give me a dime. the only people that paid me or my federal flood insurance, my home owners -- what did that mean when they denied a claim? it meant that somebody had to pick up the difference, and that somebody was our nation. i did not make the promise. george bush made the promise, i am glad he did. [applause] george bush stood in jackson square and said if you lost your home and you need a place to stay, which are going to get to a fema trailer. the fema trailers cost about $15,000, about the market price to buy, but one of the president's big contributors delivered them for about 31 dozen dollars per trailer. that is $1,300 million, just to make up for that. folks, we are already paying that bill. the difference is, the people who buy the premiums ought to pay the bill in the future, and not everyone across america. many of us discovered, starting with me, that i never would have dreamed that i would be paying $250,000 for the little tiny house of mine, but it happened. the flood insurance has only a $250,000 limit on it, so in addition to letting you buy when insurance, we want to get the amount you can purchase up. we want to get the amount for possessions up. we want to let people with condos by it, but we want to see to it that no matter what happens to your house, if you build your house right and pager premium, you come back the day after the storm in your house is gone, you will get paid. you do not have to hire an engineer. with that did not happen last time and we want to make sure it happens next time. we have talked about some things that are commonly asked. we will go ahead and let you ask questions, one at a time. let me do one last thing. i have a number of my staffers with me here tonight. going back to what normally happens, should anyone here have a social security problem, a veterans' problem, a medicare or medicaid problem, something that involves you and you want to talk to one of my staffers, i have people here so you can look someone in the face and give them information. we have ms. peggy r. be in black, bowed jackson -- bo jackson, bob carson, so does anyone have an individual problem they need some help with? raise your hand. ma'am, do you have an individual problem? peggy, can you talk to this lady? bob gerson and billy r. my two veterans experts. bob, we take his information, please? is it an individual problem? bo, will you talk to that lady in the green t-shirt back there. anybody else? social security. miss harvey is wearing the black coat here. in the black and white jacket, do you have a question, sir? ok, we will start with you, ma'am. >> we cannot hear. >> george county, mississippi. i did not vote for president obama. i was not real happy with mccain. i am not happy with president bush, the way he spent money. and not happy with obama, the way he is spending money, but i did support gene taylor. the last 25 years, he has cared about mississippi, and he listens about mississippi. there are a lot congressman up there that are shutting the doors. they are not listening to us. they are calling us mobs. we are not mobs in mississippi. we are not mobs in mississippi. but my question is, as a staff auditor, i have not seen the federal government made one attempt to clean up one messe. [applause] i have not seen them clean up the sec. in run should not have happened. people should not have lost their retirement. -- enron should not have happened. we have enough regulations to stop that, but it is not happening. there is too much going on that is not being checked. if you cannot clean up a little, how can you take away all our health care that we pay for? [applause] >> we will start in reverse order. number one, i would hope by now that everyone in this room is aware that i am not going to vote for the health-care plan. [applause] we will take them in reverse order. >> i did not mean you. >> quite honestly, it goes back to that 11 trillion dollars of debt, the fact that the medicare trust fund will collect enough money between now and 2017 to continue to make its annual operating expenses. but come 2017, because of that retiring population, because of medical inflation, because of the prescription drug benefit that i did not vote for and other things, we will no longer be collecting enough to pay the bills. three things we can do that just make perfect, common sense. number one, the insurance industry was given a one-year exemption from antitrust laws in 1946. they are still exempt from antitrust laws. that is crazy. that not only affects your wind and homeowners insurance, it affects your health care. mark has to compete with other shrimp packers. they have to compete as well. on the medicare prescription drug benefit that voted against, there was a provision that actually prohibited our nation from using our huge purchasing power from getting a better deal from the pharmaceutical companies. that is crazy. when home depot and lowe's by step, they get the best price because they buy so much. if one of the vice 10 cars a year, you'll get a better deal than someone who buys one car. that is just the way it works. it is crazy for nation not to get the best price. that provision was included in the medicare prescription drug benefit by a guy who left congress to go to work for farcical manufacturers. -- for a pharmaceutical manufacturers. something we should do to give you a better deal for your tax dollars, remove the anti-trust exemption, number two, take out that language and let our nation negotiate for better prices. the third thing is generics. i am fortunate to have a chemist/for merck pharmaceutical manufacturer on my staff. -- former pharmaceutical manufacturer. he has explained to me very clearly that generics are just about the exact same thing you would buy if you by the name brand stuff, only it is a lot less money. for example, many of you have heard of cialis. it has been around for a while, so the patent on it has expired. we checked with the drug store across from my office. right now that are selling cialis for 50 cents a tablet. but the one that they advertise on television, in every one of dad's they say tell your doctor you need this. cialis-cr is $5 a tablet. a thousand pardons -- ambien, not cialis. just chalk that up to an old man. [laughter] ambien is 50 cents a tablet. ambien-cr is $5 a tablets. for the things we buy with your money, we have to get the best price. if someone absolutely has to have the name brand, let them pay the difference. those are three things that we as a nation can be doing right now, we ought to be doing this fall to stretch your tax dollars. the second thing is, a lot has been made of court reform. the mississippi state legislature has addressed that, and i have not heard many doctors -- i cannot think of the doctors complaining about tort reform in the past couple of years. it should be done on a state-by- state basis. i voted for tort reform and i was a state legislator. i have voted for it in washington. what we need now is insurance reform to go on top of that. she made some great points. unfortunately, if you remember back in 1999, congress passed something that repealed something that anyone my age would remember which was called glass-steagall. in high school, that only taught me three bills, but they stuck with me. glass-steagall was one those three, because what it said was that the banks cannot take your deposits and go gamble with them on wall street. that law was passed right after the depression because banks were gambling with people's deposits on wall street. they lost that money. those people lost everything, and the banks walked away scot- free. so in the 1930's congress passed a very good law called glass- steagall, which said banks cannot gamble with your money on wall street. it came up in 1999. they said with all the great accountants out there, with all the great electronics we have out there, we do not need that anymore. i voted against that. i thought glass-steagall made sense for 60 years and i thought it should have stayed on the books. interestingly enough, bill clinton and republican house and senate were all in on it. to his credit, the president of the biggest bank in self mississippi, he has passed on, but he called me up shortly after that and said we wanted you to vote for that. i said mr. leo, you are a conservative guy. your bank does not need to be gambling on wall street. he thought for a second and said you are right. the bank prides itself on saying on signs out front, bailout, no thanks. waterboard going to do? -- what are we going to do? we need to pass something like glass-steagall this fall, put it back on the books, so that banks get back to their core business of banking, and investment firms do what they do, which is investments. did not mix the two. if you want to gamble, go gamble, but if you one is money to be say, it needs to be safe in the bank. the jeep you want your money to be safe. i am recognizing one at a time. i will get you, james. -- how will get to you, james. >> i am richard comrade from laurell. i know we have had this discussion before. in the past couple of years or the past six months, we have had the stimulus bill rammed down our throats, cap and trade ramps for congress, spending bills shove down our throats. >> and i guess you know i voted against all of them. >> is all done by nancy pelosi. would you vote for her again, and do you regret voting for her in the first place? >> we will see the candidates are at the time. of the two candidates last time, when came from southwest project came to sell mississippi and said she would help with our with insurance. the other did not bother to come down here. it is true. let's do this. i appreciate your coming, and at my last two town meetings, i had people who came and said they did not get a chance to talk. who is from moss point. i travel so that people do not have to. >> my name is michael jordan. >> i do not know of anyone who got here on the bus. >> i am a conservative, just like you. i am not a democrat, i am a republican. i appreciate all the things you do for self mississippi. everybody in here should. i do not have a question. i have a point i want to make. i have a nephew who lives in new zealand. new zealand is under national health care. he is 16 years old. he had rotator cuff injury on his shoulder. it took him nine months, nine months in a sling to get a doctor's appointment. his family, under national health care, had to pay half the cost of eight $40,000 operation. if you folks want nationalized health care