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After the Un Security Council signed off on it. Form to begin on iran, talking with the policymakers divided between whether or not iran should act more forcefully to stabilize neighbors and those who advocate a more minimalist approach. You are watching it live here on cspan. Good afternoon, ladies and gentlemen. May i request that you take your seat so that we can get started . Good afternoon, ladies and gentlemen. I am the associate director of the south asia center here at the Atlantic Council. On behalf of my colleagues i would like to welcome you all here today for a timely discussion on the Iranian Nuclear role after the deal. , criticala crucial juncture for iran, the United States, its allies, and the community. Rnational after 30 years of relative isolation and intensifying sanctions, iran may be entering a new level of engagement. We view this historic moment as one that holds immense opportunity. The task force serves as a comprehensive source of analysis on iran. By bringing together key regional stakeholders, the task force has made Great Strides in investigating geopolitical effects. Until now we have primarily hurt perspectives from outside iran, but we will here today more iranian perspectives. These reports will be presented by nasser hadian, who will be joined by our senior fellow at the middle east peace senior , who is going to take a broader view of the intentions in the middle east. This event is part of the south asia center iranian task force, led by our senior fellow. I would like to thank the fund for their generous and continuous support of the task force. I will now turn the floor over to our moderator. Thank you all for coming on this beautiful day. Once again, i think our timing is really excellent. With apparently the congress about to hold its nose and allow the iran agreement to go forward , one of the key questions is how will iran behave in the region . Will it take additional funds in terms of sanctions release and in the words of opponents, a march into a fifth capital . Will it doubled down on more interventionist policies or not will it doubled down double down on more interventionist policies or not . We have a guest here from tehran, nasser hadian. A professor of Political Science at the faculty of law and medical science at the university of toronto. He has served there as director of graduate studies. He has been a visiting professor and Research Scholar at the middle east institute and asian languages and Cultures Department at columbia university. Role at aprominent think tank in a run that is close to president rouhani. His areas of interest include the Nuclear Program,. Ontemporary politics he got his phd from the university of tennessee. Ownthen we have our [indiscernible] who has more than 13 years of experience working as an analyst, advisor, and corporate manager of the middle east, a security expert with a focus on the arab states of the persian gulf. Lebanon, syria, hezbollah, irans role in influence on them. Degrees fromsters the university of st. Andrews and university of maryland. I would recommend to you paper that he had a few months ago the dealt with the issue of containing iran. I would like to invest invite our guests to take a seat. ,. Why dont you, p or . Or whyt you, p dont you come up here . Has written a new paper that you can read yourself on our website, but i will begin by asking him to discuss the contents of the paper. A few years ago i interviewed a very astute journalist in iran. He told me, when i asked him about iranian influence in the region, he said that we are not going to stretch our legs beyond the capacity of our purpose. My question to you now, sir, is how big is that carpet . How big should it be . How big should it the . What is the nature of the debate taking place in a run regarding Regional Policy in particular . Professor hadian thank you very much. I appreciate you for inviting me to share my ideas with you. On the Nuclear Program and regional issues. About the anecdote that you say thatould like to there was a time in iran when the carpet was much bigger. We used to carpet every space. Now the fashion is that the carpets are in the middle and much smaller. [laughter] but of course, finer, if i can say that. Say basicallycan that there is not one wheel in iran regarding the region. As i mentioned in the reports that you have read, there were two views there. , the poor stabilization view, the one that calls for be aally a run to stabilizing force in the region. To produce security in the region. In other words, fitting into hand what you have. Afghanistan is not secure. We have another problem. Withve a lot of problems refugees, drugs, and narcotics in afghanistan. Some are worried about pakistan as well. With the laws of extremism there. And are worried about iraq what is happening there. Also syria and lebanon, to a lesser extent. So, they argue that within the next 10 to 15 years the primary objective of Foreign Policy should be stabilizing the regime. Iran should be a country that basically produces security. The argument is that we cannot andn island of security dismissive of the insecurity around us. That is the official view of iran and the dominant in iran. But there is an alternative view that is recently gaining more in the think tanks. You find this of course at the university and among the pundit. Pundits. They would argue that iran is already overstretched. We dont have any more resources to allocate. Basically we are the primary and that this is not our fight. They would argue that this would make the make us the target of a large attack. We have not yet been attacked, not because they are not capable but because they have not made the decision to do so. They can easily penetrate into our territory and explode bombs. So, why do we have to do that . The argument is that our engagement should be minimal. Minimal towards those who are vital and necessary. In iraq, damascus, and the coastal area. And, basically, in syria. Sunnis are really interested in having a representative in the government , if they want it, let them have it. But there is not that much concern for us. I mean, if they consolidated the power that would basically be a threat, not for us, but for the saudis, jordanians, lebanons. That ifment also is they want to come, they have to fight in the fight will be severe. Normally if you assume that they are not totally crazy, just partially crazy, the natural trajectory of expansion would be towards saudi arabia, jordan, and yemen. The argument of this second group would basically be that ande better off withdraw make our engagements on the minimal level. Arguments would be that this is somehow naive. That if you think that in the longer term we will not face problems, there will be a major threat if not in the short term but rather the longterm they will be a major threat for us. Of khorasan issue is very important to us. If the south announces independence, they will surely go for independence and what will be the position . Iran is the most important country that is called for preservation of territorial integrity of iraq in syria and is supporting that idea. Thatan withdraws from decision, the disintegration of these countries are easy to imagine. Say minant view with what would be the positions if there is an announcement of a claim of independence . The second groups argument would be that we have populations within our own groups, within iraq, of course. We have intelligence, security, and commercial infrastructures and we can benefit from the situation and they are not going to pose a measured threat for us. But as i said, members of this group think that these are naive status isand that the an important part of the region. We would face an entirely , with manyiddle east areas making claim for independence. Appropriate to basically support any kind of movement that accepts the independence of any one of these independent territories. We must maintain the territorial integritys of these countries. Thank you, thats very helpful. Most people in washington are not even aware of a foreignpolicy debate going on in iran. As you wrote in your paper, the dominant view in a run is that force for what they call stabilization. You know very well that what iran calls stabilization, arab countries call meddling or worse in the affairs of arab countries. So, i am going to ask you to give your analysis of the paper and how you think the iranian debate can be factored into the debate going on in the arab world, if there is a debate, how they can be influenced to see the iranian activities in a less