That involves behavioral change. We have an epidemic of obesity and type two diabetes. That is absolutely critical. Health and health care are related. Keeping people healthier longer is absolutely critical. We let this slide folks moved to the city, they walk less, they have access to fast food. The obesity epidemic is following the growth of gdp around the world and the developing nations. Smoking is a huge issue in our country. Host what is your personal reaction when you see the advertisements for prescription drugs on tv . The obesity epidemic is following the growth of gdp around the world and the developing nations. This is a huge issue. Smoking is a huge issue in our country. But also around the world. Tose choices are critical prevent illnesses that result from those bad choices. Host what is your personal reaction when you see the advertisements for prescription drugs on tv . Guest this is not a official position. It does gets peoples attention get peoples attention about the importance of health. As we watched those ads and hear about the potential side effects of medicine, i think that raises the awareness that the illness is important, there are treatments available, but they are not without risk. Our patients are much better informed than they were 15 years ago because of access to information on the internet. It allows them to engage more in the conversation and the decisions they make. Sometimes they need a little help interpreting that information as it relates to them specifically. That is my reaction to that. Host arlene is calling from trenton, michigan. Caller i wanted to take this opportunity to tell you that three years ago i was at the Mayo Clinic In Rochester and told everyone in michigan that if the example was set by the mayo clinic by every hospital and every Doctors Organization in this country, we would have much healthier People Living here. At my age i am quite cynical of the medical profession. I have to say the courtesy and absolute position while my friend was finally being diagnosed with fibromyalgia i think everyone should take the opportunity to walk through the place and see how it was. I accompanied her on those appointments and they were met to the minute. Of the diagnosis was made, the treatment was given, and five days later her disability was accepted and approved first time out. I cannot say enough about it. It is too bad every medical facility does not practice they mayos medical practices. I think they are awesome. Guest that means a great deal to us. We learn a lot from our patients. We can always do better. If we try every day to do better. We appreciate those comments. Thank you. Host a tweet guest i think you can have both. We want to be certain that we are taking advantages of everything that is known and knowable of biomedical research. The practice of medicine continues to move forward. They are getting the right care for them dialed down to the individual level. We cannot agree more. We have a center for individualized medicine. We try to make the right choice for that individual but to really engage them in that decision. Here are the options for you. Here are the pluses and minuses of those options, try to help the patient make a good decision. I think that is what i am hearing here. As a system across the country, we want to make sure we have a High Standard of efficiency and quality. Diagnoses are accurate, they are made quickly, and we get people back to work as quickly as possible. In medicine and you want to prevent the disease if you can. If you havent illness you need that right answer so you can have an illness you need that right answer so you can take advantage of what is available to you to give the best chance of being well again and getting back to work. I think we are seeing the same thing. Host nick is calling from pleasanton, california. You are him with the ceo of a mayo clinic. Caller i like very much how the clinic is run. A lot of them are in it for profit and our local hospital here, talking about the expansion of the service to accommodate people who cannot afford it. It is up to the individuals to take more responsibility. More recently i got in the mail, from two different doctors, pushing nutritious foods and how to prepare foods. Part of the problem is getting the right information and all the nutrients and everything we eat. Every doctor has their own opinion and everybody is pushing for something else. At this time i have my own Health Problems and if i am lucky i will be around for a couple of more years. Host we are going to leave your comments there and see what the doctor would like to say. Guest there is an awful lot of information out there and you are experiencing that. I think it is important to get trusted information that has been filtered and focused. There are ways of doing that. The mayo clinic website is a good website to go and confirm or deny some of the questions that you are struggling with. It there are others that can help you with that. You are absolutely right. You want to know which information to believe and when they are different like that you can ask your doctor or your nurse or go to the clinic website or in other highquality websites to help you. Host what is your biggest frustration with the u. S. Health care system . Guest we are frustrated when our patients are frustrated. Our patients are struggling with their health care bills. The country is struggling with the health care bills. The inefficiency in the system that we have talked about, the fragmentation of care, the unequal and uneven quality around the country. Whenever our patients or families are frustrated, we are frustrated. That is why we are working so hard to reduce the fragmentation, share what we know, improve our quality, help others improve the quality so the citizens in this country get what they deserve. That is highly efficient safe care