tv [untitled] CSPAN June 29, 2009 8:30am-9:00am EDT
litigation to protect intellectual property. >> host: rebecca hoffman, final question. >> host: if i want to make a video and put it on youtube and i want to use copyrighted music and be i think that it's a fair use -- i'm not using a very good copy of it -- can this pose a problem? and what, what should i do? [laughter] >> guest: well, you ended with a doozy of a question. there was one phrase you used there that i think is a real touchy one which is, you know, the fair use phrase. but putting that to the side if you're going to, if you're going to use a piece of music in a video, there's a copyright involved. and there is, there are rights that need to be, that need to be clear. now, how do we deal with that as
an industry? well, my company in particular we have a deal with youtube, and we have a deal with myspace. we've worked out an arrangement with youtube that allows youtube to put videos online, and there are, you know, different types of videos on youtube, right? there's some that are record label-created, professional videos, there are what are called, you know, the user-generated content, ugc, and that could be, you know, someone taping, you know, someone in their home singing a recording, or it could be that there's music playing in the background to a recording. but, you know, if music is involved, there's a copyright there, but we've worked out, you know, a deal -- i can't get into the specifics of it, but we have a deal with youtube that allows our songwriters to get paid.
the way it works in the u.s. is we license the professional video content. we get paid a percentage of what the record labels collect from youtube, and then for the user-generated there's a mechanism that allows us to get our songwriters paid for that content. there are, you know, there's a whole takedown mechanism where if one of our artists or writers objects to a piece of their music being on youtube we're allowed to -- we send a takedown notice to them, and they respond and take it off, and it's functioning. it's, again, this is a way of, you know, my company's goal and i think our industry's goal is we want to license our content. we want to get our writers paid for it, and i think we had to think, again, outside the box in terms of structuring a deal that works. now, youtube is also a global business or trying to be a global business, and they are running into issues in different territories. you know, they're having issues
n. u.k. and germany with the publishing collection societies that are trying to negotiate rates, but they've been unsuccessful in coming to terms, and so there's certain content that's not being shown on youtube. and again, it's a, that's a process that's evolving in terms of negotiation, and i'm hopeful that they're going to arrive at terms where they can allow their business to evolve and grow and our writers can get paid. >> host: rebecca hoffman is with the media law reporter published by bna, and david renzer is chairman and ceo of the universal music publishing group. thank you both for being on "the communicators." >> guest: thank you very much.
the patient advocate foundation here in washington hosted this event, it's about 40 minutes. >> thank y'all very much, and a special thanks to nancy and jack for turning a dream into something so incredibly powerful. i came up from north carolina -- [laughter] i've actually met a lot of north carolinians here, the di as pa sent everybody out. and when i did, nobody was at home. some people were at the beach, some people were at camp, so i was at home, and you'd think that'd be the perfect time so i'd be incredibly organized. i was not. i pulled the folder where i'd put my speech and the schedule of what was going to happen in my bag, and the speech was for an event in montana. [laughter] i write the speeches separately for each event, so it was a problem. the opening of this wonderful cancer clinic in montana was
something i wanted to talk about, but not here. [laughter] so this afternoon i got to rewrite the speech. so i'll probably look down a little more than i should, but i'm doing it because it was important for me to say something that was particular to what you all do. it's honestly, an immense honor for me to be with you tonight. to say that i admire you, that i applaud how you've decided to spend your lives would be a tremendous understatement. one of my favorite songs, angels among us, i feel that i'm among angels when i sit with you, and i'm amazed by that. nancy was saying that lea has a little halo over her head. i honestly think that's true of most people this this room. you represent the best of us from compassion and loss came a dream and a hope, and with
determination that probably the hardest thing is that longstanding every day getting it done, year after year, the horde work of making it a reality year and year -- again, you have made an immense difference providing not only better health care, but great peace of mind to millions and millions of americans. and i heard, i think, that in 2007 there a quarter million ofe were children. i think about that. it reminded me of watching a family under stress in the waiting room at my public hospital in north carolina about a year ago. i had to drink that terrible drink you drink before scans. it looks like coca-cola, it's not. [laughter] and you drink it, and then you have to wait a little while. so i'm waiting in a fairly silent waiting room with a lot of other people drinking the miserable drink and awaiting my turn from the scan, and there's a woman across from me who's on the telephone. and she's -- her daughter, i