of that nature -- >> again, i am not for the obama health care plan. >> i know you are not. i appreciate that. >> i appreciate your comment. >> medicare fraud is absolutely outrageous. [applause] we had a local incident of medicare fraud here in moss point. if someone would just take the time to look at all the cheating and fraud that is going on, there is no telling how many trillions of dollars that could be saved. [applause] >> mike, that is the list of all the waste and fraud hot lines. we have a copy of that by each of the doors. we are not a police state, my. we cannot be everywhere. if you are a concerned citizen and you are aware of it and i am not, then i would ask you as a concerned citizen who knows the circumstances -- >> i know that this lady in moss point was cheating the government [unintelligible] >> that is why we have the waste, fraud, and abuse hot line up there for you. >> i found out about it afterwards. >> again, if you see it happening, that is why they let them. i am not omniscient. if you see something that i don't, please, as a good citizen, take the time to make that call. [unintelligible] [applause] [shouting] >> sir, i have been a democrat for 28 years since i first ran for city council. i would think of vote as an american. -- i vote as an american. [applause] sir, i would remind you that several people were on the ballot last november, a presidential candidate, to senators and myself, and i am very grateful that i got more votes than them. [unintelligible] >> i am neither a republican nor a democrat. >> i am glad to hear that. [applause] >> i would like to reiterate what this lady asked just a minute ago. every time we turn around, we are fighting to save some of our freedoms. the government is getting bigger and bigger and bigger, and taking more and more, and frankly, we are done with it. >> can i ask you to be specific? >> ok, health care. i did not want you messing with my health care. i pay $700 a month for my health care, the best in the world. i do not want somebody registering my guns. i know you have taken a good stand on guns, but we are having to fight for it. keep going. i don't want any more government, none. i do not want a noti.d. -- i do not want a national i.d. [applause] . . >> [inaudible] >> can you step to the hall so i can see you prov? >> to the person that can afford $700 a month for insurance, i can appreciate that you can. if you would like millions of americans who have lost their jobs and no longer have $700 a month to pay for insurance, these are people that have to be considered also. they are all real americans. [cheers and applause] [boo's] >> folks, out of courtesy to your fellow citizens, if you like what they have to say, clap for them. if you don't like what they have to say, don't clap for them. we are all entitled to our opinions and to wheat -- and we do not have to be doing our fellow americans opinions. are you from here? >> the first thing that i wanted to know it is when tarp legislation was passed the worst time. it was 3:00 in the morning. i am told that parts of that bill were put in in just before it was voted. did you vote yes? >> i voted no, sir. both of the presidential candidates did vote for it. >> what about cap and trade? >> i voted against cap and trade also, sir. i think it is a ponzi scheme. >> do you accept pac money? >> yes, i do from the local shipyard. >> from local money? >> most all of them have a local interest. >> read the 10th amendment carefully. >> believe me, as a former state senator and councilman, there probably is not anyone in this room that better anders stands how much i want cities to do their job, states to do their job, and we are here to back them up when they need us. on a day-to-day basis, we need them doing their jobs. man, are you from here? >> [inaudible] >> who else is from moss point? how about the gentleman over here with the polka dots blue tie? >> [inaudible] >> we will get to you. yes, ma'am. >> gene? i am a resident but and the president of moss point naacp. i realize that the current health care proposal may have some problems, and you are not going to vote for it, but i think there may be alternatives on the table. is there any way that there is an alternative that you would consider the hard-working mississippian do not have proper coverage? there are so many of us who do not have proper coverage. if there is a compromise that is reached, would it provide the service that would provide the coverage that this country should provide. would you consider supporting that type of measure? [cheers] >> folks, expect york -- respect your fellow citizens. number one, 46 cents out of every health care dollar total. it is either federal money, state money, or local money, so almost half of the bill right now is tax money. medicare is scheduled to quit collecting enough to pay its bills come 2017. i think it is more important right now to keep the promises we have already made by getting congress on things like prescription drugs, taking away the insurance company's antitrust exemption, and finding, the [unintelligible] i have made new promises. the reason that you are eligible from the day you join the service is because of me. [applause] that was my fight, and we won. if you are retired military, the reason you have health care is because of me. i shut down the house of representatives. i have done quite a bit too expand health care. when you and i were kids, the only americans who were promised health care where our military. when you and i were kids, there were charity hospitals. then around the 1960's, medicare and medicaid. then we expanded military health care to keep the promise that we may to guys like henrico. if he served 20 years, we would pay his health care bills for the rest of his life. with $11 trillion worth of debt, i just don't know where the money is going to come from. i don't want to get our nation and the further into debt. you asked a great question. [applause] are you from here, sir? >> [inaudible] >> walk through the aisle. then we will get to you, mitch. >> [inaudible] >> i will get to that. i will get to you. >> as a follow-up to carly's question, i am concerned they may make little changes in the proposed bill and representatives and senators that have made their mind up not to vote for it currently may change their mind and vote for it with some little changes. one thing i am concerned about is the public option versus the cooperative option. it is my concern that under the public auction, private enterprise cannot compete with big government. it seems lately that any time the government needs more money these days, they just start printing more out of thin air or wherever. >> can i cut to the quick, sir? >> i am not going to change my vote based on any small changes. [applause] the answer is that i am not going to vote for it. i told you the three things i am for that i hope to do right now to start saving money. >> i believe you but am afraid that some others -- yesterday the secretary of health and human services said the administration was going to drop the public auction and change to the cooperative option. i am concerned that that will change some representatives and senators of mind. >> i don't mean to cut you off, but a tweaked here and there is not going to change my mind. i told you what i am for. the question was asked of me, what is the difference between this and insurace? if we have a plan that allows you to buy it wind insurance as an option, a voluntary option to your flood insurance, it has to pay for itself. it will not increase the national debt. it has to be done in a way that is balanced. when we collect premiums, we will pay the cost that goes out on its annual basis. you are really spreading the risk. in mississippi, for those who say they do not want the government in the wind insurance, the government is in the wind insurance. the state has 8 $6 billion exposure. the state general fund budget is only $6 billion. if we have a terrible storm, it could bankrupt the state. if you spread it around coastal america, you are spreading the risk. the chance of those coastal communities getting hit is not going to happen. you can ride advertisements saying don't let this happen to you. great question, and that is the difference. >> [inaudible] >> great question. the health-care bill even with the changes that a couple of guys would be able to get out of would cost the nation $900 in new tax dollars or $900 billion in new debt. we don't have that kind of money. does anyone up here have a question? mayor, would you like to introduce the council? just quickly. >> yes, we are going to start to my left. mr. tommy hightower, ward five. we have our jackson county supervisor milton harris. we have houston cunningham, our at large member. this surely chambers, ward 4. ms. ruby heel, ward 2. >> thank you. if anyone has a question after the meeting, i would be more than happy to meet with you. >> what is the difference to spending billions of dollars providing health care for everybody, and we are spending billions of dollars on a war that we should not have been in. what is the difference? >> again, i don't know if you heard it, the question is what is the difference between that and the war. it is a very fair question, and they are both expensive. i did vote to send us to war in afghanistan. i voted us -- i voted to send us to war in iraq. [applause] both of those wars are extremely expensive. both, in terms of your tax dollars, but more importantly in terms of those lives. guys like johnny pope who were buried on saturday. several people, major green from this community. we are in it. at this point, we have to see it through. i do believe we will be out of iraq by august. i just had a high-level meeting with general john kelly, marine corps three-start last week. he is convinced we will be out of their. unfortunately, afghanistan is going to be a mess for a while to come and it is going to be expensive. i think we need to get there, kill those people that need to be killed, make peace with those that are willing to make peace with us, and come home. [applause] that is a very fair question, sir. are you from here, sir? >> originally i read an article in florida. my name is pat macdonald. there was an article in one of the magazines about an investigation into the medicare problem in florida. they looked at 1700 medical providers, medical equipment, durable equipment. 