negative light. Sure. Thank you, barbara. Mywife tells me that speaking to spit speaking skills have progressed so im going to go back to basics with a few slides. Is what iran wants to do and regardless of what it wants to do, what its capabilities are. Or both, because i think that is important. The issue of iranian intentions is still a big . For me. Wasstened carefully to what said, but i listened closely to evidence of the debate, statements from leaders, and even the reporting about it, with a clear description of what the players and views are. I did not hear that today. I understand that there are certain limitations with which you have to deal with, but i think it would be extremely useful and important, and i cannot overstate this, for the Public Policy community in inhington and key players the region to know who is advocating. This is hardly an academic exercise. Let me turn to the usual capabilities. Let me see if i can work this. I think i have that printed out in case. Just i am very quick with my slides. The issue of capability is very important because in the american policy debate about iran and its regional role, those capabilities are either completely misdiagnosed or worse, neglected. I would like to offer a little bit of nuance into that, because it is important. Never underestimate what iran can do in the region to advance its own interests. The ieds in iraq, that killed soldiers. American 196, according to a declassified document. The iraniraq war that at the other end of it, the iraqis were heavily financed by arab states and armed to the teeth by the west, that side was the side on life support until the end of its life. Bala, the most successful, most lethal, most disciplined nonstate actor in the world. Thats all because of iran. Hamas, not as effective, but probably the most important Security Threat to the israeli state. The me say it only. Bluntly. Lebanon will not have a president unless iran says so. Hezbollah has no meaningful future without the decisions of iran. Future is af syrian function of israeli design. It is a function, among others, of iranian designs. All security overall is a function of iranian design. Entanglingcceeded in its main adversary, saudi arabia, in a very vicious fight. While it has a dominant influence in iraq, the only actor they can credibly threaten it today is isis. Finally, the knot can there cannot be any major wars in that area of the World Without iran having a say in it. Because of these accomplishments, iran has considerable political Bargaining Power in the region. If you are sitting in tehran today, you are feeling good about your regional position. Capabilitiesian are a very mixed bag and this is where the bad new starts. The proxy wars in which iran is involved today have stabilized not a single space and have failed to build peace. Iran may have succeeded in bleeding its saudi adversary, but that comes at a heavy price. It comes with the price of telling the world that it is supporting an illegitimate revoltedhat has against an elected in legitimate president. Today the who sees today they will neither reconstruct the country or help to achieve a political solution. The iranians have been successful in syria, but that comes with heavy casualties for hezbollah, at alienating the sunni world, perhaps causing some military overstretch for the ir gc. Terrificomist had a piece on that. Perhaps an exaggerated claim, but there is some truth some truth to it. Some of the most important and influential people today in iraq , rumor has it they fired a very anglian angry letter complaining about the handling politicians. Sunni perhaps alienating them and not handling them with care. Former irit that the gc commanders back in action to be held in check or just watch over his shoulders. There is also a price for awakening golf and arab nationalism. Antiiranian,t, if i can world does use a word like that, is at a high point today. Because of yemen some of these countries are learning how to wage combat with some of the most important and powerful weapons on earth. With all the talk about irans warfare,n asymmetric we have to remember that this is a country with very modest conventional capabilities also. The Iranian Air Force is a relevant in any military scenario or any dogfight with arab gulf fighter jets. Iran has considerable skills in land warfare due primarily to the iraniraq war. Last thing you should be worried about is their land capabilities. Territorial conquests should not really be occupying the top of our list of concerns. The Iranian Missile arsenal is quite impressive. Its not reliable, though. Lethal asrecise or as we think it is. Feelver, its adversaries that there have been progress there hasnt progress made in integrating those regionally. Short, iran is very good at asymmetric warfare. But whether it is at land or at sea, the most you can do is problems, like closing the straight of hormuz anytime it wants. But it simply cant. In closing i know i have taken up too much of your time. It matters less what irans conventions are. When we try to assess their regional role at the nuclear deal, actions speak much louder. Capabilities that i described are clearly not inadequate or inferior. The also do not match rhetoric coming out of washington or the arab gulf states that will be facing a rhizome rising regional hegemony. There may be debate inside iran today. Important debate today is between iran and the arab golf states. How it happens, i dont know. Is not making it happen as quickly as possible. Thanks barbara thanks, bilal saa. I think one thing we have to keep in mind is that the policies are based on their threat perceptions and they feel the major threats come from the United States and israel and those asymmetric policies are supporting hezbollah. I think that hezbollah would continue even if there was not in a run, but i will let you tackle some of his other points. Professor hadian for the first part of your talk here, im sure that there are many in iran they would love to hear what you said. They not just only wish, but they really think they have such a capability. But the second part of your talk is far closer to reality. Address a number of the issues you raised. First of all, regarding saudi arabia, yemen, and the gcc, they are all different. Our relationships with them are very different to. Of the demands on iraqi Iranian Security are minimum. Their manly in favor of gcc policies. Im sure that they would love to get a credit iran. Is, we haveity spent a few millions of dollars in thats all. Anyone that goes there will remain here there. , no group of tendencies. Is there any illusion that we. An do anything in yemen possibly iran gets far, far away with this, also. Something they would not be able to do. Dropping it all together to say that iran is meddling in the affairs of others, i expected to hear this from politicians, but not from you. Distant always a between perception and reality, but this is too far. They have reported repeatedly on influencing yemen. Very limited. Very limited. You know, to me saudis have basically adopted the policies regarding iran before and since the revolution where they try to contain iran. They are building important infrastructure inside iran. In a number of our provinces. Training students, spending money, giving money, building mosques, so forth and so on. As they have been trying to all alongastructure irans border. In other words, if saudis are it is basically because they feel they need a base to contain iran. There is the reason for them to be in these places. They are in the arab countries. Whatever it be, privilege or special, entitlement to intervene in these countries. But you know how much money theyre spending their. If they are in iraq, syria, lebanon, it is basically on the basis of threat perception. It is a threat coming from israel and the u. S. On the basis of that threat perception, they have defined our forces. The strategic steps within be lebanon, syria, and a rack. They have tried to have an infrastructure there to do the most important thing. First, israelis taking military action against us. Number two, retaliation in case of an attack. We are not there because we are challenging the saudis. We are not in lebanon, syria, or a rack because or i rock or iraq. We dont see saudi arabia as a threat. They are very much at the bottom. After three years ago even you could not find anything. We dont consider them. We dont consider them to be a threat. We have not developed infrastructure to deal with the challenge. That is exactly what it is in saudi arabia. If they are in lebanon, they are not there because they want to