Transcripts For CSPAN Washington Journal 20140623

Your thoughts be known and your ideas for fixing congress. Weigh in. You can here are the phone lines. For republicans, 202 5853881. For democrats, 202 5853880. For independents, 202 58538 2 2. Respond onweet, facebook or send us an email. The gallup poll looks at confidence in the congress. If you look at the pole and go back to the mid80s, you can see that Congress Congressional an uptake bys at 2003 at 30 . Leading to the current day in 2014 with 7 percent of respondents saying they have a great deal or quite a lot of confidence in congress. Have confidence in congress, you can let us know. You may want to share your ideas for fixing congress. 202 phone lines, 5853881 for republicans. 202 5853880 for democrats. 202 5853882 for independents. And onal media, cspanwj facebook. About 90 people responding on facebook. Com cspan. Send in enough to journal cspan. Org. Lets find out about activities in congress this week with Cristina Marcos of the hill, she joins us on the phone. Guest good morning, thank you for having me. Host as far as Senate Floor Action this week, what should we expect . Takingthe house will be up three bills to boost domestic energy. One is offered by cory gardner of colorado, in a Competitive Senate race against senator udall. That is also something that can boost his campaign. Meanwhile, in the senate, they will be taking up a rare electionyear Bipartisan Legislation that would boost jobtraining programs. Host telephone but more about that, why is that rare . Tell us a little bit more about that, why is that rare . Year, is an election legislation has slowed to a crawl. Last year they were going to last week they were going to take a pay measure that would fund the government until 2016. It fell apart because i could not agree to whether or not it should be subject to a 60 vote threshold. Is a hot environment topic with issues like pollution. Does that it considered as well, especially when energy is debated on the house floor . Guest yes, it is a big deal, especially with the recent epa nule limiting carbo omissions. Host carbon emissions. Host what is of note with the v. A. Hearing, what is being considered . Guest this is the third primetime hearing i the department of Veterans Affairs. We will be hearing from officials overseeing the department about why veterans have had to wait for so long to see doctors as well as to collect benefits they have applied for. As politics goes, is it still charged as far as democrats and publicans and the issues they bring or is this . Ore bipartisan in nature it is bipartisan with the department of Veterans Affairs. Last week, the house and senate hasd, the house so far voted to set up conference negotiations with the senate on chambers Veterans Affairs reform bill. Negotiators from house and senate will sit down and hammer out differences between the two goals its chamber has passed. That is on its way to becoming legislation to reform the department on president obamas desk this year. Host we listed a couple hearings coming for this week. Medicare fraud, sexual files, autism. What should people be watching for as far as hearings are concerned . Guest another big hearing happening tonight is in the house of his a committee, House Oversight committee. They will be hearing from the john koskinener about the missing emails from lois lerner. They said they were not able to recover many of the emails. Of herwo years worth emails, from january 2009 to april 2011 due to a religion due to an alleged computer crash. Republicans say that is conveniently a critical period in their investigation. Democratstion year, are accusing them of engaging in hunt. Ition whicitch host especially when you have paul ryan expressing disbelief in what has and said. You expect more of the same. Guest absolutely, and therell rightubpoenaed koskinen out of the gate. He testified in front of the house and Means Committee last week. Rest assure this will be a very partisan hearing. The abilitypressed as the summer goes on, especially as Elections Come forward in november. The worked out perfect the work out put of congress, will that slow down . Guest in the senate and has slowed down a lot in the last couple weeks. Democrats and republicans cannot come to an agreement on amendments. That had of things been relatively bipartisan like the tax extenders cap package and the appropriations bill, there is a lot of bipartisan agreement underneath it all. To because they cannot come an agreement on amendments, republicans are very upset they have not been able to amend any legislation in this congress. A lot ofen blowing up major legislation in the last few weeks. In the house, they have actually been passing a lot of legislation. Fiscal 2015ve appropriations bills. The senate is going to take up and sent to the president. Host Cristina Marcos, we are asking folks to comment on how to fix congress. This comes from a gallup poll saying that only 7 Show Confidence in the institution. Do you know if republicans and democrats are selfaware of this kind of opinion of the body . Guest and a lot of them will knowledge themselves, who are the 7 that still think we are, sent . Are competent . Whosee a lot of members have decided to retire or step down. A lot of them say this is not a productive place anymore. They do not feel like it is worth tracking down to washington every weekend and having to be away from their families if they are not getting a lot done. With thetina marcos hill, congressional reporter. Thank you. Guest thank you. Host again, the lines, 202 5853881 for republicans. 202 5853880 for democrats. 202 5853882 for independents. The topic is your ideas for fixing congress. Toof confidence according the latest gallup poll. Ralph, michigan, democrats line. Go ahead. Caller i have three recommendations, quickly. Try to limit the gerrymandering of the Congressional Districts. It does not affect the senate because the senate is determined by the state. The gerrymandering of the Congressional Districts makes all the difference. All the districts are safe. The incumbents are guaranteed reelection. I would recommend a limit to the lobbying in congress. I think there is too much money and campaigning. G money,y bi billionaires, corporations. In my stay, i live in the third Congressional District in michigan. 7 do not like congress. I can say that the chances of the incumbent being reelected 80 . Robably it goes with all the other incumbents. The districts are so well drawn that all the democrats are reelected, all the republicans are reelected. Even though we are a blue state, michigan, we have nine republicans eight or nine in the house and only five democrats. They gerrymandered it so that even though this is a 5050 or a democrat leaning state, the republicans have way more representation in the house of representatives. Host from virginia on our independent line, this is roger. Caller good morning. I think there are six things that can be done. First, restore the power of the people to the people. Remove the cap on the house of representatives, which causes a lot of gerrymandering. The constitution originally mandated that the district should be 30,000 to 50,000, that was never amended as proposed among the first 12 amendments to the constitution. That would be one thing. Also put a cap on the size of the states at one million. This would increase the representation in the senate. Put in place a legislative negligent act, if you do not pass a budget you do not deserve an office and you are removed and do not get paid. You cannot serve in any appointed position. You need to get rid of the independentonal in regulatory agencies. Congress is supposed to have the power to oversee what goes on at write regulations. They are imposing a burden on the American People. Let that tax forms indicate where you want tax dollars to go. Host interesting ideas, where do you get these ideas from . Caller the cap on the house was imposed by a statute and was never ratified as an amendment by the state. Host roger from virginia. A littleur next caller ways up, just outside of d. C. Announce andrea. John, independent line. Caller a couple comments. I like what some of your callers have to say. One of the things i think we are seeing too much of our the special Interest Groups and lobbyists. And the money that is backing them. People who are down there representing their interests and what these folks were elected to represent. It was down there promoting what we stand for . The other thing i think we all have had enough of hearing is. Lander good grief, name calling. The entire time, anytime excuse me, it gets frustrating at a time someone disagrees with someone else or you are not doing something that i want you becomeyou automatically the race card is always pulled. Or you hate people, the hate crimes come out. Or some other sort of demeaning slander. They need to stop that. And work together. Host james with another thought on twitter. Congress is working as good as can be imagined, they are not passing laws restricting our freedom. Good to our facebook page, facebook. Com cspan. Limits on theerm three in the house and two in the senate. People responding to that as well. Including theresa, who says a cap should be put on their pay. Me thoughts this morning on how to fix congress. This as we showed you the gallup , in the mid1980s it was at 40 plus, now it is at 7 , people showing confidence in congress. If you have ideas for fixing congress and want to share, the phonelines are available as well as facebook and twitter. Email, too. Lee, indiana, democrats line. Caller good morning. I know congress is a mess right now. I think republicans take most of the marching orders. They taket a slam, most of the marching orders from limbaugh. Get talk radio off the air and get him off the air so they cannot run everything by him and we will have a better america. Host you turn your direction to radio talk shows and the like . Do not think republicans can do one thing without running it by him or getting his input. Of course, he hates obama. You think that people turn to him or republicans turned to him for advice and counsel . Caller hes got three hours each day on the radio. In my area, anyway. Has those three hours to criticize, to radical, or whatever. He hates the president. It filters through congress. I am a democrat but i have voted both ways. His input means a lot. If he does not and they do not do what he wants done, he spends three hours on the radio and bashing. Have you heard him before . Host i have heard his show before. You think he holds that much sway over congress . Caller in my opinion, yes. N a republican congress, yes if republicans take over the senate, lord help us this year. Theyre going to be passing things. I voted for obama. The president will be he will be vetoing everything. Keep this in mind. If Rush Limbaugh is listening to this, indiana will be bashed. That is my input and my opinion. I appreciate you listening to me. Host charlie from ohio, republican line. Caller yes, i was just thinking about this. Wenged defending changed, the Founding Fathers wanted the senate to be elected by the state legislator. When we changed that, congress changed for good. We should look at going back to what our framers really wanted, for our senators to come right to the people in the strict tenets for our senators to come right from the people and the state senate. Host you think that would help . Caller it would bring it closer to the people. The u. S. Senate is very detached from the rankandfile people. Not sit on high and we do get to know them. If they were coming from states on its, which if they were coming from state senates, which they were supposed to do, that would come a long way. I think there should be a law that every new law you have to put to sleep on a law. We keep putting new laws on the books on the old laws are still there and nobody gets rid of them. For every new law, an old law has to be put to sleep. Host darryl from detroit, michigan, independent line. Caller the morning. I think the solution is more simple than most people are talking about. Collection areas and all that. We the people have the power when we enter the inner sanctum of the ballot box. If we have a 70 approval rate of congress, why do we elect 90 plus at reelection . Can it be done . Yes. Eric cantor, case in point. Thank you very much. American task force on palestine today has an event taking a look at the violence in iraq. See live on cspan2 that live on cspan2. At 9 00 a. M. President obama on a taped interview on face the nation talking about iraq. Here are some of his comments from yesterday. [video clip] going to be a Global Challenge that the u. S. Is going to have to address. We will not be able to address it alone. What we cannot do is think that we are going to play lacrimal and send u. S. Troops play mole and send u. S. Troops to countries wherever these organizations pop up. We will have to partner and trained local Law Enforcement and military to do their jobs as well. Would that vacuum exist had we backed moderate rebel forces in syria. Yes. The notion that somehow there was this readymade moderate syrian force was able to defeat assad is simply not true. The notion that they were in a position suddenly to overturn not only assad but also ruthless, highly trained jihadists if we would send a few arms is a fantasy. Host more on the topic of iraq in 25 minutes with Steven Clemons from the atlantic. Now, fixing congress. From florida, hello. What the the gentleman from ohio was talking about the 17th amendment. If we did make a push to get that off the books, with the 16th amendment and the irs stuff going on. Replacing with a flat tax. Repealed,get that the government collects three people. To to go to washington and one as a backup. If one of the two goes through the chambers of the various states and act like a fool, the government can recall him and put the alternate in. That would help. Like a few other people said, the money, the lobbyists, all that, it messes everything up. You can sit on the floor of the and get away with it. If we did that on the streets, we would be arrested for slander. A look at senate primaries, particularly what is going on in mississippi. This