that is affordable and longterm. Host jeff in pennsylvania, we are low on time so be quick. Caller thank you for taking my call. You have mentioned nuts and bolts. Can you zero it down to two things on the field, like an aspirin for 10 or 15 for a or is two cents to make up a they charge you 15 for a little plastic tray. Guest you are right. We are frustrated by that, you are frustrated by that. This is a system that needs to be refined and change. You need to look at what is the cost of care. What is the value of getting the care right . How do we drive more efficient and safer care . This is a very oldfashioned system of itemizing health care costs. It is a need of reformation and a very complex web that you talked about. Host how do you help patients understand their bill . Guest we are all struggling with the same legacy system that is put in place. It is highly regulated by the insurance and by the hospitals. We need more transparency, we need more clarity. At the moment no one has this right in this country. There are new models that are coming forth. This one is badly broken. Being patient and going through line by line on a bill makes patients frustrated wherever they are getting their care and making providers frustrated as well. We need to have this national conversation. It is not about the price of the bolts. It is about did they do the right thing . Did they do it efficiently, did they do it safely . Did i get out of the hospital in an efficient way . It comes down to is the diagnosis right . If the diagnosis is wrong, this tremendous human suffering, as the patient goes from pillar to post trying to get the diagnosis right at tremendous cost, meanwhile they are taking medication that may not be helpful. It is a complex question. How do we provide higherquality care . That will be lowercost care. He is up the quality of health care fewer readmissions, fewer inappropriate operations, providing safer care at a much much lower cost. That is where these integrated systems are working together with the patient at the center and we stand the best opportunity of reducing the cost of care in a very meaningful way. Host last call comes from michael in byron, minnesota. Caller i am wondering if it will be effective in rochester or the other places in florida. Host the dmc . Caller the designation medical center. Guest this is the legislation i referred to. It is a minnesota bill that provides up to 20 years of infrastructure support for growth and the Economic Development, centered in rochester and the surrounding community. The growth of rochester and the immunity as a destination. Qualitys if a high permanent jobs over the next 20 years. Qualitypect high permanent jobs over the next 20 years. To your question, it is a minnesota legislation. Host some final tweets thank you for coming on the washington journal today to be, pummeled by political questions. You are a great spokesman and very patient with us. We will leave it there. Dr. John noseworthy. Guest thank you so much. [captions Copyright National cable satellite corp. 2014] [captioning performed by national captioning institute] on the next washington journal Sheryll Cashin and Sophia Nelson on African American history month. Hen Nathan Hultman is live at journal 7 a. M. Eastern with your calls, emails, and facebook comments. New development in new jersey where a former official said that governor Chris Christie knew about the lane closings that led to massive delays on the George Washington bridge and that am might have been an act of political retribution. Governor christie held a News Conference addressing the issue. Rote this. Stein w governor Christies Office released a statement saying this. You can watch given to christies press Conference Online at cspan. Org. We will bring you updates on the cspan network. We are very focused on the sochi olympics. We have seen it take in that threat reporting regarding sochi. This is what we expected given where the olympics are located. There are a number of extremist in that area, particularly a group that is probably the most prominent terrorist group in russia. The leader of that group last july announced in a public message that the group would intend to carry out attacks in sochi in connection with the olympics. We have seen a number of attacks beginning last fall of suicide bombings that took a number of lives. Tourists difficult for us to find and adjust the rats that terrorists pose. We as a country have done a great job of addressing some of the vulnerabilities in our system. Putting together an information architecture that allows us to move quickly, but you do not know what you do not know. The probability of attacks 2001 for me is a hard question to answer. Dispersion and diffusion of a threat whereas we are very focused initially on that time now we arel qaeda, facing a much more dispersed threat. Span, theeek and on c nations top cheats on worldwide security threats. Saturday morning at 10 a. M. Eastern on cspan 2, your calls and depth. S on in tour acspan 3, confederate Winter Quarter of South Carolina general. Sunday evening at 7 p. M. Today president obama and Vice President biden met with ceos of large and Small Businesses to talk about hiring people who have been unemployed longterm. Then obama spoke about new Labour Initiative that would support partnerships for hiring for nonprofits and businesses. His remarks were about 20 minutes. [applause] good morning. My name is erick. It is a great honor for me to be here at the white house today with the president and Vice President , especially since, three years ago, i was unemployed and homeless. I am very happy to report that my story has a happy ending, but for a long time, my path forward was very unclear. I spent six years in the United States army where i proudly served my country as a combat infantryman. Work was hard, the hours long, and the