Transcripts For CSPAN Washington Journal 20160907

The hearing today, what does it deal with . Guest something called the commission on care. Something that was part of the choice act. When Congress Asked the robert to carve out six 2 60 of our budget million of our budget. Time, they came up with 18 recommendations. Of the 18, we said we agree with 15 of the 18. 12 of the 15 are already underway or already completed. For us, the commission and their findings reinforces but we are trying to do with our my v. A. Transformation in transforming the work of the v. A. To better care for veterans. Host although care delivered by the v. A. Is comparable or better than clinical quality generally available to the private sector, it is inconsistent from facility to facility. How would you respond to that . The Biggest Issue was inconsistency. Some were leaders and Lean Technology as a way to provide care. There are some who had never heard of lean. We tried to defuse best practices across. I came from the private sector, i was 33 years of procter gamble, the chairman and ceo of that company for my last years. Are diffusing best practices across the enterprise in order to make sure we raise the level of care are all veterans. Host one of the concerns about the commission was the wait time for a veteran to get care. Wit before youe started and what is it like now . Guest we had some problems. The most famous was phoenix where we had a long line of individuals waiting for care. We had wait lists. We have added capacity. In the last year, weve had more than 4 million more completed appointments. Weve added 1200 new doctors, 2300 new nurses. Clinical hours. Weve done more telehealth. Care in theirth homes oftentimes. Thanksone a lot of to expand care appeared that is great, but we need to do more. More veterans are coming to us for care. There are no copays. If you have a choice, which the , youity of veterans do want to get your knee replaced, lets a better 25,000 operation , copay might be 20 , that is 5,000. You do it at the v. A. , it is free. More veterans are coming. It is so critical that we get the congress to pass a budget for this fiscal year so we can continue to increase our capability. Its also critical that congress authorized the 24 leases we have waiting. We have 24 new leases waiting to be authorized. Theyve already been funded. But they have not been authorized by our committees. We need those to be funded so we can open up these 24 new spaces and provide even greater care to veterans. Host the hearing today deals with this Commission Report and ultimately deals with the department you serve. Will he be testifying . Guest i havent been invited to testify. Also, the invitation that was given to the American Legion and many of our veteran Services Organizations was revoked. I provided written testimony. A lot of what the commission came up with was consistent with what were doing. Im a business guy. Ive been on over 300 different trips to talk to members of congress, talk to veterans, talk to Veterans Service organizations. Is notn we put together my plan. Plan. The veterans im putting in place new leadership, 14 of my 17 top leaders are new. I put together an external that includesttee usaa. Rmer u. S. Ceo of the former surgeon general, special forces veteran from vietnam. They are advising me on this transformation because i need help transforming this organization. We are in the midst of doing that. Weve invited you to call and ask questions of the v. A. Secretary, robert mcdonald. 2027488000 for the eastern time zone. 2027488001 for the mountain and pacific time zones. Rely on thermation private sector . Put out more. Veterans into the private care system . Guest weve been doing that. ,2 of our appointments today every day, are in the private sector. The ability to do that, nearly 4 million more appointments, they rely on using private sector capability. We dont give up responsibility for that veteran, but weve been using the private sector. That was part of the choice act in the end of 2014. Even before that, we were using the private sector. Thathoice act formalized in a particular bill. Did the commissions report cite any case for more reliance on the private sector . The report was very clear on something we agree wholeheartedly with. We need to set up a broad network, integrated network of Public Sector and private sector medical capability for veterans. We dont think we should give up responsibility for taking care nature ofmary care veterans needs. But we should continue to use the private sector. The commission did not go cell so far as to say they want to privatize the v. A. I think that is a bad idea and veterans think that is a bad idea. It is not veterans suggesting it. I am a veteran. I served in the 82nd airborne division. The v. A. Is important to all americans. Done research that has resulted in breakthroughs in american medicine. The first Electronic Medical implantablety pacemaker. This last few months, weve done in operation in Salt Lake City called rather than fitting a prosthetic device on a remaining part of the limb, we put a andnium rod in the femur snapped the prosthetic device on. One of the veterans i had a chance to meet after the operation told me a week or so after the operation he could the cracks in the tile in his shower through his prosthetic. Is not yet fda approved, but we are in the process of getting it fda approved. Host one of the commissions recommendations was the establishment of an 11 member board of directors that would be accountable guest i think that is a bad idea. We dont need more bureaucracy. We have a board of directors. The Board Members is called congress. We Gave Congress 100 pieces of legislation that we need. 40 are new this year. Thanks both sides of the ill agree on. Things both sides of the aisle agree on. Leases remain from fiscal year 2015 that we need authorized. We have simple laws. An appeals backlog. We have over 500,000 appeals waiting to be adjudicated. That is way too many, it takes too long. We created a new law. It is ready to go. Weve had hearings in both the house and the senate. We simply need to get it passed. Johnny isakson and big blumenthal and our committee have put together an omnibus bill called the Veterans First act. Both sides of the aisle held a press conference to praise each other for bringing it out. We cannot get it to the floor to get it voted on. Its time to not have veterans be political pawns. Its time for veterans for us rather than just thanking them for their service, lets do something and look back on 2016 as the year that we really turned the corner for veterans. Host our first call is from mike from minnesota. He is retired. You are on with v. A. Secretary robert mcdonald. Caller good morning, gentlemen. Im actually going to the v. A. Today. One of the worst things we could possibly do is privatize the v. A. System. Several surgeries and i prefer the health care i get there. I would rather use the minneapolis v. A. Rather than the mayo clinic. They do an excellent job. I would hate to see it privatized. Guest thank you for your comments. Whenever someone approaches