challenge the israelis or us. They are there because they want to challenge of us. In all of these areas, the saudis are challenging us. Because we consider them as a threat. Iran, itng and blaming is really strange. But even a stranger can easily balance us, as i mentioned. The combined population is bigger. It could balance us relatively easily. They have a superpower behind it. They can easily balance it. Why they cannot balance this . It is an inherently political system. No matter how many times president obama tells them that we are behind you, we will give you this and that, we are going to support you, no matter how much we tell them leave us, you are no threat, we dont want to do anything other than inherently they are sourcing the , anyone who outsources it to someone else will seem insecure. So, thats natural and has been the case throughout history. Always we are worried that possibly the other guy is going to be sold or bought by the other side. Do they think that we will pay a higher price to the americans and they will side with us and be left . Unless they rely on their own resources to provide security , they are going to feel threatened in a matter what we tell them or what americans tell them. Its not going to resolve. To me we are a convenient and it convenient enemy for them. For the pundits, for the policymakers, for some of the , attacking americans , even attacking israel has a cost. But attacking iran is really convenient. In we are a convenient enemy which there will be a number of psychological desires. Look at theust behavior. As you mentioned, tell me the actions that iran has taken against the saudis. Forget about those situations at the beginning. In the last 30 years, tell me about this action you have taken against the saudis. Kuwait. After all, you have a very Good Relationship. We have a very Good Relationship and behind it, only four or five years do we have a Good Relationship. The only contribution since the revolution is the uae. Ironically, we have more than 20 iran toper day from dubai in which we practically have a very Good Relationship. So, that is strange, the smith of the threat that is there. You dont know what is there. Barbara i dont want this to just become a debate between you two. Im going to open it up to the four. Please say your name and after the microphone, ask a question. Wait for the microphone appear in front. [inaudible] ive had the privilege of being on the iran task force. Likened the jcp 02 and arranged marriage between two parties that do not trust each other and a prenup prenuptial agreement about how to make a marriage work. I would like to know, what do you think really convinced iran that this was a good time to have this particular agreement . What can iran do over the long term to make it to us make it succeed . People will be coming out of the woodwork to make it fail. I think that it was a masterstroke by the is bash by the administration, but while they can put things in place, they stink at execution. Go back to the Affordable Health care act how could they screw that up and execution . What would you recommend on the longerterm in the part of the administration to make sure that they have every opportunity for success . If it does fail, what are the means to put in place to implement that . Very quickly,an ive discussed the issue before but three reasons that make the diplomacy a necessity two reasons facilitated by the encouragement. Number one, war. War, no matter how much the thates, the country thinks he can explain the war. There are other good things to happen. So, you have to eliminate the chances of this. That is the number one reason we thought diplomacy was a necessity. From the u. S. Side, the u. S. Warght that more that cannot achieve their objectives. Basically i have discussed three scenarios of war. Reportedow, its been since 2007 but my argument is different. Started in 2003 2 weaponize its Nuclear Program. But in other words they are going to at most delay it for a couple of years and after that they are going to basically whole heart go for the bomb. If pakistan 40 years ago had unlimited resources, human and material equipment, if they started to make a bomb, they kept it. If we have not made a decision it is because it does not serve our interest. It will not only not increase security, but operability. There are multiple reasons that is the case. U. S. Thought that war would not help to achieve the objective. The number two issue was sanctions. Those who negotiated the new sanctions were important. They knew they had impacted the economy. But they have not made us desperate. Having dinner with a colleague, she asked can you take me to a place in tehran with sanctions . I told her that if you expect me to take you to a store with empty shelves or people jumping on top of each other to get food , such a place does not exist. Sanctions have not made us desperate, but it has for sure impacted our life. So, rouhani has promised to improve our lives, thats why he has to do something and sanctions was a very important factor. For americans, they thought that no matter how much sanctions can ,uickly force capitulation which means zero enrichment in a way that can happen. They concluded that it is not an option. They thought diplomacy was a better chance. Of ait was a lack lack of attractive alternatives. More sanctions on your part . Injecting more centrifuges . More sanctions in the reactor. After two years they would have come back after suffering process. He but we are talking about a more Nuclear Capable iran. 10,000, possibly 25,000. This was not attractive to anyone of us. Thathere are two factors facilitated the process. No one can plan to create the momentum. Momentum happens. It is not a planned phenomenon. But they were careful to use the momentum that happened because of the election. Are spinning, social the life of the people. So, he had a mandate. This was one factor that facilitated the process. Teams that at the same time wanted diplomacy to work. When once iimes wanted and the other did not. They both wanted these, but these factors facilitated the data. It was a regional issue, from lebanon to syria. The rack and afghanistan. So, we thought that we need to Pay Attention to these issues, which are far more important than other kinds of issues. So, we thought that, you know, these regional issues are important. Americans thought that if they ,anted to reduce the presence they did not want iran to be a spoiler. They encourage them to explore. Professor hadian Barbara Barbara i want to add to the question in terms of recommendations. We have heard a lot of talk about compensating the gcc for the iran deal, as though it is distracting from security rather than adding to it. My question is whether the provision of more sophisticated weaponry or bunker busting bombs and what not to israel in , willular, but also gcc it simply increase iranian threat perception and have the reverse effect, causing the kinds of arms race and conflict in the region . Bilal i could not agree with you more, we are where we are but i think it has been played out miserably. , thee where we are ultimate purpose was nowhere from the start. I will leave it to nuclear exports like bob einhorn and what the best way is to make sure that this deal does not fail, but i will give you the three recommendations that are quite broad, that could be useful for the immediate future and the next 10 to 15 years. Languageto have clear and consequences of failure to comply with the provisions of the deal. Thats not an option. You have to get serious about campaign deliverables. If you show hesitation or ineffectiveness, the United States will wind up with far fewer friends in that part of the world. Compensation, i dont like that term. I think at the end of the day what contributes to regional stability should be the ultimate purpose. Bunker buster bombs, im not sure how that contributes to that. An arms race, thats hard to measure. There are tons of scholarship about that, we will not get into that. Your permission it is only fair that i respond very briefly to these assertions that that ihadia made earlier quite respect. It is easier to provide a counter argument to it. It is important for the debate here and over there as well. I think the central theme of what he is saying is that iran is misunderstood and if only be better understood it, it would be primarily defensive posture in where things could be so much better. Fair enough we have a lot of misperceptions about that country. Some are failing. It is quite a notoriously opaque system over there. It is becoming increasingly easier to read through