Transcripts For CSPAN2 Key Capitol Hill Hearings 20240622

That would be a substitute for nuclear testing. They have not allowed us to go there. In the agreement, it says very little except there will be a separate arrangement tween the iaea and iran on park in. There is a lot of negotiation left to discuss. The iran issues may shift a bit in a good direction. As you all know what we think of those capabilities and intentions, at least on a softer human side of covering iran, there are now at least some relationships. We have now been able to establish some kind of human contact with at least some of the key players in iran. We are not getting anywhere close to the leader and we dont really know what happens in the inner sanctions in iran but at least now there are channels that will be aggressive relief after so many decades where we were following iran remotely and new we could follow large movements of military forces but we really felt very handicap at not knowing enough of the internal politics. We all know this agreement was negotiated by the good guys of iran, if you want to leave that, but theres a whole lot of are part of the iranian system that probably takes a very different view on the desirability of the agreement. Im not suggesting that just by all the time that secretary kerry has spent with their Prime Minister or their and on edgy minister that that is somehow sufficient but it is a big improvement over what we have had in 30 years. I think intelligence folks are aware of what others are aware of. Those webb visited iran no that there is nothing in this agreement that guarantees a transformation in iran but having said that, iran has competing Power Centers. It has a quasi democracy. 40 of the university and graduates. It is still very repressive at the top and we saw as recently as 2009 a Reform Movement that is hovering. The expedient counsel determines who gets to run. In the last time they didnt let johnny run and he was thought to be more pragmatic. The one person that was allowed to run was a little offcenter and he won. That tells me there is some sort of yearning there that visitors always report back. There is yearning the outside world. Now that being said the people at the top call the shots and my point is there are can heating Power Centers there. If this agreement goes well what i mean by goes well, if they get what theyre really bargaining for, sanctions relief, which can also be seen as a detriment of course because well have more money to do the bad things, but if they get sanctions relief in the parliamentary elections scheduled for february i imagine hell gain some votes. What does that mean . Maybe a balance in the Parliament Begins to shift a little bit. These are all concepts but its kind of what youre working with here. Matt do you think thats too optimistic . From the pentagon point of view, people take a dimmer view view of these theories of reform then maybe some other folks. Do you want to jump in . If i was doing my job right at the pentagon nobody would ever accuse me of being an optimist. I would say agree with what alan and john have said. I think we need to understand potential impact of having so many contacts between the United States and iran. If you put it in context at the beginning of this administration, the United States communicated with iranian government through highlevel letters. That was not much. Now you have senior diplomats talking on their cell phones and weeks at a time in meetings. Those are going to change International Politics but a country we dont have an embassy in that we will now have 24 hour surveillance from the iaea, that provides channels to uncover issues that we can talk through. I shouldnt underestimate the fact that we want to talk to them. Its only in our interest, even if we recognize were not talking to the full spectrum of political leaders. You had some interesting thoughts that i read about our history of misjudging iran. We didnt really see Islamic Revolution coming. We continually overestimated the moderates and been burned by it several times in the past decade. So is this time different . Do you think these talks give us reason to think its different or is there more we need to be doing or need to recognize our limitations . How do you think about it right now . Actually its very interesting when the revolution came, there was an after action and were talking late 70s or early 80s, there there was a very painful acknowledgment that we let them tell us that we couldnt talk to the opposition in iran. Thats thats very hard in a country that had authoritarian to some and very unattractive revolution but there was a period of time where the u. S. Was very important and we were had a military presence and were a major part of iranian life. They were our great partner in the region along with saudi arabia and israel. Think i much has changed. Even with a a large embassy, we had censored ourselves a bit and didnt deeply understand the society. This is an ongoing challenge for analysts in democratic countries around the world, not not just ours but our European Partners face some of the same dilemmas. You are always balancing how much you want to get along with the incumbent regine and how you want to make sure youre scanning the horizon for what might change and who are the other actors, and who are some of the rising voices in this country question that we sometimes censor ourselves and sometimes we have no access. Im not suggesting were suddenly switching hundred and 80. This will be a very gradual incremental process to widen the lens. In this. During the negotiations, the state department and public and private world has been able to open the aperture a bit for Civil Society changes. There are some Amazing Things going on at the nongovernment level between the United States and iran. Berkeley university and their university have an exchange. There is exchanges on public health, theres exchange of on environmental issues. Theres some joint issues on teaching the iranians on urban resilience because their earthquake prone and have some of the same Natural Disaster issues that we have. We are trying which is why i think we want to go back even though i think the president was very scrupulous in saying that this was just about the nuclear activity, we made no promises and it was not contingent on other items. They may have wanted a more comprehensive approach but thats not what we did. In reality, i think there is a bigger box it in which this is happening. That figure box is beginning a process in trying to engage more openly with iranians for the longterm. Whether the revolution survives or eventually it is replaced by a more open regime. By the way, anecdotally this is probably a small part of it but i have seen journalist, american, european and iranian journalist getting to know each other on twitter and sharing notes and starting relationships. Maybe theres a maybe theres a bit of twitter diplomacy happening. The journalist that go to iran are at high risk. Having said all that i think about the fact that most if not all of irans neighbors who are in real proximity to them, for lack of better talk think this is crazy talk and naive. Despite that i was surprised to see ash carter say that he expressed his support for the nuclear deal. This comes comes after a year and a half or more of the saudis railing against it and saying its crazy. First of all were you surprised to hear that reaction and then i want to talk about some more specifically some things we are doing for the saudis. In my experience i spent a lot of time speaking with the saudis and other partners about it. They were never were never so hard up against the deal. They didnt throw down a red line and say we couldnt do this. The concern was much more in the sense of, look, if theres a deal we know how the defense resources are stretched and with everything in sequestration that congress is doing are you really going to be here if the deal is done . I think theyre very savvy to realize that the deal is happening right now. The question is what is next . To your point the what is next is the most important thing thats happening right now. Everyone talks about president obama and the leaders at camp david and what does that mean. There is an effort that goes well past a year before or 18 months into years years before which i remember working a lot on which is what can we do about the abilities and dealing with the threats. The threats of these efforts that were worked on were Cyber Security Maritime Security and Missile Defense. All three of those things face a ronnie threats. We need to use this opportunity to get these countries to work more closely together because all of those threats are collective actions. No one country can deal with them. I think we need to try to find an opportunity out of what happened here to bring about some of the operation that has been hard to do since the founding of the organization a long time ago. Do you want to chime in quickly . Security cooperation, i do do think the use has made a lot of progress in that area. The president s invitation to come to camp david made made a difference but lets remembered there are very different approaches to iran. The United Arab Emirates and other spectrum of views on the sectarians and the shiite problems in dealing with iran in general. If you give it a high level of security and deterrence they agree, but when it comes to economic interaction with iran they have very different policy. Genre you going to jump in . No go ahead. Let me ask you about how we strike a balance. It seems to me thats going to be a real challenge. What matt is suggesting is that as a result of this deal, to some degree we have to flex more muscle in the region and use and reassure our allies that they just cant have the run of the place. How do you find the balance between doing that without stumbling into a confrontation that blows up a nuclear deal or whatever relationship we might have . Do you think we can walk that line . Its going to be hard. One way to get at that question is to say, remember these negotiations have been going on since 2007 in one form or another. The middle east that we are seeing today is so dramatically different than the middle east we had in 2007. We have a middle east now that is in conflict on at least four or five dimensions. Persian arab sunni shiite, reformer versus traditionalist, terrace versus regine and i could probably add terrace versus terrace. Youve never seen that before. The kind of task that your laying out for the United States is in credibly difficult. You could say say the middle east is experiencing