114 out of 1700 were fraudulent. i talk to my doctor last week before my wife had her back operation. he spent about 30 extra minutes with us. he has reported to medicare on six occasions in the last six months fraud. nobody ever from medicare ever contacted him back. >> do you see that young lady right there? >> [inaudible] if the congress and the house of representatives would make fraud charges equal to what bernard madoff got, and send them to jail forever, this problem would stop [inaudible] >> his observation was on fraud, and i will remind you that at the doors, we have hot lines for all of the fraud and abuse lines. if you see it, is your money. if you want to save your money, turn them in. i promised the former state representative behind you. >> congressman, thank you for coming. once this war is over with, veterans like myself in the state of mississippi and across this nation, are you committed to not cut our benefits in support us 100% like we have supported the united states? [applause] [cheers and applause] match, my job right now is to keep the promises that we have already made including our promises to our veterans. that is why i am not making any new promises. it is expensive. carl, i don't want to dwell on it because i consider this man a friend. it is just a gift of god that he lived. he was in the hospital for years. he can walk and he can talk. when i first saw him, i never dreamt any of this things would happen, but it comes at a price. we are going to have a price to take care of him and his boy until that man is an adult, and we will keep those promises, mitch. [applause] >> i have several questions. >> how about one in fairness to everyone else? >> ok. illegal immigration. back in the 1980's, i lived up in new jersey. on the way to atlantic city, there were illegal immigrants working at gas stations. they would have people, nine in 10 of them, living in the back of the gas stations. you called up immigration's a customs, did you know what they said? they said you are violating their privacy. >> on immigration, there is a bill that does a couple of things. i am a co-sponsor of that bill. an additional 8000 border patrol agents to secure the borders. secondly, and equally as importantly, if you think about it, they come here to work. americans go to mexico to goof off. [shouts] >> so if you take away their ability to work, they quit coming. how do you do that? [shouts] so how do you do that? if they can find out can legally buy a gun, we have a system now in place. it is called e-verify, where a potential employer instantaneously can check to see if that potential employees is here legally. number one. no. 2 is if he knowingly hired an illegal alien, we throw the book at him. you take away the incentive to hire illegal aliens. third they, it starts with each and every one of us. like many of you, i lost my house. i had to rebuild my house. i don't know how many of you, every contractor i dealt with, i said he will have an all american crew on my property. some of them would say that they are all here legally. i don't care. they are going to be american citizens. i paid a third more for my roof to get an all american crew. number one, it starts with each and every one of us. throw the book at those people who knowingly hire illegal aliens. because of some high-profile raids that of already taken place in mississippi, i am noticing a lot less of what i suspect to be illegal aliens right now. [shouting] >> [inaudible] >> i am not from moss point. i have an observation followed up by a question. you are a conservative and you regularly oppose your party on voting issues. why do you remain the party of nancy pelosi and harry reid and all of these people who continue to make us feel like we have to fight for our american freedoms? [cheers and applause] >> weaken both the stereotype. in the past couple of weeks, there have been three very high- profile republicans that got caught with their mistresses. i am not going to stereotype. i am in a party with a navy admiral, a navy corporal. my good friend jim marshall is in the ranger hall of fame. it does not make me any of those things, but i am proud to be there with those people. i am pro-life. >> did you say that you work with this bill -- >> i am sorry, one at a time. >> did you say you were working on this bill with schumer on this immigration thing? >> schuler. by the way, heath schuler came in second in the heisman trophy, but that does not make me a great quarterback. >> let's talk about schumer for a minute. >> he is a senator out of new york. >> he is planning to ram through this health care bill with a vote of 50. can you fight against that for us in mississippi? >> sir, i regret that i am going to have to ask you to repeat your question. i could not hear it. >> he has threatened to ram this health care bill with a vote of 50 after this recess. is there any way that you, for us in mississippi, can fight him against doing this? >> he is in the senate, i am in the house. i don't think this is going to become law. i think that other representatives are hearing similar things in their districts, and i do not think they will be voting for it come september. i am a representative, he is in the senate. what happens in the senate, you need to contact our two senators. >> i have been here for a little over 10 years. i wanted to emphasize that health care -- when you are a sick patient, health care is not in your interest to be run by the big business when the bottom line is profit. when you look at administration of government-run programs, roughly admission of cost are 3 cents on the dollar. others are about 20 cents on the dollar in order to do paperwork and all of the inefficiencies and profits that are involved in supporting big businesses. when you say you are conservative, and you support being not in front of your health care run by bureaucrats, what you want is your health care being run by some big corporate board that could care less whether you are sick. [cheers and applause] >> #1, and thank you for what you do. we lost a lot of doctors after the storm. thank you for being here. you don't hear me that nothing medicare and medicaid. we can do a better job. you have heard me say that we need to bring two -- we need to bring true competition. they are exempt from it. one of the reasons why they can charge that much, doctor, and i don't believe you can do this or think you could call the others and say let's charge this much money, or call them up to say -- no, you can't. but they can. it is perfectly legal for the insurance companies to call each other up and say let's raise prices and cut coverage. you take alabama, you take louisiana, i will take mississippi. that has to change. that is one of the first things i want to get done when we come back. i hope a lot of people will ask the same question that you are asking. the insurance lobby is a powerful lobby. i think it is starting to dawn on people that they should not be exempt from the antitrust laws. when trent and i got together after the hurricane, we started to compare horror stories. quite honestly, he did not know they were exempt from the antitrust laws. he knows it now. it is one of those things that we need to get the word out on. again, thank you for what you do. [applause] >> we met several times at different town hall meetings. >> folks, give daryl a chance. >> i would like to address my concerns dealing with the waste that you have up here ther. there was a plant -- >> i missed the name of the company. >> it was shut down by the epa a couple of years ago. they promised to clean up the area. all the citizens that lives in moss point were able to apply for some type of compensation benefit plan due to the waste in the cleanup process. a lot of them went out and got attorneys cannot fill out paperwork. -- attorneys, filled out paper work. i want to know what has become of that plan that was agreed upon with the epa. >> the answer is, i don't know. if you give us your information, we will try to find out for you. you of the first one that has asked me that question in about 10 years. >> [inaudible] >> i think it has been a pretty good while. if you get me that information, we will find out for you. how about this lady over here, billy? >> speaking of medicare -- >> would you say your name? >> there was a bill that was passed that a house foreign doctors to come in and be educated and become a doctor. medicare pays full amount for their education and their stake here in the united states. that bill should be repealed. it is taking money out of medicare for these foreign doctors to come over here and be educated. most of them don't go home. >> i don't know that to be true. >> i have the bill that was sent to me by another congressman a. i left it at home. >> i don't know if that is true. it does not sound right. to the best of my knowledge, the only people that are getting their medical education paid for our people that agree to serve in the military. i think the rest of them take out loans. >> there are a lot of foreign doctors here that have been educated in the united states. i think most of them were educated by medicare. >> i don't think that is to but we will look into it. how about the lady in purple? billy, can you get to that lady? >there is five more minutes. we can get into more questions. the mayor has spent a small fortune on police. we are going to honor her request that we are going to wrap this up at 7:30. we want to get many of this police back to their families. yes, ma'am? >> i reside in hurley. just a couple of remarks that i would like to make. the people in rural areas of our county recently lost some of our rights. when we feel like we are starting to lose them at the federal level, it is like adding insult to injury. people are a little fired up. >> could you be specific to what you think? >> what i feel like is that we are not having offer input as to what is happening to our health care. many other things, but i will not go into all of them. i would appreciate it if you would take a message back to us. we appreciate what you are doing for us. you have voted in a conservative manner. if you would take the message back to washington for us, that we are not idiots. we are not in the business of name calling. we would appreciate if our leaders would spend more time paying attention and reading the bills that they are passing instead of calling us names. [cheering and applause] >> ok. thank you. thank you for the way you said it. i very amok -- i very much appreciate what he said. we are going to wrap this up. this gentleman is wearing a united