me and say they like us to privatize the v. A. , i ask than three questions. Are you a veteran . Generally, they are not a veteran and certainly not a disabled veteran. If you talk to a veteran, they have generally not talked to a veteran. Their thoughts come from political ideology. Have any interest in a private Health Care System that would benefit if the v. A. Were privatized . Service Organization Called out the fact that many of the commissioners on the commission for care actually had interest in private Health Insurance companies. North carolina, diane is next. Good morning. Caller good morning. Thank you for taking my call. My husband is a retired vet. He has recently become disabled. He finally got in the process. My concern is with the education benefit. We have three sons, two in college. Ive been going through all the the military chapter discover two days later that he was not able to use it because he was disabled. Way forsome kind of bad my son not to be able to use the is in anecause he intellectually developed program the v. A. Process is not tied up with. This is a four your certification at the university of North Carolina greensboro. What do i need to do in order to academics d the funds heics needs to go to college . Guest i have a lot of empathy for your statement. Many of the limitations we have on the benefits we grant are baked into the law. We need to go back to the law and see what changes we might eat in the law to be able to provide that benefit to you. At bob. Mail me va. Gov. V. A. Becomeuld the better in taking advantage of the Technological Innovations to provide Better Services and support for veterans . Over 40 apps for smart phones and many of our veterans are finding these apps very helpful. We have an app that helps for ptsd treatment. We have an app we are working on for scheduling. These are things we are trying to do. Did, i changed 14 of our 17 top leaders. One of the leaders are brought in with the new head of i. T. Who had been the head of i. T. At Johnson Johnson and dell. She is transforming our i. T. Organization. Systems was a big problem at the v. A. Our scheduling system in phoenix date back to 1995. Our Financial Management system is written in a language i wrote at west point in 1971. We deal with over 700,000 veterans in telehealth. Telehealth is the wave of the future in american medicine and we are leaving it. Been on the cutting edge of innovation for american medicine. We need to continue that and technology will play a huge role. Host how does the v. A. Stay competitive with the private sector . Guest we spend 1. 8 billion a year on innovation. Thats a big part of what we do. A big part of it is the relationship that we have with the best medical schools in the country. When omar bradley was the head of the v. A. In 1946, he set up a system of affiliation where many of our v. A. Hospitals are right next to the best medical schools in the country. , our v. A. To durham across the street from Duke University medical school. We share doctors. We share hundreds of doctors at duke. We share over 300 doctors with the university of utah. We are getting the best doctors in the country who are doing the research, who are teaching we train 70 of the doctors in the country. Who will train those doctors . We train 70 of them. Have to doctors who teach it every day and they are doing research. Innovation becomes very important. In dayton, ohio. Good morning. Go ahead. Caller good morning, everyone. Privatization is what is killing us. Now, weentists only have four. The private sector cannot take care of our veterans. The cost is high. You came from cincinnati, you know the dayton area real good. Issues is thathe we need help recruiting doctors, dentists, nurses. One of the things i did when i became secretary, i went to medical schools to recruit doctors. I went to over 24 medical schools to recruit doctors and nurses. What i discovered was we are not competitive with the private sector. Legislation that would allow us to make sure all of our medical personnel become rather called title 38 than title 35, which allows us to pay competitive with the private sector. I look at the salary bands and i increased the salary bands to become competitive. We also loan rim person. Our loand reimbursement. We are being successful. Thething holding us back is way sometimes our doctors and nurses get treated. Host cedarcrest, new mexico. Dave, your next. Caller i was wondering if you ever thought about turning all intoureaucrats at the v. A. Auditors and have them audit the v. A. Every two years. Have you ever thought about getting the Watson Program from ibm to help with diagnosing and treating patients . Guest on bureaucrats, the percentage of employees in s head office is lower today than it was in the past. We are working on putting more more people against and more people on care for veterans. We had a meeting last week. We get a lot of help from the gao, the comptroller general of the country to audit us. We have lots of auditors and overseers. On watson, we do have a partnership with ibm, we are working with ibm and watson. The Computing Power of watson showed tremendous capabilities in our million vet project. , we haveading research over 550,000 veterans who have given us their blood samples, including my own. We have 20 i did 30 years medical history. 2030 years of medical history for those veterans. We are mapping genomes. We will be able to predict future potential diseases and solve them before they become a problem. I was with a young lady the other day who unfortunately, we had to do a hysterectomy. She had cancer of the uterus. Genome, weping her discovered that she was susceptible to colon cancer. We increased the frequency of her colonoscopies. We discovered precancerous polyps and we were able to remove them. Cancer talking about the moonshot. She said the v. A. Saved my life and this new technology has saved my life and we need Computing Power for that. Ibm andpartnered with watson and the department of energy. Host a retired vet, anthony in North Carolina. I had a unique question. , ive been seen at the v. A. Because they determined that what was considered just abrupt and stupid behavior on my part from when i was 17 was the start of schizophrenia, which im dealing with now. Anybody with anything other than a dishonorable can get the a car. Get v. A. Care im waiting on them to determine whether im honorable or v. A. Purposes four v. A. Purposes. Other than honorable is a relatively large category. Its a very diverse category of discharges. Wes not one answer need to get into your situation. At bob. Mcdonald va. Gov. Can based onas we the law the law is what prohibits us from dealing with dishonorable discharges. You should apply to the department of defense to have your discharge reviewed. Back in the days when i was a captain in the army, many of the times people may have had Something Like posttraumatic stress, bipolar conditions, schizophrenia that we didnt know then. You may be able to get your discharge changed. Host tracy from facebook asks guest we have a stateoftheart program we are leading the country