story by robert costa. Host that is in the Washington Post. A related story in the New York Times focusing on the primary raise an outside observer. Senator thad cochran fights for his political life in mississippi by taking the unexpected step of courting black democrats. Host you can read more this morning in the New York Times. Romney from kentucky ronnie from kentucky, independent line. Hello. Caller that talked about talk radio made a very excellent comment. I want to throw in, programs sharptonedge and al and hannity, for sure. These peoplening are so far apart. These congressmen should listen there isprograms no way they can work together. Then you have dick cheney making all his comments he has made in he last year or two since left office. How in the world can anything get done . I would like to see the majority leader in the senate and the house be replaced immediately. [indiscernible] together,not work they get in front of the microphones and want to slam each other. It is just ridiculous. Somebody to get up and speak for an hour on the microphone and then you have someone like bernie sanders. They are so far apart, it will never work for the good of the country. We need people that think about the country instead of their own selves. Host this is a viewer on twitter. Duty type selection for serving in congress. Debra, democrat from richmond, virginia. Caller good morning. Simple. It is very we need to cut their paychecks at least in half. They need to grow up. It is as simple as that. What would cutting paid to . What do you mean by grow up . Caller there are a lot of things that they are discussing that they are uneducated on. Instead of trying to get things straight, they are more into controlling people, ok . They are not worried about it is not money it is about money. They need to do what theyre supposed to do. Host if you watch this number can have, you will see Charles Rangel from new york featured in the wall street journal. A story related about tomorrow as well. A primary election for him. Tuesday, the 84yearold politician will face off in a tough democratic election. Host that is in the wall street journal. Phil, south carolina, democrat line. Caller i should be on the independents line. Ide, that is a little bit of what comes around goes around. He has been a problem up there forever. He just gets elected and stays there because he has a voting block. To is it now it is going bite him because the base has changed. I am shocked by the fact that i ine had two callers get already that think the way to fix this problem is by limiting free speech. Im talking about the guy from kentucky and the guy from indiana. Sorry, im going to slam him before rush gets a chance to. You think we should limit talk radio. People need to get educated. Education can come from a lot of different areas. Talk radio, is Rush Limbaugh always right, far from it . But the idea is to have an idea and Pay Attention what is going on. Rush limbaugh has helped to quash some bad ideas in congress by getting on his soapbox and letting people know what is going on. Amazing when people are educated they can realize that the idea that is coming down from congress is wrong. One more thing before i go, pedro, but i cannot with the thought that every time they pass a law they have to eliminate or shut down another law. I have thought that the longest time. I dont know how you would manipulate it. At the talk about a donothing congress, we are much better off if they dont do anything for the most part. Host the Supreme Court set to end their terminal we from today. Three decision days set for this week when it comes to cases they have heard. Eight major cases is the headline from usa today. That looks at president ial powers. This pits president obama against republicans in congress. While the branch of government s arbiter. Host among them, something you have heard about as far as religious freedom is concerned. Most Health Care Providers provide contraception. You have probably heard that associated with the hobby lobby case. 8 cases and three days to decide this week. Stay close to cspan for those decisions during the day and are posted you can hear audio and find resources on our website, cspan. Org. Bob, texas, good morning. Caller good morning. I cannot believe i am this lucky. My favorite host and my favorite subject. Thank you very much for taking my call. I know that what im going to radical toound me some people. I do not think that passing laws is going to change anything. Theyre the ones that pass them. Come on, lets face it, they are controlling everything. The only way i think that we can fix this problem is to take it back to the ballot box. Would vote every incumbent out of office every election, about three or four election cycles and it will be straight. If they know that they are going to be voted out of office if they do not give the right thing , i believe you will see a bit of change. I believe you will see a big change. That is my opinion. Just go to the ballot box, whoever is the incumbent, vote them out of office. And you will see a change. Host overall, do you think that would happen . Considering incumbent usually stay in office. Caller it is not going to happen unless the American People make up their minds that they have got to change it. Making laws is going to change it, they are badly mistaken. Believeemocrat, but i there are some good congressman and good senators but if you vote them all out of office, by the third election cycle you have automatically got term limits. I really believe that you will see a big change. Host has there ever been a situation where you voted for someone and then went back and voted against them only because you lost interest in them . Caller yes. The first time that happened to me was george bush. I really had doubts about george bush, but i voted for him anyway. Host the father or the son . Caller the son. The first election, i voted for george bush. He proved me right. I had doubts and he proved me right. Lob,urned out to be a s so i voted against him. Host patrick from twitter. You six congress with redistricting reform. Patricks thought. George says compromise. We will go to minnesota next on our republican line. Hello. Caller hello. Host good morning. Caller good morning to you. I believe we need to not campaign for four years so that were campaigning every day of the year for years and years. They should cut the amount of time that we can actually campaign billed as something that resembles more of what they do in britain, perhaps. Is not a constant battering of our senses with hatred and all of the things people want to say badly about someone else. They have to concentrate on trying to win and people would get a really good look. To studyoney of time them without having the news media and people campaigning every day of the week. Go out fory cannot breakfast unless they are going to sell something while eating. It is ridiculous. Once you are out of congress and not a senator, you should not be as aed to come back in lobbyist and make millions of dollars off of the very bills that you worked so hard to pass so that someday you could have your bucket out there collecting money again. To affect what is going on in the u. S. , lobbying for things that maybe they did not even agree with when they were in office. But now they see that as an opportunity to make a lot of money. So they are doing it. Big companies are controlling everything. I also always wonder why if we are having an election in and we people in minnesota are very thoughtful, as i am sure they are in other states. Look at the people who are running. We decide who we want. All this money comes falling and from all the other states to affect our elections. Host by outside groups. Caller i dont understand why that has to be. Why does california help us decide because they can dump money in here . Loses anybody in iowa because someone in New Hampshire the size that in New Hampshire decides someone needs to be in that position so they can get their own way in washington. We want to be able to say i am from minnesota and this is the person that we want and we voted for. But we raised money for and work for and appreciate. Wethey do not work for us, will go to the voting box and decide if the majority think they are still working for us. Host ellen from minnesota. I am sorry. Y steve from new york on our independent line. Go ahead. Caller three items i like the idea where we increase the number of house of representatives to more reflect the ratio that started at the fountain. That would put the number currently at around 7000 or Something Like that. 7000 representatives. Number two, shut down the capitol building. Send everyone of them back to their districts to operate from there. In this day and age, there is no reason why that could not be done. Number three, the 17th amendment repeal it. The senators should be elected by the constituent legislatures. I will add a fourth one. Every piece of legislation that is finalized by congress before it becomes enacted goes out to the electorate for review. Chance of 120e a , to lookys, whatever it over before it goes back and gets adopted and finalized by the congress. Host i have to ask you a question. You said shut down the capitol building. What are you do about hearings, deliberations, votes, how do you take care of that if you shut down the building . Caller the way businesses do it nowadays. They do it online and other video. They do it in that fashion. Nowadays, you do not have to be in front of someone to be able to talk to them. I would say that the last piece i talked about, having the bills finalized by the electorate, that way we do not have stupid being said that you have to pass the bill in order to find out what is in it. Thank you San Francisco. From new york. The Washington Times has a behindthescenes look at the select committee on the nausea. The select committee on benghazi. Host where that in the Washington Times. Your ideas for fixing congress. Several expressed this morning and in five minutes we will take your thoughts. Randy, wisconsin, thank you for holding on. Republican line. Caller thank you to cspan. Congress is made up of those cut branches, congress is made branches, the house run by john boehner and the senate run by harry reid. The house of representatives is half of the congress, they send bills over to congress to get their approval or negotiate or whatever. Once they get past, the president signs it into law. The stuff gets sent over to harry reid, he does not bring the stuff up to a vote. Who is holding this up and making Congress Look back . Look bad . Harry reid and the senate. A guy calls about Rush Limbaugh. Rush limbaugh has a huge audience. People thatlot of tell the truth. If you do not want to listen to Rush Limbaugh, do not listen to him. I do because he has got it right. Host the caller was talking about mr. Limbaugh and this way he thought he had over congress. He has that much power over the decisionmaking in congress . Caller he has no power. It is his opinion of what he thinks and what he reports. He cannot sway nobody and has no opinion. If you want to believe in his opinion, that is up to you. Radio talk show. If you do not like him, do not listen. Host the latest on bowe bergdahl, getting outpatient treatment. This is an the New York Times saying he returned to the u. S. And had been receiving treatment. Host angela from alabama, good morning on our independent line. Caller hi. Theave a simple fix for campaign and for congress and so forth. Give them, since we are taxpayers, give them a certain amount of money, the same, equal amount, and let them run from that. That would even it out. Lostast election, cantor money, it did not matter. Even it out. Be done with that. For the people talking about limiting terms, that is ignorant. Terms,one has only two the second term they can pass all kinds of crazy laws with no consequence. Stop saying the fox news talking points. The second one is about flat tax. I have a masters in accounting and finance. Thats not going to work. People cannot people making millions of dollars cant afford 30 of their pay, people making 60,000 a year, it is not the same. The fox news talking points. This is another thing. Before, the American People need to know what is going on. Ive been watching the news for 35 years. I do not even watch just one channel, i watch all the news channels. This is what is happening. They are treating this country like a corporation. Detroithat happened to and california. That is what george bush and the gop did to this country. Keep voting for them all you want and you will keep getting the same policies. Ok . Host angela from alabama. Usa today has a look, a piece they are calling inside guantanamo. Details on some of the inside activities of detainees there. Under the benefits section, this is what they say. For complaint is an ace, there is more freedom for complaint , there is more freedom. One day last week a detainee watched television with the audio from his native language through headphones. That is in usa today. Victor, indiana, democrat line. Caller yeah. I think we need to six congress, we need more radio stations such as Rush Limbaugh, not all republicans. Make it democrat or independent and whatever so that they can doing. What congress is and maybe even have some newspapers to tell on each other. Congress is getting away with a lot of people do not know nothing about. That is my opinion of what we need. More information about congress of the to catch some dirty stuff they do. They always go after the president , the media does, they do not go after congress. Host the papers this morning severalng iraq due to interviews yesterday. In usa today, iraq could turn into a terrorist staging ground. I will be the topic of our next guest, Steven Clemons who joins us from the lannett to talk what is next for the president. Later, a Senior Correspondent for Kaiser Health news gives us an update on the Health Care Law and its impact on Patient Safety. All that and more as washington journal continues after this. Now you can keep in touch with Current Events from the Nations Capital using any phone, anytime, with cspan radio on audio now. 026268888. The sunday Public Affairs