states marine corps hat. >> first and last, i would like to congratulate you for facing all of us. if you want my vote, you will have to do more than voting against. i want you to go back to washington and tell them how angry our fellow americans are. [cheers and applause] >> ok. come on. last one. ok, one last marine. i promised the police that they could get back to their families. >> most people around here call me buddy. there are a few things i would like to ask. let's talk about veterans. everybody in here, if you were a marine, and i have always been a marine, but when you in the 1960's, 1970's joined, they told you you would have it for life. if you were not signed up by january 3, 2003, you will not get one penny unless you make less than $16,000 and only less than $3,000 worth of property. >> buddy, i think you are wrong. >> i am not wrong. >> body, we have bob person here tonight. he is going to get your information. >> i am trying to help somebody else. >> we have had the largest expansion of veteran benefits in the nation's history. they turned that and we will continue that. thank you for coming out. god bless you. >> planning on attending a local town hall meeting? do you have a video camera? you can submit your video for air on c-span. visit us online for details. >> as the health-care conversation continues, c-span's healthcare hub is a key resource. follow the latest. also keep up-to-date with health care events like town hall meetings, debate, and even public your opinion about health care with a video. >> tomorrow, a look at health care town hall meetings with usa today reporter kathy kiely. bing west previews tamara's presidential elections in afghanistan. the author of "f p r vs. constitution -- fdr vs. the constitution." begins every day on thursday at 7:00 a.m. eastern on c-span. >> robert gibbs fielded several questions. this is 45 minutes. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> yes, sir? take us away. >> [unintelligible] the administration's overall legislative agenda. it is an uphill battle and it will not happen unless we energize [unintelligible] what are you folks doing right now to energize that pace, which seems fairly quiet in relation to what one hears daily from those who are opposed, for example, to health care? >> i think i would dispute the beginning characterization. i think particularly in the events that you saw the president do, i don't think you noticed a lack of support for providing health care reform among those that were outside the president's defense. i think the president will do what he promised to do during the campaign. that is what is important for the american people to know. we are committed to getting our economy back on track, laying a foundation for long-term economic growth, addressing the urgent need for energy independence, reforming our health care system, making our schools the very best, and making this country and our homeland safer by changing our foreign policy. i think those are the things that the president promised to do and what he is busy doing in washington. >> you are satisfied with what you are hearing on health care? >> yes. i think they are -- i think there are millions of people out there that nknow that are part f our political base and others that believed it is time that the health-care system change, that we need reform and we can continue to do what we are doing now. i think that is precisely it. >> there are others who think you have lost control of the argument and wonder if the president has the political muscle to see this through. >> stay tuned. >> how do you respond to the suggestion that you lost control of the argument? >> the argument is not over. the discussion is not over. the debate is not over. the legislative process is not over. >> [unintelligible] >> [unintelligible] i said this this morning. this notion of changing the position of the public health care plan, or the public auction was not something that any of you all picked up on saturday when the president said it. we did this this morning. >> [unintelligible] >> do you have your pen ready? >> [inaudible] >> i missed yours. >i would be happy to look that out. >> [unintelligible] >> i am going to reiterate read -- with the president. people have to have the ability to choose among insurers, driving down their cost and improving quality. if there are others who have ideas about how we can institute choice and competition, he is happy to look at this. >> [unintelligible] >> we will fight for whatever is best that brings about that choice and competition. that is what the president has always maintained. nearly a hundred people have died in the latest bombings in iraq. it is the bloodiest day in more than a year. what does this say about the readiness of iraqi security forces to take over responsibility, and is there a concern that the pullout of american forces was premature? >> this is determined by the iraq peace. it is part of the agreements that were made. i think it shows you the that the links to which extremists will always go to wreak havoc through senseless violence that harms innocent human lives. i think the president talked about this during his speech in cairo, egypt, and that not only is the violence, the shocking violence shocking, but when you factor in the fact that it is muslim on muslim violence, to the degree to which that underscores the deplorable and shocking nature of it, that i would point out that the number of attacks is at or near an all- time low. there will always be those that believe they can or should be heard through this type of violence. it is obvious that the vast number of the iraqi possibilities -- iraq the's believe -- we will assist them in securing their country until the agreement did note that it is time for us to go. >> any concern that the forces are not up to the task? >> no. i think you heard the general talk about this in the past. i don't think it has changed. >> we addressed president obama saying that health care legislation must include a health care exchange with a public plan as part of that exchange. are we all wrong in assuming that the word "must" applies to only a public plan? >> i would have to look at the exact phrasing. >> [unintelligible] it is one of the most well-known quotes. >> i have not looked at it in the past few days. >> we have it cued up already. >> we can quibble about whether he phrased it one way that time. we can quibble when he phrased it when he stood before you all in june and talk about not drawing lines in the sand. again, i think the president has stated his position. >> in terms of comments made recently by republicans on the senate finance committee in negotiations, talking about the public plan, it is still the intention and hope of this white house to have a bipartisan bill in the senate? >> absolutely. the president believes strongly in working with republicans and democrats. independent come at any that seek to reform health care. they want to see cost cuts, coverage increase, insurance reforms implemented that no longer discriminate against families and individuals. the president strongly believes we are making progress. he has had conversations with people of the finance committee. as i said during friday in mantegna and others, -- in montana and others, our preference is to work through this process and hopefully come out with a bill that has agreement among both parties in the committee. >> are you expecting any republican votes on this bill in the senate or in the house? >> i think there are many that would like to see some health care reform. i trust that the three republicans that working in the senate finance committee are doing so in good faith. i have no reason to believe that they are not. >> how is it a you can achieve a bipartisan bill when it seems you are having trouble achieving a partisan bill, between the blue dogs and the progressives in the house? >> there are blue dogs on the energy and commerce committee that voted out a bill on the house side before we left for recess. this notion that it is impossible even to get an agreement on our side with what a health care plan looks leg belies the notion that this is legislation that went through three committees on the house side. the notion that we cannot get something done like that just is not true. >> i guess i mean more of the divisions between the house and senate. what can make it to the senate -- >> i think the president has talked about that. that is what we will spend the fall doing. part of that process will be what progress the senate finance committee itself can make. working democrats and republicans, working together to come up with what we hope is a bipartisan solution. >> i just wanted to clarify something that you were asked this morning. in response to this question, have there been discussions here strategically about going all democratic [unintelligible] you said no. >> we are focusing on how to get bipartisan support, on how to get members of both parties who want to work on comprehensive health care reform. that is what we are focused on. >> you mean to say no one in the administration is looking at strategically the possibility of -- >> we are focused on a process that continues in the senate with both parties. the president met with senator max baucus in montana. they discussed the progress that was being made among democrats and republicans on the finance committee. that is our focus. >> no plan b? >> a senator in response to a question with the cn and talking about broad base support for health-care legislation said so far no one has developed that kind of support either in congress or at the white house. it doesn't mean we should quit. we should keep working until we put something together that get support. has the white house failed to get widespread support? >> the white house concluded agrees with what the senator says it there. that is why i said this morning that our preferred option is to go the route of getting all of those involved that are at the table to agree to something that can be supported by both parties i can't speak to what republicans will ultimately end up doing. the president does not have control over every person's vote on this. he can and will continue to work to try to get an agreement on both sides of the aisle on this. the president believes this issue is far too important to not try. to walk away from a perfect opportunity to bring both sides together in order to make progress on an issue that we have seen fail time after time after