here. We track the dispensing of opiates. We track it by dr. , by facility. We track it on a national basis. Doctor, by by facility. Other treatments are just as effective if not more effective than opiates. Things like acupuncture. We are the largest user of acupuncture in the country. , equine therapy, yoga. We are trying to develop a library of database evidence that shows these other treatments are effective. Will try whatever treatment the veteran requires in order to find something to be able to get them off of opiates. Host leonard from missouri. A retired vet. Caller in 1975, i got an honorable discharge. I have all the effects of agent orange. Because i do not go to south vietnam, they are refusing to label me as having agent orange effects. My private doctor put in a request for three years ago and they did not give it to me. Host email me and let me know. We thing we got to do have to go to the department of defense and get the proof that agent orange was used at your facility. Once we have that, we are able to help. The department of defense holds the information on where agent orange was used and not used. Host mark in chico, california. Caller good morning. They used to pay veterans to go and when you got you saw itafter doctor and everything, and now, they changed it to where you get paid the following month in a a lot of people cant or dont want to ride a bus. Its really hard on the individual to come up with that money to go down there. I dont know why they changed it. Thatr as opiates, i agree they were overprescribing them at one time. s been on opiates for 20 years, you dont drop 40 milligrams all at one time. It took me 68 months just to get over that di. They still want to get me completely out of opiates. Im a 63yearold disabled veteran. I dont think thats reasonable. Guest thank you. On transportation, transportation is a big issue for our veterans. Work withrd, we disabled American Veterans to provide transportation. We are working on finding ways to make sure people have available transportation to get to their facilities. , if you arees unhappy with the care you are getting from your provider, please raise the issue within your facility. They will take a look at it and get another providers point of view. If youve been on an opiate for a long time, finding a clinically appropriate way to get you off of it is terribly important. Host milwaukee, wisconsin. This is paul. He works for the v. A. System. Caller i have assignment, i will do 34 rooms, sterilizing them and whatnot. We have a lot of guys that callin and dont come to work. I end up doing not only my job, but someone elses job. The nurses look at us like we are the underbelly. They will play with their computers admit to constantly clean up behind them. A lot of times come im pulled , theto do isolation isolator room, a veteran who has , we have to suit up and clean that up. When are they going to get more employees to get people to come to work consistently so i dont have to do some of the elses job . Guest thank you for your service to veterans are the v. A. I think housekeepers are our heroes. The ones who prevent Infectious Disease from being transmitted through our hospitals. Has one of the best records in the country for the lack of Infectious Disease going for a hospital. Make sureekeepers things like ebola and hiv and all these Infectious Diseases dont transfer. It sounds to me like we have a personnel problem and discipline problem in pauls area and i will look into that when i get back. From a letter was sent out the House Veterans Affairs committee. Jeff miller said guest since ive been secretary , weve terminated 3755 people. Individual, a an a gusto, employee in georgia who is currently facing that already been found guilty, currently facing ive years in jail five years in jail for manipulative records. When you are trying to change a culture, you have to hold people accountable. Everyone reach rain and recertify on the mission and values of the organization. We do that every year now. I was criticized by some members for spending money on training. You cannot transform an organization unless you train them. We spent time on a program called leader developing leader. You have to train people if you expect a new culture. That your reasoning for not having a new board to look over the v. A. . With that undercut your job . Guest i think it would. The way the board was recommended by the commission, the Justice Department is suggesting it would be unconstitutional because you the someone in the way of three branches of government. I dont think we need more oversight. We need everybody to do their job. Ive been the ceo of a large corporation. One of the most admired companies in the country. I think we are making the transformation happen now. I need multiple pieces of legislation passed by congress. I need a budget. Its almost october 1 and i dont have a budget yet. Congress has a big role in accountability as well. Holding themselves accountable to get the bills passed to allow us to transform the organization. Of that hearing that takes place today at 10 15 deals with the possible issue of what issubpoenas the interest of the committee in these possible subpoenas . Guest many of these things have happened before i became secretary. Weve done investigations on all of them. There was no centralized policy on the purchase of artwork. When we discovered palo alto had gone further than we wanted in the purchase of artwork it depends on what number you use. E put in place a policy to stop it. We provided the information to the committee that they asked for what was the cost of the artwork. They were not happy with the answer we provided because the number was lower than the number they had noted publicly. Publiclyr they quoted was a budget line i that included furniture and many other items as well. We are clarifying that with them. We put in place a policy that limits the amount of money spent on artwork. Art therapy is one of the ways you deal with posttraumatic stress. Is a part of art hospitals all over the country. Asividuals will make masks part of their therapy to be able to deal with the experiences they had in the past. Up enough or potential subpoena is on the building of the denver hospital. As asia and mistakes in building theycal complex made mistakes in building the medical complex. ,s soon as the design was baked there was going to be a problem. Weve done an investigation as to who created those mistakes, making sure we discipline those who made those mistakes. They chose to leave Government Service before the discipline became active. Investigation the what we have not done is turned over the verbatims of all the interviews. Nor have we published them publicly. I need to hold people accountable. I need to have the ability to do an investigation. If i start earning over two congressional committees all the verbatim transcripts of every interview, that will chill my ability to do investigation. Often times these issues are used for political reasons. Would chill our ability to do these kinds of investigations. Host did you ever have a conversation with the chairman about