programs. Cspan radio on audio now, 202 6268888, Long Distance or phone charges may apply. Theawrence strickland heads National Telecommunications and information administration. Talking about domain names shifting from government control to an international multistakeholder group. Administration wanted to move the Domain Name System out of the federal government and privatize it. We announced in march the conclusion of what started in 1998, completing that privatization. Tonight at 8 00 eastern on the communicators on cspan2. For over 35 years, cspan brings Public Affairs events from washington directly to you. Putting you in the room at congressional hearings, white house defense, briefings, and congresferences. Of theo gavel coverage u. S. House. Cspan, created by the cabletv industry 35 years ago i brought to you as a public service. Watch us in hd, like us on facebook, and follow us on twitter. Washington journal continues. Host joining us now is steven mons from the lannett from the atlantic. I want, the headline, your thoughts. When it comes to president obama trying to avoid Mission Creep in iraq. The thing thats going to happen . I hope it does not. You see a slippery slope to a much larger engagement. The president showed in libya that was not the case. Some of us were worried when they imposed the nofly zone of that would lead to a larger engagement. The president demonstrated discipline in that case. This might be like that. Our general tradition in military deployments or engagement or something of this is that the 300 advisors are at the beginning of the story, not the end. Host what keeps her from going further . It from what keeps going further . Guest we have been talking to the white house, one of the interesting lines is what if isis and its allies, four or five other leading sunni brigades that have joined up, if assault on allout baghdad, the white house has said we will take other actions. We do not know if that is a lot orbombing and drones whether they have Something Else in mind. There has been no specificity. An assault on baghdad looks as if it is something unique. I would not say we are acquiescing right now, but we are ramping up to kind of deal with the spread of isis. Overnight, the border between syria and iraq virtually evaporated. Rumors that a Border Crossing in an interesting new dimension to this that would involve the jordanians. We have a special relationship with jordan that would be ear. Ght to b we are not showing the force or deployment we might if i did were attacked. Host if there are airstrikes, would human intelligence be needed to coordinate that . Guest yes, i think this 300 advisors are out there to set up intelligence wants. Essentially two systems integrate the points that would worthwhile. The obvious problem is isis has moved so quickly, it is far outstripping any capacity we could bring on in the next couple days. Host john kerry talked to several groups about iraq. What is the pitch he has to make . Guest it is interesting, the state Department Said this morning he has already met prime i and the foreign minister and now he is meeting top tier shiite clerics in iraq. The pitch is you guys to make a new social contract across iraq with kurds and angry sunnis who have been disaffected. It has been years since al maliki ran out his sunni Vice President , hashemi. He is living in turkey. The kurds protected him. Ever since, they have been out of sync. The conversations needed to happen more intensely a year or urine half about a year or a year and a half ago. This is a response to the anger in the sunni population. There is no way isis could be achieving this success, you have a lot of sunnis supporting this action. Host how do you satisfy sunnis and kurds . Guest is very hard. The kurds are interesting. Said toand his clan chance tou have a prove that democracy can work. Should you not, we will go on our own way. There is a desire in and turkey,n syria own autonomousr state. They have a semiautonomous region, but to go further. The kurdish population is going to be very hard to bring back. One of the obvious questions, i was trying to look around online. Is there someone that stands out . A sunni leader whom the shia trust, a shia leader who the sunni trust, a kurdish leader, one pops out. If you have a winner takes all formula, 2 3 of the country is always disaffected despite the sunnis having the greatest plurality inside iraq. I think the fear, when you stare into the abyss and you look how war could be, you could raise responsible something joe do biden and the former president of the caps on formulations tried to cobble. Three autonomous regions, loosely federated. Kurdish region, shia region, and sunni region. That might be the best option. Hintedecretary kerry that new leadership and iraq as far as the Prime Minister was concerned. Guest that was shocking, putting maliki on edge. No love lost between this white house and maliki for a long time. Joe biden was the point person talking to maliki. 2013 whiteovember house meeting between president obama and Prime Minister maliki, president obama has not spoken to maliki since april 2012 on the phone. Otherall happening with people. To a certain degree, i think you in this is a distancing that has been happening for a long time. American frustration with maliki while he positions iraq closer to iran. There are questions about iran didthe saudis saying why you topple Saddam Hussein and nians. Raq to the ira people are not saying do not people are not say people are saying do not roll in with troops while you frustrate the uae and saudi arabia. You need to have a leadership that can transcend these things. What the president needs to do is figure out how he assembles layers of responsible leadership higher than iraq. Borders do not matter right now. What matters is a sunnishiite contest. You have got to bring in the salaries and the you have got to bring in the saudis, iran tos, and probably the turks discuss a regional deal. With theen clemons atlantic. Numbers, 202 5853881 for republicans. 202 5853880 for democrats. 202 5853882 for independents. For iraq veterans to give your thoughts, 202 5855883. Available asmail well. On face the nation yesterday about what happens if things continue and what it means for National Security. [video clip] happens, as we watched in afghanistan, they build safe havens, they train and plan operations. That led to 9 11 and the killing of 3000 americans. This is what got them in trouble ri, the leader of al qaeda and the replacement of bin laden. They were brutal and talking about sending people with western passports back home. That is what got zawahiri worked up, not of their goals were any different. You have a group, 1 billion in lion, well armed and financed. We know they have intentions to send people with western passports back to the u. S. And europe, that is as dangerous as it gets. Six months, three months, or a year, i would not wait. Host what are your thoughts . Is veryike rogers wellinformed. The scenario is when we should be worried about for a long time. I do not think he is thellishing in terms of concerns of what could happen. The real question is, when we first invaded iraq under somewhat false pretenses with the notion that Saddam Hussein had weapons of mass distraction. One of the tension points is do you save the world and try to deliver justice to people who are living in inhumane conditions under tyrants like Saddam Hussein or do you remove Saddam Hussein to try to achieve that . Box for a pandoras other nightmares. That is essentially the story we are beginning to see repeat and over in these kinds of tensions. That said, we have spent a couple trillion dollars and the iraq war. Has time when the economy been flat on its back, you imagine what a couple trillion dollars could do in schools orure or changing the American Healthcare system. Those costs have had a tremendous effect on what the u. S. s latitude is. These are real debates. Ofdoes not diminish the kind threat that mike rogers said is there. That is why in my view prime dereliction ofs duty in terms of responsibly are presenting a group of people has stakes. I disagree that leaving a residual force and iraq would have made a difference. It would not have solved the political dysfunction we have a naive sense that if we send troops in, or the u. S. Plays parent, all the other factors in these regions and complex neighborhoods and neighbors that like to meddle will not happen. That is not the case. I do not know how to put it, play with a little bit of humility. Realize that what we need is try to contain situations and figure out how to get ice is limited. Talking about reaching out to players inside English Speaking countries like the u. S. , the u. K. , and the terror within can be a real problem. It may not have the sophistication of old line al qaeda that we saw but its a real risk. And there are ways to antenna the regional am begses of some of these countries but it doesnt mean that you can inject yourself and become the ash tor of all of these currents. Steve clemmons is with us. Go ahead. Caller i like to thank you for your guest. He doesnt sound lick a propaganda pusher. However, i have a theory an this whole thing, about the crays olicy about divine and conker. Conquer. Were on both sides of the aisle here. Its just the perfect thing. It makes everybody safer at home. Guest thank you, caller. I think that the truth of the matter is that in the best of both worlds, divide and conquer in this particular realm, president obama would be happy if everybody just get along. We talked a lot about the asia pivot in u. S. Foreign policy. Defense secretary hagel, joe biden, john kerry always talk about the age of pivot while the middle east doesnt want to be left alone. And when you go back to what begin town fold and it may have unfolded anyway despite the iraq war and other intervexs and maybe this is a kind of dark mission of Osama Bin Laden rooklyn. Osama bin laden. When you look at sriram hathwar, when you look at syria and the refugee camp, were now have more displaced people throughout the region than we did after orld war ii. So, yeah. One said can we assume that assad is holding its line against them . Caller guest assad is proven to be a very resilient leader. Isis has become perhaps and probably the richest terrorist organization in the world today and essentially its buy infusion of cash from likeminded sunni extreme air best ises, sheiks, if you will, and in terms of what they are picking up as they conquer territory. Its a napoleon like thing. Eat what you kill. And theyre getting quite a bit of wealth, money, cash, guns, and other weaponries. So, i think that it doesnt mean assad is safer, whatever. But the chemical weapons that they used war turning point that punctuated to certain degree a confidence of asaw say said that he was beating isiss and he free syrian army. Host the estimated isis fighter is 10,000. One expert described it as the walmart of ammunition. Guest one of the problem and i have a piece coming out later this morning. Its not only in the be tough on john mccain and Lindsay Graham and others who have been calling them for not adequately barred the opposition in syria. But perhaps tilting toward the islamic extremist of that. And what we saw with a lot of the money and arms that were going to the f. S. A. Is the soldiers were selling them to isis. And so you see basically a lot of resources that were being channeled through a lot of different channels to those that were the most effective fighting force. They were not the warm and fuzzy moderates but the real extremists and we have the white house really worried about arming rebels. John mccain and others were saying lest do it like the prince of saudi arabia is doing. Now weve paid a price because to a certain degree, his patronage of isis and his direction of system of the nongovernment saudi money is what were paying a price for today. Host jerry is up from rhode island. Democrats line. Hi. Caller good morning. I dont completely understand isis. I know its a terrorist organization. What i cant help but have a gut feeling also that were fighting the wrong type of war. Were fighting more of a conventional war over there. I think that we have to be underhanded as they are. And we get the terrorists too much information. If we can use the shiites against the and that works, thats fine. And let them take over and then annihilate them. This is turning into a real bad situation with these people and we have to be hard on them. And, you know, to me, in a real war, were giving them too much information that they can outman the ammunition. Everything that we built up over there from how much of our, you know, our explosives are they taking and some of our technology that weve left over there. Were just fighting the wrong war and i think were fighting a conventional war and the United States has to wake up and we have to fight a more underhanded war and be just as, you know, be like they are. Be like these people and think the same way because thats the only way were going to win it. And thats my comment. Host i appreciate the perspective. I guess whats interesting is i wouldnt frame it as conventional because u. S. Forces arent fighting this war. Guest it started in syria is you had the russians and iranians helping assads regime and you have the u. A. E. , qatar, saudi arabia, the United States, france, turkey, trying to help the syrian rebel forces. And it has been an utter mess. So you dont have the direct involvement of all these countries. You have money. You have intelligence. You have battle plan ideas. You have various degrees of weaponry that are provided but none of the outside powers are directly on their line with the exception of perhaps iran which did send some revolutionary guard in syria to help assad so its not conventional in that sense. The question of being underhanded, say you look at guerrilla tactics. What we see with isis just a organization right now because its not just a classic sunni extremist outfit. There are a lot of chechnyan. Some of the people that have been profiled in the Washington Post have been outrageously brutal and vicious, frustrated chechnyan militant who is became tired of the fight inside russia and