Transcripts For CSPAN Washington Journal 20131216

On this monday, december 16. For republicans please call you can also tweak at us. Question is posted on facebook at facebook. Com cspan. You can also email us at journal cspan. Org. We will take your calls in just a few moments but first lets turn to the New York Times to get the latest on the nsa. The headline says american intelligence and Law Enforcement investigators have concluded that they may never know the entirety of what the former nsa contractor extracted. That is from this weeks New York Times. On cbs 60 minutes, they took a deep dive into the nsa and spoke with leading intelligence officials who disagree or not with offering Edward Snowden amnesty. [video clip] my personal view is yes, it is worth having a conversation about. I would need assurances that the rest of the data could be secured. It would be more than just an assertion on his part. Is that a unanimous feeling . Its not unanimous. Among those thinking making a deal is a bad idea is general alexander. This is akin to a hostage forle aching 50 hostages shooting 10, and saying if you give me full amnesty i will let 40 go. It is a dilemma. Do you have a pic do you have a pick . I think people need to be held accountable of their actions. Host that was Keith Alexander, head of the nsa, speaking on 60 minutes. Lets go to facebook from a to facebook for a quick comment from john shepherd. That comment is on facebook. You can reach out to us there on facebook. Com cspan. But skittish take a call from sean lets take a call from sean in florida. Caller i just want to call and say that i believe Edward Snowden is a hero and an american patriot. Did was gohat he through the only sources he could to get the information out. The whole time the government has been covering this up, say it wasnt happening. I do believe he is a hero and an american patriot. I appreciate you taking my call. Lets go to gainesville, virginia on her line for democrats. On our line for democrats. Caller good morning. My comment is snowden should never be pardoned. There are so many people who try to cause damage to this great country. Keeping this country safe from all those terrorists try to cause karma is a job by itself. Russia was too happy to have him. You should never be pardoned because the next level, rounded to the same thing expecting a pardon. Surveillance making headlines in usa today, they told that is a followup to an investigation they released earlier this week. They found 43 of adults ages 18 to 29 believe the government collection of phone and enter a part ofas antiterrorism efforts say it is all right. 47 of all adults disapproved. Our topic, again, is should the United States give amnesty to Edward Snowden . Lets talk with million with william on our line for republicans. Caller good morning. He should have consequences, at least 10 years probation. If we dont bring him back here, what country is going to go next and how much more information does he have that can do more damage . I dont think we have no choice. Did him back here. See if they can get the information, what he has left, away from him. Bargain with him. We have to get him back. A couple of comments from aitter this morning host couple of comments from twitter this morning. You can ollies reach out to us on twitter. In the lab become a utah, j is on our line for independents. Good morning, accountability from choices should have consequences, they always do. They may be turned out over a long. Of time over a long. Bang over a long. Bang of ti over a long period of time. Stop doingent should that. For us to be finding out that our phones for us to find out our phones are being tapped and all the powers they have in a roundabout way they are lying to us. Do you believe the United States should give amnesty to Edward Snowden . Bass a gets a free free pass, hes done . If he has the possibility to have more information i think the information should be scrutinized by a group of American People. They can have access to all government files and make a decision for the American People instead of having always politicians that have been there their whole life making all these decisions. We are being toyed with. War on terror is another joke. But get a hold of our emotions, america. Bridgeton, should Edward Snowden received amnesty . Caller thanks for taking my call, ami first time caller. The history of United States has been that we have had many that we havee past health or changed over. I think he should get amnesty. We have this system right now, you pretty much aware of it. If a person is receiving unemployment they have to apply to so many jobs in order to qualify. I think if mr. Snowden was required to to does exactly what he did, how he did it, i think the google executives and many of these other Fine Companies along the United States and National Security people should give him an elevated position and amnesty provided he provides a service of telling us exactly what he did, how he did, to help us catch people so they cannot do this in the future. I think he more than qualifies for amnesty to be a helper to us. Does that make sense . What you say to critics who say he did a lot of harm to the National Security . Caller i think you make a very good point. This is what happens with hackers in general, a lot of hackers have caused a lot of harm to these companies, especially by stealing certain patents and selling them to china. This is what happens when you have a bank robber. Telling us how you opened the vault and got the money out and how you stole all of this stuff, it is just invaluable. Sure this is some kind of circumstance with regard to the harm he did. Then that becomes a moral question, what harm did he do to the United States where some would call him a Freedom Fighter and some would almost call him a terrorist. I think we should trap them on our side because he is just that smart. A headline from the Washington Post lets go to janice and columbia maryland, our line for independents. Think he should not be offered amnesty. He has been a total traitor to this company. With regard to the previous caller who said we should ask him to tell us how he did these things, i would like to ask him how he thinks we could ever who betrayed his country so totally. You dont believe he should receive amnesty, what do you think should happen . I guess i would really like to see him brought back to this country and tried for treason. Donald on our to line for democrats. Are you with us this morning . Him. Y have lost caller this nothing new. 1962, ther of whoctor of the fbi honestly the country was much smaller. One of the other things i would like to say is privacy is gone. I hope we are able to accept that. I used to work for an organization, i dont want to name them but it comes standard in all vehicles. Whenever we want to we could simply call into your vehicle and you would have no idea that we would be listening. That was not a practice we did on a daily basis but that is something we could do if we decided to do that. I just think this reaction is totally overblown. I dont want to give a we tapped lesson but the phones and broke codes and spied on the president in venezuela and germany and all these things. This is something that has been occurring throughout history. Shinenowden did was just a spotlight on it. I am surprised at the reaction of the American People. I know that every time i click on certain websites i end up receiving different at from that website. It is just standard. Lets go to cq roll call. Neils on the phone with us, thank you for joining us. Give us a preview of what we can expect to see over the next couple of days. The senate is coming back into session today at 3 00 this afternoon. They are expected to work through a couple more fo. Nations you will see the confirmation of and patterson to be an assistant secretary of state. That will clear the decks out to with allo move forward the important votes and the debate on the budget deal with the Defense Authorization following that later in the week. Lets talk about those bills for a second. From what youre hearing, does it have enough support of Senate Republicans to pass . It increasingly looks like it will. Just turned from ron johnson to paul ryan, a republican from wisconsin who said he was going to support it. We heard a number of republicans who said at least or have signaled at least that they would vote to break a potential filibuster, which is a vote on which the democrats really need their approach. Even if they vote against the measure itself. Theould be tough to see ,eal not going through unless and i was stress this, there have been situations in the past where Minority Leader Mitch Mcconnell of kentucky has pulled conferencey away from agreements and what happened then is there are no longer the votes were something that wasiously previously thought to have the votes. I also wanted to ask you about the fate of the annual bill that sets policy for the military. Week . T going to pass this isler the defense bill looking like it will be an easier ride at the end of the day, partly because the Defense Authorization bill has been passed by Congress Every year for the last 52 years. It is one of those annual traditions. Day, that billhe will get through before the end of the week. There will be some consternation of thee stalling because way the bill basically came to the senate floor and did not have any votes for amendments to speak of. Anytime that happens you get a number of people who are not happy with what is going on. At the end of the day that will get through to. Both measures will be heading to president obamas desk before he leaves for the holidays in hawaii. Last time we spoke harry reid was about to deploy the Nuclear Option to change Senate Procedure rules. I know a lot of Lawmakers Said they thought that would think reese what is already a very bitter partisan divide in congress. Has actually gotten worse . I think it clearly has. The first one being last weeks marathon session. The senate was in session for more than 48 hours continuously. As democrats look to push through a number of nominations, taking advantage of the new procedural rules they set up for themselves, much to the consternation of republicans. I will also give you an anecdote, which is myself and several other reporters were talking to john mccain late last sayingd he basically was he was one of the republicans who was frequently part of these yield making coalitions these was making coalitions, he saying that a lot of the normal dealmaking that would normally go on would not happen. Out for sure when the senate goes to leave for the year whether or not they are routineclear this nominations package that they normally too late at night when very few people are watching, which is largely routine military but routine military if all of that gets jammed up, we know we are going to have real trouble as the senate moves and 2014. We have been talking with iewski. Esn states givenited amnesty to Edward Snowden . That email this morning from carly in minneapolis minnesota. You can reach out to us via e mail at journal cspan. Org. On the line for democrats, what do you think . Caller i am totally against it. An active practicing attorney for 45 years. Much of it is in the area of criminal defense. The question about his guilt, that flies in the face of our entire criminal justice system. Mr. Snowden did not do anything, he is presumed innocent and is entitled to be heard at a trial. The problem is we do not have any way to bring him to trial. Before you can even speak about amnesty you have to first talk or not he has been tried or convicted of a crime. The crimes he would be charged with are all major phonies. It general principle of justice that we have in this country is the reason why we have criminal statutes is to act as a deterrent to the behavior. If there is no consequence for mr. Snowden to open up and violate his obligations of , then there is no restraining the behavior. Congress areof subject to the same statutes. They are dealing with a top secret matters all the time and they have to be very careful what they say publicly, not to violate the statute. Even a congressman or senator can be charged with the same criminal statutes. The question itself begs the issue. A finding of guilt. Host another headline about this story, that is from michael hayden, former nsa head. If steve is on the line for independents. I saw general haydens interview. I saw Keith Alexanders interview on 60 minutes. Those two were absolutely riveting interviews. We cannot let snowden have a just because the guy robbed a bank and discover the bank owner was stealing, should we leave the bank robber free . Even though i disagree with the way Keith Alexander handled it, i think he is right. Awaynnot let this guy get