not testifying at this hearing . Guest i have not. And i have each other cell phone numbers. I call him and he calls me. I went to the house and senate many months ago and said rather than holding a hearing on what occurred two years ago, three , letsr four years ago hold a hearing on the future. Lets talk about the my v. A. Transformation. About how weo you provide sameday access to care for veterans by the end of december. I will tell you about how we are going to improve veteran trust in the v. A. , how we are going to if you cancel the legislation we need. Needugh legislation we from a bipartisan come i never got that hearing in the house. Hearing in thea house where we focused on the future transformation of the v. A. , i have not been invited. Lets hear from georgia caller thank you for the work you are doing. Great job. I know it takes time, but thank you so much. Julyly for compensation in of last year. Unable to work for the last two years and they cant seem to get any information on my claim. Vso, but no information on my claim. Ive been sent out by the v. A. For the Choice Program but the information does not get to the v. A. , thebeen to a sleep clinic word does not get back to the v. A. So i can get a cpap machine. Please email me and we will look at your individual situation on the cm the exam cmp exam and the Choice Program. When the Choice Program was passed in the fall of 2014, we were required to set up a National Program to provide care to veterans in 90 days. The law was put together so quickly and it was an emergency and we understand that, but there were some things with it some problems with it. We changed the 40 mile distance. That should have doubled the number of veterans available to come into it. Weve done a lot of things to. Ry to improve it a couple of months ago, we had 200,000 authorizations via the Choice Program. It has continued to ramp up we have to get better at this handoff between v. A. And the private sector. And back to the v. A. It used to be required, the medical records to come back from the private sector provider before we would pay the bill. We have a lot of veterans going that is not a requirement any longer. This handoff becomes very important. Handoff from doctor to doctor is a very important thing. Host kitty hawk, North Carolina. Lori on our line for others. Caller im calling with a simple question. My husband was in the service during the korean war. His impression of his would only be if whatever was wrong with him was. Ombat or Service Related i cant believe that all these people using the Veterans Hospital system are combat or Service Related. A lot of them just have regular problems. What is the story on that . Guest its a little more complicated than that. Website, v. A. Gov va. Gov. The Eligibility Criteria are there. We will answer your question directly. Your husbands service in korea is a lot more complicated than that. It has to do with things like income and other things as well. Lets deal with your case offline and we will get you when your husband has earned. Host stephen in bremerton, washington. Caller good morning, mr. Secretary. Am a 100 disabled veteran. Since the ended i have several times beingppeals to the issue total and permanent. I think the v. A. Is doing a wonderful job for me. Expected, even i i going totter am get better to the point where i can go back into employment . I still struggle with issues like being around people and so on. Guest sure. Caller is compensation and pension going to be kept uptodate with the medical side of v. A. So they can make determinations total and permanent four total and permanent . I do need to improve my income. Ive applied for Social Security disability and that and disabled ause guest compensation pension exam, this is an exam that veterans it is kind of the Veterans First introduction to the v. A. It is an exam that doctor coaster with the patient to determine their degree of disability. I went around and attended some of these exams with the patients permission. We brought in some experts in something called the human centered design. What Good Customer Service Companies Used to design the lifeless for. We totally redesigned the experience. Used to design delightful experiences. Its an important part of the process of making sure we are demonstrating empathy to the veteran during that exam. And arriving at a conclusion that the veteran and the v. A. Agree on. Host this is ed in jacksonville, florida. I am a vietnam and also iraq veteran. Maybe this will help the lady from North Carolina. Has changed into a Health Care System, which was mandated by congress during the afghanistan deployment. Maybe that started clogging up the health care the system because it is now a Health Care System. Are you aware of the toxic water issues in camp lejeune that National Guard guys have been exposed to . There ttended a tea a. T. There. Guest im very familiar with that. Ive been working hard on it. One of the things ive done, ive taken a look at all these problematic issues that been around for some time. C123 crews, we been able to make a new rule, new regulation about that which. Llows those crews to get care one of the things were working on with camp lejeune, the people serving at camp lejeune are able to get medical care through the v. A. Should there be presumptive conditions . We are hoping to have some news on that within the next two weeks. Host anthony in georgia. Retired. I give kudos to you. You came into a mess and you are working through it. In light of the travel scandal where youve got employees that are transferring each other to build federal system out of money how did these people maintain positions of any influence and not be sent somewhere else . I understand it is very hard to fire a federal employee. Inflateare going to numbers and take bonuses, they dont deserve, how are they not sitting in the rubber room like the new York Teachers Association . Guest a situation we had in philadelphia, we proposed a and the merit system protection board overturned that punishment. We came back with a different punishment. The legislation ive talked allow us to take a number of employees, a large number of employees and move them into title 38, which would have the appeal process for their discipline within the v. A. We think that is an appropriate process. It has worked for those in the medical facility. Nevertheless, we will continue to hold people accountable and we will continue to suggest the punishments we think are appropriate. We have terminated 3755 people. We will do what it takes to create the culture of a highperforming organization. Specifics will you look for to make sure youve made the changes necessary . Guest ultimately, it is the vote of the veteran. More veterans are coming into the system. That is good. We have 21 million veterans in the country. 