have come here. And so youve got a kind of roving band, if you will, that extends far beyond the middle east, north africa region and toout asia of people that have been trained fundamentally and before that when you go back to the afghanistan war, that the soviets were involved. Youve got a roving class of people that are out there to fight. And the saudis are very worried about it. The saudi government has outlawed participating in a number of these terror groups because theyre worried that theyll come home and work to topple their own government. So its not conventional in that sense. And i think when it comes to u. S. Involvement, one of the debates that you have people who are acting through a higher degree of humanitarian on how to save people. You have People Killed inside syria. Youre going to see a lot of bloodshed, allegedly, 1,700 iraqi troops just summarily executed, if thats accurate. You see horrors that we soon. Seen in generations occurring right now in real time. Maybe they occurred in africa and we took no action. And people are saying we must take action now, versus others that say these currents of whats evolving in the battle between two primary sects in islam are nothing for largely christian american troops touchdown eject themselves into. Theres no wind in that and its simply a black hole for american lives and dollars and thats a debate that we need to have. Host theres a map that shows territory that shows isiss operational presence, cities controlled by them. Is baghdad a thing point . Guest yes. One of the interesting elements that everyones watching is should they try and take baghdad . Should they really try and destroy as they said they want to . Two of the most holy shiite holy sites. That, then, many people say its a suicidal act by isis and it awakens a storm in the region that is going to be hard to shut down. Because it basically puts them at the tip of a population. Theyre winning right now because theyre running into territories where the majority sunni and theyre throwing off their governors that has been tilted governance that has een tilted towards maliki. We had in the Washington Post, yesterday, discussion of some of the brigade commanders of other islam, groups that say they may have to turn their guns on isis but right now, isis is their ally. So theres another dimension that would be quite tense and difficult down the road. But if they go into baghdad and this is where the white house has come in and i think the pentagon, what i dont know exactly what options the white house is talking about, what military options they would take but the white house has intimidated to us who are watching this that they wouldnt jump shot stand by, that that are actions they could take to ramp up americas protection of baghdad and what it represents. Host the Los Angeles Times reporting that kerry in baghdad to talk with the Prime Minister there over the situation going on. I know youre not there, but whats the message that the United States through secretary kerry may be delivering now if guest to move fast, demonstrating people that are your political rivals in the government now. Thats his only chance. And weve also have told maliki that we would be open to lternative leadership. Heres the challenge though. The Supreme Leader said maliki is his guy told the United States to stay out of iraq. All of these ears issues are not silos that you can look at. Youve got players outside trying to affect the internal equation. And in this case, iran is satisfied with maliki whom they look at as a dependable ally inside iraq. Not wanting to see him go and frying rebuff the United States in doing this. So i think hes basically saying youve got one pass and that is to do some very demonthsable strategic leaps with your rivals in the country and bring them in. Thats the only way that can possibly get some of these sunnis. That time may pass. You mention youve got 10,000 isis forces. Thats not a large number of people for the amount of territory theyve taken. And if you feel as if youre a sunni leader works are you going to trust more . Maliki or do you think youre going to have a greater chance because you know have greater control, at least for selfdetermination of some sort. And that you feel in the long run, isis is only as strong as sunni leadership in iraq louse it to be allows it to be . This may be very hard to walk back. Host kyle from New Hampshire, independent line. Hi, there. Caller hi. I think that everything is going perfectly. I think george bush had it great. Destabilize the area. Let all the bad guys fight amongst themselves and get out of the air and let it happen and let the chinese worry about their fuel instead of us. Nd enough is enough. Host we go next to marianne, pennsylvania, republican line. Caller hi, mr. Clemons. I want you to comment on that Nuclear Materials which i believe they know how to use Nuclear Materials. Guest well, thank you. I dont know. I havent seen the reports about them finding nuclear weapons, bit wouldnt surprise me that isis has found or worked with various forms of stashes because one of the interesting debates that began to involved in syria was when they deployed chemical agents against certain portion of the population. There was also one debate at the time and a u. N. Investigation that actually saw that theres the possibility that some of the opposition troops who didnt specify isis and defecting generals may have also combined some cashes. There was an effort for some time to get various areas of the defecting units to ally some of the other affected brigades. This is would be the tasks that prince ban doer of saudi arabia had which was to organize a large fighting force, possibly assemble them in scombrorne take this unit and try damascus fight damascus. There were a number of commanders from the Syrian Regime army who were defected and there was concern that they had access to some of these gas agents. They didnt have the Delivery Systems for, but that were possibly used. So, this is very, very murky. And i should emphasize that theres a lot we simply dont know that hasnt been reported, but these have been the things that have come out by way of the u. N. Investigation and to some degree, relatively dependable rumors. Host here is howard from leesburg, virginia. Independent line. Hi. Thank you for covering this. Host go ahead, please. Caller my question is what part of this equation does china or could china play in all this . And the other question is why is it costing us when we should be paid back for the funds and the costing that we spent over there . And thats the root of my questions. Thanks. Guest regret questions. Rule of thumb in military deployment is count on a million and a half dollar per person per year for an individual deployed. 300 deployed advisors is automaticically minimum 300 million and that doesnt count costs for veterans and other source of support that we provide those who served in armed forces over a period of time. That was the rough cost. In afghanistan, we were spending 120 million a year. So you get these iniquitys and look at the costs of these things. Thats the cost side. N the issue of china, china is remaining a strong distance away from most of this, viewing the issues of internal instability is not of their concern. China has not yet said or acted as if areas beyond its immediate sort of South China Sea sea and its border territories are those that it would engage in the kind of adoption of problems that the United States has where russia has, for that matter. Russia and the United States are similarly behaved than china is. China tends to look at these questions in terms of what will it do to their longterm Energy Supplies . Their concern is maintaining stability while trying to grow and praise another 300 Million People out of poverty. So whats going on in iraq . It matters when it impacts its longterm oil and Energy Supplies and the cynical calculation is those oil and Energy Supplies will be sold to someone in the future. Theyll be there no matter whos running the governments and china will be the buyer. Host rachel mad do you said mr. Obama is right to insist he will continue close consultations with kroenke but theyre both sfwrong they think the consultation consists of congress being told and not asked what should happen next. Guest rachel mad do you has written a piece saying you continue to bandwagon on these hings. Those authorizations expired, however. The president punctuated the expiration on that date when we removed combat troops. So rachels saying you cant go back and rewrite that history because she would like to see a vote in congress among those people. As we saw in syria when members of the house and senate were home on Labor Day Weekend and news had been reached about the syria chemical weapons tackle, there was a lot of weapon and Congress Herd from constituent around the country saying we do not want to go to war. So the steps begin being taken to strike syria were walked back because the American Public just said no. And rachel is basically saying you cant do this as a parlor room deal without coming back for the opposition. A powerful article. I think its going to to be tough because if youve got a unique moment of bipartisan support in leadership in both sides of the coach, they will not constrain the white house. Host senator feinstein was on the show talking about intelligence and if there was enough intelligence to spot the problems with isis. Well get a response and get your response to it. Ok. Well, obviously, we know about isis. Weve seen its developments in syria. Were aware of the fact that they are recruiting fighters in europe. Theres been arrests in spain, france, and germany. Theyve tried to assassinate the head of security in beirut. And they were responsible for the killing of three or four people at a brussels synagogue. They are vicious. They have killed thousands of people. They have cut off heads. They are a major threat. Taste brutal bunch. Did we know that a third of iraq could be taken over so quickly . Did we see that coming . I would have to say no. Bit think its a real wakeup call for in the United States because they do want to develop the host when she says that intelligence probably wasnt as a peak when it comes to isis what, did that suggest to you if guest well, i think it suggests that we have a model and sometimes it is very, very hard. I mean, to a certain degree, a lot of us, people like myself and Rachel Maddow saying this has looked like vietnam. We try and prop up the side that we like but ultimately, once you remove yourself when you take off the training wheels, the other side proves to be pretty resilient as well. With regard to isis, i think i would disagree with senator feinstein in a sense that earlier this year and at the end of last year, but particularly in february, our National Security advisors convened a and ng of intelligence asically said this expanding Islamic Militant si inside syria, which extensively we are not formerly allied with them, but we have the same purposes. We had to say our alleged partners in this process looked pretty awful. And were very worried. And so, she tried to basically get the formal and more importantly, the informal Financial Support for both the Al Qaeda Affiliated front and isis cut off. And so we have been as feinstein said, we had been watching isis. Weve been seeing it grow. It was one of the projects that a lot of the saudi money. Its no it was no coincidence that after president obamas trip to saudi arabia at the end of scommarge his meeting with king abdullah, two weeks later, the prince no longer held his post and it was in part of the concern about the nurturing of the isis group. When you think of february, march, and now april and now were in mid june. The speed with which isis has now struck back and taken advantage of conditions inside iraq just moved is something we didnt anticipate in intelligence services. Im not sure how we might have, but it does show that theres been a concern that martin dempsey, chuck haguele and others have had about this group for a long time saying theyre the ones that are getting the arm so theres been a bandwagon saying lets arm the syrian rebels. And that money has been flowing into isis. Host next up is gayle from the independent line. Caller i want to go back the syria thing. Like we are not responsible for giving syria help. When we left our planes, our military equipment, billons and billons of dollars in iraq and well probably do the same thing with afghanistan when we leave there. And this has taken over by the terrorists. And when is our country going to grow up . And not leave our equipment there. Guest the United States is not leaving equipment in syria because we dont have equipment in syria. We havent will be fighting ourselves in syria. Weve been help agent a low level to provide low level armments and Strategic Planning device and what we often called other capabilities which means intelligence. We havent been leaving that merril. What has been happening is the money thats been used to boy ther weapons system. Buy other weapons system. The weapons carbs it that level that are being provided are in fact, once it had been taken over by isis at various points or comingled with the f. S. A. And other elements of the Syrian Opposition who have been fighting assad and theyve been very adequate leblanc rolled and supported with weapons by russia and by iran. So you do have different sources of supply coming in but its not u. S. Forces leaving deployments. And in the case of iraq, you had United States spending an awful lot of money training iraqi forces, helping to arm those forces and we saw four divisions just collapse in the early stages of the mosul takeover by isis and a lot of those weapons cashes were left behind by the iraqi forces host last call is from minneapolis. This is mette from our independent line. Caller good morning. Two points, quickly, if you could please verify them for us. Is it true that is allowing a lot of isis fighters to come in to syria on iraq . And also, the nationality of the isis fighters. Is it true that they are saudis and kuwaitis . People who we consider our friends and with defend them . Thank you very much. Guest thank you. The two