with this. He cannot have a path to freedom. We should maybe consider stripping him of his citizenship. Another headline this morning the summits will be a net 3 00 with a schedule around 5 30. Lets talk with mike on our line for democrats. I think if they are in government, they should be fired on the spot. Took an oath to defend this nation. He took it upon himself. The time of all of these scandals. He thought he could add on to it. These ron paul supporters and all these republicans calling him saying he is some type of hero, these are the same people that when george bush passed the eight passed the patriot act they were clapping. This nation is apparently of war. Treasonablee of war acts are punishable by death. If we are at war and george bush nowthe patriot act this has been done since j edgar hoover. This is nothing new. Nobody here is surprised the government is doing this to citizens. These guys took an oath to defend this nation and protect the secrets. He took it upon himself to try to damage the government. This guy deserves nothing but to be brought to justice and put away for a long time. Talking recently about the house budget chairman paul ryan and patty murray. Post shington what patty murray had to say about this compromise. [video clip] toughcannot take on the discussions unless we learn to use the word compromise. Come here with passionate things i care about. I know chairman ryan comes with passionate things. If we elect each other and that is all we get rewarded for, we will never get to those big discussions about tax reform or strengthening our entitlements or Immigration Reform or any of the big challenges of our country. Trying to bring some respect to the word compromise. I think it does pave the way for other people to do what we have done. That was senator patty murray talking about the budget deal. We have one interesting tweet from a former nsa employee. He writes a couple more tweaks more tweets feel free to tweet at us at c span wj. George in south carolina. I think snowden should be brought back here, tried, thrown into prison. He had these instructions, he knew it when he took office. What these Young Americans do not realize, this has been going on so they can enjoy their so called freedom that they think they should have. It they cant like leave these come leave this andtry any time they wish go to another nation to live and find out what it is like there. Dont let the door hit them on the on the way out. Lets go to our line for democrats. That i am veryve confused. Openingme believes that up and telling the truth is always a good thing because i tell the truth often and i do not live. It is kind of confusing for me in that regard. However the other part where i am not confused is i would never tell secrets about our government. As citizens we all know from the time we get old enough to vote that the government has a right to keep things interNational Security private. We are asking for trouble if we dont let our government have national secrets. And then there is National Security we should have the right to know certain things about ourselves. Of droneske the idea out there spying on us. When we lived in baltimore and they started doing the i guess they were drones. Stoplights ande then went on. Your license plate number, using the us cues that they were trying to catch people who ran a red light. Knewat point in time i something was up. You could feel it. It irritated the heck out of me. Another email this morning. Bill writes that email from bill this morning. Topic, should the United States give amnesty to Edward Snowden . Sandy is on our line for independents. Are trystingnk we toward a police state and most people had no idea it was even happening. I really appreciate the courage sacrifice that Edward Snowden made for us. On our line for democrats, victor is calling from michigan. Good morning, what i wanted to say is we were told during the Bush Administration that the rest of the world hates us because we love freedom when in actual lee when in actuality people hate us because we do things that are kept hidden. A lot of the messages he released are up diplomatic snafus he really start diplomatic snafus. We should be doing them when we are not doing things that are wrong. Clarity and openness is what we need to know. If our country are doing things that are wrong and created a situation that were then going to send our troops and to try to do stuff, that is wrong. Know what our government is doing. We should not be doing things. This man exposed wrongdoing. And that is not wrong. Thank you. States let politicians take harder donations. Toiticians will be able reconfigure Campaign Contributions our topic this morning, should the United States give amnesty to Edward Snowden . Plane in Houston Texas on our line for independents. People should realize the country was started by a group of men who had total distrust in the government and they were rebelling against it i commend Edward Snowden because i have total distrust in the government. Discussion of getting a better Federal Reserve system owing to come about in the budget . In oklahoma, our line for democrats. Thank you for cspan. I am a widow of a veteran who died of agent orange. No, Edward Snowden should not be given amnesty and i dont understand why the American People are surprised that the government is listening. It is as ancient as rome. Anotherave spied on one since ancient times. Didnt you think mr. Cutin may want to turn him into a spy . Maybe we should send more agents to russia. This marks the oneyear anniversary of the massacre at sandy hook in newtown connecticut. The Washington Times reports that is in this mornings Washington Times. A couple of more tweets on our topic this morning. One more tweak this morning one more tweak this morning. Morningore tweak this alan in maryland is on our line for independents. Thank you for cspan. Edward snowden is a hero. He didnt really do anything to the people. All he did was embarrass our leaders. Andleaders are lying to us they shouldnt be lying to us. We shouldnt hear the stuff from them. He has to tell everyone about it. It is wrong. The war on terror is a farce anyway. Not like we are capturing terrorists with us. Why do they need to listen to our calls if theyre looking for terrorists outside our country . In maryland, charlene is on our line for democrats. If anyone watched 60 minutes last night, they would learn that the potential damage is too great. Power and how much information the enemy can get, i think something needs to be done. Question of the day, the question of the day should have been who is the entitlement class . Is the longterm unemployed or is it the exxon, major corporations that dont give a living way, the question of the day is who is entitlement class . Pico that people deserve to get back into the system, not to be thrown as everyone is under class. Same question, joe in new mexico on our line for republicans. Should Edward Snowden received asylum . Caller yes, he should receive asylum. Host next up is mark in North Carolina on our line for independents. Caller is this me . Did you call for mark e e for mark . Host yes, you are on washington journal here co on washington journal. Agree with the woman who called about walmart and all of that. I wont get into that too much except i agree with her. I do believe Edward Snowden and i wouldrdoned like to see george bush and his administration wrought up on war crimes. I dont think Edward Snowden should be prosecuted until that happens. America brought back to , we can be sure he will be assassinated by the cia or by some sort of Government Agency anyway. Do you think releasing the scores of documents did more harm than good . It can do nothing but good. We are the most powerful country in the world. We have the most powerful military. We have 100 times more power in our military anyway. This, americans need to think about what europeans think about and no and have fought for centuries. When people have a small number of people have all the your and all the money, look at them with suspicion until they prove otherwise. Why dont americans do that . And it understand that believe Edward Snowden is a hero. Robert daniels writes should the United States give amnesty to Edward Snowden . Republican line for my kansas. Us . Ou with caller i am. Statesple in the united are very concerned between what is good and what is bad, what is legal and illegal. The United States becomes a waste capital of the world. We have those that protect the freedom and the rights of the people to tell the truth. When the government makes more secrets and the people who are when the immunity is snowden has the right thehow the difference tween crisis america is facing. Justin is on our line for independents. Should Edward Snowden received asylum . I believe so but i should be weary. I hope in the future we consider him a hero and give him a holiday. Go lions. When we come back were going to be joined by americans for prosperity to talk about divisions on the budget deal within the republican party. Later we will be joined by alex lane on the healthcare laws latest enrollment numbers. They were the first country thisorld to provide allows monitoring of vital signs without having to have entries of monitors. It can really be a game changer. Remotewe are a monitoring solution, to be up to put devices in patients homes. This device is an anticoagulated device. A patient would have to go to the doctor maybe once a week to get a blood reading and as the data goes in to the device and as they go into a nursing senator that nursing center, they can alert the patients cardiologist peter one thing i am on is providing a model for health apps. A can ofby a cam soup, some people care about sodium and other people who care about sugar. Similarly we are developing a tool and we have done this for personal health records. These folks do not resell my information. A consumer can help navigate this union talks the governments role in supporting mobile healthcare technology, tonight on the communicators at 8 p. M. Eastern on cspan two. Cspan, we bring Public Affairs events from washington directly to you, putting you in the room at congressional hearings, white house events, briefings and conferences, and offering complete gaveltogavel coverage of the u. S. House all as a Public Service of private industry. We are cspan, created by the cable tv industry 34 years ago and funded by your local cable or satellite provider. Now you can watch us in hd. Box washington journal continues. We are joined by the federal Affairs Manager for americans for prosperity. Thank you for joining us. I want to start out by talking about the budgets hell passed by a wide margin. Americans for prosperity came out with a statement. Walk us through that decision. Of the things that alarmed us about the budget deal was the overall spending levels. Very concerning to us was the fact that the overall spending levels exceeded the Budget Authority for 2014, the level that was agreed to by the budget control act. Spending level for this twoyear agreement is about 1 trillion in order to pay for some of that higher spending this deal uses a number of revenue increases. If i understand correctly, isnt that a win . The statement no new taxes is really not a reality. It is just taxes and another name, like airline fees. Let me be clear, americans for prosperity actually support many of the changes but we disagree that these should be used to offset higher spending elsewhere. If you want to join the conversation, for republicans the number is what are americans for prosperity doing to get their message out to lawmakers . We are key voting against this budget deal as we keep voted against it in the house. Another thing we are doing is many activists am a we have over 2 million activists. They are also calling up their members of congress, letting them know that we oppose the spending levels on this budget deal. We are doing a number of things. Number of people have what isse that the alternative the echo the alternative the echo the alternative . Guest if the Senate Rejects this budget deal, if they block it from going to the president s desk, the government is not going to shut down. That gives Congress Time to go back for the holidays, come back, come to an agreement on a clean continuing resolution at the appropriate spending levels. Caller host our first call comes from georgia. Herbert is on the line for democrats. The economy is Getting Better right now. If they would have been putting instead ofpport saying no to everything that was going on i think our economy would have been better than it is today. Knowhave been saying you for the last five years. It is sad. I am 63 years old, fought in the military, i have never seen anything happen like this. Even charlie said something when the