could tell it was pretty quiet and impossible not to listen to this conversation, her daughter has already gone back for a scan, but they hadn't started it when the insurance company called and said that the scan would not be covered, and she was called as well and told that it would not be covered, and she was on the phone. and her voice ranged from pleading to crying to anger to confusion and back to pleading. i left before the resolution of that, but this woman's voice has stayed with me, echoes in me that this is exactly the kind of thing that we can't have happen, yet it happens over and over again as you all well know. i'm not telling the audience here anything that you don't already know. our health care system has holes, and it has shortcomings. every system in the world of any kind has short comes, but this is more than that. our health insurance company particularly for the 16 million manes who have individual coverage or for the 25 million
who are underinsured and certainly for the 47 million who can't afford the premiums at all and, therefore, have no health insurance, that system is really broken. now, we can call the conduct of the insurance company rep rehence and immoral, i sometimes that i have to admit. we can bemoan the fact that the law says the insurance company has afiduciary obligation with their stockholders but has no to its insureds. but we must also say, and we note that we know that the system exists, that we know that some insurance companies give bonuses to their claims managers who deny claims or rescind policies, that we know this and yet we have done nothing to correct this heartbreaking misconduct. these devastating eventually terminal diseases -- i have one -- are difficult. we know this too. and you know this because your case managers walk hand in hand with a lot of these patients
through this difficult process in their care and treatment. statistics being what they are and also because i met a lot of you as we did the book signing earlier, i know that there are survivors of my disease in this room, and i want to thank you for being my companions on this road, but you know -- [applause] and i actually talked at least to one of you about this, you know the roller coaster of it. the news isn't good, and for some of us we know there will likely come the day when the news isn't good, it's all we can do not to drop to the ground. and even when the news is not devastating, we stil lifelines to keep us steady, some things we know are constant like our insurance coverage. [laughter] the scan results or the seat in the chemotherapy room that we know we're going to be able to go to. take those away, and we drop
again. but just as the floor beneath us is shaking, the insurance company pulls not the rug, but the whole of the earth out from under us from too many of my brothers and your brothers and sisters. you're tired of it, i'm tired of it, and i think we have finally gotten to the point that america is really sick and tired of it and wants to do something about it. i often talk about the importance of commitment of patients not to see themselves as victims. i tell the story about deciding your own fate. the story is frivolous, but there's such a truth in it. it's 1956, i was 7 years old, and i was walking to church with my parents who taught sunday school. we were all going together. my parents gave us our allowance and our donations to the church on sunday morning. and understand that it's 1956. i think they gave it to us on sunday morning so we wouldn't spend it on saturday because the stores were all closed on sunday. so we were walking with our dimes, one for the dish and one
for our pockets, and my sister has taken the dimes and is shaking them in her hands the bay children do, making that rattling noise. and as we stepped up on the curb, one of the dimes popped out, rolled down the curb and down into the drain. my sister is 5 years old. it takes her not a second to say oops, there goes the lord's dime. [laughter] [applause] she was not going to be a victim. [laughter] and i will tell you that nancy has grown up, and she is not a victim. [laughter] i often talk about the importance of this because the questions of people living with cancer bombarded sometimes with sobering diagnoses, with pitying looks, with some pretty somber
statistics now and again, and you're undergoing physical and mental burdens of the treatment and the disease both of which are sometimes overwhelming, sometimes they are so encumbered that it's hard for them to muster the strength of spirit to recognize they still have silver in their hands, and that's their own human dignity. but you know sometimes it's even harder than that, you have more taken away than just, you know, the years at the end of your life that you think, well, this treatment is going to at least give you, that you think you've got a difficult path during the treatment, but you're going to have the years after it. but some people face greater hurdles than that, and that's when they don't think they can get the treatment at all. i felt empowered because i had those things, i felt empowered against my disease. but the truth is it's hard to resist when you don't have any weapons against it. the newly-diagnosed woman i sat
next to actually in that exact same waiting room, she was hardly able even to stand, she was so frail. her shoulders shuddered, she wondered whether she'd be able to work and if she couldn't work, would chef health insurance in order to -- chef health insurance in order to get the treatment she needed? how was she going to be able to drive herself here or there after treatments? who was going to take care of things that needed to be taken care of? there was a mother who told me that she had sold her car because she needed the money to cover the cost of insurance co-pays. she said that was okay, though her voice was not particularly convincing, she could always take the bus. we as patients need in these moments to have some certainties, some lifelines. we're trying to find a cure for cancer, we could always do more, of course. we need to find a cure, too, for our health insurance system that leaves too many of us shuddering and in fear.