9 million use the Health Care System. We want that. We also measure better and satisfaction. Veteran satisfaction. Veteran happiness with wait times. For primary care, its about five days on average nationally. Days. Health care, 23 is theobert mcdonald veteran affairs secretary. Mr. Secretary, thank you. Our next guest will be congressman phil roe of tennessee. We will hear from him, next. Later on in the program, our weeklys light weekly s. Otlight on magazine washington journal continues after this. I will be a president for democrats, republicans and independents. We are going to win with education, we are going to win with the second amendment. We are going to win. The cspan radio app and 26pan. Org, monday, september is the first debate. Bys president ial candidates debate at Longwood University in farmville, virginia. On sunday, october 9, Washington University hosts the second president ial debate. Leading to the third and final debate between Hillary Clinton and donald trump. Live coverage of the president ial and Vice President ial debates on cspan. Watch live or anytime on demand at www. Cspan. Org. , you can. Cspan. Org watch our Public Affairs and political programming any time at your convenience. Go to our home page and click on the Video Library search bar you can type in the name of a speaker, sponsor of the bill or even events topic. Our homepage has many current programs ready for your immediate viewing such as todays washington journal. Www. Cspan. Org is a Public Service of your cable or satellite provider. Check it out at www. Cspan. Org. Washington journal continues. Host representative till rose served the state of tennessee and is a member of the veterans ares committee. We were talking about the hearing that takes place today. Why wasnt he invited to testify . Guest what we are going to do today, this is the commission on care. Report. 300 plus page the secretary was complaining about that. We want to hear from the Commission First where members the Veterans Affairs committee is the most Bipartisan Committee in the congress. It is a privilege to work on the committee because we try to do the right thing for veterans. We want to hear from the commission on health care. Anyone can give their opinions about this. Host what about the issues he brought up as far as the changes hes made concerning the v. A. . He puts the heat on you as far as providing him a full budget to help him do what yesterday. Guest lets talk about the the discretionary part has been on the statement since 2009 because of the act that was passed in 2011. The budget has almost quadrupled since 2000. Since ive been in congress i was sworn in in 2009. They went from spending 90 billion to 160 billion. Now, almost 180 billion. Money is not the problem. Its the management. We are having a little business meeting before the hearing this morning. This is a letter that chairman miller wrote to secretary mcdonald. , 2015, i requested the following information to v. A. Has not provided that this isup about the artwork at palo alto. Weve seen this scenario before with the v. A. In denver. That one really bothers me, how was attent the v. A. Managing the project in colorado. Host we talked about the role of congress in the oversight i want to get his words out there and then let you respond. We give congress 100 pieces of legislation that we need. 40 our new this year. They are simple things. Things both sides of the aisle agree on. We simply need them to pass it. We need them to pass a budget. We dont have a budget yet in the fiscal year is running out we have leases from 2015 that we need authorized. Simple laws, like an appeals backlog. We have over 500,000 appeals waiting to be adjudicated. That is way too many. It takes too long. We brought veteran service , Congressional Staff and others together to devise a new law we created a new law. It is ready to go. We had hearings in the house and senate. E simply need to get it passed the committee has put together an omnibus bill called the Veterans First act. Both sides of the aisle held a press conference to praise each other for bringing it out. We cannot get it to the floor to be voted on. Its time to not have veterans be political pawns. Its time for us to say rather rather than saying thank you for your service, lets do something that transforms the v. A. And look back on 2016 as the year that we really turned the corner for veterans. Host what about these issues hes brought to the table . Guest he has the ability to do those things now. Theres not any reason why we put resource after resource. I have a good friend of mine who died last year and im still working on his claim. His daughter had information it hade department been shut down. Its about management and accountability. You dont need another law to run the v. A. Right now. The v. A. Is a huge organization. When i came to the congress in 2009, there were 250,000 people working at the v. A. There are now 330,000. 32,000 people who are schedulers and they cannot get scheduling done. It is about management and accountability. I agree with him completely on the budget. We need to get the budget passed. We appropriate money around a isup of departments v. A. Done on a biannual basis. Host are you satisfied with his leadership of the v. A. . Guest i am. I like secretary mcdonald. Host what changes would you like to see him make . Guest when he talks about i think when he talks about accountability, no one has been fired from the aurora debacle. Planned toospital spend 600 million. You get into things and you change. That was supposed to be completed in 2013. A 2017 oral now is 2018 with over a billion dollars. I have been in the process for helping the bills. Them, your contractors, your people who lend you money, would stop. New orleans has had problems. Florida had problems. It has been so bad that we took it out of his hands. Our guest, a member of the Veterans Affairs committee, you will see him at 10 15 on cspan3 to talk about these issues. Other issues concerning the v. A. The numbers will be on the screen for those of you veterans in the eastern and central time , 8000. 8001e mountain and pacific. Our first call is from margaret in oklahoma on our line for others. You are talking. Caller i dont know if you are familiar with dr. Janet im all but she said medical doctor and a National Health doctor and she said neither side had an answer. God told her to take the amino and this is a simple it is. When you are under huge stress like our troops, it wipes out the amino acid in your brain and that is what makes your neurotransmitters work. That is what is wrong with our troops. There is something called the pain stress bearer in san antonio, texas. I have talked to veterans. Asked how he was doing and he had a problem with his hips and he said yes, and im already going to the pain stress center. It does help them. It restores their brain. The man who called in i believe it was a marine his dad said he was ready to kill himself. To his regular doctor, not the v. A. Because they had him on all these psychotropic drugs. Colorado, thein eagle summit ranches which were wonderful for our vets. Host what would you like our guest to address . Caller i would like him to check into the pain stress center. It is something your body needs. Thank you for your call. I am a physician. I served in the v. A. And the Second Infantry Division in korea a long time ago and there are some