guy who died says something against our president. He said something and stood up. Need to stop having this division in our country. This country is divided between the politics. The tea party is dividing us by nationality. We dont need this division in america. It is time to put this stuff aside and accept people above people. Stop looking at the 47 . Ones that are doing the distraction. Fighting nes i take issue with the assumption that the economy is doing better. It is but this is certainly a recovery that is slower than others and the past historically. We have seen millions of people, millions of americans who continue to struggle to find work. Americanslions of upset with the implementation of the president s healthcare law. These are issues that americans for prosperity here at the state level. I talk with many of our states directors and they tell me how fed up our activists are about the overspending that is coming out of washington. Host paul ryan is set up with outside groups and weighing in on these conversations. I would like to get your response. [video clip] i think these groups are valuable. Lookay i look at this at it is this, they are part of our conservative family. I would prefer to keep these conversations within our family. I was frustrated about that, as well. Tea party as invaluable in helping keep the taxpayer in the game, keep washington accountable. Majority, wethe deserved to lose it. Wet were doing here today, have two thirds of the house conservatives voting for this. I think this is a step in the right direction. It is not as far as i want to go but it is a step in the right direction. I appreciate chairman ryan for being more to poetic than speaker boehner. Position hasnt changed, americans for prosperity has been very focused on the overall spending levels throughout this budget process. We are very concerned about keeping the sequester and about overspending in washington. Another item is the fact that a lot of early reports and my conversations with the capitol hill offices give me a lot of clarity based on the budget deal. It was correct that this budget deal was close to 1 trillion. Our key vote alert was correct. Randy is on our line for democrats. I was asking the question about americans for prosperity. I want to know how many people out there that belong to this organization actually have a job and depend on middleclass jobs. It is always ok for them to get taken off the back. Lets just take their pensions and lets make them the ones they wont even talk about tax loopholes and taking taxes from them like they should be and closing those loopholes. Very concerned about why we do not do that. I am part of the 99 . I am a retired construction for 30 years and i am just barely getting by. They should be able to keep their pensions. To address the first part question,ler, his americans for prosperity activists are normal people. They are your neighbors. They lived in all 50 states and they are just hardworking americans. I traveled out to the states a lot. I meet with a lot of our state chapters and i chat with people that are activists and the one thing they have in common is just in opposition to the president s healthcare law, overspending coming out of washington. These arent the one percent. The other thing i would like to address is the colors second point. Positionng been the that we need to take to clean up our federal tax code. Post,e a recent blog americans for prosperity. Org. You can see where we are calling for cleaning up the tax code and getting rid of these targeted handouts across the board. Lenny is on our line for democrats. A couple ofve things. Are you guys curious about the tea party, go online and watch a wonderful documentary called the billionaires tea party. Americans for prosperity was funded by the coke brothers by the Koch Brothers. But i find offensive by the conservative think tanks they are corporatefunded think tanks. They try to tell we the people but somehow the interests of corporations are the same as we the people. That is absolutely not true. The second thing is they come in the form of the heritage foundation, the cato institute. Americans for prosperity is one him a competitive error Competitive Enterprises to. These are not conservative think tanks. These are rogue corporate think tanks. The founders were terrified of tyranny, andigious in corporations hijacking our democracy. Please go online and watch that the mock you that documentary. What is your response to the things i am saying . Corporations and we the peoples interests are not the same thing. These explain yourself. I will take my answer offline. Guest the millions of americans are not the 1 . They are not billionaires. They are concerned about what is coming out of washington. We our a number of focused on overspending and implementation of the health care law. Question the assumptions host we talked about how John Boehners comments and lets listen to what he had to say. [video clip] they are misleading their followers. Theyre pushing members in places they do not want to be. They have lost all credibility. They pushed us into this fight to shut down the government. I was not theow strategy i had in mind. If you will recall the day before the government reopened, one of these groups stood up and said, we never thought it would work. Are you kidding me . You all know me. I say what i mean and i mean what i say. I am as conservative as anybody in this place. Overhe things we have done the three years i have been speaker have not violated any conservative principle, n oot once. Host a very animated speaker john boehner. Guest the speaker was talking about the defund effort, americans for prosperity never participated in that. He is so upset because groups like mine are reminding him of the promises made to the American People, the promises they made to control spending, to reduce spending. Chairman ryan and chairman murray, it breaks this agreement. It trades higher spending now for the promises to cut spending in the future. If you look at the report that came out, the cost estimate from and 57 happened in 2022 2023. If congress is not willing to cut spending now, what reason do the American People have to believe that congress will cut spending in the out years. Host we are talking with Christine Harbin Hanson from americans for prosperity. Matt is on our line for independents. Caller good morning. People fored to americans for prosperity. Callers, of the other youre a corporate lobbyist. People andassroots commented people in the streets who follow your beliefs. Your beliefs are snake oil. Youre not telling the American People you are trying to destroy pensions. Unions. Ot believe in you have done everything you can to bust unions. You do not believe in a middle class. You follow your corporate sponsors and their beliefs. You are destroying america. There as i am concerned, will not be any lobbyists allowed in washington, d. C. We the people are the lobbyist. You take the constitution and twist it and distort it. Host we have gotten a lot of questions about how afp is fu nded. Guest we have a wide donor base. Two of our donors get more attention than others. Whoave thousands of people provide support for our organization. Some more than others. Some send us as little as five dollars. To frame our organization as a tool why two wealthy people is completely false. We are a grassroots organization. We believe and a prosperous middleclass. We advocate for policy solutions at the state and local level that will lead to that. From mike on our line oklahoma. Caller i and a retired lieutenant colonel. I am now in my eighth year as a public educator. I am well versed in the outcomes of our government spending. I want to thank the young lady for her organization and what they are trying to do. It doesntpend, matter if you are republican or democrat. If we continue to outspend what we take in, you do not have to look very far. We cannot collapse as a country. That is the overall entire message that needs to be sent to everybody. If we do not reign in our spending, it doesnt matter what else happens. Thank you for your time. Guest the caller echoes much of our position and americans for prosperity. He sounds like an activist that i talked to when i travel to our state chapters. People are concerned we are spending much more than we take in. An unsustainable fiscal path for the country. Host we have a couple of questions from twitter. Guest americans for prosperity came out of has been around for about 10 years. Organizationof an called citizens for a sound economy. We became our own organization, americans for prosperity, about five years ago. Overspending, i am a federal Affairs Manager. I weigh in on the legislation coming in on capitol hill. I spent more than half of my time or an equal amount of time opposing much of the legislation coming from republicans. We call it as we see it. Andemind republicans democrats they should live up to the agreements they made to their constituents. We are not a partisan organization. We call it as we see it. Host scott in lakeland, florida. Caller good morning. I heard mr. Boehner say he was a conservative. He has increased the debt. The people are outraged in this country. What makes him think if we put him back into power, they will do anything different . They were sent there and they have failed because of mr. Boehner. Guest i will not comment on personnel issues. Pointller makes a strong that the American People are fed up on this overspending. Carolinaneth in south on our lines for democrats independents. Caller i am a retired old terry of us are. Military retired officer. We spend the most in our military with things we do not need. And our military matters and we ca. I appreciate the statement that we call it as we see it. The Biggest Issue is misinformation. The fact thatt she thought this recovery is the slowest in history. We have had the deepest recession since the depression, which has no other markers in our history. If she could speak about the whole truth, i would appreciate her speaking to that. Saide could speak to, she americans for prosperity did not take a position with regard to what speaker banner was talking about earlier. They she talk to whether did come out against shutting down the government over health care and what that could have done to avoid, spending more they takeh they say in opposition to spending more money. Shut the spend more to government down and to bring it back. Mentioned, americans for prosperity did not call for shutting down the government in order to defund obamacare. We are not calling for a shutdown now. No one has the appetite for that kind of false choice. There is time to pass a continuing resolution at the appropriate levels, even if the Senate Rejects this budget deal. One other point. The caller talked about runaway spending in the military. I think this is a great time to bring up we are talking about Discretionary Spending right now. The biggest right now is entitlement spending. Social security. That is something americans for prosperity has worked closely with capitol hill and would like to see some real changes to that. In the wallcle street journal. It talks about some of these competitive races. Republicans have the best opportunity to win back the senate in a decade. By thes are frustrated cash to be spent trying to deal with internal feuds. Host what is your take . Guest i hear his frustration. We are not undermining anybody. Were reminding elected officials about the promises they made to their constituents. We hear politicians say they want to rein in spending or they want to put washington on a better path. When they get to office, we see them break these promises. Exceeding the spending levels is a broken promise. This is something that americans for prosperity and our millions of activists are concerned about. We are educating and letting people know, shining a light on this. Incumbentlieve seven have youhave asked endorse them . Guest we do not endorse candidates. Virginia on west our line for democrats. Caller good morning. I had three points i wanted to make. Unemployment, medicare, Social Security, and government pensions are not an entitlement. They are paid for at least partially or wholly by a souction in peoples wages those costs can be met by the employer, or they are taken out salaries asons they go through their work cycle. Is easy when you are 30 to not worry about pensions. When you are 61, you begin to worry about pensions. We consider ourselves a so called christian nation. We say it is the individuals responsibility to watch after those less fortunate. We are a government of the people. We are the government. We have a responsibility to watch after others through the auspices of our government. Profits on wall street are out of sight. Corporate profits are at all time high