time. that is why the president goes at this not ideologically two different things, but how do we get the best reform for different people? that is what his focus is on. >> did you say the $250,000, not raising taxes on these people making this is a line in the sand? >> the president reiterated that the other day. >> is the commitment on the public auction equally as strong as the commitment by the administration -- >> i think i have answered this like 12 times. >> so the answer is no proof >> i will go slow. the president -- keep writing choice in competition. [inaudible] choice and competition for people entering the private insurance market in order to hold down costs, provide quality of coverage. we have to have choice and competition the preferred way is the public auction. if there are others that have additional viewpoints are other ideas in policy that institute that, he is and we are ready to hear them. >> is it wrong or correct to say that the commitment to not raising taxes in this health care bill is equally as strong as having a public option? >> i am not going to get into ranking those things. >> that is not a line in the sand that you have drawn? >> i am not going to get into ranking different priorities like the pre-season college football poll. >> why don't you have him come down here and tell us again? >> it did not work the first time? >> [unintelligible] >> i am saying that is his preferred option. his preference exceeds that of all this. >> take it or leave it. >> do you guys accept any responsibility on the fact that some of these other issues on health care that you have had to fight against whether it is incorrect interpretations of the bill [unintelligible] is it all the media's fault? >> i don't think anybody here believes we have pitched eight no-hit game or a perfect game. i don't think that is the case. >> so you guys need to do better? >> 22 continually be out there. -- we need to continually be out there. one of the big macs was this notion of government making end of life decisions on behalf of seniors. your poll shows that that myth is not believed by the american people. i think the president has had an impact on what the perception -- on the perception of what the health-care bill means on those decisions. >> [unintelligible] >> 45% is not half of the country. if you get 45% in an election, you don't get sworn in. i think we are heartened that a majority of the country, and i think the same number of seniors believed that that is exactly a myth, and the president has dealt with it. will he have to deal with others? sure. that is why he is talking to leaders today. he will do a radio call-in show tomorrow and will continue to try to make progress on this issue. >> [unintelligible] >> i don't know if he did on one of the earlier calls. i don't know if he will learn not. >> robert, when you talk about, not to belabor the point further, but the president is open to do any thing that will do a number of things including bring back cost. has he seen anything outside of the public option that will do that? >> i think most people have said that they have not yet seen the full details of what a co-op would look like in terms of evaluating their full effectiveness. >> is the radio call-in show -- >> no, this is [unintelligible] >> secondly, senate democrats have been meeting for more than a month, trying to figure out what can be done through reconciliation. they feel like they have made a lot of progress on the options. are you saying the white house has not participated in those conversations? >> i can certainly check. >> would you check that? they certainly believe you have been. they have been calling it planned be. >> our focus is not on what happens "if". our focus is on the here and now. >> do you believe you can do in significant health care bill with 51 votes? >> that is not our focus. >> what is your sense on the security situation there, just hours leading up to the vote, and what are the stakes of the president's strategy leading up to this election? >> as the president long said, the elections of the most important event that will happen in afghanistan this year. we wish the afghans well in their election tomorrow. as i said, i think this is an important event. in choosing their own leaders. in terms of the security situation, obviously, the president increase our troop commitment to afghanistan based on a belief that the security situation for these elections were tremendously important. we continue to monitor that. look, i think this is an important event. the president's policy is one that he is focused on getting right to a new and comprehensive strategy that he announced. to defeat, dismantled -- i am sorry, too distraught, this matter, can defeat al-qaeda and its allies. this is important for our national security, our homeland security, and the security for the rest of the world. >> what would you like to see changed? >> i don't want to do that before tomorrow. we will have some comment about elections when they are completed. >> are you still confident this will be a legitimate election? >> will look forward to observing what happens tomorrow. -- we will look forward to observe and what happens tomorrow. >> can you talk about the phone call that a president will make about health care? is there a more targeted message that he will try to get across? >> he already has completed a call this morning with rabbis that he was invited to join as they get ready for their important holidays and the messages that they will have, the importance ofor faith leaders, the importance of health care coverage for millions of americans. but the message is not different to them than it is for those that go to a town hall meeting or listen in on a radio call in share. his principles are the same. his desires to seek a comprehensive reform, cut costs for families and small businesses, to make it more manageable four budgets of the federal government, state and local governments, and the important insurance reforms that he has discussed over the past few days. >> this is quoting the new york times. as strategic decision that the feeding of the proposal is more important to their political goals than solving the health insurance problems that americans face every day. is that rahm emanuel"s view? >> i think there are many in the leadership that appeared to not support reform that does the very things i just talked toe d ed about. i will go back to a number that was in the nbc poll. they asked about the approval rating for republicans in congress on health care. i think it was 21 approved, 60 disapproved. we have heard this from democrats and republicans that the american people know something has to be done. they can continue to watch their premiums double. they can continue to watch small businesses go out of business or drop coverage they want to provide to their employees. we can't have any more than we can have a government bureaucrats in charge of health care. i think the vast number of people in america now we have to do something to get out of this spiral of health care that we are in. . . >> i have not read a lot of comments from senator mcconnell that will lead me to believe he would be supportive of their efforts. >> there is a survey that as the congress should approve a health care plan even if democrats were for it. it denies terms and in no -- 59% said no. how does this factor into the white house public opinion? >> it factors and how i talked about today. our preference is to move forward working with democrats and republicans. we think that is important. we believe that those that are working to try to get that agreement are doing so because they think healthcare reform is important. we will continue to try to make progress on those issues. >> the preference and does not overtake the desire to achieve some legislative result this year? >> i think the president has been clear on that. >> you said there was an indication that the three republican negotiators have said that they are in favor of health-care reform. more recently they have said things that depart from that. what was the president specifically reaction to senator grassley's comments this week that he would not vote for a bill if draw support from the republicans' tax cut. >> i'm trying to remember whether we talked about it and what he said. we take it on face the you that senator grassley and senator snowe are working to find a solution in a comprehensive way. >> they have said several things. >> i am not going to tell you that we have not found some confusion in what has been said in setting a bar differently than how they might be negotiated. we believe that those three individuals and others are working right now and in good faith. >> what has the republican leadership and the house -- is it purposely of shutting itself? >> kundra 32 what rahm emanuel said -- i would refer you to what rahm emanuel said in a story you wrote. >> they set up structure. >> i have not seen a lot of action on the part of republican leaders to enunciate clearly what they want to do to cut health-care costs, tried to cover those that are unfortunate enough not to have coverage, what they want to do on insurance reforms. i have not seen them overwhelmed with that as a focus. >> what is the president's view of some of the conciliatory moves we have seen from north korea? >> stepping back for a second, the president had a good meeting yesterday with former president clinton. our goals have not changed as it relates to north korea. largely because their responsibilities of north korea have not changed. the injured into agreements -- and they entered into agreements that require them to end the nuclear weapons program our continued goal is to denuclearize career. we are certainly hopeful that whenever signals they may or may not send that it feeds them back to the process of living up to the responsibilities of that they agreed to. that has always been our focus. >> after listening to clinton is today, is he more optimistic? >> -- yesterday, is he more optimistic? >> no, good try though. >> a couple months back, the president asked secretary days to look into ways of relaxing the do not as to not tell policy. have you guys heard anything back from the secretary on that? what i will check on that. >> the president said he felt an urgency about that. the secretary asked for 20,000 more troops. >> i think the president has long believed that the policy did not work for our national interest or national security interest. i will check with