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tv   [untitled]  CSPAN  June 19, 2009 1:30am-2:00am EDT

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affordably for the working-class and middle-class public. and you are a congressman and be provided by our tax money the best insurance for yourselves. how can you provide the same plan which you have for the american working class people? we are working hard, we are paying taxes, we don't get what you deserve for our work. we're not asking a favor, this is our right. health care is a human rights, education is a human right, you provide public education -- one not provide a public medical system for the working-class people? >> guest: the caller purports to know what the middle-class and working-class america want. i think he is mistaken. again i repeat 80 percent of the
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american people say their health care is either either good or excellent. second, there you hear a fundamental divide in the caller between his point of view and mine and that is that everything that is desired is not just desirable, it is a right. it is an entitlement. health care is a right. well, a right is an enforceable plan and, as a matter of fact, it is in a right in this country. housing is important, it is not a right and it seems to me that we should probably avoid casting every policy choice in this country as a right because this kind of right talk makes it very difficult to split differences. >> host: ohio for george will, we have six minutes left. >> caller: good morning c-span and mr. will. a first of all abc in the white house, there will be no money that will come out -- c-span
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news to talk about dick durbin and can i disagree with you on iran and north korea. i believe iran is more dangerous than north korea. north korea banks from the food and get it all from china iran, they fun hezbollah and libya, they fund hamas. there are finding al qaeda in iraq so myself i think they are a lot more dangerous. >> guest: the caller may be right, they may be more dangerous and he certainly right that they are dangerous. >> host: this is martha in rockland, maine on democrats line. >> caller: hello? this is martha clarke in that rock landed and out like to ask mr. well, why you included insurance companies in the health equation at all. they bring nothing to the table are in the business to make
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money and to prevent health care. thank you. >> guest: that seems to me is an eccentric view of the current function of history of insurance companies and our country. i don't know quite how to grasp the thought of there to prevent health care. are they trying to make a profit? yes and the way you make a profit in this country is providing something that many people want to buy in there for the market is i think in nine in that sense that it gives a profit oriented company an incentive to provide products in this case health coverage to the people want in those countries that thrive in excess of the decades are doing just that. >> host: what are you reading this summer? >> guest: well, elmore leonard has a new novel out and george bell, this is a new novel about so i am reading some novels.
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in listening to recorded books and driving over here and will listen going back to the history of jacksonian america called awakening giant. >> host: there are predictions that the books might go the way of news and that is all digital. >> guest: well, the candles are out there and i tend to like the great thump and the feel of a book in my hand, but i am a fossil. >> host: with regard to newspapers, what do think of the consolidation going on in the business and the displacement of journalists who have been covering the news the way we have been accustomed to for such a long time being replaced for the coverage on the internet. >> guest: id is stunning and clearly there's not get an alternative economic model that will work. you can give away the contents, i can put it on the screen and except the same revenues. the technology driven part of this change in the newspaper business happens to coincide with an gets confused with the
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problems caused by the economic problems. department stores and automobile dealers are great newsdealers and that has collapsed so it is hard to know what the shape of the crisis would be denied: with the economic downturn but the right is clear subtracted the economic downturn and the new technologies make everything different. my daughter is 28 years old and she moved to los angeles from new york in needed a job and apartment she went by the los angeles times. it would not occur to her -- she would go on to craigslist or on-line and do it that way. the collapse of classified advertising is an enormous part of the problem of the industry. >> host: old communications, newspapers and television or one recommendation, the internet is dynamic and your call in and get less commentary after posted in
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newspaper web sites around the country. do you read the comments? hazmat when they are called to my attention, but i do nothing else if i tried to follow all the reverberations and ricochets that are out there on the internet. >> host: when you read them to the cast nuances? my short, and i respond to a bunch of them. >> host: next call from north carolina for george will on independent line. >> caller: good morning, george. i am trying to get a little more understanding of our economic downturn problem and i know is get to the accountability problem with wall street but i don't ever seem to addressing the accountability of the ims procedures and actually move is our world financial broker and you are we really intended to and who have the party had to pay back which i feel like the