the long negotiations between the United States and iran. There is still a lot that we do not know. What he describes as stabilizing efforts are seen by the adversary as nothing but destabilizing. Its not a theoretical conversation. There is a substantial amount of. Vidence against irans claims what is a run doing for the saudis to threaten their securities . Theres always been indirect compensation through proxy warfare. When lending. For to a man who singlehandedly broke that country and caused a tremendous amount of human catastrophe and tragedy and also has contributed to spillover of the civil war into iraq, that in no way contributes to stability. When iran contributes terrorist acts and place itself inside kuwait, that does not contribute to stability. When iran provides military , andtance to a militia yemen is not a priority, regardless just to really poke at the saudis, that does not contribute to stability. The verdict is still out. There is plenty to play. Like no other actor they are fighting isis. Professor hadian one area that we have active against the saudis is not just their stability. As i mentioned to you earlier, there has never been direct confrontation between the two countries. My final point, you can describe how they do that directly. There is 22 praise in iraq. But it is worth asking does the end justify the means . When they recruit militias to fight isis, that exacerbates sectarianism that prolongs the survival of isis. Actions at this list of that are really incontrovertible , as there is not much to debate in terms of them having a negative impact on stability, im not sure why iran is misunderstood or why there is so much to debate about the regional role. At least how the arab gulf states view it and how many folks in this town also view it. Barbara ok. Ok. I want to give the audience time for more questions. This is something i wrote for the u. S. Institute of peace. Some years ago. But i think that this is still true. Iran puzzles appear to be largely defensive, to safeguard the system against foreign intervention and to prevent and minimize actions that might run counter to iranian interests. In the service of that iran has been willing to sacrifice many noniranian laws. I have never heard an assessment of a country that is bent on offensive action. Its always defensive. The gentleman right there, if you could take the microphone . Say or name and ask a question. Say your name and ask a question. Could you talk some about the assembly of experts selection next year . Do you see the Guardian Council blocking a substantial number of moderates and reformists again . To think it will have a positive or negative impact on moderate success . Bilal thats a great question. Professor hadian the election is next february. Questionsswering your , yes, we expect these forces who are prothe government and think they are for modernization , we expect to see a massive disqualification of the big names. But still we expect to win the election. Hopefulthe people are from what has happened. Although they are not going to see any tangible impact in their life, the hope is there, the optimism is there. The optimism will lead to basically increasing of the participation rates. As the participation rates increase, the chances of these forces winning elections or higher. As normally is the case, the president s have been able to give the control of the advisors. An10 year election entirely different thing. For those of you who do not know, its a minimum of 86 people who are all supposed to muslim clerics. Not to be clerics, but normally they are clerics. Functions. Hree main to supervise not supervise, but check the power of the Supreme Leader. In the case of his death, to be replaced. They are not all that important terms of the daytoday affairs of the country. But they are important for appointing the next Supreme Leader. You know, again, we the promodernization forces are about as helpful as we can in having major input in that election. It is going to be elections and thehe society arrivals of hardliners. Chance ofa good winning that election. [laughter] barbara very quickly. Professor hadian regarding a sickly what you said about bahrain regarding quickly what you said about bahrain and kuwait, im not sure where you begin to get the information that iran exploded a bomb in kuwait. It was a barbara discovery of explosives that they said came from iran. Professor hadian there is no incentive on the part of iran to do anything with kuwait. Bahrain is a different case. The government there has been so passive in its reaction, to be frank with you. For many it was really humiliating to see saudi arabia sending forces and their rate invading bahrain. Scapegoating iran for what they are doing. To see that why should they do that . Why should they send their forces . Kuwait. Are involving we are involving iraq. We are involved in lebanon. But we are not involved in bahrain. Barbara we mentioned this earlier and i wanted to give you a chance to comment. The impression that we get in this country is that it was a huge win for iran and a huge loss for the United States, but there is a substantial component of individuals who think they gave away too much, so i wanted to give you a chance to mention that. Thank you. Adian i have been critical of that myself. I doubled up on criteria for accessing. These criteria are for the timing. Strategic composition on what was given. Irreversibility reversibility issues. Timing, we are talking about cash promise. Pages of the documents, you will see that in terms of the timing. The confession that iran has given is far more. Remain remove from thosefuges hands. You have to dilute or get rid of about 11,000 kilograms of enriched uranium. You have to transform the core of the reactor. After we did all of those things , the iaea should say im satisfied. Then the sanctions could be suspended afterward. Frankly, i would not have signed the steel, i would have negotiated it differently. What happens if the iaea says i am not satisfied . What happens if the u. S. Congress passes a law preventing the president to take whatever measures he is supposed to take . What would happen . We would get rid of 2000 centrifuges. We would get that other 5000 into this one. Thats exactly what happened. Course, optimistically i trust the administration, but it should not be a line relying on trust. As you say here, it should have relied on a different kind of verification and way of handling this issue. Number two, strategic weight was given. Not one of those guys who says it should be 50 50. Thats too much to expect from iranians. , as iven quantify done in my books. Quantify what was given earlier and what was taken to me. What is more important is the composition of what was given and taken. What i mean by that is, basically preferring to have only had three cascades of secondgeneration centrifuges closing down iraq. Are centrifuges in the hands of the first generation, which are very old models. Of. s what im critical the composition i want, given what was taken. On the u. N. Side you have four principles guarding the negotiations. Number one was basically four. Asses then there was the issue of detection. That is why you basically supported a very robust education system. There are a number of things beyond that additional protocol. But also beyond that additional protocol. Number three, number three is back out or sneak out. You are complying or cheating. We are happy enough to have enough time to react. The time to decide for one bomb. It is now two months to three year. That we want in one subject of basically centrifuges and enrichment processes. Why we have to go down to 300 kilograms of enriched uranium. Many of the things we are going to do are easily reversible. Iraq is a reversible. ,iluting or sending these out this stockpile of enriched uranium, is irreversible. All this time you are calling it practically the sanctions are irreversible, but theoretically legally they are very much reversible. It is basically in the agreement and the structure of the architecture is there. Say by thisi criteria, what was given and equal, butken is not i supported the deal. I support video . Because the consequences of the deal. The consequences are very important for me. And, re secularization, and relationship. Barbara you wanted to Say Something. Bilal just a quick moment. I would like to go back to the key point, which is the main argument of the paper, which is this date. I am fascinated this debate. Im fascinated, but we are not ending it. Barbara you want it to be more specific. Bilal let me frame it a little more of the differently. What