those guys on that. -- on what congress has made. i want to reiterate one thing. that pathway for them to come back and live up to those responsibilities is open. that door is open for them to walker. we hope that whatever they are doing regardless of the signals that they send, that they will walk through the door and live up to those responsibilities. one of the messages that we have had and others have had in dealing with north korea is their belief that a nuclear weapons program will raise their international stature rather thean that program in defiance of the agreement diminishes of them and further alienate them. >> for you aware of this delegation in north korea from the u.n. with richardson? >> aware from news reports. the state department has to approve travel outside of a certain radius in new york for diplomats that are acting -- any of these meetings is independent of the administration. i would ask you to talk to new york's and governor richards and specifically about reasons why. >> [unintelligible] depressing clinton and president obama speak about healthcare? >> they spoke about number three. >> for their questions about healthcare? -- they spoke about north korea. >> were there questions about healthcare? >> i will not go into private conversations that are had between two -- this president and former president clinton. >> that will affect us all. were there more topics and then the numbers 3 in that meeting? >> not that i know of. >> is obama splitting the cost with the government? >> i am merely trying to figure out my vacation. --they have paid for their vacation like a paid for it in last august and a hawaii and last december in hawaii. >> can you talk a little bit about tomorrows online [unintelligible] does obama feel his supporters need a more pep talks to counter some of the efforts that opponents are giving? >> i think the president just want to update those that have been involved with him for a long time and where we think karen healthcare reform and how we can continue to keep them involved as we discuss important issues throughout the fall. it is something that we have wanted to do for a while. the schedule had an opportunity to do so. >> do you think they could be more involved than they have been? >> we know people have busy lives. i become many of these people have been greatly involved and giving other time and money and energy in this and other efforts. we hope they continue to do so. >> is the white house concerned about the journalists giving tell then -- being arrested for giving tell thalibn information? >> we have expressed our concern about the policy. are we -- we have the belief that journalists should have the freedom of access in fully covering tamara's elections. >> i too quick healthcare questions. have you received an answer on the poker question? >> i will try that today. >> in ca texas hold m. guy? -- is he a texas hold him to die? >> i will ask him. >> most americans no longer believe in the death penalty. section 1233 was taken out of the house bill. what can you do to reassure voters that the other provisions [unintelligible] >> i've not following the section that has been pulled out. >> about the end of life. there is a report that it has been dropped. is that not true? >> this is in the senate finance bill and nobody has seen. what i am saying is that the president is going out there and it explaining what those provisions are and what they are not regardless of what section of what bill and it was time. i think it is something the president has been focused on doing. i think it has more to do a sustained dialogue in dealing with the mr. prince's stations -- misrepresentations. >> there is a discussion entry in the white house and farma. can you say what is at that meeting? >> let me look at it. i think we put -- i have to look at what it says. >> is the white house looking at the meeting with richardson in north korea? what i do not know what is on the docket to discuss. i think without understanding the agenda or reasoning for this meeting, it is our hope that the north koreans will pick up the responsibility that they entered into in hopes of seeing a denuclearized korean. if anything further is that goal, it will be a positive thing. >> to the administration get the green light to this meeting without knowing what it would be about it? what's the status bar and has to approve the travel. -- >> the state department has to approve the travel. >> there was a group abthe went to look at guantanamo. has the group been sent to look at leavenworth? does that mean that the michigan site is the only one under consideration? people have a right to know what size your being -- what sites are being looked at. >> part of this is a meeting with local officials. let's not perpetuate this notion that somehow somebody suit in and nobody noon -- somebody swooped in and nobody knew. i have no informations that we have done site visits or court evaluations anywhere other than the facility. >> that is the only option? >> no type of decision has been made. this was not a visit intended to -- this was an evaluative visit. this is not a final decision or anything like that. i think there are obviously certain things that aspects in a facility that anybody would like to see and we are evaluating a facility that many of those local beliefs would be a good fit and provide the full employment on a prison that has close. >> twothings. [unintelligible] >> i think in many ways, state elections had a confluence of a lot of factors that determine how people might vote. i am from virginia. i am reminded -- i live in virginia. i'm from alabama by birth. if you go back either 1982 or 1970 -- i think i have this right. the party that occupied the white house the opposite party has held the governors mansion in richmond. i can do this back to at least 1986. i think it is 1986. it is quite a while. >> did the white house anticipate the ferocity of the attacks of dependence as in developing strategy? >> if you go back and watch what senator mccain's critique of our health care plan was in april or may of 2000 a, it is not any different than it wyou hear opponents making now. if you go back and participated in a debate in 1993 and then somehow disappeared from anything political and were sealed off from the news for 15 years and came back and decided you wanted to critique the health care plan -- you probably would pick what they are saying which is not true. this is -- i think the attacks are standard. and they are tried and true. they have in the past, because of the backing of certain interests, won the day. the president has entered into this discussion with all of those involved in the health- care debate in a different way. he hopes and believes that the outcome this fall will be different than the one we have seen over the past many years. thank you. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> coming up on c-span, the center for immigration studies hosted a study on immigrants and the health care system. they issued guidelines for businesses to deal with an outbreak of h1n1 swine flu. congressman gene taylor hold a town hall meeting in mississippi. tomorrow morning, a journal of health policy called health affairs posts a conference looking at the government's role in health care. you can watch live coverage on c-span2 beginning at 8:30 a.m. eastern. >> this fall, and to the home to america's highest court from the grand public places to those only accessible by the nine justices. the supreme court coming the first sunday in october on c- span. >> according to the center for immigration studies, one out of every three people in the u.s. without health insurance are immigrants. the organization hosted a discussion today on immigrants and the health care bill. this is an hour and 10 minutes. >> this morning. i am the executive of critiquing the impact of immigration. we do not have the views on things other than immigration. there is no stand supporting or opposing any kind of reform on health care. our staff and board certainly have a pretty wide variety of views on health care as well as other issues. healthcare being such a big part of the economy is an important thing. we do have a contribution to make. there has been some discussion already of the immigration aspects of the health-care issue. from our perspective, and that has been limited because it has been mainly about the issue of legal status. will illegal immigrants be subsidized by some taxpayer funded health care program? that is an important aspect of the issue. our speakers will touch on it to some degree or another. the important thing i think is to understand that the problem of emigration as relates to health care is not strictly one of legal status. it is not limited to illegal immigration, as important as that is. it is a question of immigration overall and the impact it has on health care. illegal immigrants are not a different species. their people. they come from the same countries and families of legal immigrants. to understand comprehensively the impact of immigration on health care, you need to look at all immigration not just illegal immigration. that is what we aim to do here today. for many years he has worked in both immigration policy fields and in the health policy field. he has a lot to bring to this discussion. last is robert from the heritage foundation, a private the nation's leading scholar on the issue of welfare reform. over the last several years he has been doing significant research on the issue of immigration and its effects on public services and costs. the three speakers will say their peace and then we will take questions and answers. >> i am director of research at the center for immigration studies here in washington as congress debates health care reform, the impact of emigration is or should be an important component of that debate. whether illegal immigrants get the access to some new government program for public auction has been discussed to some extent, but the overall impact of emigration has not really been discussed. we at the center do not have a position on what form healthcare should take. i am sympathetic to some of the president's proposals, but that is not the focus of my discussion. i am instead going to discuss with the data tells us about the impact of immigration on the nation's health-care system. i am going to primarily rely on data collected by the government. what i think that will show is that it is very difficult to imagine getting our health care