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first t.a.r.p. and stuff that bush was and was really all about. thank you. >> guest: well, the caller is a good point. call the problem of transparency and there's an awful lot of money including the money from people in nashville and north on a sloshing around in the system and we are not sure who is in charge of it and is was giving people a sense a high sense of anxiety that will sooner or later when a political advent. >> host: last question from joe, republican line is a less. >> caller: how are you? how do you factor in medical tort reform and why is it discussed in the bill proposed? >> guest: you're right, a defensive medicine that is oft -- doctors ordering tests and pharmacology simply to fend off the trial bar in case something goes wrong and they are blamed for negligence of some sort and no one knows how much paillettes a 20% to our health care bill in this country. the president talking to the american medical association the other day said tiptoed up to the
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edge and said i am for tort reform but -- and the clapping stopped and the blues began, he said i am against capping awards under malpractice. which means he is not really for a very much tort reform and the fact that is not surprising because of the trial bar and the trial lawyers are huge contributors to the president's party. >> host: as we close here come and give people a glimpse into a day in your life. we were talking in the beginning about how many issues summon a complex, how you spend your day and getting to the point to make a decision about what your column will be? >> guest: when i first on a writing a column i asked bill buckley my friend, you ever have trouble coming up with things to read and he said no, the world annoys me three times a week. the world and noise coming interests, amuses me a lot more than five times every to a
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switches hamid karzai right. i think the happiness a columnist barry's inversely with the help of the republican the more problems we have the more fun it is to write and this is to say no more a great time to write. >> host: how do you stay up that all? >> guest: read constantly incessantly beer and i read four or five hours a day. >> host: we appreciate you being here taking time out of your reading and preparation to listen to our callers questions and some of their the simmons with their points of view and compliments. thanks again. >> guest: i enjoyed it.
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now the second day of the senate health committee meeting on health care legislation. christopher dodd of connecticut is acting chairman stepping in for ted kennedy who is being treated for cancer this is three hours. [inaudible conversations]tñ >> committee will come to order. we have a quorum present and i think my colleagues for being here this morning and the me say yesterday was a long day of opening statements but i think worthwhile and given the magnitude of the legislation and the importance of it, i recommended a time in a row and obviously i wasn't too rigid to put it mildly about that a doll. members i hope felt they had an
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adequate time to express themselves on the overriding issues and concerns for what we are confronting with all this so i thank them and was happy to spend the time and probably ought to give a special award to jeff bingaman since he was the only member who did not make an opening statement yesterday but was involved in both committees, on the finance as well as running back and forth as a day between both committees as they were working. senator, by unanimous consent your salmon as long as you want to be will be included in the record along the way. today we are back on the agenda for the affordable health choices act what i announced yesterday going to proceed with the markup and that is title two, the quality section which our colleague senator mikulski has been a tremendous amount of time at the hearings. since january on the subject matter and i went to several of the hearings with tremendous witnesses than talk about the paradigm shift of going from the quantity based system to a
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quality based system, value base system as a way not only of improving the quality of health care but also contributing signaling an eye to the cost issue which is an overriding issue for all of us on these matters. what about my to do today and tomorrow for the half day or so i worked throughout is two continue to it by the staff to work on the various amendments that have been already submitted out of this section of others. i gather is the room and let senator mikulski address the issue but i gather there has been some possibility of agreement on the ids that haven't arrived yet unless getting closer to an obviously on prevention and the workforce issues and issues involving long-term services and support in the fraud and abuse title. i really encourage our staff and members to be working to see if we can't achieve some understanding in those areas as well as we move forward. we will reconvene and again on monday on this issue of the
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markup assuming complete work on the equality section as well as the prevention areas and will move into these other matters as a long and in the meantime i mentioned to senator enzi we might have an opportunity to meet with our former leaders that have produced a paper themselves and senator daschle and senator dole, senator baker and senator mitchell. demise said at a breakfast meeting for members to meet with them to have a discussion about their various ids which could be helpful and do that maybe in the middle of next week and see how things are moving along and chat with mike enzi in terms of timing. but let me turn to senator mikulski and thank her immensely for the job that tom harkin and jeff bingaman and patty murray have done all along with others in developing these ideas and quality prevention coverage as well as workforce issues. i'm going to ask senator mikulski to lead the debate on