i want to know is, as this is happening, is this a typical and i know it is not a good description moderate versus hardliner, what is in the cap questioner what is in the camp . It is across the board. ,ou can find them on hardliners the revolutionary guard, the think tanks, the policy makers, professors of universities, they are all debating in different think tanks about this policy. What should be done . Generally, the government is a supporter. Not everybody in the government supports. There are key positions in all of these laces. All of these places. As you mention, you mentioned a good point. The indication of what i said is in the actions. Iraqissee in practice and iranians are not moving with muslims, it is a good way of knowing the second impact of the policy. Same thing in syria. Places that the syrian government, as well as the iranians, are putting up a strong fight, but places they dont care, it means the impact of the second group on the first roof the first group. These of the actions and you can look at the indications. Barbara right here. My question is related to what you justice test. I would like to hear from to what you just discussed. I would like to hear from both of you because it seems you would have different perspectives. That those were putting the face on the iranian Foreign Policy is basically so the money manei. E honeyms that the real rouhani honey camp is capitalizing on this. My question is, to what extent do you think they are actually testing the waters for actually exceeding restrictions and coming off of some diplomatic andtion within the region achieving all of these objectives in the region, or whether they are sort of khomeinis tools, putting lipstick on the involvement in the region. Prof. Hadian it is not a good dichotomy. They are not all that fundamentally different. Khomeini has been seen as a powerful individual, basically like superman. That is not the case. He is a very pragmatic general with a relatively good sense of the situation on the ground. Bring toey factor to your attention is, these divisions are not being made by anyone doing individual any one individual. They have an institution called the supreme council. They all debate all of the issues. And oncete it there the decisions are made, they will be implemented by everybody. Institution, there are those who can be more zariful than the reef awnd solemanei. Bere are some that could argued are more powerful than both of these men regionally. Honey rouhani has arguably been more powerful than anybody else. Whether one of them by themselves makes his decisions. That is not the case. Basically, it will be discussed and they will finally make a decision. Though the Supreme Leader has the authority legally to veto normally hes, but will support the decision that supreme made by the National Security council. It is not a oneman show. Rif is a negotiator. Bilal i could not agree more. I will share with you a recent conversation i had with a senior rouhani official. The iraniansian are incredibly smart. They show i get economy of views between practice and the figures, but in practice, everyone is working so harmoniously, he said. Perhaps not as well, but within a system so but not with any system so fractured that the world would like to believe. Mrs. Hassan from pakistan. I am a journalist. Is caps on from pakistan. I am a journalist. I have a question for nasser. Fear in the middle east that it will fuel an arms race in the region. Tantamount toalso recognizing iran as a nuclear power. How would you . Respond to that fear prof. Hadian how would you respond to that fear . Prof. Hadian the reason we have arms is to prevent an arms race. When you discuss the alternatives, the alternatives are not all that attractive. Weaponization, for sure, we know its going to lead to an arms race. That would stop basically any nuclear arms race. Said,ming ourselves, as i we have all of the resources and we dont need that tough of armament to be able to defend ourselves for the future. The type of threats we are is crime, refugees, chaos. It is not the need to have sophisticated weaponry or whatever. Those of the needs that we have. Us we hope that it can help to concentrate more on the region, and to stabilize. The first group, which are prostabilization, they would to meetgo all the way americansate with toward stabilization. That is the type of threat we are really worried about. Barbara the front here and then back over there. I have a question for you, bilal. You keep mentioning the threats to iran. What are the specific threats coming from the saudis and others toward iran toward iran . The saudi government is a very closed, type lyrical structure. Closedtype political structure. They have been for centuries. They are more afraid of a collapse rather than a threat coming from iran. Officialwish we had an from any of the goal state to speak your because the last i want to look like its ive is if im here to speak on behalf of the gulf states. Mentioned earlier, the threat is not direct. It is indirect through the proxies they support throughout the region. Both countries, which seemed to be the main adversaries in the region, have weapons in a number of theaters, whether it is iraq, syria, or others. Each one back its own proxy. Unfortunately, in many ways this confrontation is seen as zerosum. Me, a were to push Security Threat coming from iran to saudi arabia is what is going on in yemen. And how the threat is perceived, that the backing of their of this and their allies, that seems to be the biggest threat to saudi arabia. Going on in lebanon, as you. Now, iran supports hezbollah half of the lebanese population sees that as a major detriment to the stability of the country. Perhaps the biggest damage that has happened in saudi interests ,nd security interests as well no secret about it. Implicit acknowledgment was those behind the assassination were syrians, the iranians, whoever pulled the plug doesnt matter. I will go back to the same thing over and over again. It has never been a direct confrontation between the two. It is asymmetric, conducted through proxies. Thank you for the terrific panel. To thei did not respond saudi state collapsing. Maybe well get to that. Sorry about that. The iranians have emphasized after the deal, focusing on the , and a Deputy Foreign minister has said that there might be iran gcc stock iran gcc talk soon. Why has begun . Is it the gcc or the saudi side that has been reluctant to engage . They have traveled to kuwait and qatar, but the saudis are reluctant. I know for a fact they are some ofo approach them the time to deal with you regionalist to deal with the regional issue. Personally, it is hard for me to convince them otherwise. They have made up their mind, and no matter what is happening it is hard to practice. As i mentioned by no matter how much we tell them, we are not perceiving you as a threat, they perceive us as a threat. We are also a convenient enemy for them. I dont know why that would quit unless some major things happen in the region. Toy may decide to come and cooperate with others. To contain this insecurity in the region. Beal i dont think it would useful or fair to try to understand one threat perception and disregard another completely. Useful conversations between these two heavyweights is long overdue. It is ridiculous how it has been. Ser obviously blames the saudis were not having an interest or not being ready for it. I think the conditions are right for it. I think the saudis were definitely be interested. Prof. Hadian they are waiting collapses andd then they will say. But it is hard to do a negotiation right now. Right now, to negotiate to come up with a solution. Have a does iran practical solution if assad falls . Prof. Hadian analysis in tehran assad wouldal of lead to the collapse of the regime. And that will create more chaos tot no one interest is going prepared for. The ideal is for him to leave office not run away, but two or three years down the road. Butassad would not agree. That should be the results of the negotiation. The consequence of the negotiation. Assad were to say, king solomon king solomon, i would love to submit myself to you. Is, in syria they are fighting not assad, but us. They are not fighting saudis in syria. Bill jones from executive intelligence review. I was wondering if you could Say Something about the changing threat perception in iran, given the dramatic changes in the international situation. For decades, this was the u. S. Versus iran. The u. S. Policy was to isolate iran if they could not get an maneuver. But it has also changed by three things. Chinas role in