house in order without getting the immigration house in order. i'm going to rely primarily on government data and a population survey from 2008. that is the most recent data available. it asks about health insurance coverage in the previous calendar year. that would be how much you had in 2007. the survey is collected by the u.s. census bureau. it is our primary source of information on health insurance coverage in the united states or any population. most of the information i will cover is available at our website www.cis.org. in 2007, 33% of immigrants did not have health insurance compared to about 13% of native- born americans. immigrants account for 27.1% of all u.s. residents without health insurance. we can see this in figure one wishes to my right. -- which is to my right. it shows that immigrants are 12.5% of the nation's total population, but they are 27.1% of the uninsured. this is just the immigrants themselves. we can keep the camera on figure one a little longer. the impact of immigration is not just to find to the immigrants themselves. the democrats also have children whom they are often able to provide health insurance for. it the children who are born here under the age 18 are included with their immigrant parents, then together they comprise 31.9% of all those without health insurance to place this figure in context, the year 1 shows that immigrants and their children are about 16.80% of the total population. this means that about one out of every three people in america without health insurance is either an immigrant, legal or illegal, or a u.s. for a child of an immigrant. the total number of immigrants and their children is 14.5 million in 2007. what that tells us is that when we are talking about the uninsured, which is a big part of the debate, immigration is a very large part of that story. it is not the whole story. it is just a large fraction of it that is often not adequately acknowledged. there is another way of thinking about the impact of immigration. we can look at how much increases from immigration. the government report, the number of uninsured is of about 64 4 million. in 2007, there were 5 million immigrants who had arrived in united states since 1999 who did not have health insurance if we just take the 5 million and/6.4 million. we find that 78% of the growth is issuable to these newly arrived immigrants. if we add in the u.s.-born children, that figure gets to be over 85%. in other words, if we had no emigration after 1999, most of the growth would not have occurred. immigration is not only impact the side of the uninsured population. it also plays a role in the medicaid system. medicaid is the primary government program that provides health insurance to people with low incomes. it goes by different names. in california, it is called medical,. there is also a special program for children. it is on medicaid. when we talk about medicaid, we are talking but the big program. in 2007, 19% of immigrants and their u.s.-born children were on medicaid weekd. we can combine that with the share that are uninsured and figure two in does that. what it shows is that 47.6% of immigrants and their u.s.-born children were either uninsured or on medicaid. that means that almost half of the immigrants and their children have no health insurance or have it provided to them by the government. they bought him shows that about 25% to about 1/4%. why are so many lacking? the large share without health insurance is partly explained by the large share to have a very the levels of education. about 1/3 of all immigrants did not complete high school in their home country. that means of a typically work at jobs that do not provide insurance and it often cannot afford on their own. among illegal immigrants, we estimate that about 55% to the graduate from high school. we can see the importance of emigration to this question by looking at statistics. if we look at college educated immigrants, 15% are uninsured. immigrants to do not graduate high school, half are uninsured. a big part of this is education. it is not just education. cultural factors also seem to play a role. if we look of a fluid emigrant to have a college degree and compare them to affluent natives, and the natives are two. -- the emigrants are 245 times more likely not to have health insurance. i was looking at households less than $5,000 or more a year. -- $75,000 or more a year. the immigrants in that position are much less likely to have insurance than a native. there are other reasons. immigrants often come from countries where health insurance is not that common. they often come from countries where it is provided by the government automatically. these two factors also play some significant role in why immigrants still often choose not to. one thing we can say is lack of health insurance among immigrants is not caused by immigrants' willingness to work. in 2007, 3/4 of all immigrants on the job. there is no fundamental difference between the work. this is not being caused by immigrants sitting at home and not doing work. the reason so many do not have health insurance is their low educational attainment. there is no single better predictor of how an immigrant is going to do in the modern american economy and then there education level. this is true whether we were to look at welfare, income, homeownership, or health insurance coverage. we have only talked about all immigrants and their kids. what about legal status? we have estimated that 64% of illegal immigrants are uninsured. they account for about one out the seven people in the united states without health insurance. if we were to count their u.s.- born children, it is more like one out of every six people without health insurance in the united states. this is not the whole story. about 7 million uninsured illegal immigrants. that is about a million we count the u.s. children. a lot of folks are concerned about costs. we are in the process of trying to develop more precise estimates. our best estimate is that we are spending about $4 billion a year providing health care to illegal immigrants. that is just public spending. $4 billion. it is more to count their u.s.- born children. uninsured illegal immigrants use significantly less in healthcare than uninsured native-born americans. they tend to be younger than native-born americans. health-care costs generally rise with age. illegals are relatively young and so they tend to cost less than a uninsured natives. although the stereotype is that illegal immigrants go to emergency rooms all the time, this is not really correct. the problem is not so much that they go more often than the rest of the population read there it is that when they go there much more likely not to pay. that is why it is a problem. 13% of native-born americans are uninsured. they pay the vast majority of the time. more than 60% of illegal immigrants are uninsured. they often do not pay. when illegal immigrants use emergency health care, there is often no corresponding stream of revenue going to the emergency room to offset all the costs they create. this is the reason why emergency rooms to get so overcrowded and areas with but illegal immigrants. illegal immigrants are using the system without paying for the system. we can also calculate the cost of taxpayers of the whole thing of what legal and illegal immigrants cost. charity pay on top of the cost to taxpayers from all immigrants who are uninsured, we are estimating that about $11 billion a year. what if we try to provide medicaid to the uninsured immigrants? the cost of the very high. if we decided to cover just the uninsured illegal immigrants with medicaid, even taking into account of their much your age, it still cost about 15 billion to $30 billion a year. providing medicaid to all uninsured immigrants and their children would be enormously expensive. that to be $60 billion a year. what about an amnesty or legalization of illegal immigrants? would that solve our problems a? the president has made statements that he thinks an amnesty would solve our problem. the answer is, nmo, would not. lack of health insurance is very common among illegal immigrants. in 2007, 1/4 of those of the green card did not have health insurance. that is more than twice the rate for a native-born americans. if we look a green card holders who do not have a lot of education, 35% are uninsured. in that sense, we think that more illegal immigrants would have health insurance. there is a cat. if we look at those less educated green card holders, another 28% on medicaid. that means that we have not result the cost problem because we did not solve the underlying problem which was that illegal immigrants are unskilled. we think that 80% have no indication beyond college. a majority have not -- no education beyond high school. a majority have not even graduated. 80% are either high school dropouts or have early high school education. we have to ask the question if you can have health care reform about immigration? can you let illegal immigrants stay in the for the large cost? the answer is in no. if the illegals stay, the costs will stay as well. we either enforce the law and reduce the illegal population overtime or we just accept the cost. if one still favors an amnesty, the have to be honest and make it clear that in areas like health care, the costs are significant for letting the illegals stay and may actually get quite a bit bigger if we legalize them. legal immigrants are free to stay, of course. in the future, we have to decide whether it makes sense to continue to allow in so many legal immigrants to do not have a lot of education. some research shows 1/4 of legal immigrants have not graduated high school and some research shows that 1/3 have not graduated. a very large fraction of the illegal flow is quite unskilled. most legal immigrants are allowed into this country because they have a relative here. this means that most legal immigrants are selected without regard to their education or impact on taxpayers for the health-care system. if we want to avoid large costs, we would need to significantly reduce the number of legal immigrants who are allowed in the future. there is still one final point that bears mention. the large share of an illegal immigrant on medicaid should not be seen as some kind of moral defect on the part of immigrants. the vast majority of emigrants do not come to the united states to get free health care or to sign up for welfare programs, though that often does happen. the vast majority of