Something Like i dont know, like the four year war in europe akin the 17th century which was about religion commerce, territory and ultimately it was sorted out after all those years. Thirty years. It may be thats what were seeing in the middle east now. For the United States, almost, almost anything we do is going to be provoked and opposite reaction somewhere. I think we have to handle this very carefully and in the inspection process, but there are going to be disputes. Were talking about this as a relatively done deal the delicacy here is going to appear that sometime in the next 90 days for example, most people i dont think realize that iran still has to work out with the iaea a roadmap for how the iaea will behave and what it will have access to and how inspections will actually work. Thats going to be contentious. Then inevitably we are going to want to look at something they dont want us to look at. At that point i think we reach the crunch point. Irans view which they have expressed is if we back away from this agreement then all bets are off with them and they start enriching again. They quickly become, i think a Nuclear Threshold state again. We have to calibrate all of this. What of things really go off the rails and there is talk about a military option . Option . You warned in 2012 that a u. S. Strike on iran would be a very bad option do you still feel that way . And i want to throw in one other question. What about the military thats penetrating this 15ton weapon does that change the way you feel about it at all . Could we still do it strategically questioning. Yes i dont think so, you dont dont have to follow up with 20000 troops. Although heres my first caution about that. When you look at the history of warfare, one thing stands out above Everything Else. When you inflict violence, you dont inflict violence, you dont know where its going. You dont. You may think you do but you dont. Thats the first thing. If we do that, do that, we better prepare very carefully for option b, option c. [inaudible] what this agreement does is it buys us time. Thats all it does. If you believe that ten or 15 years from now assuming the iranians follow the rules and play the agreement out they would then have the capacity, as the president acknowledged, to become a nuclear state. But we bought that time and given the turmoil i just sketched out in the middle id east, thats not a bad idea. We dont know where theyre going to settle out. We talk about the saudis and im not sure why the king is saying what hes saying but theyre in a interesting situation now because the close relationship that we have postdates the fall. Prior to that iran was our big partner in the region. Now the saudis in saudis in a gypsy and must be looking at this whole arrangement saying is there a tate tonic shift here . Is our overall position in the middle east less than it is because as we look ahead here, if you were going to cite the certainties, i would say one certainty out of this is iran is going to become more powerful, for better or worse, more powerful in the region. Either with this agreement or without it, but particularly with it. What is that going to mean . Be specific. I know youve spent a lot of time looking at these scenarios but what are couple of the friction points we will have to be really careful about question marks. Weve already had some tension in the last month. As i going to escalate . I agree with what john said. When we look at iran, they will have an increasing population and increasing youth population. This is not a disarmament agreement. The thing you talked about is the Major Concerns are what they can do with fiber issues and other things. I remember being on an Aircraft Carrier in seeing these small iranian boats that either have contraband or a water skier behind them or something that could be very deadly to ships going through. Those are the types of things that iran will have that we need to be very wary about what theyre doing. Its not in their view to shut down the straight because of oil doesnt flow, particularly now that theyre getting back in the market, but still the fact that they can have that threat and uncertainty and were still not sure exactly what theyre doing, those are the issues we need to be aware of. Let me give you testament from an israeli foreman intelligence officer. This is what i agree with. It will also puncture the impression that ive may have given that im optimistic. I do see potential for good things coming, but this former intelligence officer, very senior see that this way. Three scenarios all mention in terms of the leagues likely first and the most likely last. First scenario, transformation in other words what i think the administration is hoping and to a degree betting on, is what all of us talked about as a possibility and that is that iran through all of these contacts and through the changing nature of that society, 60 of that society have grown up transformation could occur. Its conceivable. Second scenario he calls it the north korea scenario. In other words, they play along for a while. They follow the terms of the agreement for a year or two. Things are going well but then they either break out of it or theyre caught cheating and that the whole thing breaks down. Thats essentially what happen what happened with north korea in 2002 after an agreement in 1994. Then scenario number three, he calls it strategic patients on irans part. What does that does that mean . He said they play the game. He said in his view this is probably the most likely. They play the the game with some minor bumps and hiccups along the way. They get through the inspection process, they do at this is supposed to do, they hold their enrichment to 3. 67 for 15 years and in years ten through 15 they have the opportunity to experiment with some more sophisticated center fuses. They play it out and year 15 they become and they move toward becoming a Nuclear Power. The operational implication of all that is that even if i had or he had the order of things wrong, we probably need to prepare in our operation are planning and diplomacy for all three of those scenarios. If you want transformation, how are we going to help bring that about . If we want to avoid the north korean scenario how do we do that. If they actually played out and become a Nuclear Power in 15 years from now what does that mean . We need to think about all of those scenarios. Also i the invite someone who really doesnt like the deal to chime in here. There has been been some optimism. Okay in the green shirt there,. There has been substantial evidence that the North Koreans have been sharing Nuclear Technology with the rainy and since perhaps beginning of the century. That means that iran could have material in north korea and probably has plans that the North Koreans have developed devices themselves. The question is how does that affect our ability to inspect this agreement, especially because many people have said that is the critical factor Going Forward . The way to think about that. The way to think about that is what you need for a deliverable for a Nuclear Weapon . Thats the biggest threat and thats what were stopping. The Nuclear Material and the enrichment and the Nuclear Device that is testable and works in a delivery mechanism. Those are three very difficult things to have. We are incredibly paranoid to make sure that we are looking at this shortage intent and make sure they dont have any of them but the thing we need to realize is iran needs to get all three. With iaea inspectors it is much harder for iran to do those types of things. Even if you get that knowledge which once its there, that knowledge exists. You cant eliminate knowledge to create Nuclear Weapons. At most we can do is to try and stop and regulate the behavior and even if we dont know what their intentions are, we can make sure we do everything we can to crack down on behavior. I think thats the approach we need to take with that. As i look at the agreement in the same way i approached iran, it was distress. In no way did the behavior depend on trusting iran, it was using leverage to get them to the table and do everything we can to keep them honest but we really dont know what the hell theyre going to do. I think in the broader, we havent gone to the broader perspective on nonproliferation, but i cant help but say this sounds a little bit flaky, but flaky, but i think there is more the United States could do to delegitimize the weapons. I think were going in the other way. Were re validating that Nuclear Weapons are the market very advanced countries. I think there are final debates that happen inside the United States, were watching pakistan pakistan, india, china increase their arsenal and we miss the opportunity to change the aspiration for Nuclear Weapons. Im not suggesting i believe everything they say, but they say all along we have not been listening, irans goal is to be like japan. That is to stop short of actually assembling or deploying Nuclear Weapons, but or deploying Nuclear Weapons but to demonstrate the technological ability so only and extremist scenario, where they they felt their existence as a state was at risk they would accelerate a programming go to the finish line. It took us a long time to trust japan. We are not ready to give iran that level of confidence but i think we may be making some very big assumptions that everybody in iran wanted to go all the way to a weapon and there is no internal constraints on that in terms of going that far. I think youre right there is a difference between Nuclear Power, Nuclear Threshold and going through all the cost to become a Nuclear Weapon state. I think for us this is the opportunity to test that. That is what its built around to make sure we understand its not a homogenous view in their population. General hayden has a question , but i dont know where he is. There he is. Matt i agree totally there are three critical paths to a weapon and how to assemble that the material the Delivery System so if Ballistic Missiles are one of the critical paths and its going into the negotiation we said quite publicly they had to be included in any final agreement and we took them off the table because of the iranian insistence, how did they enter backend in the last two weeks in vienna and now we are going to lift the sanctions on the Ballistic Missile program and eight years or sooner. I think to be frank and obviously i wasnt in the room and those parts of negotiations the nature of the negotiation and what you can get and what you cant. Theres a maximum position the United States wants and we remain very concerned about the