levels. Upper bracket income has gone off the charts in the last 15 years. The economy would collapse if we raise the minimum wage to give those a better life. How about if we give these that nonough of a wage longer would need food stamps or government assistance. They would be off of those rolls. Towould be corporates job take care of those costs. Host we will let you respond. Guest i would like to address entitlement spendings. When you look at your pay stub and you see the amount taken out for Social Security or medicare, back goes for that does not go into a lockbox. The money taken out of my paycheck is not the same i would take out for Social Security benefits. Looking at the entitlement spending, this is going to beome, we are going to paying out more than we take in within the next few decades. This is something that poses the biggest threat to our nations finances and needs to be fixed. Mclean,is is lucy in virginia. Caller good morning. Thank you for taking my call. I agree with the principles for americans for prosperity and some of the other conservative groups. Realizeme we unite and no one on the conservative side would be elected unless we take a stand and redefine our message. To control how the media delivers the message and it is always slanted. If we are being accused of not wanting children to have health care and all of this total baloney, we will never get elected. It is time we get our foot in the door. Togethercoming to work and not risk all of these by mary challenges, which could lead to more and more democratic votes and they have no concern debt the huge deficit and we are in. So we have to be real. Thet i think many of statements the caller made highlight why organizations like mine are so important. Why grassroots organizations are so important to keep elected officials accountable. We are not a big d democrat party. We are committed to Economic Freedom and getting people back to work. Ourink that is why motivation is so important. I think it is something the caller has mentioned. Host another question from twitter this foremost isirst and overspending in washington, opposing the budget deal that has spending levels greater than 2014illion for fiscal year and that is one way we are standing up for hardworking american families. Another way we have been doing this is by being a strong opponent of the president S Health Care law. This is something that americans for prosperity has worked on tirelessly, ever since the president first talked about the id in a campaign speech, highlighting the problem of implementation and advocating for free market reforms to our nationS Health Care market is something that americans for prosperity works on a lot. Host a question from email from sue in new jersey. Guest i like the sentiment behind the persons tweet. Tire of the scrutiny of who is paying for what and where these donations come from. We focus on policies. I think it is important to look at what an organization advocates and out who their donors are. Host john on our line for democrats. Caller i am sure you tire about splitting the donor base. That is connected to our mockers see. To our democracy. I do not know a lot of people who worry about overspending more than theyre worried about redistricting, like here in ohio. Suppression is taking place and is real. It truly is suppressing votes in this state. Native support subsidizing oil companies. Employment andt food stamps. Children, older people have those needs. I do not think that you represent the people as much as you represent the largemoney people, the things taking place. You are against unions. They help the economy. Guest i think evidence shows states that have strong right to work laws, Healthy Business statess outperform the on the other end of that spectrum. Americans for prosperity looks at the research on state outcomes like that and we call it as we see it, advocating for free markets, labor regulations is something that is very important. Host our guest this morning is Christine Harbin Hanson with americans for prosperity. Joseph is on the line from florida. Caller good morning. Merry christmas. Are you there . Host we are here. Caller thanks. A couple of things. Im going to hit on one thing. You have these social liberals calling it and putting this woman down. Lets give it a break a little bit. We do not want to bus the bank or put people on the street. My mom is 78. These folks arent Social Security and need their cola. We have union guys calling up. Private votes. They are scaring companies overseas. Look at history. These unions close the companies. They said we have to negotiate tough with this company. We have to show them we are serious. They scared companies to go overseas. What came first, unions blocking companies . All kinds of perks. Come on. The lavish lifestyle of a union. I respect hardworking americans. That they are scraping to help our families, to pay our taxes. Do not call us the thugs. I own two companies. Come on. That 17yearold that i bring in that i train their first job. I have to pay them levin dollars or 12 or 13. Lets get people up. People are giving and giving and giving. Give it a break. We need a social safety net. Host we have to let you go. Guest i wanted to address one of the points the caller made, that we need a social safety net. That brings up another common misperception about americans for prosperity. We do not want to get rid of the social safety net. Towant congress to be able strike a balance and providing for some of the most Vulnerable People and also protection for taxpayers. Host mike is on our line for independents. Caller good morning. You guys are great. If americans for prosperity is such a grassroots organization, is probably only because the Koch Brothers can pay for a fantastic pr to convince poor people it is in their best interest to support these corporate policies. If you look at any of their policies and ask yourself, is this going to benefit corporate interest first and middle class and poor interest first, who is going to benefit from this policy . I think you will find it is the corporate interests. The argument is it they will invest in the economy and everybodys vote boat is going to rise. We know that does not work. Guest i work with a number of strong, hardworking people who are also committed to Economic Freedom. We are the real deal. Organizations like mine really want the best for reining in washington, making sure hard working americans can provide a good life for themselves. Host mike from virginia. Caller good morning. Host good morning. Caller the Koch Brothers may not be paying you a lot of money, but they are paying a lot of money for the organization. If they were to take their money out of the organizations, you guys would probably be on the streets along with everybody else. Guest there is nothing to respond to. Host ed is on the line from anaheim. Caller hi, my name is ed. Ian in my ross perot politics. Ross perot said if you find out what happened, follow the money. Lets talk about the big elephant. All those jobs that got sent to china and india and everyplace else. Spending have a tax problem but a taxcutting proble m. , wee did not cut, cut cut would not be talking about the spending issue. I think we all know. I am stuttering. I will hang up and wait for the response. Guest prosperity for hard working americans. Host that is all the time we have for this segment. We have been talking with Christine Harbin Hanson americans for prosperity with. Thank you for joining us. We will be back and joined by alex wayne to talk about the latest enrollment numbers for the healthcare law. And later, Charles Ornstein well talk about the Medicare Part d drug plan. First an update from the cspan radio. A new poll of iowa Voters Holding a bign lead in popularity among voters in the 2016 race. Has a 73 unfavorably ohiog among republicans. A majority of republicans said they have a very unfavorable view of hillary clinton. The poll is based on interviews with 650 iowans. 7. 3 argins of error are for republicans. Two prisoners have been transferred to saudi arabia after a security review. Both bands were considered to be at high risk of rejoining al qaeda. Made a statement that says in part, the United States is grateful to the government for its willingness to support ongoing u. S. Efforts to close the detention facility. The United States coordinated to ensure that these transfers took place with appropriate security assurances and in a way consistent with our humane treatment policy. The transfer brings the population to 160 prisoners at guantanamo. Those are some of the latest headlines on cspan radio. I wish you both a happy christmas. To greet you,re mr. Santa claus. Lets begin on thanksgiving day this year. Would you mind autographing some of the christmas seals as a special favor for santa class . I should be delighted. It is one of the things that i do best. [laughter] have, santa pen you claus. Me. Y father gave it to it has some of the dogs hair. Roosevelt if Edith Roosevelt to grace coolidge. Competitionnt cam wants to know what is the most important Issue Congress should address next year. Make a five to sevenminute documentary. The deadline is january 20. Get more information at studentcam. Org. Washington journal continues. Our next guest this morning is alex wayne. Out about thet Insurance Plans. Walk us through what it means. 365,000. Re up to about they are still about half the pace to reach this goal they had before the launch of the exchanges of enrolling about 7 Million People by march. They hope to get a big bubble of people this month to have coverage starting on january 1. Host how likely will it be they will reach that benchmark . Guest they have a long way to go. They do not use that 7 million figure very much anymore. Showing 11 had tried to get Health Insurance using healthcare. Gov. They said they ran into problems. How alarming of a stat is that for the administration . Guest i do not think it is much of a surprise. They knew there were problems into early november. That is why they launched the repair effort. They think they fixed a lot of consumer issues. There are problems communicating after you enroll and select a plan. They have to send a form and there is some jargon. They have had some trouble sending those forms. Host our guest this morning is alex wayne, Health Policy reporter for bloomberg news. Republicans, 2025853881. Democrats, 2025853880. Independents, 2025853882. Heard criticism coming from republicans and democrats. What are you hearing in terms of these latest numbers . Guest democrats are getting relieved the administration appears to have fixed the major problems with the site. A lot of people have a bad sentiment about healthcare. Gov. Statess bled over into that are running their own enrollment states that i work better. The have been lower enrollments in those states than they expected because these problems have stinged the entire system. The Administration Needs to work through that. Host has the administration said have a plan to restore Public Confidence . Guest they have talked a bit about a large Public Awareness campaign they are going to launch at some point. They have enlisted celebrities to promote the law, the lead singer of maroon five. He is going to try to convince people to sign up for the healthcare law. I do not know if having a favorite celebrity is going to convince people to sign up for Health Insurance. Obama got annt ie of the the la year. Walk us true what is walk us through what is true. Guest the president was selling his healthcare law and said if you had a Health Insurance plan you like, you could keep it. Do notthat award i fax ofwith politica awarding this lie of the year. People who had Insurance Plans theyre happy with are losing them around the country. We are not sure how many people are losing their plans. It could be hundreds of thousands to 4 million, 5 million. Andle are losing plans being forced to sign up for new plans that might be more expensive. It was and unfortunate use of words. He deserves some criticism because he used that phrase to public. Law to the this law is not going to affect you and in fact it has. Host st. Louis, missouri, from brenda. Caller hello . Host good morning. Brenda. My name is which one would you get on . Would you do the Affordable Care act . Is there medicaid or medicare . Guest it depends on your age. Caller i will be 60. Guest you are not eligible for medicare unless youre disabled. Depending on your income, you sign up for the Affordable Care act programs or medicaid. If youre of low income, either medicaid or an Exchange Plan is going to be very low cost and perhaps even free for you. Caller thank you very much. Host question on in email this morning from ron. Guest that is a great question. They are not enrolling as many people as they would like to. 