immigrants, including those here without insurance, hold a job and work. the problems i have discussed our an unavoidable consequence of allowing a large number of immigrants to work but have very little education. as a result, they or their children are uninsured or use a welfare programs like medicaid. if we want to reduce the uninsured population and avoid large costs for taxpayers, we need to enforce immigration laws and reduce illegal immigrants. on illegal immigration, we would need to allow many immigrants to have a higher education. thank you. >> immigration will affect and be affected by the health reform legislation that is being crafted by the house and senate. there are 12-50 million immigrants their mere presence means that every provision of the legislation that is designed to extend health coverage to those without insurance will potentially expand the taxpayers cost by billions, if not by tens of billions or more. many immigrant households have children. they are automatically eligible for a government health care of various sorts, even if their parents are here illegally. government agencies and nonprofit often only look at things like income levels and other similar qualifiers when they are enrolling new beneficiaries in public programs like medicaid. the often overlooked once immigrant status even though that could disqualify someone from program precipitation. today, i will focus my remarks on the main immigration implications of the house and senate bills. i will make a couple of observations about the senate finance committee's legislation, although there is no legislation from the committee yet. it is of being negotiated. -- it is all being negotiated. health reform legislation contains a number of provisions that opened the door to taxpayer funding of immigrants' health care. that is for illegal aliens, illegal aliens who are supposed to rely on the sponsor for financial assistance during the first five years in the country and for certain immigrants who sponsor other immigrants. we will look at the taxpayer funded premium subsidy. h. r. 3200 title 2 relates to coverage. this section or title create a government agency to regulate health insurance. individuals and employers will have to go there for government approved health insurance. it will run the public auction. it will operate a graduated subsidy program. section242a defined to is available and how many credits that they can receive to determine the amount of the premium subsidies reviewed the bill qualifies all lawful permanent residents regardless of their sponsors pledged responsibility for the requirement five-year bar for most programs. section 242d exclude receipt of these premium subsidy premiums from counting as welfare. taxpayers will subsidies -- subsidize households up to 400% of the poverty level. section 242 generously subsidizes many people, including foreign born well into the middle class. on the house bill, that would be up to $80,000 income a year for a family of four. the money does not count as welfare payment. that might potentially risk deportation as a public charge or jeopardize their ability to sponsor other immigrants. the credits are available to sponsor illegal immigrants and foreign born immigrants sponsors themselves. the senate finance outline indicates that the bill will subsidize insurance costs up to three times the poverty level. let me talk briefly about public charge doctrines. public charge doctrine is a longstanding u.s. policy dating to colonial times and has been vigorously a part of our immigration policy throughout our history. it is supposed to protect the country from importing people who become a burden on society. would-be immigrants are denied in pieces on public charge grounds. they have to low-income whatever other factors would cause them to not give them a visa. this goes on continually. very few immigrants in a more are deported for the reason of being public charges. it pretty much that once you are here you are safe. the 1996 welfare and immigration reforms strengthened a public charge doctrines somewhat. immigrant sponsors now must sign a legally enforceable affidavits to support. in the must have earnings of at least 125 it% of the federal poverty level. their household income is deemed available to the immigrants who is applying for programs. because the provisions to suspend some welfare reforms requirements, it tends to weaken public charge doctor. the bill creates a situation where sponsors of immigrants and the immigrants themselves can collect taxpayer dollars for health coverage when immigration policy would require that they be more self-reliant. section 242 of the bill states illegal aliens are excluded from receiving federal payments under the affordable credits premium subsidies. but there is nothing in the bill requiring a screening of affordable credit recipients, such as screening them through the save system. one congressman offered an amendment in the ways and means committee to correct that but it was defeated along party lines. senate legislation amid the same eligibility verification requirements that would insure that only lawful immigrants and u.s. citizens benefit under these programs . now let's turn to medicaid. title 7 under division b of the house bill 33200 expands medicaid eligibility to those earning 1/3 of but the official poverty level. the minimum income required of immigrants sponsors falls below the sponsors eligibility for tax payer funded health care for the poor. it is at one 1/3%. the health bill expand medicaid eligibility to 50% above the official poverty rate. that leaves an even larger gap for immigrant sponsors who are poor enough to be on medicaid to still sponsor and bring in additional be some holders. this aspect of the legislation has an undermining of fact on the public charge doctrine. section 1702 of hr 3200 expense of the prohibits saves, which administer medicaid about making further determinations about new enrollees' eligibility. one such provision requires states to presume someones eligibility. in other words, these provisions set up a system that amount to be kind of in role first and do not ask questions later -- enroll first and do not ask questions later. it to apply the same verification standards and existing verification system that is in the medicaid statute. this taxpayer protection amendment was lost by a single vote. senate legislation omits any verification requirement of once eligibility. -- one's eligibility. finally, let's look at the mandate exemption. the finance committee outlined like the help and house bills mandates that individuals must carry health insurance or else they face a fine. the finance outlined says that illegal aliens will be exempt from the individual mandate. that is interesting, but it sets up a system where you have americans and illegal immigrants you have to have coverage or else pay a fine. illegal aliens with the escape both the mandate and any fine for being uninsured. it appears that this sets up for illegal aliens to be free riders. they would still received taxpayer paid medical services. legal aliens will be free from any responsibility or sanction that other people would bear. to conclude, these bills expand government health coverage and a taxpayer funded subsidies for government controlled private insurance and the public option. they make it easy to enroll new people in government run health programs with what amounts to a build in willful ignorance about characteristics which would be disqualifying, such as being here on a temporary visa or being is still under one sponsorship requirements were being here illegally. the bill makes no provision for ensuring that only lawful u.s. residents benefit from these programs. the health reform plans that are on the table will create new incentives for illegal immigration. they will preboard illegal aliens by giving them help care at no expense to themself further weaken the public charge doctor and that long served a national immigration policy so well. thank you. >> thank you very much. as we have noted in the previous comments, immigration is primarily disproportionately lower. 1/3 of all immigrants are lacking in high school degree. the pfizer are lacking a high school degree. eight you agree a person who lacks a high school degree pays more in taxes than they receive in government benefits, you would believe that this system is good for the u.s. taxpayer. if you believe that someone who lacks a high-school degree possibly receives a smidgen more in government benefits than they might pay in taxes, and then you would recognize that this system both legal and illegal is very costly to the u.s. tax pay er. since immigrants are disappear fortunately less educated, they are reducing the average education level of the u.s. work force. if you believe that reducing the average education level of the national work force is good for an economy, and then you would believe that the current legal and illegal immigration systems are good for the u.s. economy. if you have an antiquated belief that having a higher education work force is good, you have to conclude the both legal and illegal immigration is currently unfortunate in terms of quality economic growth. in the united states, our country spends over $700 billion on welfare assistance. that is cash, food, housing, medical care for low-income people. these are programs like medicaid and public housing. of that, roughly $100 billion more goes to lower skilled immigrants they are a substantial and significant portion of the u.s. welfare system. the way that i would characterize our current immigration system is the highest level of immigrants that come through the legal system -- it is as if it is a transnational welfare outreach. spending 5% of gdp on a means tested welfare is not sufficient, we need to reach out and rake in more people into the united states so that they can enroll in this system. the u.s. had a very generous system of support for less advantaged individuals. it'll be difficult to provide a level of support to an unlimited inflow of a low skill individuals from the third world. that is what our immigration system currently does. if we were to look at the current health care reform legislation, this takes an unprecedented step in opening of the u.s. welfare system to illegal immigrants. under the current law, we have had a system of i did it -- identity checks that prevents adult illegal immigrants from getting on to

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