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this and we recognize her. >> thank you very much senator dodd and good morning to all of my colleagues here this morning we are taking up title to, the quality section. and after that i believe senator dodd it wants to proceed and prevention. these two titles go hand-in-hand and even interface with each other. once you hear the conversation we've had over the last several days has been related to the cost of health care. there is no doubt that it is skyrocketing. in we see as to all public health policy experts that the issues of equality and prevention could in the long term until late reduce the cost of health care while it increases health outcomes. in my area we focused on those issues, five big issues that
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were readily agreed upon by all as drivers with their needs to be improving in quality. production and administrative errors, the administrative simplification preventing hospital readmission within 30 days and also better management of chronic disease as well as creating equality infrastructure that would be appropriate in data collection. if we moved in those directions i am going to offer some amendments now, but before i do between now and women gather i would really say to my colleagues i would recommend to them reading the report issued by a former colleague and former leaders, bob dole, tom daschle, howard baker, george mitchell became special envoy mccone de really crossing the divine and
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believe in many of their recommendations to mozilo the outline of promoting high quality and high value. i will refer to that later on in the debate but i think everyone would really like to lead -- read how we could get to solutions on a bipartisan basis and there is a fairly agreed upon consensus in the area of quality. but let me move on now to the hard work of the day. the first thing i to do it is offered to technical amendments and i seek unanimous consent to adopt the mikulski technical amendment and the dodd technical amendment. my understanding is it is reviewed by the enzi staff and these incorporate time ago and limited technical qualifications to tonawanda, they are not changes and on a direct subsidy of policy. a there are editing typos. there is notable clarification which includes corrections to
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the definitions of the patients entered a medical home. it includes senator dodd's clarification regarding evidence informed information rather than evidence based information and as i understand senator dog that comes from the national academy of pediatrics and also included senator hatch's clarifying amendment to include chiropractors as part of the community health teams which is more than agreeable to us. in ens the standard of iom to define what is primary care and the rise authorization for such sums as may be necessary to carry out this title so that is a brief description of the amendments and ask unanimous consent that both mikulski and donna be accepted. >> is there objection?
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of those in favor say aye. by unanimous consent they are a great. >> the amendments are agreed to? >> yes, ma'am. >> i understand the first amendment senator reed, jack reed to mcnamee apologize, we need all members to adopt, in order to have a discussion so we will have to wait until a couple more show up and i apologize. >> we will lead the votes to sign it. we need a two? otherwise you could have unanimous consent. i've been two those kind of meetings. in perhaps we could proceed to the discussion on senator reid. >> thank you mr. chairman, thank you senator mikulski baron and would offer an amendment to section 218. this is on behalf of myself as senator as a, a month to thank them for their thoughtfulness and i also ask unanimous consent
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that senator hatch be added as a co-sponsor. >> without objection. >> this is what amendment goes to the drug tax box which has been shown by researchers to give consumers significantly better information and more understandable information. recently fda's risk committee recommended the fda adopt standards to disregard the change, the essential changes that would apply to promotional labeling and printed advertising so it would not a and sustanon beyond the model itself would be promotional advertising, the magazine circulars etc. and this has been agreed to with ranking member. we do not intend angelina to this place in the decision. if they propose this before than
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the have a year to promulgate the rules so i think this is entirely consistent with a reasonable approach to adopt in this immense senator and see. >> i think the senator for working on this and i don't think the current presentation of drug labeling is helpful, it's a highly technical document designed more for the trial lawyers and the patience and i think that's senator reid is really onto something with steady and the report and i am pleased our sows are able to work out this bipartisan solution and i'm pleased we been able to reach agreement on a provision so i co-sponsored the amendment and i want to thank senator reid and senator hatch for working on this issue in coming up with a solution. >> any other firm comment. we are missing the necessary votes so we will have to lay this amendment aside until the