questions on turkey. I believe that we are tightly coordinated with turkey, the United States, france, turkey, and others are working together formerly. That said, when you look at the border towns in turkey, its complete chaos. Weve had journalists that had been kidnapped inside turkey and brought in syria and held by al news ra or by isis. Weve got 34 declared journalists that have been held and kidnapped. And so, i mention that because when you anyone thats been in those areas know its close to the old wild west as you can imagine. Very little governments. A lot of confusion. And so i would say no. I would be very surprised that turkey was allowing easy quick access one way or another. But that doesnt mean that informerly, theres a different level. Theres a lot of corruption at these fwords and a lot of wink and nods. Its sometimes a gap but on a formal level, turkey has been upportive. Its amalgam of syrians, sunni cousins that are worried. Theres an element, you know, as in anything. Theres a sort of rainbow, if you will, of perspectives on whats happened. You have i was with a senior iraqi official the other day who says one of our big problems is we essentially have a revenge culture. So when you have people relatives killed and then the call to others to relatives to other members of related tribes to come in, that they can be part of that. So, absolutely, i believe saudis and kuwaitis and others are certainly part of the mix but that doesnt mean that saudi arabia is formerly supporting it nor kuwait. The real problem with this conflict and i dont think its as defined as well in or media is the effective dimensions of these civil conflicts that youve got a lot of people being propped together, trained, put into effective fight force, armed to the teeth and get incredible military experience and theyre essentially vagabonds. Theyre essentially not attached to the former military of their nations. Host if the political restructure is reformed, do you think that violence could decrease in the country . Guest yes, i do. I think that is the only hope that this point in has to be real and genuine, and when an important sunni leader in a rack on a hiatus. S put trust was completely collapsed. It may take time, transcendent leadership in some of the groups, and i do not see it today. We started talking about Mission Creep. What dictates that we go further . Best baghdad may very well a tipping point. One of the things i would be worried about if i were in the white house looking at this is if baghdad were to be attacked and you begin to see the quick expansion elsewhere outside the sphere. In the language that was trying to reach out. We saw that kind of thing. It may change the calculus for involvement. Descended esch began to. Ee an insurgent things that way out of the iraq region. That would really scare us. Editoratlarge with the atlantic. You can find his writing at the atlantic. Com. Rau, seniorordan correspondent on Kaiser Health news will give us an update on the healthcare law and what it does for the impact on Patient Safety. Later on focusing on the government regulation of the ecigarette industry. First, this news update. News thisternational hour. John kerry in baghdad to meet with the iraqi Prime Minister to meet to personally urge the shiite led government is to give more power to political opponents before an insurgency sieges more control across the country. Reporting the meeting is not expected to be friendly as officials in washington have floated suggestions the iraqi premiership resigned as a necessary first step for dealing with the terrorist uprising. The Prime Minister has shown out no sign of leaving. Listen tohave long but ultimately ignored u. S. Advice. An egyptian course has convicted three journalists for Al Jazeera English and sentence them to seven years in prison each on terrorismrelated charges. The egyptianthem producer moe mohammed were sentenced today. Mohammed sentenced to three extra years on separate charges. They were arrested in december as part of a crackdown on islamic supporters of mohamed morsi. Electoralistan chief officer has resigned and if it to resolve a political crisis over allegations of massive fraud as a runoff president ial vote earlier this month. The officer is denying any involvement in the alleged fraud and stepping down for the national interest. He suspended cooperation with the process and demanded he be suspended. The crisis has threatened what western officials had hoped would be a peaceful transfer of authority. The current president is constitutionally barred. Those are some of the latest headlines on cspan radio. Religion is a powerful identity forming mechanism. It is part of Human Society, securing out who is us and who is them. Religion answers that question pretty easily. If you pray like me, ee like me, go to the same church as i do, then you are us. If you dont, you are them. You can see easily have that easily leadd very to extremism, marginalization. Religion may be the most powerful form of identity formation. As powerful as violence. How do you know who is us and who is them. If youre fighting alongside me, you are us. Fighting against me, you are them. So they have been much more aligned than we would like them to be. Religious scholar and bestselling author, reza aslan. Taking your calls for three hours. In the months ahead, former texas congressman and republican president ial candidate ron paul. September 7, former chair of the u. S. Commission on civil rights mary frances mary. This month, online book loved discussing amity slaves the forgotten man, the new history of the great depression. Start reading and joined others to discuss this in the chat room. Host joining us now is jordan rau on the Kaiser Health news Senior Correspondent. Your latest piece takes a look at Patient Safety as part of the Affordable Care act. What is the connection . Guest they have a number of different programs intended to approve programs. Is the newok that program that will be starting in the fall that will penalize a quarter of the nations hospitals that have two high rate of infection in patient harms. Host why did the act center on those things specifically . Uest this is a big issue one in 25 patients get than affection. One in eight gets a condition such as a slip or fall or blood clot. It is very expressive expensive for the patience. They add a lot to the healthcare system. This was a way to use the purchasing power of medicare, toh is the biggest insurer incentivize hospitals to put more emphasis on doing a better job. . Ost what are the main causes human air or are things attached t . It jaco guest it really varies. Urinarydstream and tract infection, a lot of it has to do with the long tubes to inject chemotherapy or take you blatter you youre an out of the bladder. Often times they are left in far too long. Sometimes from convenience and other times because it is too hard to get in and out. For other stuff there was a lot of complicated issues and do not have the roots of them. Hospitals have studied some of these for a long time. Some of them not so long. One of the challenges is they are changing. You are getting a new strain of bacteria and germs more resistant to antibiotics and harder to fight. The other issue is readmission. The center for medicaid services, when it comes to readmission rates, rehospitalizations, rehospital i within 30 days of a discharge, that increased in 2013. The rate was 18. 5 in 2012. About one hundred 50,000 fewer readmissions. Talk about them overall. Why does this factor into concerns under the Affordable Care act . Readmissions are very expensive. Hospitals traditionally have had financial incentive. As you mentioned, very common thing, particularly right after a patient has left. Two years ago the first of the programs created by the Affordable Care act was instituted. Medicare began penalizing two thirds of the hospitals. This year increasing up to three percent of the payments. The government said that has led ofa decreased in the number readmissions. That program was phased in and another program looked up more quality issues such as patient death and patient ratings. This is the third piece. Host our guest to talk about issues that Patient Safety. You want to ask him questions about what goes on when it comes Patient Safety. If you want to ask him a question question, here are the lines 202 7370002, 202 7370001 for democrats and independents 202 6280205. Youran also tweet us questions or comments. Send us an email as well. The hospital gets fined. How did they respond to the programs put in place . Guest of resignation and objection. A lot of the hospitals feel penalties are not precise enough. That they are getting punished because they have much more sick patients or other factors. There is some of that. Overall i think hospitals have seen this is the way it is. Congress has passed the law and has several euros several years to prepare. A lot of them taking action and things they can address the most, readmissions. A lot of hospitals very active in setting up new programs to follow the patience. Giving patients who may not be able to afford the dedication, getting it for free. Your colleague writes 2600 hospitals could be affected just on the readmission portion alone. Guest readmission, yes. Trying to remember the exact number. In the 1500s. Treatede all hospitals yes. Ly . Guest there is some adjustment to the risk portion if you have a graded number greater number than infections but everyone can get the same penalty. One concern about the new program penalizing the conditions is the Teaching Hospitals will overwhelmingly be the hardest hit. 54 of those in the nation have received what are called preliminary penalties, which medicare has said he have not finished the calculations but along the way this is where you are. So the associations that represent them are very concerned there is something particularly that they are doing that is not being fairly factored in. Host a viewer says preventative care, not so much. A lot of time hospitals have given patience the discharge papers. You have been here, follow the instructions. Sometimes they do not do it. Sometimes they do not understand the instruction. That is the major preventative thing. Along with giving some education and setting up of doctors appointment for a followup appointment. Is onf what is going on the far end. Caller yes. I wanted to know whether United Health care have bought kaiser. Kaiser health news is not related at all to kaiser permanente. No relationship to the insurer at all. So i do not have the answer to that. Caller good morning. I am just joining you. I am wondering if what you were just talking about limiting readmissions, if that could possibly cause hospital institutions to lie or reject patients similar to what happened with the ba va scanda. Guest probably not. It has not been much concern about that. A lot of the patients are your runofthemill patients. Ones that come in for heart attack and ones that come in for heart failure, pneumonia. Hospitals cannot just turn them away at the door. That has not been a major concern so far. Gina on the independent line. Gene. Caller good morning. I am a registered nurse of 36 years. I do Home Health Care. One difficulty i find is with the standard of care, patients are often, particularly elderly patients are discharged home to people who do not have the foggiest idea what to do with those folks, and even though they have been given instructions, it does not have a necessarily good outcome. Has been theree has been a major cutback on Home Health Care registered nurses being able to go out and monitor those patients. So what i would like there is much to see host go ahead and keep going. My hasbeen just turned this up. I apologize. What i am saying is that it is the mosticult for even critical patients to get a registered nurse to come in and andajor dressing changes family members are not equipped to handle. That ai think it is true lot of the problems that have been are in the home and patients are discharged. It is obviously cheaper to treat them and if you can keep them out of the recuperation facilities, it is a great thing. There are pilot programs medicare has started to try. To sendo find new ways people to the homes, not just nurses but in some cases physicians to bring back the long dead housecall. To the extent they can do this and a costeffective way it will be a win for everyone. When it comes to patient complications, decreased by nine percent from 2010 to 2012. 130 two complications for 1000 hospital discharges. 2010 145 complications. How does this get compiled . Who theesponsible you go guest information varies from place to paste. Cms uses medicare billing records. All of the hospitals submit the bills and then they analyze them. Fairly archaic method. One of the problems with tracking all of these is anyone in the hospital knows how google or netflix is better organized technologically than the hospital. So we do not have very good access to patient charts. Not a lot of standardization. It is hard to get accurate information. Cms uses the best thing for them. Host new york. Republican line. Caller hello . Ok. Ofive on the south shore long island. I see the Urgent Care Centers popping up all over the place. Open from saturdays and sundays, most days of the week 9 00 at night. They open early in the morning. I believe they are relieving the emergency room. It is because of the Affordable Care act . Do you have any information on that . I do not think most of that change has to do with the Affordable Care act. I do not think most of that change has to do with the Affordable Care act. Emergency rooms are extremely expensive. Weights can be hideous. A lot of the effort is within the industry and market to find cheaper other ways to address patients who have the problems. Host from arkansas, mike on the independent line,caller but it needsutside to be told. Here in texarkana we have two major hospitals. I had a stroke a few years back and my wife told me the story because i did not know it. Admission. Ter i was knocked out. The doctor came in after that and ask my wife to what happened and spent within three years three minutes in the room. And was billed for three consoles. Did not examine me. Did not take my Blood Pressure except asked my wife what happens. The bill paid 400 85,000 and 500 65,000 for a doctor coming in and asking what happened. 