Ballistic Missile program regardless of theres an agreement or not. I think the way i look at that is without an agreement they have the ability to accelerate and do much more. The fact that we are able to have some matter of reduction on that and at the same time, thats just within the terms of the agreement itself. While the agreement itself is going on, the United States potentially has more insight into the program even though were not inspecting military sites, just by having discussions with iaea. The other key part is, as you know, plans to increase the amount of integrated air Missile Defense and Ballistic Missile defense needs to proceed apace at exactly the same time. I think we need to see whats possible in the framework of sanctions and what we can hold together with International Sanctions on that but while doing that, make sure we are doing everything we can on the defensive side with our own technology to make sure we can moderate as much on the delivery side. I see eli lake who i think we can count on for some pessimism. The leader of iran has anyone ever seen it and why hasnt it been published . I understand they submitted it to the United Nations as a formal document so it does exist i just dont know whether anybody knows how to legally and politically accepted as a legitimate document that would have influence on other countries. Hes done it, but most people say you can also issue something to do the contrary. I do think there is there is a discourse in iran that says Nuclear Weapons are not islamic. Take that thought very seriously and sometimes i think it doesnt make the threshold of being an important development. It exists. It was submitted and i will try to find it for you. My understanding is it was submitted to the United Nations even before these negotiations reached an active phase to explain the position of iran on the treaty. Im in a take the next question. I want to thank you for a very thoughtful panel. I have have two quick questions. The first is what do you think this deal will have on the nonliberation regime . A lot of people are saying that at the end of the 15 years on where iran stands that other entities will want to be threshold bike. Two given given the length of the plan or the agreement, some say there might be requirements within usg to help monitor this over the next 15 years . Maybe the creation of a legislative committee that we would have an Ongoing Group and an expertise. They talk about the lack of expertise and im curious how you feel about those two points . Well i think that would be a good idea. Particularly a group of knowledgeable people. Thats a hard one. I can see it cutting both ways one positive thing with regard to iran north korea quit as you know, if they accept the Additional Protocol and they stay in the npt regime at 15 years this particular agreement expires but there npt membership does not nor do the privileges of the iaea to inspect them and monitor. Those those dont expire. If they stay in the agreement. Part of what we have to do is monitor their adherence to the agreement very carefully. Now if they shift to a threshold status at 15 years, yes others will want to do that, although its although its a little hard to appear into the future about Nuclear Technology 15 years from now. Right now i would say why wouldnt iran want Nuclear Weapons . From the standpoint of their national interest, countries look at what happened. By all accounts they are able to assemble Nuclear Devices and probably they can put one on a missile and that has to make us a little more guarded and how we view north korea. People observe that. I think i think that will be a constant struggle over time and it will require more constancy of commitment than we have shown to eliminating Nuclear Weapons. We make a few speeches and convene some conferences and go back to whatever else were doing. We have time for a couple more. Hi pamela brown, fax news. Fox news. The following statement was given, personally i feel the uranian leadership has very wisely and pragmatically gave call this a disaster if you would like. Personally i feel the uranian leadership has very wisely and pragmatically save their country from a very bad situation called a disaster. This is in response to me asking him a question. I dont know what others think but id have to assume what the intent was, in the absence of an agreement like this and in the presence of u. S. And really commitments that it was plausible part of the agreement that military operation might be carried out. You asked before if i had the same opinion about that and i gave you half an answer but i think one of the problems with the military operation is that apart from not knowing where its going to go is that you would probably drive the adrain and people together in support of the regime. I dont dont think you create anything else. I think thats probably what hes talking about. After all this agreement is a pretty good agreement for them. If anyone here wants to read the 159 pages, i encourage you to do it. If you need some shut eye. The last 50 pages the point i want to make his we sanctioned the hell out of them. When you look at the last 50 pages it is list of things we sanctioned. We sanctioned everything except for maybe childrens toys and im not even sure about that. That got under the table but it didnt take them from getting within two or three months of a Nuclear Weapon. Think about that. Lets take another question. High hello, hasnt the train left the station on this . What would happen if the United States congress, with congress with a vetoproof majority vetoed the deal . Essentially china, russia and india have begun lifting sanctions for all intensive purposes. We couldnt put the genie back in the bottle. We couldnt get back the sanctions we are ready have. What is congress thinking about whats next because we cant reinstate those sanctions . I think you raise a really important conversation thats good to conclude with. I firmly believe that this could make the United States safer now and in generations to come. I also believe we need to have a robust and open debate about what this means. This is an important part of the United States security and we need to have a debate where people on both sides can air their concerns. That said i think a be a tremendous mistake for congress to vote this down and for congress to hold back. We need to go in and part of the reason we need to have this debate is as we talked about on the panel, the types of resources the United States needs in the region are not free. Under our budget problems that we have right now i think Congress Needs to debate this issue, understand what is in it and also understand what it means for america as a commitment to our own interest our allies within the region. I think only by having that debate will it make us stronger and come out whole. I think were almost out of time. You want of time. You want to say a closing thought . This period of risk of sanctions is going to get complicated. Its not going to be blackandwhite. I think the iranians themselves might be political backlash that hasnt been released to the average iranian citizen. Your point is at least partly correct the other countries will abide by the agreement even if we were by a unilateral choice say we dont want to abide by this agreement. We still have lots of unilaterally imposed sanctions. Do you want to bring us in for a landing john. No i agree with that, i think its a good idea for congress to debate this because i dont know how you evaluate what we set up here, but i think most of us would personally say its a pretty evenly balanced, if you add up the advantages and disadvantages of this agreement. There are disagreements to this agreement. Iran gets a lot out of it but we get something out of it. What it is is something were not very good at anymore and thats a compromise. [laughter] on that note, thank you so much to our panel, thank you for coming and great questions. Thank you. Thank you. That was a perfect ending. Cspan. Org. Washington journal continues. Host douglas holtzeakin is the former director of the congressional budget office. He is also the president of the American Action forum. He joins us this week to discuss a report that finds Health Care Spending has jumped up from the historic lows of recent years. Is that jump something americans at should be concerned about right now . Guest absolutely. If you look at the foundation of our federal budget problems, if you look at the concerns about wages and not rising in the united hates, all of those are linked to Health Care Spending. The big federal spending programs are the Affordable Care act. The biggest compensation costs employers have are there health programs. If premiums go up they cant pay as much. To see the spending jump back up and the way that it has is really concerning. Host was this jump expected as a result of millions of people joining the ranks of the insured through the Affordable Care act . Is this something that was budgeted for, or unexpected . Guest it is the classic horserace. The Affordable Care act is something that unquestionably was going to cost money. It covered a lot of people. That was the real point. The point of getting People Health insurance is to allow them to spend more on health care. That was going to push spending up regardless. It is also true that the Affordable Care act was enacted at the bottom of a bad recession. Inevitably as the economy got better people were going to spend more on everything including health care. But they put some things in there they were hoping would Keep Health Care less extensive. And that would outweigh the expanses in coverage. It does not look like that works. One of the architects of the avaca who is now up at the university of pennsylvania, has said we have to go back and do that job again. Host here is the wall street journal chart on Health Care Expenditures that we are talking about. After historic lows of recent years on Health Care Spending, it jumped in the previous year. What led that jump in Health Care Spending . Where their specific aerie is where people were spending more . Guest a great use of irony here is that there was a jump on Prescription Drugs. You hear about hepatitis c thousands of dollars per dose. Prescription drug spending is 10 of healthcare spending now. It was 10 in the 1960s. Despite all the. It is not Prescription Drugs. It is the meat and potatoes. Hospitals and doctors. We spending more on those services. Host and the projected chair of the Gross Domestic Product Health Care Spending is expected to be upwards of 20 of gdp by 2024, outpacing economic