things that work for some patients and dont for others. One of the things we dont understand very well is the narrow function of the brain neural function of the brain. I will be glad to have my staff do that. Host david from houston, good morning. I am trying to find out when i first applied for disability they told me for what Service Connected . I have bad knees, bad back, i. As in the 101st airborne they said when you get a little older, you are going to feel all. Hese aches and pains so they gave me 10 on each k nee. I have injections in my shoulder, so i am trying to figure out why does it take so appeal . Have an minutes, at you 10 look through your file a few minutes, and dismiss you. You get 10 ound and on each knee. Guest thank you for serving. I could never figure out. Thank you for what you did. I do in myt district. I have a staff member a staff member assigned to take care of nothing but veterans. That is all she does. You have to go down and sign a release so we can work on your behalf. I recommend you go to your congressman you shouldnt have to do that but many times it can help. I agree with you. One of the frustrations i had, it is better when i came to washington. There were one million veterans awaiting their claims to be adjudicated. We put enormous resources into it and there should just be a presumption always lean in the veterans favor. That is what i would do. Sign a release and have your own person working on that behalf. They are incredibly good advocates. That is what i would do. Host walden, new york, frank is up next. Caller thank you for taking my call. The v. A. For quite a few years, a veteran from the vietnam era. Years, i saw a lot of incompetence in doctors. Problems, i was really burned out by the time i my time was that not productively used to take care of veterans. I was an xray tech. One doctor was constantly , andng me up for a veteran i tried to institute a test that was so simple and so easy and so whichte called a doppler we normally do for corroded arteries. Manager and she refused based on what they told her. It is just an example of andentional obstruction again, i cannot understand how these people would not want to help veterans, especially ones who are in severe pain. Did read the doppler for me and she didnt care what the conventions were. She said this will be done and. He reported it host thanks, caller. Guest it appears what he is talking about is a simple path for arterial circulation. Accountability and i appreciate you looking out for what is best for veterans. That is one of the things that we are looking at in dva system, a system to hold people accountable. One thing i did when i was in practice, the v. A. Was not an efficient system. Sometimes a doctor and a worse , the Job Descriptions were not clear. That needs to be very clearly defined about what your Job Description is. System i had to close my door in private practice. Because i just couldnt earn enough money to do it to keep it open. What you are saying, there needs to be accountability in the private sector and the Public Sector. With the system benefit from reliance on the private sector . Caller i think competition helps. One of the bills that we are going to pass is there are about seven different ways we can get the a care. They decided there was a system before where we found all these long waits. Someone call the minute ago and talked about sleep. Many dont have a sleep lab so they would use the local hospitals. They chose to use just the v. A. Choice program. The program was not ready for prime time and they didnt use the other systems. We are going to consolidate those different systems into one, so it is very clear. But a pass along how complicated they make this. The simplest thing i did in my medical practice was make somebody an appointment. Program came out your doctor said this patient needs to be seen by a specialist outside the v. A. Then they had to go to a front desk for approval. Then it got sent to washington, d. C. There was a hiccup along the way, that process started all over again. It looked like they were getting seen on time but they werent. What you heard the secretary say about five days and six days, that is not what we are hearing. Host from florida, tony. Good morning. I am back in the army, and it took me 30 years to get on medical. On, i turned these 1010 forms in because i got 600 notnth and they ended up turning a form. Anyhow, they took my disability check for five months. You need to clean house in these places where you turn forms in because they dont turn them in. They leave them on a desk in the go in the luggage. Guest what i would recommend you do is contact your local the because that is unconscionable. If you are living on that amount of money and it is taken away because of a paper snafu, and believe me if we stayed here long enough you wouldnt be the only one we would hear that from. That is what i would do. Guest . At is vso guest that are in service organization. Host are they incorporated to the commission on care . Guest yes. It is a tremendous group. I want to get you that. These are very skilled and competent people. Health care professionals, physicians, service donors. Host if you want to find the report for yourself and read it our representative, phil roe, serves on the Veterans Affairs committee. On his call is gene in jacksonville. I have been going to the va hospital in michigan for 15 years. It is the best medical care i have had in my life. Occasionso there two unannounced for urgent care and i never had to wait more than a half hour to be taken care of. All you have to do if you want to fix the v. A. Is just send them down to how ann arbor is run. It is the most efficient place ive ever seen and i am a korean war veteran. , if theys behind this want to privatize the v. A. , i think that is behind the lie. There have only been two improvements on the v. A. In ann arbor. Once when bill clinton was president and now under obama. You guys didnt take care of it. After the persian gulf war, you flatter the country with hundreds of thousands of wounded and sick soldiers and you just werent prepared for it. I dont think there is less than 1 from world war ii and i am 87 years old and i am one of the youngest korean war vets. Guest there are 154 v. A. Medical centers in the u. S. Ann arbor sounds like a great place to go, i have one a mile and a half from where i live in tennessee, i hear great things about it. What we found out is if you go to one v. A. You have been to one the a. V. A. We have seen inexcusable weights for colonoscopies. People who have waited months and months. Thinkingd g. I. Doctors they may be developing cancer. It sounds like ann arbor is a great place to go and i hear the same thing for my medical center. Number i a huge think the secretary is trying to do this but most importantly, part of that v. A. Is the leadership just like with any military unit. If you have a bad commander you have a nonfunctioning unit. I think almost a third of the medical centers around the country dont have a permanent leader right now. That needs to detail those. Our guest in kingsport tennessee, our