we can, i know we can do this. we have to fix the things we can fix. it's simply wrong not to. we connect with one another, the reason i was so wonderfully inundated with letters and snail mail after my diagnoses was because people want to make that connection. that becomes a lifeline for them. when we try to connect, too, with incredible support groups like the patient advocate foundation. these are all useful and all important, but the problem still exists as long as there's a need for the patient advocate foundation to help individuals get the care and the health insurance policies and the actual conduct of the insurance companies that they need. we as a society, as a country need to make certain of something. this is a simple rule seems to me, and this is, you know, when you ask what it is you want, you want that people who are sick and get the care that they need. it's not -- it's just as simple as that. [applause]
sorry, as i fool with my hair. a lot of people in this room know just what i mean. [laughter] at this moment in time we are at the crest of trying to wrestle out a health care and health insurance system that follows that rule. what do i think that means? our health care costs a larger percentage of our country's monetary production than any other industrialized nation of our gdp than any other nation. do we have the best health care then? well, if you measure it by our finest institutions scattered around the country, i think the best health care in the world is available right here. people travel here from distant places in order to get the health care that we have, though we know that those clinic doors are not open to all of us. i wanted to celebrate the life and lament the death today of fair a faucet whose -- farrah
fawcett. [applause] she lived longer than anyone predicted she could perhaps in part because some of the treatment she got was right here in this country, we have such good care. people come from around the world, as i said, but not all of us get it. some of us get no care at all. measuring as a nation whether we have the best health care, we need to look at something other than the isolated cases of somebody flying in for some rare and difficult procedure. we need to consider -- that might be your children, answer your phone. [laughter] as we're measuring as a nation whether we have the best health care in the world, we have to admit that we're far from it. in terms of longevity, we are 36th. first in how much money we spend, 36th in longevity. and we're far from the top on infant mortality.
when a quarter of the population, 1 in every 4 of us, is either uninsured or underinsured, it's no wonder we have those statistics. we need to get the costs down, there are so many places not engaged -- so many places that are not actually in the health care delivery system that are not actually involved in providing health care itself. some of those drain money from the system and in a way that we can address and fix. the administrative costs of insurers when medicare and medicaid are 3-4 percent and some insurers are 30-40 percent, you've got to figure there's some sort of administrative waste in there that we could tap. billions in profits even in good times, perhaps, you know, taking the fiduciary obligation to the stockholders maybe a little too seriously. we're not selling refrigerators, we're providing health care.
with layers of administrative health coverage people, most people have never heard of. health benefits administrators who are, in fact, managing profits for the participants in the health care system, not your profits, but the profits of the businesses involved in it. i don't mean to pick out only a few places, though, because we need to look at the entire system of something, of anything that does not provide direct care to patients and see whether we're doing it in the most efficient way and whether or not there are necessary profits at any of those levels. any cost that does not result in direct, efficient, and effective treatment of patients, and i want to emphasize effective treatment of patients or the training of health care providers needs to be considered by each of the political parties and by everybody involved in the process as they evaluate, honestly, whether or not the costs that they'd paying need to be reduced. the government needs to look at
it because in terms of dollars, we're the largest purchaser of health care policy, health care services in the country. the health care providers and the insurers all need to look at these different levels. we've already gotten a promise from the insurance companies that they will bleed out some of the excessive costs over the next ten years, i think it was $2 trillion? i don't know whether they want a quid pro quo, but why would they not want to eliminate that anyway? why didn't they do it last year? [applause] i mean, thank you, but -- [laughter] some of the cost savings that we want to see happen are actually going to cost us money in the short term. we need to get health care costs down in the long run by being healthier. we need, we can be healthier, of course, if we live and eat better which we need to do, but also if we get screenings and diagnostic tests that will
reveal deterioration in our health care, in our health at the earliest possible moment so that we can get treatment and, we hope, stop the progression of those diseases before they become debilitating and costly to treat. it's much more cost effective to treat diabetes than it is to treat the results of diabetes untreated and undiagnosed, for example, if somebody suffered from kidney failure or stroke. those are extraordinarily expensive thing, much less expensive and so much better for the live of americans if we can address these problems before they get to that case. yet insurance companies have fought at the state level the covering of testing for diabetes and even in a couple of states successfully the coverage for the supplies for the treatment of diabetes that has been diagnosed. we worry, too, and, you know, this is one of the topics i'm sure that those of you who have been visiting have heard about the strain of the baby boomers