growth. Explain why that is a problem. Guest historically if you look at the horse race between costs what we spend on health care, and income, gdp, costs are beating resources by about two Percentage Points a year. That is a projection in this. If you go up to 2021, we are going to percent faster on cost than on resources. You cant continually outstrip your budget and expect things to add up. It is a problem for the nation as a whole. It will turn out to be problems for individuals. It turned that to be a big problem for the federal budget. Host if you want to join in this conversation as we are talking about Health Care Spending with douglas holtzeakin. You can join us. Democrats, 202 7488000. Republicans, 202 7488001. Independents, 202 7488002. I want to go back to that chart that showed Health Care Spending at his story close in recent years. What is the reason in your mind, that that spending went down . With it due to the Affordable Care act . Guest there are a couple things going on. We have the recession. People dont spend money on anything ending off some Health Care Spending. Number two, we had the phenomenon of employers really changing their coverage, and pushing off to employees, more cost, more data couples. People react to that particular. They spend less. That was going on before the Affordable Care act. A lot of the slow it slowdown happened before the aca. The aca put in place some additional things. Cut to providers. It also has these organizations known as Accountable Care organizations. Hospitals, doctors they say go take care of people and we will pay you a fixed amount. That was the biggest attempts to control costs. I dont think it worked out very well, but the bigger pressure came from the employer side. Host before we get to calls your thoughts for controlling healthcare spending Going Forward. What would be the single most effective thing to do in the future . Guest for me, start with reforming medicare. It is the big driver of both how we spend money but also how we treat patients. The number the issue with medicare is we dont have the budget. If you have a program that basically says, you can spend all you want of someone elses money, you are going to get a bad outcome. Host lets start in randallstown, maryland where ray is waiting. Our line for independents. Caller good morning. How are you . Guest how are you . Caller i am trying to understand about the aca. People call it the unemployable care act. I would just like to know, how is it paid . Some people say we take it out of medicare. Some people say we have got taxes on devices. And then there are all these fees and things like that. How is it being paid and how are my deck tax dollars being used . Guest good question. It turns out all the people youre talking to our right, at least to some degree. There are eight taxes. There is a tax on medical devices. There is a tax on Health Insurance. There is a tax on very high Health Insurance plans called the cadillac tax. There are a whole series of taxes that were put in the aca as a part of the bill. The remainder was intended to be taking out of spending for medicare. The allinone insurance program, the Medicare Advantage there were cuts on the possible providers. That combination of spending less money on medicare and adding taxes was supposed to cover the bill for insurance subsidies and the medicare expansions in the state. Host and with medicare expansions in the states, where are we in that process . How many states you dont have to give me an exact number if you dont know it. Guest a quiz excavation we still have 11 that are complicated considering it. After that as it is because about 10 of the bill. Some states, for political reasons, are not ready to consider. Some are just worried about the financial cost down the road. There is a very healthy skepticism that the United States will just change the rules. They will say, you know we promise to pay 9 of that, good luck with the rest. Host we are talking with douglas holtzeakin. He is president of the American Action forum. What is that you for viewers but dont know . Guest it is a center right think tank. Host bruce is in jacksonville, florida. Why for independents. Caller i have one little pet p. That is when you put medicare and medicaid together in the same sentence. I pay for my medicare for 35 years. Medicaid is free. Now youre cutting medicare benefits, taking the money from medicare when you are expanding medicaid. I live in florida and we spent more on medicaid than we do on education in the florida budget. I just dont understand where the money is supposed to come from, all the young people that were supposed to join that havent joined. The subsidies that the government is giving away, and you estimated your income the first year and the irs is handling this. Doesnt the irs know exactly how much money you made the year before . I dont understand. I will shut up and let you answer. Guest there are a couple Different Things going on here. First, on the medicare fraud, it is true that individuals have played paid payroll taxes and premiums. But in the end they do not pay the full cost of medicare. It is 75 subsidized for general revenue. Over lifetimes the estimates are most people will take about 200,000 more out of medicare than they spend then they put in. Everyone has paid for some of medicare. No one really pay for all of medicare. Medicaid, financing is split between federal government and the unites and the states. The florida problem is a very familiar problem. Medicaid has grown, and the cost has grown so rapidly that it is taking out big chunks of most state budgets. The states really do three things. They do education, health care and prisons. There is not room for much else. That is why it people are so concerned about the resurgence of Health Care Spending. There is big pressure at the state level as well. The last thing the caller mentioned is the notice notion of subsidies. That is neither medicaid nor medicare. That is the new Affordable Care act, individual purchase of insurance. Subsidies are geared towards peoples income. They have to estimate your income. They say this is what i think it is. Eventually you said, if it was higher, you had your subsidies taken back. If it was lower, they give you more subsidies. I will call that a highly imperfect process. It is really hard to do. And our earned income tax credit, which asks one question, how much did you make . Payment error rate is 25 . Host under or both . Guest both. In this program, we dont have to ask what cspan page view, we have to get information from cspan about what kind of Health Insurance they offered, whether it is affordable or not. Matching of this information in realtime turns out to be horrifically difficult. It is not happening right now. Guest waiting in illinois on our line for independents, good morning. Host we are talking about Health Care Costs and taking your questions on it. Caller i have two questions. One is regarding malpractice. How does that add to the burden of costs on health care . Not just with regard to insurance that people have to carry, the Health Care Providers have to carry, but also how they practice medicine. The other question i had was are people looking at all of the new rules that are coming into health care and all of the administrative salaries that are having to be paid for people to become reimbursed . I am talking about on the Health Care Provider site, people are hiring more people, coders etc. , for people to collect. I think that is probably also adding to the burden of Health Care Costs. That may be unanticipated. Guest the questions. On the first most people will most doctors will cover carry malpractice insurance. A policy against being sued or otherwise being accused of you miss using their expertise. That is an expensive policy. That gets put right into the cost of health care. The bigger piece, as the caller mentioned, it changes the way people practice medicine. Defensive medicine lets use an and i are mri just to make sure. An expensive thing to do. It adds to the cost of health care. There is a lot of evidence that tort reform, it can lower the Health Care Bill. Different states have added caps on the damages you can impose on doctors. There are health care mediations where if you follow health care practices, you are exempt from the prosecution. There are a lot of things to be done. It is a promising area to reduce the cost of health care and still get highquality medicine. Host talking about the growth of Health Care Spending, some of the numbers from the report that we havent talking about, health care of a share of the nations economy has been projected to grow from 17. 4 in 2013 to 19. 6 in 2024. Accounting for nearly one dollar of every five dollars spent by 2024. We have seen a lot of stories about mergers and the health care industry. Is this growth and Health Care Spending a factor in those mergers of these Companies Getting together . Guest unquestionably. The first question is that the numbers are always so big and the economist and he wants to caution everyone it is not that we are spending 20 of our gdp. It is that we are not getting our moneys worth. It is fine to spend a lot of money on something if you value it and you get it back. We do not get the quality of care that we should for the money we spend on health care. The issue is not how much we spent, it is a low value system. Overuse, underuse use, and misuse of these fabulous medical technologies that the u. S. Is the world leader in developing. We are not getting Quality Health outcomes area that is the challenge. Consolidation has come in two forms. For years now, we have seen the consolidation in the providers. The hospitals merging, hospitals buying up physician groups so that they become art of the hospital practice. A real concentration of market power in each of the local areas. There has been a concern by many, myself included, that this will lead to them having the ability to jack up their prices and make health care more expensive. Recently, we have seen a different kind. Large Insurance Companies merging. Aetna humana, cigna getting together so that we have three Large National insurers. That is not trouble me on the face of it. We still have 800 odd Insurance Companies across the country. The competition will be in local areas. In buffalo with hospitals and doctors consolidating and insurers trying to negotiate. If the consolidation helps to negotiate, that could be a good thing. The jury is out on net how this will play out. It is worth looking at. It is an important issue and how this will play out. There is no bigger domestic policy