50 ,ntire country is about half the pace they would have needed to be at to reach the 7 million goal. It is safe to figure the states have signed up about half as many people. Michelle in minneapolis. Caller good morning. The subsidies. Two spots there are that say people do not get a subsidy through the federal exchanges. Only if their state has created the exchange. Everybody gets out there and says it is so affordable because you will get the subsidy. What will happen if the people in the states did not create their own exchanges . The people that live in 37 states may not qualify for any subsidy. We are talking about the people supposedly can qualify for a subsidy. That is going to hit the fan. I work for a large company. I cannot imagine what is going to happen next year when Small Companies start kicking people off their medical plans. Thank you. Is the subject of a couple of lawsuits that are working their way through the courts right now. The Obama Administration has been sued in states covered by the federal exchange. The subsidies are only available in states that run their own exchanges. What the administration has said and they are backed up i democratic members of congress and the congressional budget intent of congress was to make subsidies available everywhere, regardless of what the law may say. There was a regulation that makes the subsidy available across the sky and he. You can sign up for insurance and get subsidies in 2014. We will see how these lawsuits turnout. They probably will not be resolved until the next Supreme Court term. People in states covered by the federal exchange can rely on subsidies for at least this year. Is going to be some problems with the law. Congress may have to rewrite it. We may is not possible, have an Effective Health care intem or Affordable Care act states that choose to run their own exchanges. Host Kathleen Sebelius was questions about enrollment numbers last week. [video clip] 360,000oncern is the number is fraudulent because it is not those who have purchased plans yet. Thoseou return, give us who have purchased plans. We did not take over the private insurance market. People will purchase from insurance i have told you who has enrolled. That is why we are frustrated. Host your response. Guest he is attacking the way the administration defines enrollment in the healthcare law. Enrollment ifrted you select a plan and you put it in your shopping cart and leave the site, they consider you to have been enrolled. That is not the last step in enrollment. The last step is you pay year ensure. You make that payment directly to your insurer. They have been reporting numbers to us about people who of selected a plan and put it in their shopping cart. Host robert is on our line for republicans. Robert, are you with us . Go ahead. You are talking with alex wayne of bloomberg news. Anyone i do not see have could think that this is going to work. By any means. The guy can sit here and make ok. Ses why things will be a certain class that gets i do not understand how he can defend himself. I am a little nervous. What i am saying here host it sounds like we lost him. Guest i dont know if he was talking about me. I am not here to defend the law. Generally it was intended to address a problem in the country of 48 million uninsured. It has some operational problems. We will see how they sort out. Host question from twitter this morning. Guest that is a great question. It looks like they will wind up enrolling fewer people into the Affordable Care act then will lose their plans that they had before january 1. We may wind up with a net loss of coverage, which would be a practical problem for the administration. Host michael is on a line for independents. Caller ys, good morning yes. In relation to the state now we have one Insurance Company which is blue cross, blue shield. States that are instituting the exchanges, trying to entice other Insurance Companies to join in the exchange, particularly in the states where you have only one insurer, which kind of the feats the purpose because there is no competition. Massachusetts, the system first started with a great deal of issues. Basically once those issues were ironed out, health care was top notch. Massachusetts is one of the great states of the health care program. Hospitals and doctors, the denial of insurance almost one away within the first year. I have my treatments that i required. They are trying to have insurers two. Only one aror guest the administration has pointed to massachusetts. This is a six month period. They have until the end of march to and role. They say look what happened in massachusetts. They started slow. Of itsusetts has only 3 population uninsured. They were the example of where this can work. As far as competition, new insurere has only one and their other states in a similar situation. I think West Virginia only has one ensure. Insurers have been attracted to states with large urban centers. New hampshire doesnt have a lot of large cities. One thing they have done to create more competition. There was some money put aside to fund Insurance Companies in every state. They have scaled the money back. There is only about 24 of them. I do not believe there is one in new hampshire. If they are successful, perhaps they will move into new hampshire. Care lawn the health first started out, with heard about the technical holdouts it difficult for people to get in. Guest the problems with the consumer side of the website have largely been fixed. We have a difficult these as reporters judging that. We call these navigators to help people and role. Enroll. They use the website all the time. We call these organizations and ask how it is going. Late november, they said things were Getting Better. Now they are pretty much able to use the website without too many problems. Durham, North Carolina on our line for democrats. Caller good morning. Point on your a behalf. You are talking about millions of people. That is a lot of people to have to put into this new system. I think people think it is supposed to happen overnight. Like bill gates putting windows together. It took a while to get it right. Medicare. Get i do not know how it compares with whatever plan was available for the Affordable Care act. A woman said she might qualify for a program in which you might have to pay anything. They are paying 80 on medicare. The other part would come out of your Disability Income. They would have to find you some other plan. The whole thing about medicaid, it is different statebystate. The only way i can get medicaid, the money i am paying out adds up to a certain number. Or he could be 100 on my Disability Income every month. I have a cousin that has disability as well. She only worked half her life. She is on medicaid. I have worked a lot longer with medicare. The premium comes out of my pay for the medication portion of it. I have not heard other people talk about it. Other other plans for people who get medicare that we can pick up some in the Affordable Care act in the programs you are talking about and maybe not have to take money out of our premiums, which we need that. Guest if you are eligible for medicaid, that makes you ineligible for subsidies on the exchange. You cannot buy an Exchange Plan and get a discount. Eligibility for medicaid is extremely low in North Carolina and other states that have chosen not to expand. If your child is an adult, generally youre not available for medicaid. That will not change in North Carolina. If youre a childless adult and earn less than 100 of the federal poverty level, you are not eligible for medicaid or for subsidies on the exchange, i am afraid. Host we have a question on e mail. Guest no, hes not. He has not ordered insurers and state to restore those policies. Tohas asked them nicely please extend those policies for people that would otherwise lose them at the end of the year. There has been a variety of responses to that. Some states have refused. E a not going to let people continue with these plans because we need them to join the presents in order to what they call a good risk profile. Of peoplea good mix in the exchange. A lot of those people are pretty healthy. You need to be healthy to get on an Insurance Plan. The president s requests has been met by a variety of responses. Host gordy is on the line for republicans. Caller hello. Host good morning. Caller when the Affordable Care act was being debated and when it was rolled out, i just heard through a couple of sources that clause in obamacare at the federal level and that the whole program as it was set up would be turned over to the states. I never heard much about that since. Is there any truth to that . Guest there is a clause that allows states to get out of the Exchange System starting in 2017. They can create their own Health Reform plan however they would like to do it starting in 2017. The plan has to cover as many people as the Affordable Care act would cover. The only state that is planning to do that is for mont ve rmont, which wants to go single payer to cover everybody in the state. Host and a question from twitter. I know. O, not as far as host david is on the line for an dependents for independents. Caller if you could, about the quality of health care. Havercial base insurances whittled down providers, doctors, nurses and to reimbursement and contracts using loopholes and antitrust laws and getting very little reimbursement. That has caused these offices to double or triple up on seeing patients. A medical provider cannot possibly effectively think about a patient well enough in order to get things right the first time. E have the Affordable Care act the government has the relative value. That has become the gold standard. State insurances have pickup the fall and trying to do what the relative value is. Used to have insurance you may be managing some of the plans for the state employing the same old shenanigans in whittling the providers, especially community providers, which increases access to care. Me oran your speaker tell foresee some of the policies or if he can direct me to some of magazines orks or the policy thinkers, what can he tell me about how deficiency is going to be maintained when you have commercial insurances doing what they can to cheapen the relative value of the medical service . Guest of for like the caller might be a medical rider. You raise a great point about access to care. The healthcare law is supposed to cover a lot more americans. Just because you have an insurance card does not mean you can see a doctor. We will start looking at how good the access really is. A lot of these plans have they have a narrow set of doctors and hospitals youre able to see with your new insurance card. It remains to be seen how the public will accept that. There were things back in the 1990s called hmos. They are still around. There was a backlash against a Narrow Network of providers. People wanted broader choices of health care. That is where you got the ppos, because of the backlash. Hmos. Ans really resemble lets go to lisa from kentucky. Caller hello . Host good morning. Have been living with my significant other for the past 10 years. It is his home. During the course of the 10 years, i have been taking care of my elderly parents in North Carolina. I have been watching the difference and how the Health Care Laws have taken states in the different states. One governor is trying to cut everybody off. Now i am stuck in a quandary. In 2008 and my mom last spring. My significant other has decided to end the relationship. I have to move back to North Carolina to my sisters. Housewife. A i heard you tell the lady from North Carolina that i would i know i am not eligible for medicaid down there. I would not be eligible for subsidies. Will i be stuck paying fines . Guest no. , youu dont earn enough will be exempted from the individual mandate penalty. You wont have to pay that. In North Carolina, you will have trouble finding insurance unfortunately. Host south carolina. Republican line. Has beeny husband trying to enroll in the Affordable Care ever since october. Onhas constantly had errors his file. He cannot complete the process. I am wondering if there has been any investigation into this the selection criteria to determine eligibility and complete the process. Has preexisting conditions. I feel like there is some type of selection criteria that does not allow him to enroll. Due to his status. Could you comment on that place . Guest that is not the case or should not be the case. Entire point behind this law is to allow people like her husband to get insurance even though they have preexisting conditions. It is now illegal for insurers to refuse coverage to people with preexisting conditions. You trysuggest resetting the application. The government added a feature just a week or two ago there now should