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requisite number of members show up. senator mikulski, you have any additional amendments you want to propose? >> there were amendments to be as suggested to him by senator greg on improving data collection which i know we would also recommend that we could proceed on. >> mr. chairman, if you would indulge me there are two elements we have worked on with senator mikulski incentive it in a stabenow like to move to an amendment which hasn't worked out. >> wait, there are amendments. you had a greg amendment nine related to share in decision making and you had greg an amendment 10 related to data collection. >> those are agreed to. we will just except those only get a quorum and now an offer
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the brennan and 35. >> can we hand out? and as soon as one more member shows up we will cover these amendments that have already been discussed. >> what page? >> which title is this? >> it goes to title to generally, title three anti-war generally. >> it is the gao review of the activities of those titles. >> we now -- and to have 10 or 12 here? we only have 10. we're still missing people. >> i can talk about it if you don't mind. >> go ahead and give max mr. chairman, as we all know and the president has made the point and
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is totally inappropriate, one of the average has to be to reduce the cost of health care and the rate of a growth and cost over the years because we are basing -- >> [inaudible] >> i do. we are facing an unsustainable situation in our federal budget which is jim and in large part by the cost of health care. we know that we have a approximately $38 trillion unfunded liability in the medicare accounts. another large amount of unreliability i think in the range of $10 trillion in the medicaid accounts and we also know that health care is not taking 17 percent of gdp headed toward 20% of gdp in the these numbers are simply not sustainable for our government coronation and thus one of the core elements of health care reform has been not only to get everybody covered which people on our side are totally committed to it and to give
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people quality health care which we are equally committed to put in the process develop proposals which reduce the cost of health care. and then bend at the curve has become the term to month and the cost curve. and the president called for banning the curve and i congratulate him for that. and of the chairman talked about the sun number of occasions. certainly senator casey and senator hayden have talked about it just yesterday when discussing what the effect of a really good will this program would be so i know there is consensus around this table that we should attempt to do that. senator conrad has really been a leader on the issue of dead and this government and the fact that the dead is the threat has become really a watchword for us. unfortunately beyond not doing well by the police he has the point down. was advised by cbo and myself in a letter that they wrote and i will quote it briefly in the record that the rising cost of health care will cause federal
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spending to grow putting the federal budget on an unsustainable path. to quote again the federal budget is on unsustainable path. >> we have 12 members present -- i think the amendment we discuss this senator mikulski and recommended as well as senator reid is senator enzi and the two amendments by senator greg and senator mikulski, they have been agreed to on both sides and i ask unanimous consent those amendments adopted -- without objection is so ordered. >> that is a good start mr. chairman. [laughter] >> we have gotten five done -- we are debating senator greg amendment number 35. >> so this amendment addresses that issue of spending because as we know this bill has been scored only a sixth score because the cbo did not have the full bill and it is a score that
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will increase by $1.3 trillion with an offset of about $300 billion in new taxes so the net being $1 trillion and when you throw in the potential for the medicaid and a class act store on this bill and the potential for the government plan tile depending on how it is involved on this if in an up with a bill that is easily headed toward $2 trillion price tag that is unfunded which would go right on top of our debt and only aggravate dramatically our debt situation. unfortunately it does not include initiatives which have been suggested for containing spending and ceo has given a number of those such as accountable care organizations, bundling payments to hospitals and are some preventive and well as programs but cbo suggestions are not included. increasing the cost sharing for patience and and the president's
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own proposals are controlling cost not in here that he set up just last week which represent $300 billion in potential savings. so what i am suggesting in this amendment is before we go ahead with initiatives which are represented as being cost savers when actually some of them are being scored as expenditures that we should have an independent umpire take a look at these proposals and say are the cost savers? the purposes of title two, three and four and to contain cost using new initiatives in the area of prevention and quality specifically and workforce so if that is the purposes of these titles then why not pull these titles accountable to that purpose? which is to contain cost. and so all this bill essentially does is very simple and says that gao will review the


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