next call is from linden tennessee. This is wayne. This is lynne. I have an uncle, my grandfather, my father, my daughter, my uncle, one of the frozen chosen from the korean passed away last june and i was taking care of him and i also have a grandson in the military. My daughter was in the military and i have a granddaughter getting ready to go in to the military. Uncle lived is my with my mother and she passed away in 14. To tennessee and gave him care in a nursing home facility. Humboldt had a 500 person waiting list. So he ended up in another home who put him in there and left him just like a mushroom. Put him in the dark, he stayed in bed, his feet never touched the floor again and he just passed away this last june and i up in aur guys that end nursing facility. Whyt you just described tennessee is called a volunteer state with your family. What a heritage. I agree with you. It is not just in the a but with chronic care for the elderly. Mother that passed in march of this year and it is a huge problem. She was 93 years old and i am sure your uncle was near that or had to be. The v. A. Problem, it is a societal problem. Homes,re some great v. A. One is just opened in clarksburg, dennis c tennessee. Quality care is a huge issue for all americans. Host sierra vista, arizona, james. Good morning. Caller good morning. Live about 72 or 74 miles from andv. A. In tucson arizona it takes me an effort to get up there but im going to tell you something. I have been in that hospital more times than i can remember and i dont know where they get their nursing staff at but i am telling you, they are the best that i have ever met. In my entire life. Conditions, irt am a vietnam era veteran, i have issues, and, cancer every time i walk in that place it is mr. What can we do for you today . I dont know where they get their staff but they show me nothing but a petite and respect. Respect. Y and have waiting lines, and three or four years sometimes to get colonoscopies done but i have never been treated with that much respect. I just had a head injury at my local hospital in the era vista sierra vista and they just got me out. So it was like, are you serious . I fell in the bathtub and got a concussion and in four hours i was out of the hospital. Guest thank you for your report. You certainly are getting the respect you have earned when you have served our nation and the military. Host from texas, linda is up next. Caller i hesitated calling anduse you are a republican a lot of you believe in privatizing the v. A. And i just dont think that is right. But i have a reason why the clinics are backed up. They have this ridiculous rule that they wont accept a civilians prescription. I need glasses and i have been trying for three weeks to get an appointment. I have to go through the primary care doctor to get referred to , to getxam clinic referred to the glasses clinic, to pick up some glasses. Have already prescription from a civilian but they wont accept that. That is one of the reasons clinics are backed up. Them out to sending specialists, they are going to have the same problem. They will have to go through all these clinics just to get a prescription filled. Guest i think your point is extremely well taken. By the way, some people may believe in privatizing the v. A. But i do not. I think we need to make the system better. I do think the v. A. Needs some competition. The needs to offer veterans a choice to go outside the v. A. And get their care. That is what the report also said. I agree with you and one of the things that ought to make this i served in the u. S. Military as a physician. Battalion,nd medical also in seoul, korea. I should be able to get credentials as a certified v. A. Dr. I want that information to be passed back and forth. That is what the commission on care suggested that we do. Andave talked about opioids how opioid addiction is a huge problem. Databank in the state of tennessee that requires information be put in by practicing civilian positions physicians. The v. A. Doesnt share that information. Agree with you, you shouldnt have to jump through those hoops. You should drop this prescription, you should be able to get this. Host one of the recommendations was establishing another independent board to oversee v. A. Operations. Is that something you agree with . Guest i agreed with 16 of the 18 things that were in there and we obviously need more study. The Congress Needs to hear from the Committee Commission and then we will bring the secretary in. Plus, there are some constitutional questions. Host such as . Guest the authority you would delegate from our requirements oversight. I think the secretary needs to report to the elected officials. That woulded if undercut his ability to oversee the place . Guest it could. We dont need another bureaucratic system. Host from delaware, this is lloyd from magnolia. Caller good morning. Was the Hospital System with the va hospital in wilmington, delaware is great. Also in dover. My problem was i had a heart attack at 6 00 in the morning. My wife called the va hospital and they told us to call 911. She called 911 and i was taken to the local hospital and after the bill was, refused to be paid by the v. A. Because i didnt get a referral from my doctor. This bill came to 72,000. They took me through a whole lot of loops. Luckily, even though i am a vietnam that, the Senior Citizen picked it up but if i was younger i would have been stuck with a 72,000 bill. Go call 911me to you should be able to get treatment if it is an emergency. Guest i 100 agree. I hear this all the time. You did exactly what you were supposed to do. You were in an extreme condition with a potentially fatal heart attack, you did exactly what you should do. You received treatment and the v. A. Should take care of that. No question. I have no argument whatsoever. Host summerville, south carolina, our line for retired vets. Duke, good morning. Caller im just going to make a brief comment and listen to your response. We appreciate you taking the time this morning to be on the air. Are you still with me . Downturn ofn the the economy here, the program was not financed. It was not a new appropriation on the program. Many veterans were left out from the age of 35 to 60. I find that to be absolutely appalling. I am a veteran from the vietnam era during the draft, at a time in which i couldnt even vote in this great democracy that we have today. Was 27. Y draft number thank you for serving during the vietnam era. I had lastthings week when i was home was a manufacturers roundtable. What we are finding is that today, everybody is having a problem. But today, veteran unemployment is lower than the civilian population. We are actively seeking veterans because of the skills that we bring. The skills that are missing in the workforce, i guarantee you, you were raised to show up on time and give a full days work and be there at 8 00 and 5 00 when the whistle blew and that apparently is not the case today. Employers are actively seeking veterans because of the skills they learn in the military. Host here is out, tampa florida. Caller thank you, mr. Rowe for