be a reset that in somewhere on the screen when he goes into his application. Just start over from scratch and try it again or call the health help number and see if they can walk them through it. Host over the last couple of days the administration has announced more parts of the rollout that will be delayed. Can you talk about those . Guest sure. Getting hard to keep track of all the delays. They have delayed an Insurance Program for Small Businesses. It is called the shop exchange. It is not available right now online. You can sign up through brokers or over the phone, but you cannot use the website. They have extended an Insurance Program for people who are very ill. Those people joined the pre existing conditions Insurance Plan back in 2010. Whos designed for people are sick and could not get insurance from commercial insurers. They have extended that through the end of january to give those folks more time. They cannot go a month without coverage. Host oklahoma city, oklahoma. Independent line. Caller i was calling to find out the president decided there would be a list of required items that everybody will have, nobody gets an option, this is the one and only plan that everybody will get and then you have for Payment Options and different deductibles. What uv what if you have religious objections to anything on the plan . Will the federal government create an option . A person of faith, do you have to choose between od . Ernment and got g what is the federal government going to do . Exemptionre is an from the individual mandate penalty for people whose religious faith forbids them from carrying insurance the abortion issue, which i think its what youre probably talking about, is a little trickier. Law if you exemption dont support abortion. Republicans have asked that the administration make it clearer which plans actually cover abortion and which ones dont. I dont think that is very easy information to get as you were signing up right now. Im not sure whether the administration has made that more transparent. Host a question from twitter. Guest sure. The United States spends more money on health care than any other country in the world and doesnt get Better Outcomes than most western european nations. Cost is an issue. The administration has pointed to data showing a pretty dramatic slowdown in the rate of growth of Health Care Costs. They are not going backwards. For sure. This healthcare law, for all that it does to try to expand coverage, the things that does on the margins to reduce cost ash we dont really know how much of an effect they have had yet. How much of it is retired tied to the recession, putting off Health Care Services and how much of it is tied to the Affordable Care act. Host West Virginia. Democrat line. Caller good morning. There is a serious problem. I dont know if you are aware of it on Medicare Part b, supplement plan. I dont know if you have ever known this, but it has been this way for years. If you got a supplement plan with these companies they have to give you coverage when you first sign up in your initial signup period from october to november when you turn 65. If you want to switch companies after two or three years because of the price being different, so you want a cheaper price, the company you try to switch to has the right to deny you for pre existing conditions and that is underwritten in the guidelines the Insurance Companies have and it has been that way for years. Nobody is going to address that problem, so i am trying to bring it is somebodys attention. If the aca says it is illegal for Insurance Companies to deny you with preexisting conditions, but medicare has got it in there, it needs to be fixed. That is what i wanted to ask you about. Guest there is no medical underwriting, as far as i know, in medicare. I dont think private insurers are able to deny people with preexisting conditions coverage. They wind up denying most medicare patients coverage. Host pleasanton, california. Democrat line. Caller hello. This. Een listening to there is a couple of things this guy said that bother me that bothered me when i first heard it. These startup Insurance Companies that are supposedly being created being created by whom . Those sound like a scam. Like the house mortgages. These organizations are a few people selling a mortgage to somebody, but the Financial Company that had to approve it they were just skimming people. People. Ing i am afraid that these new private Insurance Companies, so called, are going to end up being the same thing a big scam. Where are they getting the money to cover these Health Problems of the people that are signing up for them . , it still sounds to me like the current major insurance panies have their plans they divide up the least expensive and the most expensive into different plans. How was anybody supposed to know what kind of illness they are going to have tomorrow or next week . Sick and this illness is not in your plan, they could deny coverage. Also, the costs are not going down. Overall, the insurance costs are going up. Guest the caller makes good points there. The cost of health care is not going down. Nothing in this law has reduced the cost of care. What the Administration Says is that the slowdown in the growth of Health Care Costs we have seen over the last few years is somehow tied to the law. We dont have any agreement among healthcare economists about whether that is true. As for the startup companies, theyre getting money from you and me. It is loans from the federal government to private organizations, nonprofit groups basically, who are launching these companies. People are right to wonder whether they will exceed. Health insurance is a competitive market. It is difficult to be a start up in that kind of market. We could well see some of these companies fail. Taxpayers could lose money if that happens. Host we are talking with alex from bloomberg news. Tim on our independent line. Caller i have a comment and a question. Comment i think the biggest problem with the Affordable Care act is taking away our freedom of choice. You are telling us we dont have the choice to go to the doctor we choose because we are not enrolled in the plan. Revenuetion is how much did they anticipate making on those that dont enroll on the fines . I donthe fines have the number right in front of me. It is a significant figure in the billions of dollars that they expect to collect from people who refuse to take insurance. Is 95 or oneyear percent of your income whichever is higher. Host ohio. Democrat line. Caller a comment. Im a democrat. This Healthcare Program is going to work. Now, im a medicare recipient for disability. I have Medicare Part b. Medicare part b is going to work. I dont foresee any problems. I havent really dealt with a supplemental insurance and i dont see why they just cant have some of these Exchange Programs where you can walk in and somebody could help them out when they have trouble. The deficit and relieving the debt to the kids i believe the president is doing the right thing by creating the Affordable Care act to cut into the national deficit. Car people have to have insurance, so why not have Health Insurance . That with the government wont have to worry about the indigent. Guest i will take the contrarian point of view. The thing about Car Insurance you hear that analogy a lot there is nothing in the law that requires you to buy a car. It is not a perfect analogy. Host one more question from twitter. Guest yes. You could do that. You could get insurance by doing that. It is not a terrible idea. The only thing that come might come back and bite you is that in 2015 when you file your taxes and you dont have the income you said you had, you may have to pay back the subsidies you got before. Jack in wilmington, North Carolina. Independent line. Caller good morning. I have been sitting here watching this segment and i just want to say, first of all, i am extremely impressed with your knowledge on the range of questions that you have taken your this morning and answer them all admirably. I would also say if i was there, i would take you out to lunch after this because i feel that the work you have done answering these questions has just been impressive. If in fact you were an Affordable Care act apologist, i would also say i feel you have been very honest to the issues. You have not sugarcoated anything at all. I think you have a great job. Done a great job. Up my question is i understand recently i came across a piece with there was the largest of carriers pulling out of large markets like california, for instance, and considering that this is a policy or rather a law that the Insurance Companies have had a big hand in writing, i wonder if you could speak to if that is something that the aca does in fact have some control over and what you think might be the inevitable outcome of all that. Guest sure. You are right. A couple of the big insurers United Health care have decided to sit out the first year of the Affordable Care act. United health care is only participating in 4 or 5 states. They want to see how this all sorts out. There are a number of insurers who are still in the game. Etna has gotten into the exchanges in a significant way. Blue cross blue shield plans are involved time. Big time. Wellpoint also has a huge stake in exchanges. Some insurers all sitting on the sidelines are sitting on the sidelines. Host that is all the time we have. We have been joined by a Health Policy report are from bloomberg news. We will take a quick break. When we come back charlie will joinf propublica us to talk about the Medicare Part the drip d. York democratic senator Chuck Schumer speaking earlier on msnbc said it is safe to say that a compromised budget bill avoiding the Government Shutdown will pass the senate this week. He went on to say that most members of his party will back the 85 billion legislation and at least for republicans will join him on the passage. Mitch mcconnell wont let the legislation go down. They want to get it to the president s desk before lawmakers break for the holidays. Republican leader Mitch Mcconnell wont let that legislation go down and you can hear live Senate Coverage at 3 00 p. M. Eastern on cspan radio and always on cspan 2. Smore economic news. Of the Labor Department says productivity increased at a numeral three percent annual rate in the third quarter. That is up from an initial estimate. Pace since thest end of 2009. Rose because Economic Growth was much hunger than previously estimated in the third quarter. Productivity is the amount of output per work hour. Labor costs fell. Inflation is rate staying low. Disrupt ors to prevent nearly 150 shootings or Violent Attacks in part christ steering gunmen to Mental Health providers. Ofmall fbi unit is based out quantico, virginia. That is some of the latest. Im standing in front of the 1905 wright flyer three, the practicalrst airplane. Was constructed and flown in less than six years time between the time that they built their kite and the success of this particular airplane. This is also a plane that was built less than two years after the first flight at kitty hawk North Carolina. What is interesting to think about is that the wright flyer flu four times on one very historic day. The airplane behind me, the 1905 wright flyer three, was capable of repeated takeoffs and landings, repeated flights for upwards of 40 minutes by october 1905. This airplane could fly graceful circles, figure its, it could bank him in turn, fly very much like a modern airplane flies. Us is very much a modern airplane, capable of being controlled through three independent axes of flight. Is more from Wright Brothers Aviation Center next weekend as booktv in American History tv look at the history and literary life of dayton, ohio. Washington journal continues. At this time, we take a closer look at how your taxpayer dollars are spent. This week, our focus is on Medicare Part d. Joining us is Charlie Ornstein from propublica. Partin to us what medicare d is and how it operates. Guest sure. The Affordable Care act is complicated. It Medicare Part d is more narrow. It is the Prescription Drug component of the medicare program. About 36 people 36 it helps subsidize their drug costs. It is hard to believe that it was just a decade ago that if you were old or sick, you were really struggling with your Prescription Drug costs. You are deciding whether you could pay our rent, buy your food, pay your car payment, or whether you would buy drugs. S is how to really be a alleviate those choices. Host about 60 billion spent on this program in 2012. Providehat goes to payments to insurers to provide drug coverage under Medicare Part d. Government, but it is controlled by Insurance Companies. They bid each year to provide coverage for people in different parts of the country. People have the choice of choosing a Medicare Part d plan. The government plays an amount of money to subsidize the cost of everybody who has Medicare Part d, especially those who have low income, they get a much bigger subsidy. Drug tossedhose exceed several thousand dollars. Host Charlie Ornstein of propublica. It if you would join the conversation. 