the middle east. The promise of the silk road theomic belt, which is on confidence of iran and other players. We saw that prudent is now sending troops to syria putin is now sending troops to syria. Wholeis concern that the thing is spilling out into chaos and he wants a different trajectory. From thetten support europeans on that. The u. S. Is critical and saying the usual things, but the others are saying, maybe this is the way we have to go to get a diplomatic situation. And thirdly, the refugee situation, not only the biggest i to taking refugees, but critical voices being raged by the u. S. And others. That is a different ballgame them what we are working in. How does that change the threat perceptions in iran . They would say, ok, that is exactly our argument. Though, in other words, you have to continue the type of policies that we have had. As i mentioned, there not just one group in iran. Hey have debates the agreement would give us a good chance to play a different role. It would give us a chance to be resecuritized. And one once they have securitized iran, they will be able to pass a number of resolutions for security concerns. Hopefully now, they can move toward research resecuritization. And then normalization and in ,eal with regional issues particularly with china. More and more, china is no longer a factory and is a market. A player in the world. No longer is the Energy Security to be taken for granted. Power, china is going to be the biggest economy in the world. Sure about to be Energy Security. In other words, that is why they are going to be in iran, not , or seeking the market looking at them as a factory, but rather to seek a more strategic partnership. We are in the midst of a lot of debate about china. Chinas role in the future and chinas role in iran. Barbara john, did you have a question also question mark also . Right here. John from the u. S. Naval academy. My question is really about these debates on both sides of the persian gulf. Voicestion is, are there in these debates that are advocating for better relations with the neighbors . In other words, saying, look, these arer problems our neighbors. They are not going away. We share our culture and history and a religion. Therefore, we need to change the , which is nottion in our interest. To report to you and analysis, there are these think tanks in iran. As an enemyee them or a threat. They Design Strategies for how to deal with them. They consider them exactly as a neighbor. Even in the last two years, how do you find a voice that would say, no, we have to have a Good Relationship with saudi arabia . The hardliners and all supported a better relationship with saudi arabia and thats what they thought, jim john on that in a job that is what they hmadinejad wanted to go to. There are a number of forces within iran who are ready to improve the relationship with saudi arabia. As i mentioned, it is very much onesided. We dont consider them an enemy. Why should we consider kuwait or qatar as an enemy . True, thater part is we are at the top of their threat list. I once personally was talking to the National Security advisor. He is a arab. Anaren. He is an arab. And he said, in fact, to improve the relationship, because of the same language utah, you may be able to give them more the same language you speak, you may be able to give them more confidence. For sure, we have to take initiative to put to rest of their concerns about us as a threat, but it will not be an easy thing to do. As i mentioned, now, and in particular the last three or four years, we have become their convenient and any their convenient enemy. There has to be a reason why they believe it. Barbara just add to it and we will get a quick answer from bilal. Dont you think the animosity goes back to when the ayatollah aboutni started talking the royal family as a legitimate an illegitimate presence . During the iraniraq war when all of the arab countries except for syria , and myd saddam question is also to bilal. Wait sosaudi arabia long to send an ambassador to iran . Thenumber two, when iranians got involved in syria, why didnt the saudis get involved . Prof. Hadian that is a good goes, but that does past the decade of revolution. We had a better relationship with them, particularly rough on rafny particularly sanjani. Is the negative against one another. Thoseose arent not are not the reasons why we should have a better relationship. We have to look at the action, not just rhetoric. If you look at action, the gcc was not against israel. They were not for or against iran. At the beginning, we did not even call them saudi arabia. We called them high jobs hajabs. Much at they beginning of the revolution. But afterwards, things change. And we cannot explain the. Urrent behavior then we had a much different relationship after those years. You speak with much confidence and candor. It is really something to admire. If you were to go to court with , iegal case such as yours think the judge is going to have a hard time really defending you. Understand that truedless of how valid and irans claims are today, that country has tons of it leading tons of explaining to do to the rest of the world. It is not enough to be right, if it is in fact that you are right. You have to explain it to the community of nations around to that simply do not believe what you are saying. The problem also is that there is tons of evidence that goes against what you are saying. Whatbody wants to believe you are saying, but it is really hard to. Side, john, you asked who is really interested andnhancing relations creating a dialogue between both sides. Speakalways a mistake to of the gcc as one entity, and you know that very well. Ofthe top of that Community People who are actively advocating for a dialogue is the moneys. Manis and they have been for a long time. Never confuse the saudis with the kuwaitis or with others in the region. It is not entirely adversarial, but not impossible. Bahrain has a difficult perspective when it comes to iran, and they are in an entirely differently for reasons of their own. I think qatars relations with iran, and you alluded to it, are drastically improving, to the chagrin of their neighbors. Saudi arabia, we have been talking about it all day. There is no point. And you are exactly right, that perhaps the most intense and ever terrio an adversarial relationship is between abu dhabi and iran. And both of them have their own reasons. As you very well said, dubai has fewer concerns about iran than abu dhabi. Are out of time. I invite you to stay and ask further questions if you have them. But i think this has been a very interesting debate that we have had here on the iranian policy debate and i thank you very much for coming. [applause] [captions Copyright National cable satellite corp. 2015] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] speaking here at the Olympic Council for about an hour and a half at the Atlantic Council for about an hour and a half, and if you missed any of it, you can fight in the cspan library with otheran. Org related discussions. And later tonight, live to iowa for remarks by president obama on College Access and affordability. He will be holding a town hall meeting at North High School in des moines. And later tonight, democratic president ial candidate Bernie Liberty university in lynchburg, virginia. He took part in a q a day today. Here are some of his remarks. Senator sanders let me take moment, or a few moments, to and you whamotivates me the work that i do as a public servant, as a senator from the state of vermont. Let me tell you that it goes i am far from a perfect human being. But i motivated by an i am motivated by a vision, which is this in all of the great religions, christianity, judaism, islam, buddhism, and other religions. And that vision is so beautifully and clearly stated in matthew 7 12. And it states, so in everything do to others what you would have them do to you, for this sums up. E law and the prophets. Hat is the golden rule do unto others what you would have them do to you. Rule and itgolden is not very complicated. Frank, as i said a moment ago. Understand that the issues of abortion and gay marriage are issues you feel very strongly about. We disagree on those issues, i get that. Suggestme respectfully that there are other issues out there that are of enormous , andquence to our country in fact, to the entire world. And maybe, just maybe, we do not , and maybe, just maybe, we can try to Work Together to resolve them. [applause] of ourcan watch more road to the white house coverage. We will be watching showing senator Bernie Sanders remarks at 8 00 