issue that how fast the Health Care Spending grows. As i said earlier and leads you to all of the problems we worry about. Wage stagnation, state budgets are under pressure. Federal budgets which are politely, i disaster. Host john an awesome wash wisconsin. Line for democrats, good morning. Caller i wanted to make a few comments. He said that he was working with centerright groups at washington. We know that washington is completely corrupt and overpopulated with special interest such as douglas holtzeakin, who is probably working on behalf of the Republican Party and Koch Brothers and the rest of the rightwing organization. Host while we talk about how his group is funded and then he you can ask your question you . Guest we are funded by private individuals who believe in the mission. They are grounded in the facts and not ideology. We take pride in the fact that everything we put out is filled with data on a particular problem. We have a preference for marketoriented solutions. And Efficient Government solutions that will now be get between the revenue coming in and the spending going out. We are not allied with any of the groups that he mentioned. I started the think tank five years ago. Largely because i was unemployed and not is what Unemployed People do. I am very proud of it. Caller can i respond to that . The funny thing is that we have been hearing the same dialogue coming from vested interests for years. At the same time, these people are telling us they are not increasing wages in this country. They are shipping jobs out of the country. They are getting the government and trying to make people believe the government is a bad thing. Yes, people are willing to trust corporations over the government. The government is allegedly us the american people. What we are doing is seating all of our authority to corporations. We cant pay more taxes to finance all these programs in this country. The answer seems logical. The people at the toptier income have to pay more taxes, corporations have to pay more taxes if they care about this country. Guest i cant speak for the entire business community. I know i have done. I started out with myself and i have 3400 employees. 34 employees. We have 15 employees and turns at any one time. We pay them as well as we can. You want to grow your business. You want to make sure you have a working environment that is productive and enjoyable. Guest edmunds on her line for independents. Host good morning. Caller good money. My question is about Health Care Costs and the dissection of pricing. In the Health Care System im a patient but also a consumer. My question is that whenever i ask the question of a medical procedure that i will receive, i will ask how much will this cost . The person at the hospital or Doctors Office looks at me like i am from mars. What do you mean how much does this cost . Your insurance will cover this. As a consumer, it is no different than when i apply for a mortgage. And why not entitled to a estimate of how much these procedures will cost . Can you comment on that . Guest i think that is a good point. I had my it hip replaced recently and i asked how much that would cost. I understand the reaction. Host did you get a price . Guest i did get a price. There is a lot going into understanding the cost of things. If you are a private business, being concerned with your customers as part of the business model. The ability to give individuals the choice to go somewhere else is a key part. For government money, once you take taxpayers money, you all a level of transparency that is well above that. You have to say exactly how much something costs and why. We do not get that. That is an important thing we need to keep pushing on in these federal programs to get some transversely. That is exactly right. Try to get some transparency. It is a very contentious lot to say the least. My take on what is happening in the Health Community is that it sends a wakeup call. People now wonder how much things cost. Never before when i went to doctors do people say, there is something we can do that is cheaper, too. That was never part of the conversation. That is a good thing. Host does encourage shopping around . Guest there is a limited ability to shop around. We know that. It has changed the way that doctors, hospitals, nurses, they didnt think how much something cost. They were trained not to think about it. The medical training was all about the medicine and the oath, and doing harm, and extensive testing, making sure you do things. Now we have to worry about how much it will cost. Someone is going to pay this bill, and some of it may be the person sitting in front of me. That is different. Host a question on twitter. How aggressively does medicare renegotiate for medicine and services . Guest it doesnt negotiate. Medicare has an elaborate vice pricefixing scheme. It is not a negotiation at all. The only place where you get negotiation and medicare is in the vantage program. Traditional medicare, and then you can opt into a onestop shop where you sign up for the medicare vantage program, pay your fixed premium, the government pays a fixed amount, and because they have a fixed amount, they have to negotiate with every hospital and doctor for the least cost. That is the only negotiation going on right now. Host to new mexico where jed is waiting on a line for republicans. Caller [indiscernible] host youre going in and out. We will come back to you. But so do melvin, indiana, line for republicans. Caller my question is on medicaid. How much of the state policy medicaid funding is provided by the government . Guest it varies by state. Something called the federal matching rate. The average is 55 federal and 45 stake. That has been true for a long time. The exception is the new Medicaid Expansion in the Affordable Care act. The government takes a 100 of the cost for a couple years and after that, 90 forever. Host our state ready to revert to the 10 from what they are paying in right now . Thinking ahead of that to budgeting . Guest i hope so but i dont know. Some of the governors have been more cost cautious. Some have worried that the deal will not stick and they will worry a will and is paying more than 10 . A third of fact because of the advertising of these new categories of eligible medicaid, people who were previously eligible and did not sign up suddenly show up. When that happens, the state is on the hook for the for sure. For the full share. There are hitting costs showing up. That is an issue. Host is on the line for independents. Mike caller i was talking about the problem that lots of people have. The last job i had for 25 years i lost it, nobody was hiring. I was too old. I was about to get medicare. I have Health Conditions and as time progresses they will get worse. I was wondering how that care will be covered, and will be covered, and the quality of the care. Iq. Guest if i understand the question right, right now, you could go to the exchanges and buy coverage right now. If you have Health Conditions where failure to treat will worsen your health and make it more expensive in the future that would make a good thing for everyone if you do that. You would get subsidies from the federal government to afford that insurance. Once you become medicare eligible, you will get the full range of benefits for medicare beneficiaries. Presumably, that will cover your conditions. I dont know the details. Host they say health care for all should not be a budgetary issue. Close one or two of the 300 redundant bases around the world and fund health care. Is it possible you will be of doing that . Guest the largest budget item in the federal budget is not the pentagon, it is Health Care Costs. It is not feasible to close redundant bases and they are federal Health Care Bill. We have to deal with the cost of health care itself. People are always uncomfortable with the notion that we have to do that. Presumably, it means we will do Center County and cuts to the actual we will do for cody and cuts to the draconian cuts to the care we have. Under uses valuable Preventive Care that will make cost lower. We have to do better. That is the key. Host after washington, stevens is a early with us this morning. Line for independents. Caller one of the questions that i have is that we look at some of these dates that completely embrace the aca early on. A good example is oregon. Their complete implosion of their system how does that affect costs for health. Guest the big implosion in oregon and many other states was the issue of building the exchange. The electronic work in place where insurers would provide their product. Those who wanted to buy insurance with federal subsidies would go and take among policies. In principle, those electronic exchanges were supposed to coordinate that activity. I give my income, they send it to the irs, they do the checking, they take that information and send it to the Insurance Companies. The Insurance Companies know what is going on. They get their premiums. We know what happened with healt hcare. Gov. It was worse for some of the states that if it themselves. Oregon was a disaster. Hawaii managed to sign up 1600 people for a cost of 60,000 per person. A lot of bad examples. That is a big expense of these days. One of the things Going Forward is will the states managed to maintain exchanges or will they get together and regional groups, although to be federal exchange . The jury is out on that. This has not been a good story out of the aca. Host have given Success Stories . Guest there have been. It is like most things. You get successes, you get failures. The failures were not only costly, they got in the way of the program working. Host to delhi in detroit, ohio line for democrats. Debbie, good morning. Caller a quick comment. Someone earlier talked about the Koch Brothers. They have created jobs for americans. No one talks about george soros who is in bed with president obama as they are communist. We should not be having this discussion. Host your question youre calling in on our line for democrats, are you a democrat . Caller i am a democrat, but i am not voting for democrats or republicans. They have sold our country out. We are screwed. This should not be a conversation. Who are they to tell us that we have to go do anything to get their health care . It is all a big plan. As anybody knows, as in full you are screwed. Planned parenthood taking out baby parts and selling them. Neither the republicans nor the democrats will do anything about it. We talk like we are some educated people and that we really care about who is sick and who isnt. Who is getting the care and who isnt. Host