202 5853881. Democrats, 202 5853880. , 202 585 doctor 3883. Independents, 202 5853882. What made you get involved . Is 10 years since Congress Passed the medicare modernization act. We became interested in the way that doctors prescribe drugs. When we started covering the payments that Drug Companies were making to doctors for speaking and consulting. Drug companies have had to settle big lawsuits against them. As a condition of the settlements, they agree to publicize the amount of money there were giving to physicians for speaking, consulting, meals. The bigger question we had is do these payments influence the prescribing . We wanted to get at this issue a prescribing. Medicare reimburses for 1 out of every 4 prescription for in this country. We filed with the freedom of information act. Were several months, we able to get some aggregate information on all of those doctors. We created a tool called prescriber checkup. We found that doctors across the country prescribe drugs in very different ways. Normal,them are explainable variations and some of them are not. There appears to be a lot of inappropriate drugs being prescribed to seniors and the disabled and doctors who may not the prescribing in the most costeffective ways. Host our first call from texas. Democrat line. Caller hello . Thank you for taking my call. I am on medicare prescription d. They claim the doughnut hole is disappearing. It is kind of confusing when they say that. People think they will say less. Next year, the doughnut hole will start at 2800. I am a diabetic. Nott my insulin and i did know the doughnut hole included what you paid plus with the par missy paid pharmacy paid. When i got the insulin, it was 853 dollars that the pharmacy paid. I had to pay 500. My insulin started costing me close to 500. Continue getting worse. I am retired and i am on disability. I cant afford those kind of prescription costs. Youed to know would explain to people that that doughnut hole is going to make our prescriptions go up. On top of that, the pharmacy my pharmacist told us i could go to canada and get the drugs cheaper than i can year. Would you please answer that. Guest sure. A whole lot of questions. The doughnut hole is the part of Medicare Part d when after you have a regular amount of 2800, youhen unit are responsible for in much greater portion. When you were in the doughnut hole, you used to have to pick of the cost of your medications until you came out on the other side. Under the Affordable Care act, that is being reduced. In 2020, you will not see that added amount. Right now, if you took a brand name drug in the donor hole doughnut hole, you are responsible for 40 of the cost. A generic drug, you are responsible for 72 . With insulin, that will be very expensive. That will be paying a lot in the doughnut hole and out the other side. Some people do go to canada for the drugs. There are different programs that focus on that. I would also encourage you to look into whether you may qualify for the low income help. Y, also called extra it is a component it will provide reduced premiums and copayments for people whose income is low enough. If your income does not qualify, apply fornt to pharmaceutical programs. Call from tupelo, mississippi. It democrat line. I would like to know host are you still there . Caller yes. I would like to know why the claims keepe part d going up and why they not only go up, but they are adding co pays to more and more startedons when part d the premiums were low. Each year they go up. Land ent up 20 plan went up 20 for next year. Could you help me out . Is an important question. Consumers have choices within the Medicare Part d. If they go to the governments website during an open enrollment. Period, they can choose from dozens of plants in the area. They have monthly premiums that rates from 15 to 140 in some places. A lot of people make the mistake of saying staying in one plan and not comparisonshopping from yeartoyear. Then you lock yourself into the plan and the costs keep going up and up. It is important to check every year, because plans increase and the monthly premiums. They could increase cost sharing for particular drugs and they may take drugs and on and off the formularies. Sure to compare it comparison shop from yearto year. Analysis has shown that seven out of every 10 medicare recipients over a four year period did not switch many of them are not getting the best value for themselves. Host we want to go to a question from twitter. Guest i dont have a total number for the duration of the program. The program started in 2006. The Medicare Payment Advisory Commission estimated that the outlay last year was about 62 billion. That has been going up over time. The projections for medicare over the course of time come in below estimates. Not as many people enrolled as anticipated. A lot of drugs have gone off patent. There are now available generically. Not as many drugs are coming on the market. Both a combination of not as many people enrolling as well as big cost brandname drugs going generic has led to the program coming in below average. Host birmingham, alabama. Republican line. Caller i wanted to know i wanted to ask a question about who getS Health Care or not. The prices seem to be going up and up. Guest Medicare Part d is only available to people who qualify for medicare. That is if you are over 65 or you have disability. Some people who are in Medicare Part d are dual eligible. Meaning they run medicaid and medicare. Open to the general public. It is not open if your drug costs are superhigh and you want them to go on down. The good news for the general public is that a lot of big name, very expensive, brandname drugs are losing patent protections. There is a huge patent cliff. You may have heard of lipitor. That went off patent. Plavix when off patent. Ofn that happens, the cost those drugs go down in whole lot. That is helpful to people who were not in Medicare Part d. Theyre able to buy these medications generically and saving a lot of money. Host our guest is Charlie Ornstein with propublica. Is there a baseline way to tell just how much lower income people who are in Medicare Part d pay for their prescriptions . Guest Medicare Part d for low income medicare picks up the monthly premium if you are in certain plants to qualify. When you are in it, typically you will not pay more than 6. 60. In this lowre income subsidy, they tended to use much more brandname drugs than people who were not on the low income subsidy. The reason for that is that they do not have the incentive to ask the physician to switch them to a generic drug. The cost of programming a lot of money. One los angeles. Your who treats almost exclusively low Income Patients who spent 10 million in one year. On an individual doctor basis, there is huge potential for savings. Massachusetts. Independent line. Caller good morning. I will be the holiday scrooge. This is a perfect example where people demand controlling a federal spending. It when it is for them, especially the elderly, they dont see that as wasteful or something that should be addressed. B d the republicans did that to good elderly votes. They never paid for it. It is a kinship contributor to our deficit. It is a hypocrisy. Most of our spending goes to the elderly and their stealing from our younger generations. They dont seem to get that. Guest i think you are right. What is interesting about , it was part d president george w. Bush and the Republican Congress to see that this law was passed over democratic objections. Democrats supported government for seniors. Ugs but they wouldve done it in the government away. This was a republican run program. To imagine a scenario today where you would see republicans pushing for an Entitlement Program that would cost the government tens of billions of dollars per year. I think you are totally right. Host a question from twitter. Guest well, but this is medicare. Those are two different things. Disabled, a senior or you can sign up for medicare drug coverage under Medicare Part d. If you dont get coverage from your employer, you can sign up for a plan under the Affordable Care act on an exchange. Those plans have to cover drugs. Mandatory benefits under the Affordable Care act is that all plans have Prescription Drug coverage. That was not the case before the Affordable Care act. One of the reasons the Affordable Care act was passed is to ensure that all plans to provide coverage for Prescription Drugs which they had not been in the past. An of ,r next call from florida. Independent line. Caller good morning. I had a couple questions. Idea what they current unfunded liabilities dollar figure is for Medicare Part d and medicare . Two tommy did medicare users expect free medical care . Caseu know about the court with the Supreme Court said that you had no legal right to your Social Security donations or contributions . I would like for you to talk, especially about the third question. Thank you. Familiar with that case. I will look into it. I think that the way that medicare was created folks who were seniors would be entitled to a certain level of care. You are entitled to it under the law. Medicare part d works differently than the other parts of medicare. Part a and part b are government run and are funded through the Medicare Trust fund. Part d is taxpayerfunded. It is not something that is affecting the life of the trust fund, as far as my understanding of it. People pay their premiums for it. It is optional. You can sign him for Medicare Part d or you have the option to not sign up. If you do not sign up and then you later have drug needs, you pay a penalty for not signing up. Whenwant you to sign up you dont, so that you can help subsidize the cost when you do. Host our guest is Charlie Ornstein with propublica. Roaring river, North Carolina. Identifying as a Medicare Part d dr. Or recipient. Caller i am a recipient. Thanks to cspan. I just recently, after four privateof being a eligible for medicare, i get tickled at people getting confused about the aca. Once you start with medicare, then you get confused. You mentioned canada and i have been listening to cspan this morning. A quick question. The medical look at insurance in the United States, dont you think it is time we look at canada or britain . Guest that is a tough question. I want to do with one of the things he raised first. The complexity of Medicare Part d. It is complex. Particularly for seniors with Chronic Health conditions or if havere disabled and overriding health issues, to go online and enter your drugs and search between several dozen health plans and choose the one right for you and remember to check that every year during open enrollment into switch plans that is a lot to ask somebody. I know i has served as a helper with in my family to help relatives sign up for this. Every year i find that people rely on me to enter their drugs into the system, to enter their pharmacies, to find a plan that is right for them. Fortunately i have that knowledge and i have the time and i want to help my Family Members. Not everybody has a Family Member like that. Theres a lot of confusion. Seniors end up in plans that may not be right for them. As for your question about canada and the u k, it strikes that wethere is no way already politically as a nation to have that conversation. We are having a tough enough time discussing having an individual mandate in which people have the requirement to buy coverage and it does not seem that even the democrats and liberals in this country are not really beating the drums for a singlepayer or a Government Run Health Care system as you see in other countries. A question via email. Explain the penalty of not paying an Insurance Company for drug coverage, then meeting up at a later date needing it at a later date. Turn 65, youou have to unroll and medicare unless you have insurance through your employer or a retirement plan. If you are still employed, you would wait and then get your Medicare Part d coverage when you retire. Point, you do not sign up for Medicare Part d after your open enrollment. Period, i believe that every month that you do not have that coverage, you pay a certain percentage. 1 per month. That can add up. That is tacked on if you do sign up. They do not want everybody to sign up when they need expensive drugs. This is supposed to be a pool. To oneall contributing another costs. While you may be healthy today, to more you tomorrow you may be on very expensive drugs. Host North Carolina. Independent line. Im a 67yearold with a disability. Every year for the last 2. 