duty was dangerous. After my Honorable Discharge from the military in 2008, i returned home from california to begin a new life with my wife and daughter but was quickly met with the realization that there was no work for a skilled heavy equipment operator and i was struggling to make the transition to a new career. I cannot find work in the construction industry, so i started to apply for fast food restaurants and retail stores. With no luck, i was motivated to work and i wanted to work, and i knew i could contribute to society like i had in my military service, but i felt helpless, lost, and more importantly, a disappointment and failure to my family. I was very fortunate to find online a new program started by Pacific Gas Electric company in california called the Power Pathway Program that offered job training and skills to people who had no experience in the utility industry. I quickly applied and was accepted into a 16week program in San Francisco and im happy to share that i graduated the pg e Power Pathway Program in 2009 and was hired in 2010, where i currently work as an apprentice electrician in eureka, california. I want to thank pg e for giving me this opportunity, and the work they provided me restore purpose in my life and gave me a sense of direction once again. I am glad that pg e is expanding the Power Pathway Program to address longterm unemployment and for signing on the president s initiative. Let me end my remarks by thanking president obama for bringing companies together to help on work for thousands of americans who only want the opportunity to succeed. Now it is my honor to introduce the president of the United States, barack obama. [applause] thank you. Thank you so much. Thank you, everybody. First of all, let me thank erick for being here and sharing his story for his service to our country. Erick, everyone recognizes what a Great Success story this is, but also the notion that someone with this kind of skill and talent was having this kind of difficulty finding a job indicates the challenges we face. I want to thank all of you, Business Leaders, philanthropists, elected officials, all members of my cabinet and administration, not only for coming, but for committing to more Success Stories for more people like erick, making sure that everyone in this country who wants to work as a chance to get ahead, a paycheck, and the structure that a job provides to people. I said in a state of the union, while the economy is getting stronger, businesses like yours have created 8 million new jobs in the past four years. Unemployment is at the lowest it has been in five years. We all know we have more to do to build an economy where everybody who is willing to work hard and take responsibility can get ahead. We have to do more to restore opportunity for every american. The opportunity agenda i laid out the gains with doing everything we can to create new jobs here in america, jobs in construction and manufacturing, American Innovation and energy, \steps we can take to streamline our tax code, incentivize companies to invest here, things we can do to make sure that we are continuing to lead the world in innovation and basic research. We have a whole lot of infrastructure we can build that can put people to work right away. We have a couple trillion dollars worth of deferred maintenance in america and the ramifications of us taking that on would be significant. We have to roll faster and put more shoulders behind the wheel of expanding Economic Growth. Step two is making sure every american has the skills to fill those jobs. Step three is we have to guarantee every child access to a worldclass education, from early childhood, to college, to a career. [applause] step four, we have to make sure the hard work pays off, with wages you can live on, savings that you can retire on, Health Insurance there when you need it. Today we are here to focus on that second point, connecting more ready to work americans with ready to be filled jobs, so folks out of work can apply the skills they have already got. Getting people back on the job faster is one of our top priorities, but i have to confess, last month, congress made that harder by letting unemployed insurance expired for more than a Million People. Each Week Congress fails to restore that insurance, roughly 72 million americans will lose their lifeline. For our fellow americans that have been laid off through no fault of their own, on implement insurance is often the only source of income they have got while they look for a new job. When erick was out of work, it is a lot harder to look for work if you cannot put gas in the gas tank. If you are worried about whether there is food on the table for your kids. If mom is not making the rent and paying her phone bill, it is a lot harder for her to follow up with a potential employer. On implement insurance offers that security is about losing your livelihood does not mean that you lose everything you worked so hard to build. That is true whether you have been out of work one month or six months, but those that have been unemployed the longest often have the toughest time hitting back to work getting back to work. The longer you are unemployed, the more unemployable you may seem. This is an illusion, but one that unfortunately we know statistically is happening out there. According to one study, if you have been out of work eight months, you are likely to get called back for an interview only about half as often as if you were out of work one month, even with the identical resume. So we are here tonight to say that is not right. We know there are folks like erick all across the country who have enormous skills and talent and capacity, but they need a change. I invited a mother of two boys to my speech. She was employed since college, never collected on implement benefits, never dependent on the government. Impressive yo