485,000 and 565,000. Guest i think consultations and dr. Spending holiday time with patience is obviously in short supply. I am not asand va butr with the ba in general financial agreements do not encourage encourage doctors to spend a lot of time with patients. This is a common complaint that they do not get quality time. [indiscernible] as far as he admission, how does that affect hospital staff . I assume you have the . How much of that is volume and the busyness of the hospital . Guest you mean whether they have higher rates of admission . I dont know if that has to do with volume. There are incentives to fill. The majorst part factor that has been influencing readmissions is hospitals tend to have a lot of poor patients and higher admission rates. The reason for that, is it fair to hold the hospital accountable for that. The patients leave, and if you are pursuing a poor urban area, you do not have access to or the ability to afford the kind of food you need to get better and the social structure to make sure you are taking medicine. Sometimes you cannot afford the medicines. That has tended to be the determining factors. Host pennsylvania on the democrats line. Iller are you talking to me . Am referring to an article in the Kaiser Health news on june 18. Hospital observation care can be costly for medicare patients. Of the penalties that medicare is imposing, what is they are not being admitted. You can be in the hospital for several days and find out your care is strictly observation and for medicare patients, strictly him on medicare. Low medicare population. That leaves them with quite a problem if they happen to be discharged run their from a nursing home. The nursing home is not covered a cousin in patient care is required. The hospital not required to tell you you are in a observation status. You can be in there for several days on an inpatient unit receiving all the same care and inpatient gets. Not be able to tell one way or another you are not an inpatient, except whenever you leave your bill will be different. You will be responsible for many more expenses. You are absolutely right, observation care is a big issue right now. Theyspitals admit people should not be putting and, they cannot sometimes theyre not paid or they are audited. So there is pressure to not admit some people. They bring them in for observation care. Financially what it means is instead of being paid out of , it is paid out of Medicare Part b. Patients are responsible for much larger portion of the bill. Implications to what happens afterwards. It has been a very difficult issue for the industry and government to resolve. Rules that say you have to be admitted for observation . Not know that there are rules. There is a difficult thing. You are admitted for something, technically parsing is technically what not what you want to be in the middle of doing while you are dealing with a heart attack. Host is there differences in care as far as the extent of i dont think so. Mainly a financial issue. Caller thank you for taking my call. I have a question about the 30 debris admission penalty. I have heard it applies even though the readmission is not related at all to the reason the patient was admitted in the first place. For example, perhaps a person had a serious infection the first time but the second time they were in a car wreck. It still counts as a readmission within the 30 day time. Is that true . Number two, why is this only related to medicare patients who are by the definition of their age the most likely to have many conditions and more likely to be readmitted . Thank you. Two great questions. Yes, that is true. The hospital can get penalized for a readmission not related to the original cause, with the exception is if it is a planned readmission already prescheduled. The reason for that is practical. It is very difficult to parse what caused you to come back in. The government decided this is the way we are going to do it. Since everyone is being judged against each other, we hope it evens out. The second question, can you aost me what it was . Guest followup on twitter. How many are using the hospital as a basic malady . That is an issue with the emergency room. One of the goals with the is to reduce this. The question, why were there so many remissions . Why are they focused on medicare . The reason is twofold. Number one, that is whats medicare has power over and responsibility over. No idea how many many are done. There is various movements to do. Imilar programs these are at the vanguard and private insurers will have implemented similar policies and will fall. The government gives them cover, as at work, so they will cut your moneyay for readmissions, because that is what the government decided they are doing, too. Hopefully a trickledown effect that will make the policies not just cover elderly patients. To health it comes care associated infections . One and 25 has had one infection. Total of 722,000. More than half occurred outside the icu. Can you paint that picture for . S cap go guest the infections are serious. Some of them easier to address. Some of the ones like cdif and mrsa are harder to deal with. There is also increasing numbers in the community. People may not even realize they are carrying them and then come into the hospital and they are in a weakened state and a variety of other reasons. 7500 is a significant number. The cdc set a target amount of reductions between 2008 and 2012 and in almost all of the cases the industry was not able to get down to that level. So it is a big frustration and everyone feels it needs to go a lot lower. Talking about Patient Safety at hospitals. Jordan rau our guest. Our guest publishes stories as well as newsrelated issues. Talking about patient set safety. And next caller is from kent. Small practice a here. The Family Practice physicians admit patients. The independently operated emergency room admit patients. Seems unfair for the hospital to be penalized in the pay for performance if it is the position who is making the the patient. Ismiss plus, there is a tension between medicare rules where you can day so many days and then you are out. The risk of following that rule causes possible readmission. Who is in charge . Someone in the hospital itself supposed to be accepted or potential admissions . Guest good questions and points. My guess is your hospital is exempt because critical access hospitals, rural hospitals mostly, the hospitals the only game in town have been excluded from the programs we have been discussing. They probably are not being affected at all. Regarding responsibility, my understanding is up position has to be decision has to be credentialed. So the hospital has the overall legal responsibility for what goes in, and it there is a risk problem with regard to admissions, that is something they need to address. What about the statement you can only stay in the hospital so many days under medicare . Quite right. S not medicare plays pays a flat fee. Hospitals have a financial incentive to get you out. Paid 20,000. So that has always been around for several decades and has a weight always been a concern. On the other hand, there are reasons you want to recuperate. Kathy from delaware. Caller i have two questions. On the state are there state or federal laws to look at health care changes. Six second question, are there limits about how many hours similar to violence and Truck Drivers . Thank you. Two good questions. Are there preferment . I do not think there are. That is the debate about medical malpractice, the issue there is disincentive for doctors to fess up to the problems because they may be sued over it. There are interesting experiences where doctors have been taught to do this and be more worth right. A huge debate over whether limiting the medical liability will encourage cancer among doctors. Positionselieve dr. Are limited on ours but residents have voted way back to the case in new york city wish initiated and. Which initiated it. Residents cannot hold the three long workingnight around the block. It is still not quite clear if it is improved patient care or not because if you are with the patient and the clock rings and you have to get out of there, there is a danger some of the information that you know and the new dr. Is not aware. An effect. Obviously no one wants a doctor hallucinating from exhaustion. Host russell on the democrats line. Caller good morning. A lot has been said about the 40 veterans that passed in arizona. It came to mind that a lot of people died waiting for care at medical centers all over the United States. I wonder how much higher it is in states where the governor used to expect that expansion except the expansion of medicare under the Affordable Care act. Medicaide expansion of , the program for the poor, and nother that affects, it has been totally determined yet. I would say it is still a bit early to tell whether the the states that have expanded patients whether the are getting treated better than those that have not. Obviously if you have insurance, you are probably more likely to go get care. There have been studies in oregon that indicate that actual attendance at an emergency room or hospital is higher for those that have coverage. For one of the responders the program, leah binder said this. The report sounds exciting but not helpful to families that want to protect them selves for getting protected by household era. What is the group and how would you expand upon what she is thinking . Guest the leapfrog group is a purchaser. They have been very active trying to improve quality and transparency around quality. Not nearly as transparent as it is. I am not sure what she says in the email. In our story we talk to her her. About why arebate they more likely to be penalized . Her view is there is concerned there is not much to patientlaced safety. These are busy places, training residents. Doing research. If the places what have to put the prioritize it in a more. Traightforward an essential part of everything they do. Steve from the republican line. Good morning. Thank you for taking my call. I have a friend locally. Obviously needing medical care. Now he always went to the hospital. Recently they would not admit him only for observation. It is apparently not paid by medicare and cannot afford to because it is only for sick person with heart conditions. They both are retired. So they have to take on the very six sick person. True the know, is it readmission policy only applies if you are admitted as inpatients and does not imply if you are under observation, because it seems the hospital tries to cut down the number of but onlyons reported for observation. Is used s true when medicare is used they only look at patients admitted. If you just came in for observation care and left and came back, that would not count. It is also true there is a big debate about whether hospitals are pushing patience towards observation care so they did not have to worry about this. Additionaleen an study by the government that is pretty murky. I am not sure anyone can draw a conclusion. There is some evidence of it may be happening. Answer. No clear certainly a legitimate concern for patients and for people want to cut down on the readmission. Host is that from the initial government study . Guest they actually did their own study. The issuehave raised so much as they did their own preliminary analysis and published a paper to look at it and do not think it is a big factor. The people who track this closely like the associated american medical colleges are very concerned. From louisiana. Wondering, i just go to a charity hospital. I was wondering why i see a lot in 30,000riving up independent line. Joy. I was just i know you have been over the readmission, and i can understand the point , i was just inking that i was just thinking that is have had experiences with the where there are different types of admissions like Car Accidents and sometimes it is repeated because my friends have habits and personality within two months have had three different hospitalizations. [indiscernible] host what would you like to guess to address . Wondering if it is forible for a smaller congress to focus, upcoming focus to fliers, the flip term for those that are free admitted obstinately are a major cross on the system. There has been interesting initial efforts to really birddog them. In new jerseyngly where they have thrown a lot of resources at identifying patients that are being transmitted over and over again. They can be for anything. Incredibly bad health. Obesity and related diseases can be because of the ability to manage themselves, so the idea is if we invest on the front end and really target these people, even block by block and put a lot of resources to cut back on that. Get readmissions in a year is a very serious and. To some extent that is unavoidable for people that are very sick or nearing the end but to the extent it can be dealt with. The hospital is the most expensive place to treat someone. You can do to treat them elsewhere is going to be efficient. I am a home health nurse. I have been practicing for 15 years. I have noticed is patients with congestive heart failure, diabetes, diabetes theyses that are forever, get put in the hospital and rehab and get sent home to home somewhere they never really get good teaching. The hospital gets them well enough to go to rehab. They use up their rehome rehab days and come home to home health and we try our best to teach them about diabetes, congestive heart failure, to stop them from going back into but the thing i have noticed is the hospitals are not doing what they really need to do for the patient before they send them home. I have had rehabs discharge people. They take their fully out and the patient has not even urinated and they send them home. There is a breakdown somewhere. I know it has to do with the forprofit system. The use of all the medicaid days in the hospital and use of medicare days and the rehab facilities. Homethey come back out to health. Once they have used up all of their days, the hospital is like you will have to pay i want toket . Guest point out the majority of the hospitals in the country are nonprofit. Arery sizable number forprofit. The issue the caller raised about chronic problems not being addressed is totally true. A triage unit basically. Dealing with the immediate problem. Things like obesity and hypertension, diabetes these are things that have to be dealt with constantly along the way. There have been places that have done interesting things. He mentioned somewhere they send people out. I did a story a couple of years ago where there was a maryland hospital where you cannot have the high salt diets. So they started putting together recipes of the Popular Foods and solve the door that were lower salt. So you can try simple things like that. Obesityl know, the problems in the country is hideous and getting worse. That connects with so many diseases that land people back in and you are just patching them back up. How does the Obama Administration knows these are a success . Thet they are tracking readmission numbers very closely and have seen a decrease. Tracked the center for Disease Control and prevention to track infection. There is a decrease in that after the penalties go into effect. That will be a major impetus. They also look at the building records. There is a fair number of ways you can track this stuff. But it is harder to determine what is driving it. Is striving for particular institution a high rate of infections or what is driving acceptance. For a lot of these things they do not have perfect ways to deal with it. Kaiser healthau, care news. Thank you. Coming up, we will learn about the ecigarettes industry and the fda oversight of it. First, another look at news from cspan radio. 