5 years, since a qualified part get billed every month from a certain Insurance Company that says i was put on the program by medicare. I dont use the company, they have no record of me ever using it, but yet every year they say we need bills and we are billing you 36 per month for your drug coverage. They are taking it out of my Social Security. Why would that be . Why would i need the Medicare Part d if i am 100 connected to the v. A. . Guest if you are 100 Service Disability enacted and you get your drugs through the v. A. , you would not need a Medicare Part d plan. Perhaps you were added during a session some years ago or you had an Insurance Agent come to your home and you signed a document which signed you up for Medicare Part d. If that is the case, you should medicare,are, one 800 explain that you want to be out of this. Word enrollment key period ended on december 7. And next year,it during the open enrollment period, call up and tell them you want to disenrolled from the Medicare Part d plan. Or you could be in a Medicare Advantage plan which covers both your Health Care Needs as well as your Prescription Drug needs and that could be what this premium is for. If it is just a Medicare Part d plan only, you should call one 800 medicare and see what you can do. Richard in north dakota. Republican line. Caller yes, thanks for having me on cspan. My question is that a lot of the other countries who have socialize their health fall under having one national , which it ispany illegal to make a profit, and then the bills are divided among the citizens and everyone pays supposedly the same rights. Our problem seems to be that we have kept the big money going and the Insurance Companies have not come up with a real way to address the bills that people cannot afford in their health care. Another thing is that there has been no explanation after once this starts and you can into the exchanges how do you cancel it if you lose your job . If the government or irs just going to keep adding on bills that you cannot afford to pay even if you do not use this coverage . There are a lot of unanswered questions. And my incomeoyed taxes will go up over 5 from being five percent. Unemployed. I think this is an attack on Small Businesses so that we can not with big corporations. Money out tong our Insurance Companies. I have never been to the doctor. I had to go into the doctor when i was in the military for some dental work. I am 45 years old, i have been selfemployed for 24 years, i have never been to the doctor. I would have had to pay these insurance premiums, i probably would not be selfemployed and be a Business Owner today. I think this is an attack upon our free system. It is or straight it orchestrated by for individuals the government to keep individuals from having anything more than a job at walmart. Made aernment has shambles of the system that they have run already with the lotsyers dollars going to of drug addicts that were produced from the hospitals and doctors. Tot unfortunately we have let you go and give charlie a chance to respond. Guest two points. With socialized medicine, it is not necessarily run by an Insurance Company. It is run by the government. Are not paying premiums. It is a right of citizenship. That is not the system we have in this country. Access tooes offer in the country and that was decided in 1965. The question about losing a job under the Affordable Care act theyre able to change the insurance policies or drop coverage if they have a change a major event in our life their life. If somebody had a wellpaying job and they have gone to becoming completely unemployed, they are able to go and potentially qualify for subsidies under the exchanges. They dont have to just stick it out for the rest of the year of something major happens. There is opportunity to make changes. Host i wanted to go back to the role of doctors here. What percentage of doctors a regularly giving out brandname drugs and what connections did you observe between them and the pharmaceutical industry . That the reality is people should be concerned about the drugs that doctors prescribe. Here was a huge variation just because a doctor tells you that you should take a drug, that doesnt mean you should do a research research. We found that doctors who were statistically different from their peers the prescribed drugst a rate rugs that was that a deviation from their peers 50 of them have financial relations with pharmaceutical companies. By comparison, doctors who did not fall into that disproportionate group only receivedose doctors similar payments from the Drug Companies. Doctors who used a lot of brand name drugs were much more likely to have relationships with Drug Companies and doctors who did not. Fort smith, arkansas. Republican line. Thatr you hear people say they must know their doctor and if they dont know who the doctor is, they cant trust him and so forth. On the jumbole get jet, 747 with 400 injures and fly over the ocean and they dont know who the pilot is. Why dont they organize their Health Care Just like they did with the faa and doctors can be government workers and get paid a reasonable salary . That way it helps out some of the unemployment problems and help out with the health care. They could have a national lottery. To get it off the ground and get it running because of the economy situation like it is today. A lot of emphasis on rates for risky lies like motorcycles and people who smoke. We shouldnt have to pay the same rates as people who have risky lifestyles. Guest let me address that first under the Affordable Care act, there are different rates for people who smoke and dont smoke. States have the right not to charge different rates. Your first question about aviation, youre not the first person to suggest that there are some connection and that health care can learn from aviation. In aviation, you have checklists. You have systems that are designed to provide extra layers of protection in case a mistake is made. They have to run through checklists before operating the aircraft. They have to inspect certain things. A girl through these things before they fly. Health care has been a late adapter in that regard. On, somebody was operated there were a lot of mistakes made in the operating room. They have now instituted timeouts, were before surgery is done, everybody takes a pause. The make sure they have marked the right organ to be operated hasthat anybody in the room the opportunity to stop the surgery for any reason. We are still learning from aviation. Theres is probably a lot that we can learn. They have a lot of builtin safeguards. We all have to be active consumers. Asking the doctor questions. Not be afraid to ask questions about things we dont understand. If your doctor has different prescribing patterns than his peers, you should be empowered to ask questions about that. New york. Democrat line. Caller good morning. My comment has to do with the doughnut hole. First, thank you for cspan. It serves a Tremendous Service to us listeners. True facts without too much bias. I have supplemental insurance through my union that would cover expenses on my Prescription Drugs beyond what coverage i had before. D,e i was on Medicare Part you hit the doughnut hole, there were something in that water that says you cannot have coverage to cover those extra expenses. I dont understand why that is in effect and why you cant purchase a separate insurance policy to give you coverage when you hit the doughnut hole and all of a sudden you are dumped into this i cost. Guest excellent question. For Medicare Part a and b, you can buy a medicare supplemental policy. It helps plug the hole. When you are in the hospital and you have to pay to dr. Bull of deductible of a 300 per day, it will pick up the costs and the copay for a physician visit. Cannotcare part d, you pick up an overlying supplemental plan to pick up the cost in the doughnut hole. You cannot buy another layer of insurance to pick up extra costs. I dont know the reason why that wasnt created. Of supplemental plan related to drug costs were not allowed under the act. Prescriptiontioned patterns of doctors. If i may health consumer, where do i find that information . Guest it is not something that medicare makes it available to patients or doctors right now. You can see the results we got by going to propublica. Org checkup. You can look at this in a number of different ways. Type in the name of a physician, look at a state name, clicking on the state, clicking on a specialty, looking at all the doctors in that specialty and state. Or look at it through a specific drug. Say you are a patient or a religion of a patient who has a Mental Health condition, you can see the percentage of times that a doctor prescribes an antipsychotic drug, for schizophrenia or bipolar disease, december and to someone over 65 as compared to their peers. These are not recommended for patients with dementia. If there prescribing at a rate higher than their peers, that may give you pause. Similarly with narcotics. Finally, if there are drugs the American Geriatrics Society they have a list of drugs that are potentially inappropriate for seniors. We have taken that list and match it up with the database to look for the percentage of every doctor and other Health Provider who fall on that list and how that compares to their peers. We offer some metrics to take your provider and compare them to others in their specialty and state. Toledo, ohio. Independent line. Caller hello . Thank you for taking my call. I hope i can get everything in that i wanted to ask and i will be quick. I just heard a young man speaking about how Senior Citizens are getting money from the government and he acted as though we were freeloaders. I hope he can be reminded that most of us who worked at least 40 years we paid into both Social Security and medicare and some of the money we are getting back his money that we paid. They also need to note that we are still taxed on our Social Security benefits and we still pay a premium of our Social Security check it month each month to medicare, even though we are being retired. 100 six dollars per month, plus i have to pay my retirees Health Insurance it alls and when i add together, i am paying over 300 per month for my health care. The other issue that i found after i retired about five years ago is fraud. I had a doctor who was a podiatrist who will meet trimmed andnly trimmed a toenail Social Security and medicare were charged a fee for toe surgery. I think someone needs to look into it the billing practices of some physicians. Those are my comments. Guest i think your point about how much seniors have to pay for health care is still a very legitimate one. If there is a copay for being in medicare. Then you have your Monthly Payment to be in Medicare Part d. Then you have the copayments that you spend for your outof pocket drug costs. If you have a medicare supplemental plan or a medigap policy, you are paying for that. It can add up to hundreds of dollars. And yes, the government is spending more at of the Medicare Trust fund than it is taking in and we do face longterm issues about the sustainability of medicare. As far as fraud, this is a huge, huge problem. It is a huge problem. We have heard from people who have looked at their explanations of benefits that we taking set, i am not this drug, why is there a record that medicare is taking this drug for me . If you see a problem, call medicare or you can feel free to drop me an email. We help people to look through these things. People lookingof for fraud. You should keep an eye out for that. Host our last call with Charlie Ornstein of propublica is from ohio. Independent line. Caller i wanted to talk a little i was in a large industry that was an International Company for a long time and i had a back injury. I am on the flipside of that coin now that i am part of medicare, because im going through two major back surgeries. It is two totally different worlds. Partf the reasons medicare b was even brought up is that elderly and disabled were paying high cost when it came to medical bills and it was very unaffordable. What about all the drug pushers . All of the pharmaceutical companies that are going into the offices on a regular basis and giving them pens and papers and free samples and things before you prescribe anything else . That topgap for host i have to cut you off. We are running short on time. Guest there was a huge amount of marketing and drugs. That is why you should always ask, is there a generic medicine available . Is there a nonmedical alternative that you could try before going on a drug . Host we have been talking with Charlie Ornstein with propublica. That is all the time we have. 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