on medicare. but we know many of the people entering medicare have as many as five chronic conditions, some of them untreated because they said i don't need to get health insurance, in three years i'm going to be on medicare. so something ends up not getting treated, and by the time they get in medicare, we're talking about a much more expensive treatment than we might have had had we had a more timely diagnosis understanding that's not going to save us money in year one. it's going to cost us money in year one, but what does it do in year five and year ten? we can make an enormous difference by our willingness to understand that you have to fix the roof before it caves in. we almost always fail to consider the cost of the uninsured among us, and this is another thing that i think a lot of people, americans are uninformed about. if you have health insurance today, you think you're paying for the health insurance that covers your family. well, you're paying a little more than that. about $1100 of the insurance that you pay for your family
actually goes to cover the uninsured. in order to cover their costs, health care providers have to spread the cost among their other patients. and the result is that we pay that $1100 more. i'm not happy. say i'm disquieted. by those who create a fear in all americans that all americans be taxed by health care reform. just the opposite is true. those of us with health insurance are being taxed right now with the uninsured $1 is 00 -- $1100 a year just because we don't have health care reform. we want to get health care costs, if you want to get those down, you're going to need to make sure everyone has insurance. the she could thing -- second thing is to make sure everyone has health insurance. the patient advocate
foundation -- [applause] has been a true leader with respect to pre-existing conditions, and so you well know that the coverage of pre-existing conditions with premiums that are based on community-wide ratings is essential. i met a woman in cleveland in march of 2007, and i'll talk about her a little later, but i was giving a speech in cleveland and at the book signing that was afterwards she came up to me. because of the direction she came, i think she sort of came to me from the elevator, so i thought perhaps she hadn't been to a event. she was dressed in a suit and stockings, so i assumed she had been at work because why else would you wear them? [laughter] and she spoke to me in a whisper, and she said my name is sheila, and i'm afraid for myself and for my children because i found a lump in my breast. but i don't have health insurance, so i can't go see the
doctor. her employer didn't provide it, she couldn't afford it, and if the lump was cancer and she didn't get it treated, it was arguably a death sentence for her. in america in 2007. a working mother. shame on us. and shame on a system that actually disincentivizes, and i'm sorry for that word, from getting us from getting treatment. if she'd been attentive to the rules on pre-existing conditions, she would know not to get that bio-- biopsy. if she identified a pre-existing condition before she had insurance, she wasn't going to get covered when she did have insurance. we have created this system that makes absolutely no sense if the purpose is the delivery of health care. if the purpose is something else, to make profits for somebody, maybe this makes sense. but if the purpose is to deliver health care, this is completely
backwards from the way it needs to be. the final thing i want to talk about but, unfortunately, not the final thing we need to do is to create legit mitt competition for private health insurers. this has been one of the major sticking points and certainly a sticking point for profit centers who have no interest in the health care reform debate moving forward, and chief of those would be some of the health insurers who do not want the competition. but our premiums have gone up 119 percent in the past ten years. there's, there's a number from that i think in the year between 2000 and 2006 our health insurance premiums went up 6.4 times father than our -- faster than our wages. more than six times faster than our wages. the ways in which we can reduce these kinds of numbing and unsustainable numbers is to get some real competition in the marketplace.
one of the health care insurance companies' arguments is that a public insurance company would be able because of their nonprofit status they're not needing to make a profit and lower administrative costs to offer lower premiums to customers. yes, that's exactly -- that's my next word. yes. yes. what exactly is wrong with this? [laughter] that's the point of competition in the marketplace. [laughter] i realize that insurance companies don't want to have that kind of competition, but let me assure you, the american public desperately needs it. it's really simple. [applause] a lower-priced product, and we see them all the time, insurance policy -- we haven't seen that, but we'd like to -- a cellular phone, a pair of running shoes goes on the shelf and the company has to make the case why it's worth more, or they have to
price more competitively. they could offer a better product or price more competitively. this doesn't seem that difficult a concept to me, and the fact they're trying to make this something we really, really don't want to have happen is, you know, makes you think you're in one of those backwards worlds that children's cartoons sometimes move to. [laughter] i have to say that does the fact that the public insurer doesn't need to make a profit put it at an unfair advantage? i don't think so. there are right now for-profit and nonprofit insurers in the marketplace. i have never heard the for-profit companies complain that those pesky not-for-profit companies are having an unfair advantage and, in fact, according to health insurance colorado.net which was the only thing i could find this quickly this afternoon, they -- [applause] hearing it from denver, right?
they are not. in fact, the cost of policies is about the same whether it was a profit or nonprofit. so the fact the insurance companies are using it as one of the reasons we don't want to have a public provider, that we need to have profit as part of the picture is certainly wrong. back to my sister for a second. as the dime rolled out of her hands the words formed on her lips, there goes the lord's dime, now, we forgive her because, first, she was 5 years old, and in this case the someone else was god, and nancy could be forgiven for thinking he had a much better chance of getting that dime than she did. [laughter] we learned something else, too, we learned that those who are dependent on our remembering them and planning for them can be the first to be jetsonned in a moment of need or a moment of greed. another argument was made quite cleverly last night on the questions to