p. M. Eastern time. Followed by Carly Fiorina speaking saturday at the annual stretch kennedy patriots picnic in new hampshire. Tonight on the communicators, n will team epstei discuss the upcoming broadcast spectrum should that will allow auction that will allow companies to bid on airways space. One thing i do want to emphasize, we are not taking spectrum from broadcasters. It is a voluntary auction on behalf broadcasters. Broadcasters continue to be an service, butuable Congress Passed this act where broadcasters on a onetime only basis will be able to relinquish toe spectrum rights in order take part of the proceeds of the following auction. Is congresss determination and the fcc and limitation to use Market Forces to make available more low band spectrum to meet more wireless broadband needs. In other words, the need for broadband spectrum is burgeoning by multiples, exponentially. There is not a lot of good broadband left. This is a novel method that congress has put in place and that the implement. That the fcc is to implement. Right after the communicators on cspan2, a House Oversight hearing about security at the usmexico border. Here is a preview. The battle tos increase security and rule of law in mexico is going to be a longterm battle. We can see what has happened in colombiacolumbia and those are the types of things we will have to help mexico make. Continuing those types of programs that we started in co lombia and we are currently running in mexico to improve the judicial system and the police, all of this will Work Together to make this a safer country. Thank you very much. Before the gentleman yields that, i will point out that there is no police force in nuevo laredo. You can contravene them, but there isnt even one. It is run by the drug cartels. And shame on the state department for cutting peoples pay their in the state department. That is not the way to build morale and do other things. Youre getting tens of billions of dollars and you will cut those peoples pay. You can talk about training a local police force, but there isnt one to train. Can watch the entire hearing tonight on cspan2 at 8 30 p. M. This year marks the 50th anniversary of medicare and medicaid. For my administrators talk about their work during a forum hosted by the aspen institute. Our final panel gives us an indication of where we are headed. It gives me great pleasure to introduce the leader of the giant nonprofit and Partnership Organization with a membership of more than 37 million. Jeanine is from california where she was the Founding Partner of a Government Relations firm and previously served as the executive director of the Bipartisan Commission on california state government, organization, and economy. Welcomingn me in janine english. [applause] janine thank you very much. I really like the idea of this panel. What we have learned and where we are headed. Conversation brings meaning to this 50 year anniversary. This is the perfect time to take stock of the incredibly important programs and really think about the future. Medicare and medicaid have shown for many years that our country can deliver on the promise of Affordable Health care. This is really a basic need for everyone. But we know these programs face challenges, especially as the boomer generation gets older. We need them to stay financially sound, but americans also are counting on medicare and medicaid to continue fulfilling this vital mission. It is essential that we discuss responsible ways to keep these programs strong and effective, ways that dont harm individuals who need that health care. This panel is the reminder that haveare and medicaid benefited from leaderships on both sides of the aisle. They have grown and evolved with bipartisan support. Aarp believes that an inclusive policy debate, one that recognizes how important these programs are two families all over this country, will lead to the best possible future for medicaid and medicare. Im really looking forward to this discussion and hearing what our distinguished panelists have to say. We are very fortunate to have judd. Derator jackie you probably know jackie from her awardwinning career in broadcasters listen. Or many years, she was the star at abc tell for many years, she was the start Abc Television news where she reported for world news tonight, primetime live, and good morning america. But you may not also know that jackie also specialized in health care. After her television career, she moved on to the Kaiser Foundation where she served as Vice President and executive producer of multimedia. I am delighted to turn the program over to jackie and leave this conversation in her capable hands. Thank you. [applause] jackie good morning, everyone. Im delighted to be part of this rich conversation and to join the conversation with nancy and apparel and gail wolinsky. I want guess that everyone in this room knows their history. And it was also published in greater detail in the brochure. I will contribute a little bit of history to the first panel that got us going. The Kaiser Family foundation, we decided to produce a documentary to mark the 40th anniversary of medicare and medicaid. Treat andgreat privilege of interviewing the president who, ms. President who mrs. Robert for to, and his name was dr. Edward and its. In 1994 and heim was 90 or 91 at that point. He was spry and dynamic, and then ast as convinced he was 40 years earlier that medicaid would create what he arounda socialist yoke octors next across america s acrossr. s neck america. I make this point to say that thisons run high in country about this topic even 50 years later. Weve seen it play out politically on a fairly annual basis. Coming from a background in journalism, i cannot ignore the headlines of the day. Yesterday, they passed a dock ended apparently is going to the white house. I would like to turn to both of whator a quick analysis of you think of this legislation that was passed. Is a terrific compliment. Im sitting in reflecting on the role of the ama and the passage of medicare and medicaid with respect to the socalled reform of the way that medicaid pays its positions. It is very good and i think it will help to strengthen medicare and will have spillover effect in all of the other programs as far as moving to positive ways to pay the physicians. Gail i have a particularly pleasurable response to the passage of this legislation because i was administrator on hand when the relative values scale was first implemented. And also, the 25th anniversary celebration of medicare and medicaid. Time a betterhe strategy than what had been used previously in terms of using that what was out in the insurance world, the customary fee schedule. In fact, what we have seen over time is that focusing on very small unit of service to bill, which is inherent in the relative values scale, with a spending limit laid on top of it , that both pushed the physicians in unhelpful directions, not being awarded are encouraged, or sometimes in easily allowed to focus on the best clinical outcomes and the most efficiency, and then engaged in the worst kind of proactive guilt. Because if spending grew too fast, all fees for good or for physicians and all services were uniformly reduced. It was inherently unfair. Unless of course, congress intervened just before the reduction was to take effect and stop it. But the uncertainty caused so much frustration that the ama was focusing way less time on the sgr fix and not been able to focus on the bigger issues. When medicare was passed, i found the ama very helpful in lending and doing outreach in explaining and doing outreach. Or the relative values scale im sure this will be a happier time for them to have finally moved away from the spending. And i think it is always important to bring it back to the beneficiary side. What impact will this doc fix have . Beneficiaries will know they have a stable system physiciansment of and it will encourage physicians to look more broadly at their care and the providing of Preventive Care and the things they need as opposed to worrying about cuts and how the gdp performs. It should give all of us really encouragement that on a bipartisan basis pretty overwhelmingly, congress was able to get together on this issue and find common ground. I think that has been an important part of the history of medicare over the years. As gail said to mother have been Different Things that have been tried and it is an incredible laboratories were trying to advance policy. Incredible things have been tried. Sometimes they work and sometimes they dont. Congress has been able to get together to work on the next iteration, the next