deadly in detroit, ohio with her thoughts. John and philadelphia, line for independents. Caller how are you guys doing . I have a quick question. Is that all right . Host go ahead. Caller it is about aig and obamacare. I was curious. Personally, you are a good guest so far. You know how aig got bailed out recently, a couple years ago . I was curious what your mindset was not how i got bailed out but Obamacare Obamacare is now working on fixing medicare, and it is cheaper. I am curious what is your mindset are not that part, personally it is on the tip of my tongue. Medicare is now down in price and all of this stuff. My question is, what do you think not just obamacare medicare medicaid, i am 87 years old. I have a grandson named billy. My question is host are you asking whether there will be a Health Care Bill out at some point . Caller yes. That is what i am asking. Guest the aig bailout from the financial crisis aig was a horrifically managed enterprise, as it turns out. I was on a Financial Crisis Commission that congress created. We listened to testament from the aig executives. They do not even understand the contracts they entered into. When push came to shove, they did not honor those contracts. It was disgraceful. I do not think we should ever were that kind of behavior. Medicare and medicaid are different issues. They are government romance. I admit those programs have also to private physicians, hospitals, nervous nurses device companies. We are not relying on any single one of them to provide medicare and medicaid in any way that will ever require bailout. Our Biggest Program problem will be keeping those programs funded adequately and making sure they are operated efficiently. The big problems are at the state and federal level, and not the individual Companies Providing the care. Host flag is on the line for democrats. Good morning. Mark, good morning. Caller i have two questions. You were talking about the price of medication. I believe it was in 2005. Somebody stuck in a bill, a spending bill, where medicare couldnt negotiate for prices. Va does, i am a veteran. I think that is a raw deal. The second question is Insurance Companies make 20 off of premiums. It seems like if we got rid of Insurance Companies, we would save 20 right there. With negotiating prices, a raw deal for all citizens, people should be really upset about that. The 20 that was given away to big corporations, apparently there are only three of them now. The insurance corporations. We are getting a raw deal in this country as far as insurance. Guest two things. The first is the Medicare Prescription Drug program passed in 2003 while i was the director. There is a provision that precludes the secretary of hss hhs from negotiating on per the half of the Prescription Drug program. The logic is that these Prescription Drug programs will have five or 6 million seniors in them. If you can go to a drug company and say i can get you 6 million customers and you need to cut me a good deal, that negotiation can keep costs down. It has come in 25 cheaper than we projected at the time. There is an enormous amount of competition, great levels of satisfaction among beneficiaries. It is our most successful entitlement. I would not want to change it one bit. It would be a mistake. We have seen the success, and we should try to make Everything Else look like it then change it. As far as Insurance Companies they are everybodys Favorite Group to beat up and health care. There are lots of reasons why they have earned that spot. It is not 20 profit margins. They would love to have 20 profit margins. If they had that, every one of us would have our Retirement Savings and Health Insurance companies. We dont. Margins are a lot thinner. They are not the hot the cost of Health Care Systems. The cost is hospitals, doctors the care it sell. Insurance companies are a tiny are on top of that. Host line for independents good morning eric. Caller how are you doing . Health insurance is screwed up. Nobody wants to pay for. My question is, how do you have money for wars and you dont want to help help anybody in america with their health . I am veteran. Ive been in the war. You rich people you dont want to pay anything. All you want to do is drill for oil. Go to war. You dont pay taxes. Host do you use the va system . Caller i use it, but it is so backed up. You would go to you would die going to that. They push you off for a year. Host do you want to talk about the va system . Guest i did not come on the show to defend the system in any way. It is disgrace to our veterans to have a system that is so dysfunctional. The administrative failures get in the way of people getting the care they have earned and deserve. I am not a va expert, but we hear horror story after horror story. Host you are the director in 2003 guest this is not a new story. This has brought tension and dollars attached to it because of the recent influx. We have long documented the inability to process applications, the fact that they are behind an electronic records. The number of reforms of forms they have to fill out to get care. There is a whole list of things that is wrong with the va. It is one of the stories that sent like a culture that needs to be revamped. Host john in florida on the line for republicans. Caller good morning. One quick comment. Then i will listen to your reaction. As we all know, the irs is involved in the aca. I was totally amazed when i filled out my tax form only one line that asked to you have Health Insurance . Yes or no and then you move on. They do not ask for any validation at all. You get your registration and they asked for your Insurance Company and number. They dont ask for anything. What is stopping someone from lying and moving on. Thank you. Caller guest Going Forward, there will be a matching of the income. There is the initial part of that was whether your employer provides your help and for insurance that shows on your w2. Now you have the obligation to be insured. That is an individual mandate. There will be more checking to make sure subsidies and incomes are right. We know that. Host a couple minutes left with American Action Forum Director douglas holtzeakin. Line for republicans in new jersey. Caller thank you. It is interesting. You said a little while ago that it is not how much we are spending on health care but what we are getting for it. This is precisely the argument that republicans used back in the 90s when they said in order to block Health Care Reform, why are you messing with something that is 1 7 of the economy, what it was at the time. Now it is approaching 1 5 of the economy. I imagine the argument on escher get stronger. Why do you say what you really think which is that they want to block reform because they dont want big donor basis of the Republican Party, the Health Insurers and the big chain hospitals, to lose a vital source of revenue . Guest i guess i would question your reading of the history. My experience, for example, in 2007 i was the policy director on the john mccain campaign. Every republican candidate in that cycle had a Health Care Reform plan. The notion that somehow republicans have come up a long time and to this day opposed Health Care Reform is wrong and counterfactual. You know there are five or six Health Care Reform proposals. Competence of reforms comprehensive reforms. They are different approaches to the same problem. My view of the problem is that republicans and democrats agreed there is a problem. Health care they just have different routes to those ends. Host if you want to read more about his work, you can go to a website vulnerability and protect everyone. Monday night at aiden eight eastern on cspan2. Not next a discussion on isis recruitment their tactics and motivation. The danger posed when foreign fighters return home. From George Washington university this is one hour 30 minutes. Good morning and welcome everyone to the university. Thank you for joining us today. We also welcome our viewers watching at home on cspan. Obviously this is a timely set of topics and couldnt think of three other people anywhere to shed some light on the foreign fighter challenge. Clearly its not a new phenomena but in terms of the scale and scope it is unprecedented. The numbers are staggering and continue to grow. The various guises and forms in which it takes is relatively new. We did a major study on this about five years ago. At that time, it was a challenge but by no means in terms of the scope are dealing with today. We were looking largely at americans and somalia joining up with al shibata. Also dozens at that highest point of americans joining up with the taliban. Then we saw al qaeda in the arabian poem peninsula in terms of. Those numbers in terms of how significant they may have been are dwarfed and what were seeing today. In part due to technology and ease of travel and in part by other motives like we will learn much more about. I had the privilege of introducing lorenzo who is leading our new program on extremism. is thinking about. Following lorenzo i had the privilege of welcoming a good friend of mine who is groundbreaking work on the foreign fighter challenge in the u. K. At icsr which he has been directing for how long now . For seven years and peter votes from germany but has been living in the u. K. And is one of the go two guys on all Things National security counterterrorism and his son some phenomenal and peered the base research and policy related research. Last but not least im delighted to also welcome hernando who bodes from spain. He has done tons of groundbreaking studies, papers Research Empirical and policy related in terms of not only the foreign fighter from mom and in spain but also more generally speaking counterterrorism. Bottom line here is you were not going to get three better scholar practitioners shedding light on this issue and our hope with a ball of our offenses to shed more light on the topic and there is a lot of light and there is a lot of heat so i will turn it over to you lorenzo to kick us off so thank you. Thank you very much frank. Its a pleasure thank you all for coming. This is a wonderful turnout. We were reluctant to have an event on a friday morning almost august. Peter was more optimistic about the turnout. You helped us to have this wonderful turnout so thank you for coming and the first event that broke them i had the pleasure to direct here at the center for Homeland Security here. The first event on such an important topic with wonderful colleagues and personal friends. Its really important for us so thank you all for coming here. We get to discuss the dynamics affecting virtually