9 15. The organization for the prohibition of weapons, the Group Overseeing the destruction of serious chemical weapons programs is the last of the countries acknowledged stock ill has been handed over. Organization director general speaking at a press conference earlier says the final eight percent of the routine hundred tons stock pile has been loaded onto ships in this. Port. Meanwhile, the European Union has placed sanctions on 12 of the government, singing they are responsible for serious human rights violations. The 12 will be banned from traveling to the 28 nation bloc and eu assets will be frozen. I report by the Human Rights Watch says serious rebel factions are recruiting teenagers as young as 15 to fight in the countrys civil war. Turning to today in washington, president obama plans to encourage more employers to adopt familyfriendly policies i hosting a daylong summit on the topic. The United States is the only industrialized nation that does not mandate paid leave for mothers of newborns. President obama says he would like to see that change. Those are some of the latest headlines on cspan radio. Now you can keep in touch with Current Events from the Nations Capital using cspan radio. Congressional coverage, Public Affairs forums and todays washington journal program. Every day listen to a recap of the events of 5 00 eastern. You can hear audio of the networks and the Public Affairs programs beginning sunday at noon eastern. The Radio Program on cspan now. Religion is a powerful identity forming mechanism. It is part of Human Society they bring out who is us into his them. Who is my group and to is that our group . Religion answers that pretty easily. If you pray like me, even like me, go to the same church as i do him and then you are us. If you dont, you are them. You can see easily how that kind mindsetoup and outgroup can very lead to extremism, marginalization. As i remind people, religion may be the most powerful form of identity formation. Just as powerful as violence. How do you know who is us and to his them . If youre fighting along me, you are us. If youre fighting against me, your them. Have been much more aligned than we would like it to be. Religious scholar, rreza aslan, live at noon eastern sunday, july 6. August 3, former texas congressman and president ial candidate rand Paul Ron Paul and the chairman on condition commission for civil rights and childrens rights. Discussing amity slates, the forgotten man, the new history of the great depression. Start reading and join others in the chat room. Tv, television for serious readers. Joining us now, anna edney for Bloomberg News who reports on the fda. Good morning. You write a story about the fda is turning to the attention of the ecigarettes. A lot of themest can look like a cigarette. It mimics smoking in a way. There is not the tobacco inside of it. It is going to heat up a nicotine vapor. It still has the addictive substance in it. What else was in there is not uniform across the industry. You can smoke it pretty much like a normal cigarette. You smoke it in the paper comes in like a normal cigarette . As far as the liquids, is nicotine in the liquid . You said no one knows for sure what is in the liquids . A trade secret or why is that . Www. Cspan. Org some have reported guest some have reported what exactly is in there but the fda has proposed they need to give them all of the ingredients. Of them. Is in most different levels. Since it is derived from tobacco, that is how it falls under the possible tobacco. These are taking off. I guess it was in 2012, last in 2013 they tripled in sales. 1. 5 billion. People predicting 3 billion this year in sales. Market growing really fast, especially without regulation. Host can anybody gain access to these . Pretty much. There are companies that have said we do not sell to minors and they try to set up systems, whether they are ordering online or in the convenience store, where someone under 18 cannot get the products, and there are states that have said no, but by and large it is murky. Why would someone choose this over a regular cigarette . Guest the not yet proven thought is they can help people stop smoking. So maybe it would be more to it. Who would switch there are critics who say it is really just a bridge so they can smoke and a restaurant or smoke in our office and smoke a real theyette in places where can smoke a real cigarette. There are a lot of advertisements lately, you have probably seen them on tv with Jenny Mccartney and things like that. People are getting interested in them and seeing them as an alternative. Whether they get people to start smoking or whether it is learned it yet. You should advertising. One has a picture of santa claus. This is the picture of stuff you are seeing advertisingwise . Guest for sure. There are tv commercials. Some of this is stuff that Cigarette Companies cannot do anymore. There are a lot of lawmakers senator durbin in illinois, who and thehese are at kids celebrities are things that kids are picking up on. Santa claus obviously. Host they have certain flavors you can buy apparently. I goes to the whole kits market some would say. Right. There was a hearing last week in the house where some were cherry,up the may bear, orange. Kids love those things. The fda looking at regulating the ecigarette industry. Westerns directed towards our guest. If you have questions, you can call these numbers republicans 202 7370002 democrats 202 7370001, independents 202 6280205. You can email or send us a tweet. Guest the proposal they have put out there is not as far as some want them to go. They want eCigarette Companies to submit to them an application for the fda to clear the product for review. What exactly the am application would entail yet, we do not really know. I think the fda is trying to figure that out. The company took two years to make it a proposal. They are not pulling everything off the market. They need to get the review cleared the fda to stay on the market. It will prohibit sales to minors. It will stop sampling. If you go to a concert or maybe a nascar race, then you see these companies handing out free ecigarettes. It would stop that. Again mentioned before, companies would need to submit the ingredients list to the fda. If i accompany selling the product, how am i reacting to pretty happy initially. Some expected online sales might be banned, as well as the flavors might be banned. Since the fda has not weighed in on that, they say theyre initialuntil the proposal is final. Since they have not weighed in, they were pretty happy with the way it came out. They think this is something so far they can comply with. Is the happiness determined by how big the company is an the ability to meet this without financial risk to the company . See a i think you do Happiness Level growing based on the company. There will be standards they will have to meet. Good currentm manufacturing practices on how they make the product. The bigger you are, the easier it is for you to gear up. Most of the bigger ones have probably been given been gearing up because they knew this was coming. Host our guest is with us until the end of the show. Judd on the democrats line. Good morning. Good morning. My question is for the regulation of ecigarettes, i noticed many people under the age of 19 are using it, especially around pennsylvania and other large cities and suburban areas. There is no regulation. The ingredients are not listed for most companies. I think people should know what they are putting in their bodies, especially if there are not serious regulation such as cigarettes. Youretes you know putting nicotine and chemicals they use to filter those into your body. Are right. In a lot of places there is nothing yet. There was a new industry that cropped up before regulators could get ahold of it. That is the proposal, to stop the sale to minors and take care of some of the things you brought up. Host we have set a lot a site of mine for ecigarette users. This is hannah from kansas. One more time for hannah from pittsburg, kansas. Going to jeff. Jeff from texas. Republican line. It going this morning . Yes, four years ago i was smoking two packs of marlboro rolls a day. I was going through almost two cartons of week. Ecigarettes came out. I got the nonnicotine ecigarette. My mom, wife, children all told me there was no way i was going to quit like that. I quit in 30 days flat. I was done. Even the ecigarette was done. So i know they work. If you guys regulate them to so so that they are so expensive, then you will never get anyone to quit. That is what i am worried about. Host what kinds of costs are you paying . I paid 32 for oneer month worth of cigarettes. It was good for 30 days. So i smoked that for 30 days. When i was done, i handed them off to a friend. He ordered the filters come and he smoked it and quit. So they are still given to my friends and all quitting. Host why do you think it led to becauseting . Caller what i found is when you smoke the ecigarette, it gives you the hits at the back of your throat like a regular cigarette does. It takes the craving away. After three days of doing that nicotine is out of your system. Then you have to get rid of the habit of getting up to go out and smoke a cigarette or however you do that. Congratulations first of all. I have not heard a lot yet, out about the cost of these going up. Maybe it is more regulation, that might come up. Stay tuned for that. Host mason is next. Caller hi. Good morning. I use ecigarettes. I have been a smoker for a long time. I believe that it is a legal substance. I enjoy smoking and i should be allowed to smoke. There is a lot of prejudice against smokers. Surgerycing major back because of a bad injury. Discriminatoryre because i smoked. Person ismatter if a on crack or an alcoholic. They will take you anyway. If you smoke, they will not do the surgery you need to do to get back to life. I found ecigarettes as a possibility. When i looked at the ecigarettes, i could smoke them in the hospital. It is water vapor. It relieves that oral fixation for me. When i get i smoke. This gives me the alternative to having something in my hand and the oral addiction. I am concerned about the regulation on two parts. I am worried about the cost going up and regulating the so heavily that they become the same thing cigarettes are. You are looked at as a secondclass citizen yet again. With the regulation of fda, i do not understand why they would stop the free sampling, because there are so many out there and they taste so differently. You are trying to find something comparable to marlboro lights. That would get rid of the opportunity to switch and quit. Host you can smoke fees in a hospital . Caller you can smoke them anywhere. It is true, it is just water vapor. It does not harm those around you. Host thank thanks. Guest some of the criticism is it is being done at you fence where there are a lot of under age kids. I mentioned music festivals. Nascar, maybe not as much. Seene vapor, i have not any hard evidence of what affects it might have on those standing around you while you are smoking it. One of the things the fda is trying to do, and i heard a talk yesterday. Out are trying to figure where the might be a middle ground. They think they might be a possibility for these. They want to make sure they are not getting people to start smoking. They are trying to make a continuum where you have cigarettes on one end. You have lozenges or gun on the other. And some might be in the middle, like ecigarettes. Host you mentioned a hearing that took place. Barbara boxer was questioning an executive about ecigarettes. Heres what she had to say. [video clip] why did your Parent Company say kids may be vulnerable to try ecigarettes due to abundance of fun flavor such as cherry, vanilla, and you sell them. Are you marketing to children . No, i am not. Guest who is attracted to ch, berry, vanilla . Adult smokers. They are . Interesting. Guest most adults do not go for cotton candyflavored things, particularly when theyre looking to smoke. St host greg host greg. Caller i think it is crazy when you have lobbyists, the tobacco lobbyist that sway the fda to look at regulation. Damage thathow any has been caused by ecigarettes. Bet you neveri even tried an ecigarette. I was listening to barbara boxer. She was naming these various flavors. Sherry sounds good to me cherry sounds good to me. Those are great flavors. We are going to say these are for children . That is crazy. Let americans decide for themselves. Stop trying to regulate