solution. Gail and instead of worrying about a 20 reduction in their fees, which i think they knew wasnt going to happen, worryciaries should not about what is going to happen. Health care professionals have tried to do the right thing by their patience all along. Patients all along. Wanted to about how to increase value and encourage efficiency when we had a payment push you inreally the opposite direction. Fortunately, most of our professionals ignore those schedules with the fee and did the right thing. I would hear so often, both running medicare and then i share the Advisory Commission for its first four years. I had physicians say, you guys make it so hard for us to take care of patients the way we trying to spend time talking to them if they have diabetes or other chronic. And not feeling like we are pushed financially to do things as opposed to just taking care of the best health cap health outcome. There arel still other issues to be solved. How much more a physician should be paid and what counts for bonuses and what counts for penalties. And and i have a lot of work to do. Jackie lets take a step back in the longer view. The pace of change has accelerated the past decade. In part, under your watch. Health care new models of health care, new pay schedules. Primary models do you see that have legs for the next 10 to 20 years to fundamentally address some of the Critical Issues we are facing . Nancyann i would start with i cannot help as we are sitting here celebrate in the medicare , the feeling of my grandmother who was one of the first beneficiaries and was 67 when medicare was passed. Had a Kitchen Table she little box of her bills at the table and she was talking about whether medicare would help her. As we look toward the future, it is really important to remember the stories. For me, it is my grandmother. For other people here, it is someone else in the family. It is important to remember those stories. If we look at the future and where the program is going, to always hold fast to the best of hasdicare is done done, which is to provide a stable, Affordable Health insurance system for seniors. And my grandmother lived to be 98, and im convinced that one of the reasons she did was she did not have to worry about health care costs. And it also afforded her family members the ability to not have to worry. That is huge. Whatever we do, we need to keep that in mind. And i think we will. Related to the new programs being developed now and being implemented around the country, to try to lean toward more teambased care, toward what is for a population caring group of patients, trying to help them get better, showing outcomes as opposed to just the fee for service a la carte system we have had in the past. Medicare advantage plans are growing in part because that is what they are offering to work best for Medicare Beneficiaries. Not only news is that our hospitals and physicians and other Healthcare Providers not opposed to them, they are embracing them. They are working to take them to the next level. Private sector insurers are doing the same thing. Gail let me try to spend about the new models and what we know and dont know. Cms, is an effort with centers for medicaid and medicare services, groups trying to come in and put bundles of payments together. Withy, that is hospitals physicians, hospitals with postacute care, or home care order nursing facilities home care, or Skilled Nursing facilities. Part of it is seeing that it is improving care to the patient, improves patient satisfaction, and also reduces costs. Those are baby steps toward a integrated delivery system. Getting physicians and hospitals to Work Together to agree to combine surfaces services and efforts. And if they can show some savings and quality metrics, very important, then we get to show the savings with medicare. One of the problems we need to recognize is that the Pilot Projects that we are trying a very good idea. Try before you roll it out toward all hundred three 6 million seniors 446 million all 46 million seniors. The groups that are being the most entrepreneurial and organized, jackie and probably the most frail. Gail whether the populations are more or less frail can be measured. There are risk adjustments. Is, if we were to do this for the entire country, with the results the same . It is hard to tell. One of the things i found as a former researcher from a former policy person, is that what works on a smallscale is not always work well on a big scale in this country. You might have a Pilot Project work really well in a few areas of one state, but when you try to replicate its and see what happens in eight states, sometimes it is more of the same. Places, it just introduces problems you didnt anticipate. Make sure that what looks like it has legs, so to speak, producing better care at a lower cost, can be scaled and replicated. We will have to drive that. I little job is to this about whether we are going to find things that work i am a about whethered we are going to find things that work, and maybe its because ive lived through that project of paying a single amount for heart valve replacement and bypass surgery. Thisked really hard to get pilot off the ground, much harder than i thought i would have to. I assumed i would say, lets get this done, and it would happen. Itl, 18 months later actually happened, and i was yelling and turning all the way there. And then after actually, by hadtime nancyanns term finished, she supported it. Then it just kind of died away. We will have to really support these changes. While we are seeing a slowdown now, it is not clear what is causing the slowdown, or whether it will continue. And with all of the baby boomers coming on, there will be a financing challenge even in the unlikely event that we saw a continuing the future. We will have to take advantage of these initial successes, but it is too early to know if they are really in part she is right because back in the day, i was there for the 35th anniversary of medicare and medicaid and you were there for the 25th. Back in our day when you did a demonstration program, it was just that. Small and very contained usually. These demonstrations have been authorized now for medicare, they are very wide scale. 10 or more of the Medicare Beneficiaries have access to one of these accounts. Laterl know sooner or whether they work. Secondly, if they do work, if we are able to control costs and increase quality, then the secretary has the ability to roll them out nationwide. That is not something that the secretary had when you and i were running medicare. And i think that was built into the law because congress realized that we really want to see some of these things work and encourage the private sector to change, because why would you have an and give incentive if you thought it would be like the one i did before and it will be a few years and i have to put every thing back the way it was . I think it gives incentive to the private sector as well. Are really of acos struggling. It is a fine way to get people who have not working have not been working together to Work Together. The socalled pioneer acos, those who are willing to take the risk of loss and gain, and then those that dropped out, and then those who are in some of they areer versions, struggling. This is not a criticism. They are trying something new. If you do not have failures, you are not drive not trying the right thing. Some people cannot do it. Jackie the title of our panel is lessons learned. Aboutd ask you both seeing success and then seeing it tail off. What did you learn when you were in government and how did you make it stick and grow in a system that is common flex as complex as it is . Nancyann one example is this very one. I, too, have the experience of a number of services that were quite small, quite geographically contained, and then they would die. An experience i had taught me that and i think president johnson could have told me this, probably to be successful, there needs to be more than one persons congressional district. You need to have not just the senator from virginia but the senator from texas and the senator from idaho invested in looking at the success, seeing why it is helping medicare, and helping us strategize about how to expand it. That is one thing i learned. Ms. Judo we cannot have a conversation about medicare without talking about the baby boomers. You just alluded to it. I think i heard last night that enrollment in 2030 will be double what it was in the year 2000. These are mindboggling statistics. How does the system absorbed all of us

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