every country on the planet. We receive countries and regions that have never been affected by dynamics of foreign fighters and are seeing in small numbers of their citizens and other residents going to syria and going to iraq were at this point also going to libya and other places to join isis and isis affiliated groups. Its not a new phenomenon. It dates back to the early 80s at least but the numbers are new. If we look at it or much much compared a point of view we are here to talk about the u. S. And the european perspective on this. The numbers are arguably different between the two sides of the ocean. European numbers of foreign fighters course the province empirically determining the numbers finding the right numbers, peter has done great work and trying to determine that but obviously its extremely confiscated effort with Law Enforcement and intelligence agencies having a problem doing that but the number of european foreign fighters are much higher than the number of American Foreign fighters. The size of the problem is completely different. If we are looking at a european european we see countries like france with an estimated 1200 individuals, germany the u. K. And the six and seven hundreds in smaller countries like elgin with a staggering 400 individuals. Some eastern European Countries like kosovo which is a tiny country three or 400 individuals , these are completely different numbers from the u. S. The latest numbers given by the government by the fbi we are talking about 200 individuals either traveled or attempted to travel to syria so we are talking about and much smaller number because a lot of people have been intercepted so that 200 member should be further reduced. I think the numbers deceiving from another perspective. Here in the u. S. There are legal tools and more in general a certain attitude from Law Enforcement which is significantly more aggressive than in most European Countries. A lot of the very effective tactics that the fbi uses single variations that they have not used in europe and i would say they skew the numbers significantly. I would probably suspect if any european Law Enforcement agency were to use those tactics the numbers of people they arrest rest in every country would skyrocket and be different. Why are the numbers of different in europe and the u. S. . I dont think theres just one explanation. Think they are a combination of factors. The first one is logistical difficulties. Its very easy to reach eventually syria. Some people call it an easy jihad. It takes 100 euros. Believe in the morning and for many countries you even need a passport. You just need your Identity Card and you reach the Turkish Border with syria. Its slightly more complicated and more expensive from United States. Theres a second reason that has to do with the fact that in the u. S. We do not need the recruiting networks that we see in europe. Not that is completely nonexistent in the u. S. But in europe we have significantly more established and sophisticated structures of recruiting networks that do not exist in the United States and even though the internet for social media to some degree recruits networks a lot of people would argue nothing completely substitutes the facetoface interaction. In most cases you can buy isis with an on line interaction. It does happen in some cases but the vast majority join isis and other groups because you have some personal connection to somebody who has connections there. Theres a third reason on the macro level that has to do with a very different level of organization between european and other communities. I do not want to overstate the problem in europe. Periodically when we see analysis for sample in the postcharlie abdel Charlie Hebdo environment communities in the radicalization of segments were exaggerated but unquestionably there are problems on the Organization Europe where there are significantly higher numbers than in the United States. We do not see in the United States the groups that have been instrumental in a european setting and radicalizing immobilizing a lot of people from syria. We do not see them and i see too many cases of the numbers are the first big difference in the u. S. And europe. I would argue there are a lot of differences in terms of dynamics between the two. In europe and im simplifying things a lot and generalizing i think we see a lot of clusters and a lot of radicalization mobilization. As i said the on line propaganda social media has a huge role to play here but the personal relations that people have earned questionable. People that eventually leave for syria and iraq. If you look at maps were into vigils go to syria and iraq from different European Countries come from you will see they are not evenly divided many times but they come from certain towns, certain cities and certain neighborhoods in both cities. It generally theres a human factor connection two or three guys to go first and may call friends, cousins classmates. They talk to them through social media but its the means for which they reach out to people back home but its a personal connection that predates the conduct on social media. Thats a different dynamic in many cases from United States where were you see more scattered individuals here and there, less clusters and a greater role of the internet began in the United States there is a spectrum. On one hand we do see quite a few cases of individuals with no physical connection whatsoever. They radicalize on line and eventually decide to mobilize because of the interactions they have on line. If you have read some of the very good journalistic reporting that has been done in some cases the United States there was an excellent New York Times article two or three weeks ago about this girl in Washington State who was completely groomed that i think thats the right term thats been used often on line. This is somebody who had clearly no personal interaction with any cluster but i do think we see in the United States there were cases of small clusters. Not what we see in europe but we see groups of people to mobilize together. There has been a tension as frank was saying the problem that dates back to 2006 in and 2007 the somalis in minneapolis. He we are seeing clusters of somalis mobilizing with syria now there are but small clusters throughout the country have been dismantled senator daines st. Louis. Recently in the last few weeks a group of young individuals in new york and new jersey area. Some of the smaller groups in the boston area, a group in brooklyn so we have seen the small clusters. Again nothing of the size and the sophistication of the european dynamics that we have a spectrum United States. Just a American Foreign fighter seen as scattered individuals here and there were radicalizing on social media is an oversimplification. It is indeed more difficult to travel to syria and we do not see the clusters we see in the u. S. And thats one of the reasons that explains why in the states we have seen in compared terms a disproportionately large number of loan at theres attacks. Some of them in one way or another link to isis. For example the shooting attempt and the cartoon event in garland texas but they act that are difficult to categorize and find the jihadist footprint. Chattanooga. Im thinking about the hatchet attack in new york. Think about the beheading in oklahoma. Very strange cases very difficult to categorize but clearly some inkling of jihadist ideology there that there are a lot of other issues Like Mental Health with personality disorders and so on. One could argue in this is that the hypothetical level that a lot of these individuals in europe find it much easier to go in the direction of syria and iraq. For one reason or another they dont find that outlet that they might basically let their anger in the radicalization out. The final point and i will wrap it up here in the most interesting part is the q a part for sure is a different approach from the governments point of view on the two sides of the ocean. On both sides particularly on the european side there has been a strengthening of the harder part of a counterterrorism spectrum. Legislation have been on both sides of the ocean but particularly some parts of the the efforts have been made so the europeans felt they needed to tighten some screws and being a bit harder on the traditional counterterrorism side of things on the u. S. Perspective where there is a Legal Framework that is generally speaking much than European Countries somewhat lacking on the u. S. Side is the counter violent extremism. Which is increasingly seen not just in your not just in europe not just in your off United States is crucially important. And i apologize for the shameless pitch. We have been focusing on disasters and we should report when we launched last june about the status of counter violent extremism in america and basic way what we argued is that the United States lags behind most European Countries when it comes to ever every since. There is a strategy but its poorly implemented and severely underfunded. And it is clear this is something that was said in testimony before congress by a variety of top Law Enforcement officials recently we cannot in the United States arrest our way out of these problems. And there are cases in which its very difficult to operate with a traditional Law Enforcement tools which are certainly effective, dont get me wrong but in some cases are inadequate and thinking about the increasing number of minors that are involved in mobilizing. Sometimes its difficult to use from a legal and ethical point of view traditional Law Enforcement tactics. Theres there is a lack of evidence in many cases. Im thinking about the case of returning foreign fighters. Its sometimes very difficult to bring charges against people who come back from syria where its clear from an intelligence point of view that person went to syria and did not go there to go sightseeing. Nonetheless bringing charges in a court of law is much more difficult and we have seen cases obviously where its very difficult. One case is very interesting in california who went to fight in syria with isis with alnusra but there was no evidence to charge him was that he came back to the states with no evidence to charge them with them basically was approached by an fbi sting operation and was convinced to join alqaeda and he was arrested for that. We have somebody who was not arrested because of what he did fighting in syria but what he was planning on doing which was going to pakistan to join alqaeda. In that case it worked out great one way or another it worked but its clear in some cases there is a