every doggone thing. Cover those issues and thought it might be important. On the flavors, you are probably right. There are some adults who are interested in all kinds of different flavors. There are kids who possibly could be interested in them or. Couldnk that is the fear be interested in them more. Host reservoir flavorings. What is the concentration of nicotine . Guest it really depends. Didnt get concentrations that are a step down. That what you can get down to zero. Ou can go toin y the website and see three different ecigarettes. Host you tried one. What was it like . Guest it wasnt pleasant. It wasnt harsh. I had to try. It was a bit harder. It was fine. It was not a bad experience. Host as far as rules for how these are used, same as cigarettes . Is that changing for ecigarettes . They doew york has said not want these indoors. Similar l. A. Has prohibitions. Some states are starting to pick up on that i want to limit that like cigarettes are limited. Ant this is rob, ecigarette user. Hello. Rob, go ahead. Edller i have used i smok a pack of cigarettes a day. You can use that indoors. It did kind of irritate my throat. I think it is all about the government has tax money. People are not smoking and off. They have to put their hands in it to get tax money. Iest as far as i can recall, do not think they worked out much on the tax end. At least as far as to the level that cigarettes are taxed. It is not something that has come up in my reporting as much. I am not exactly sure what they are making up versus what they get from Cigarette Companies. Host the fda working on the Research Side as far as the longterm effects . Guest they have a pretty big program they are trying to follow users and everything like the in figure out what likelihood of smoking versus cessation is with these kinds of things. Next, forest up hills, new york. Caller good morning. Smoking for about 56 years. I considered myself a smart as a, but i was as stupid lot of the callers you have just gotten. Ok. People,o say to at least i know what im going to die from. Im going to die from lung cancer. Ith these people woul bravado did not realize all the sicknesses do not show up for 20 or 30 years. You want to find stupid, it was me. Because in the 1960s, i started getting what they called copd. Chronic oppressive pulmonary disease. I have emphysema. Thank god it is not that bad at this point. I have taken breathing tests where the person giving me the test would get up and try that i should push air out of my mouth wasuse the signal he trying to get was going nowhere. In other words, i cannot breathe very well. And it only gets worse. Host as far as the fda, what do you think given your experience . Caller ok. I no longer smoke as of a year ago. Say i do not do is smoke. The cigarettes are the same thing that i was using. Up until last year, it was costing me 550 a month for cigarettes. That is getting on a train to get about . 80 a pack cheaper, too. Host thank you for your comments this morning. Guest a lot of the disease with cigarette smoking show up a lot later once you have been doing it for 15, 20 years. We dont have that much experience with ecigarettes. That is research that needs to be done. Host what about outside medical organizations . Guest i have not heard a lot yet as far as the medical organizations, whether they have decided it is something American Cancer Society has been cautious and not behind it as a cessation device. I havent heard anyone saying ban them or get rid of them. Host what about the Tobacco Industry . Guest they are makers of these products. Blue is your most popular ecigarette. That is owned by a company, the third biggest tobacco maker. The thirdbiggest menthol seller in the u. S. Also r. J. Ris and reynolds have gotten in on it and testing some in different parts of the country. Their executives say they want smoking,ate tobacco which is an interesting comment to hear. Their companies are one and the same. Host david up next, good morning from new jersey, an ecigarette user. Caller i smoke cigars every once in a while. I started smoking an ecigarette whenever i wanted to smoke a cigar. I do not want to talk about myself. I want to talk about my son. Ive been telling him he has to quit smoking cigarettes. He ticked up one of these ecigarettes and is not have a real cigarette since. I believe this is a cessation device. I think it takes the place of fixation you have when you smoke cigarettes. I smoked cigarettes back in the 1970s and 1980s. I quit cigarettes in 1981. I know how difficult it is. The longer you smoke cigarettes, the more difficult it becomes. He picked it up on april 1 and is not had another cigarette since. He is using nicotine. He started with 18 milligrams of nicotine and now hes down to two milligrams of nicotine and the next one will be down to zero. Himself of the nicotine slowly and using this to get away from active smoking. I think that is the most difficult thing. Guest that is great that your son will be able to get off cigarettes with this. Himink a lot of people like that have been able to use ecigarettes to stop smoking. Sayingt think anybody is it could not be a cessation device. They want to make sure there are not other factors to it. Doesnt make nonsmokers pick up a cigarette . It is like a gateway to smoking or doesnt allow smokers to continue smoking who might have otherwise quit . They are trying to balance that knowing there are a lot of Great Stories where people stop using cigarettes altogether. Host a San Francisco converse woman said she will introduce legislation that would restrict ion advertising. Alk about the television advertising. What are we seeing . Guest a lot of the commercials tend to glamorize it. The biggest complaint about them, i mentioned some of the commercials. People think it is the commercial is a typical thing to do, bringing back the idea that smoking was cool. Tore are lawmakers who want jump ahead of fda regulations and get legislation passed. The screen captures from Jenny Mccarthy commercial on ecigarettes. Jim is from new jersey on the independent line. Caller thank you so much for taking the responsible approach to this argument today. Something i dont think your industry has seized upon. Aday smoker. Ack i realized i didnt have the physical addiction anymore. Once you know that that is gone, that is 90 of the battle. Are you consider what you up against. Jenny mccarthy. He didnt think marketing the product with cotton candy and cherry names. There are so many dishonest people in the industry. A lot of the lawyers and politicians, you cannot trust a word they say. This is long overdue that we get rid of this industry entirely. Nobody benefits except for the people that line their pockets. Guest that is something i have heard during the hearings, the house and senate. This is what it feels like, tobacco all over again. They think the advertising and the flavors that cigarettes used to have, it is coming back around with ecigarettes. Some of the hardliners want them heavily regulated and if made some of the same complaints. Host what kind of rules how the states put on ecigarettes . Guest we are brought up the not smoking with ecigarettes we you cannot smoke a cigarette. They have jumped in on the age restriction. They want to keep them out of the hands of minors. Though said then the big ones. Host here is john from fort myers, florida. Caller h hi. I was wondering how you feel about the fda is judging people. This could be good. We are allowing people into School Systems to teach people. The major problems are Secondhand Smoke and thirdhand smoke, when people are smoking cigarettes. They actually want to smoke the cigarettes. Aboutcurious how you feel judging people toward smoking and maybe denying them job offers because they do not smoke. Guest i havent heard of anybody being denied a job because of ecigarettes. Tellnk as far as i can with the regulation, i have not seen a lot of judgment. They are trying to find the middle ground that regulates an industry. People are inhaling what is in the ecigarette into their body. There are people around them them might also do the same. I have not seen a lot of judgment on this. Host cloris. Caller yes, i smoked ecigarettes. The vapor that comes from the ecigarette, it would be the same as if youre sitting beside someone that is on the nebulizer are using an inhaler. It has no effect on the person next to them. Some of the ecigarettes do have whats in them written on the box. You can look up the chemicals to see what they do. It is so much better than the cigarette. Less. End up smoking it you are not getting all of that tar you would be getting from a regular cigarette. Host what made you convince to make the jump . Caller i am a registered nurse and among the longterm unemployed. There are a lot of hospitals that will not hire people that smoke. Host thank you. Guest i think that you make a good point. There are some that have the ingredients on them. You can look them up on the internet or the package. The idea that they are harmless has not been proven yet. There is a lot of anecdotes that it must be a believe that it must be harmless because it is mostly water. I dontthe ingredients, think anyone has had any longterm exposure to. Host any sense before how we get data if they are harmful are not . Guest that is not something that we will have this year, this data. The Industry Days we took off in 2011, 2012. If you need 20 years, it would be that long. It is not something that in other countries, it took off long before. We have to wait to see. Host greg is from medford, new jersey. Caller i am greatly concerned with the regulation. If you look at the economic thatt analysis, one thing no they admit after the riod, theyrace pe expect to get 25 to 40 applications per year. Their are more than 10,000 onyx available right now. 9 ofa plans to ban 99 Electronic Cigarette products. The history seems pretty happy with it. Seems to benefit. They are going to fall by the wayside. I think that is not being covered enough. Shops, thesmaller harder it is for them to meet some of the regulations, it requires a lot of money and time to get these applications together to turn in. We mentioned the happiness with the regulations is at a higher level the bigger the company. Some of the smaller ones might not be able to meet the demands of the fda. People predict a lot of consolidation. Some of the bigger ones buying up the smaller ones that might not be able to do it on their owns. They werearchers said deeply concerned that putting ecigarettes under the category of tobacco would do more harm than good. This is a world issue. Who, most companies together and i guess they called a Tobacco Consortium and trying to figure out what kind of standards the ecigarettes might need. They have had battling letters. The one you just mentioned and another from another group of scientists and advocates who said the opposite. About theorried effects that not enough is known. Fda isnt as the involved as other countries on what the who is doing. Line,on our independent hi. Caller hello . I am from pennsylvania. Host go ahead. Hostcaller i would like to knoy there is this upheaval about ecigarettes. I dont hear anything about smoking pot. That goes into your lungs. Why is the government so worried about legal substances . Thank you. Fda would not regulate an illegal industry. There cannot be standards for something that is not supposed to exist. Marijuana is coming up a lot more. There are some places that legalized it medically or for recreational use. The issue with that is the research on whether it works for medical uses are not is done through a different organization, the National Institution on drug abuse mostly. The fda is not as involved in the research to figure out whether it works for something. They would get involved on approving the Clinical Trials as well as if someone tried to make a description. Host we will focus on colorados experience with Recreational Marijuana on friday. Kevin from indiana, ecigarette user. Caller how are you guys doing . I wanted to talk about the marketing to children thing with the flavors and stuff. I have been using ecigarettes for a few months now. I love the sweet flavors and the fruity flavors. I have been into about four or five different shops where they sell the ecigarettes in the flavors and the juices. They i. D. Everybody that comes in there. If youre under age, they tell you to leave. If the shops are doing what they are supposed to be doing, kids are not going to get what they are looking for. Again, i am 25 years old. I like the fruity flavors and the sweet stuff. Guest in a perfect world, you are right. Shops doing what they are supposed to do. We all were teenagers once and probably got a hold of something we werent supposed to. It seems that kids can always find a way around an age restriction. Host can the public weigh in . Guest they still can. The fda was going to cut off public comment. You have until august 8 to submit a comment. Go online and find the regulation where fda made the comment on that. Ecigarettes. Ng that is it for our program today. We will see you tomorrow. [captioning performed by national captioning institute] [captions Copyright National cable satellite corp. 2014] secretary of state john kerrys meeting in baghdad today with iraqi Prime Minister Nouri Almaliki and other iraqi leaders. Secretary kerry will personally urge the shiite led government to give more power to political opponents before sunni insurgency seizes more control of the country. To keeplitants captured border posts yesterday along the frontier with jordan and the other along the frontier with syria. The u. S. House is back today at noon eastern for general speeches and seven bills at 2 00. After the votes the debate begins on the bill to reauthorize the Commodity Futures Trading Commission through 2018. The senate meet at 2 00 eastern for general speeches and at 5 30 they will vote on judicial nominations. Watch the live coverage of the house here and the senate on cspan two. President obama participates today in the white house working families summit, bringing attention to issues like paid leave and flexibility with work hours. Cspan3 has that live coverage. Missouri senator claire mccaskho