problem with evidence returning foreign fighters. The advocates are not the silver bullet. It doesnt work in all cases but is obviously something that the United States needs to be strengthened and theres a lot of talk about it in constructive dialogue with the administration about it but more tangible resources should be put to use. I was asleep at that. Thank you lorenzo in one of the things i hope you pick up on if is not in your comments are the q a the returning foreign fighter from him as an issue and i think the public numbers are approximately 40 returning to the United States and how does europe handle the scale and scope of the numbers are greater can you turn of them around to be part of it counternarrative . Also they should be criminally prosecuted but i would be curious how europe is addressing this and if there are any lessons the u. S. Can glean from that. To you. Tonight thank you frank and thank you lorenzo. Im happy to be here. The response talking about this is my team and i discovered two and a half years ago that they were going to syria and not only were they doing that they went there and they maintained their on line social media profiles. They maintained facebook profiles twitter account instagram and it became possible to follow them which we found exciting and interesting because they were almost posting diaries from a battlefield grade we started broadening that and we do have a database containing 700 on line social media profiles of fighters inside of iraq. We have communiques with 100 of them and we have done fieldwork on the border with syria so we have a pretty Good Conference of idea and what im saying now is greatly to a large extent based on what we learn from this. This is a phenomenon that did seeds and surpasses everything we have seen before and in the case of europe which represents perhaps 20 of the overall foreign fighter population in iraq approximately four to 5000 people. Whats particularly interesting is that smaller European Countries are disproportionately affected. Of course the largest European Countries are producing the greatest numbers but particularly the smaller countries that are have we effect that countries like elgin denmark. There are 32 points i want to talk about. The first is motivation and the second is the idea of on line increment and i want to hit on what frank was asking about and how they have been dealt with. There is no monolithic foreign fighters at least not in western europe and not the most of the people we have looked at. There are number of different motivations and they have changed over time. Its perfectly fair to say that the people who went to iraq in 2012 in early 2013 were not necessarily committed extremists. They all had a very strong sunni muslim identity. They went there because they feared what was going on in syria was genocide of the sunni population of syria carried out by conspiracy led by bush are all assigned with i ran and hezbollah. They were being told on the internet that is being muslim means anything to you at all youd have to come and defend their brothers and sisters because the arabs are not helping. We are on our own. There was a principle or kerman narrative in the early of the conflict and if you look at the literature on foreign fighters you will see throughout history and different ideological movements the defense begins the existential threat has been a great mobilizer. They narrative shifted with the rise of the socalled Islamic State and the second peak of recruitment happened about a year ago in the summer of 2014 when Islamic State declared its caliphate and had a string of military successes which most of the people were interested in building a caliphate. They are thinking it is coming now, it is real. We have to go there and be part of it. That second waive of recruits arguably was more extreme in orientation and intent than the first waive of recruits that i described before. Of course in addition to that what we have also seen it since last year since about august the start of the western air campaign we have also seen a reemergence of the west verses islam narrative that have not been as dominant even a year ago when we were doing fieldwork meeting with fighters. You almost have to remind them that we were also they were hating the United States and its western allies which was a myotonic experience of someone has been interns interviewing these people for 10 or 15 years. Especially for europeans geographical proximity makes it easier for people to travel however i should also point out in this is topical considering whats been happening over the past few days it has been very easy for them to cross the border to turkey and to syria. I can tell you we were doing fieldwork that in april 2014 every taxi driver can tell you where the foreign fighters were staying, where they were praying. The uniform shops where you walk in and they ask what group are you you with an you say eyes as he gives you the isis uniform. All of this was happening totally in the open. Was almost inconceivable the authorities were not knowing about this and perfectly plausible that they were not wanting to crack down. Out of fear that there may be a retaliation against them. My fear is the infrastructure of these groups is so embedded within that country that it becomes very hard to do something about this in a substandard way. My second point is on line recruitment. On line recruitment is something that is featured nelly isis as a social media but in our experience as far as western europeans are concerned its not the m. Most important one. Whats new about what isis is doing on line . Its not the videos. We have had videos for many years. Also we have had from a high cut and our iraq alqaeda and iraq 10 years ago. What is new is not orchestrated by isa central. Its something that is more organic and comes more from the bottom up. What is new and that is a fact that is often neglected and forgotten and not appreciated is that it is possible now for one of these fighters in places like europe to talk to actual fighters on the ground and the battle zones. From our observation that the most powerful aspect of the isis social media campaign. Remember all a khomeini that guy from alabama who is going to somalia and the giant alshabaab and for 45 years ago there was a lot of excitement because it was possible to tweak the sky in somalia and he would tweak that. What you now have our 600 seven, 800 talking to people in paris london and brussels every day and its their output not isis centrals output that gets people the most excited. Its easy to see why. The bottom line is those personal clinic patients from fighters they get personal to want to be a recruit. On the one hand they create identification. Imagine you are a muslim and a deprived suburb of paris and you know he dont have a lot of opportunities in french societies. You look at these pictures of fighters with guns amongst brothers being heroes in that new society. You look at these pictures and what do you see . You see yourself. You see somebody like yourself. You see someone who is a hero in that society who is incredibly successful empowered and admired yet who six months ago someone exactly like you with no prospects in European Society with no hope and probably a life of petty crime edit them. And that is incredibly powerful moment when people see these pictures and start identifying and are able to communicate with these people. It makes it personal because it creates personal ties. We know from social Movement Theory that activism requires a lot of personal ties. His one of the risque more endangers endeavor the more ties you need to have in order to get the commitment and loyalty and create the social obligation. Speaking to a fighter enables exactly that. If you speak to a fighter on the battlefield for a month every day you develop a relationship. You develop trust rating makes time for you and you feel honored by the fact that he makes the much time for you and the ask you now you have took him over. Its completely different from watching a video where an anonymous person says i want you to come over. They explained for example if it was all about the internet that would make sense at all. The internet is everywhere. The distribution of cases would be equal or even across countries that we do see a lot of recruitment from relatively small towns not because the internet. Thats because you are upset people who play football is play football with each other and went to school with each other. The e. U. Have one or two of them going over staying in touch with the people. Com and successfully bringing over the rest. That is being replicated and everywhere in europe you find the same pattern. Its still about peertopeer networks which are powered by the internet but it is not the internet that is reckless. To american viewers american players. My final point is really important that we get this right when i gave you the numbers at the beginning i should say these are not members for people currently on the ground. These are figures for everyone who has gone over the past two and half years. 10 of these people are dead raid they have died in battle. 25 to 40 of the numbers for each of these european patches that i talked about, 25 to 40 depending on the country have already returned to their european home country. The current foreign fighter population of britain for example is not 700. 700 is the figure for the last four and a half years. On the ground at iraq are probably right now between 200 and 220 but 250 have already returned to the country. The question is of course what to do with them. In our observation and again its important by our empirical issues there are three principle groups and to call them the three bs. There are those who are disturbed. There are people who are not as fairly fully ideologically motivated by those who have been brutalized and traumatized by the conflict and western ideas even if they are not part of the terrorist network ideologically and then there are the socalled dangerous. Those are the people who are coming back established with military training equipped with military Training International networks and perhaps the motivation to carry out attacks in the west and depending what you believe the percentage for that are perhaps 10 to 25 . The third group are the socalled disillusioned hand here it is important to keep in mind what i said at the beginning that a lot of people thought they were joining a different kind. A lot of people have become disillusioned because of how the conflict has turned out. A lot of people also went there long before the islamic