your fine work. I am the gentleman that has been up there four times. I have been waiting 11 years for my case. My latest problem is the v. A. Offered to cut off my foot and i went to the hospital across the dr. Sent me there with the hyperbaric chambers using total casts which were not available at the v. A. They saved my foot but now, the v. A. Used by medicare on that and i havent worked for 11 years. They wont pay for it. All of your primary care is off three weeks ago i thought i was suffering from a heart attack and the v. A. Wouldnt pay for the ambulance to go from their primary care to the hospital, they were going to sit me down within a hundred dollar bill so i had to drive myself. Thank god it was only anxiety. There is also a concern that the i know the house of representatives have passed many bills. It is ridiculous. You can have a sit down for guns but they wont have a sit down when 22 vets are killing themselves a day. I want to thank you for your fine work. Guest and think it is you still have your foot. It is one of the things that we t to do, to allow veterans you get an option. I believe this. This is one of the problems with the american Health Care Systems. We have given the decision to insurance companies. That. Uld return veterans and their doctors should be the ones able to make those decisions. If you have a worry about the Health Care Decisions being made for you, you should have an option to go somewhere else and seek a second opinion. I practiced medicine for 31 congressore iran for before i ran for congress. You received different care and better care. The v. A. Should welcome that and one of the things i want to say is this is transitioning to Something Else. This one made me fall over. Anddepartment of defense the v. A. Have two different record systems. I have one in my practice. Those two systems couldnt talk to each other. They spent a billion dollars trying to make those systems absolutely nothing was done. Said was we are going to get an offtheshelf system out there commercially that will schedule and bill. The v. A. Has an antiquated system that they have done a lot of work on but you cant get that information if you are in one v. A. Seamlessly transitioned into another v. A. A continuity of care if i am a soldier, you should be able to click a button and information should seamlessly be at the v. A. And no loss of information. That is in the commissions report. I think they are going to have to bite the bullet and do that. It is complicated to do. Those systems need to be on the same platform, on the schedule. Now they are trying to put a new Scheduling Software back to make it easier for veterans to get a point. Appointments. But the v. A. Doesnt do a good job of paying the bills. That is because the Software Package is disjointed. Have one in hr, one in scheduling and one for health care. Bob. An oklahoman veteran, caller thank you for what you are doing. Our local v. A. In oklahoma, they are a great hospital. The people are just super nice. And again, they treat me with respect. The only problem we have is parking. There is very limited parking over there. I dont know what they can do to fix it. We need to get something done on that because they see a lot of people. A lot of veterans. Every day, it is full. People, they, the are just great and i have been using them since 1973. I have not one complaint and i have been taken well care of for my injuries and general health. I wouldnt be alive today if it wasnt for them . Host thanks. Guest one of the problems i facing as we. Is are changing from concrete buildings to more outpatient care. I hear parking everywhere i go and the local v. A. s in the parking garage, it is a huge problem everywhere. Transform. Needs to a 100 bed hospital today, when i 1977, weracticing in would keep a patient for a week. So it is completely transforming how care is given. Showing up at peak hours and clearing out by 5 00, i promise you that parking lot is empty by the end. It is a transition both in the private and Public Sector. Host what are the next steps as far as improving care . You said the secretary would be able to respond but what would you like to see happen as far as improvement of v. A. Care . Guest i think we have to get a standardized Health Record system. Two, accountability. If you have less than 10 people fired because of these problems this was egregious what happened. Sign theirme in and name to the record and it was never entered into the system. When a patient went off the electronic record, they would move somebody from this one to this, acting like there was no wait time. Nobody got less than 10 people have been fired. Nobody has been held accountable. That is unbelievable that you have done that. Have had people who have had one nurse who was drunk in the hospital and was apparently in an operating room and nothing has happened. There is one other person who was in a hospital directorship where these rates these weights occurred and she got paid 76,000. Hink, to madurais modernize this system, a veteran can get their care inside or outside and information should be shared seamlessly. The other thing we have to do this is the hardest thing is to do a view of the v. A. As a facility. Not every v. A. Needs to do everything. If you get your heart operation done at a Cleveland Clinic where they do a lot of them, we have a facility at home, you get Better Outcomes so we have to make sure that v. A. s go to the best place. To be a systemwide look at all the medical centers and facilities that we have had and i think those are the things i would look at. Host craig is from henderson, North Carolina. Good morning. Caller good morning. How are you doing . Guest doing great. Host go ahead, you are on. Caller good morning everybody. I am a veteran, back from korea tothe service from 1972 1974. Korea, sometime in the late 73, i got my left hand cut and i could no longer use my left two fingers. When i got out of the service, i disability andet they said i didnt qualify. On, years went by and my mother kept pushing me to get my disability. And i still cant use my two left fingers, it has been the same way since 1973. I spent my last year in the service at walter reed before they closed after they close valley forge. And i finally got my disability in 2008, and everybody tells me i should be able to go back and get my disability back from the time i got out. When have sent letters they told me to send them, and never got a response. Thank you, and i hope i am not the one who so you up. I was in korea when you were there. Would contact your congressman and create a case file for you and go ahead and appeal this. It sounds like it is a serviceconnected claim. The Veterans Affairs committee, he is a republican from tennessee, you will see him and the Committee Later on today at 10 15 on cspan3 as we air that hearing. Thank you for your time. Offt right before we get the air i want to give some shout outs to guys i have served with. Strauss,on dr. John thatherry, mike fischetti, was many years ago and we are great soldiers and great people and i want to thank the veterans who called in for their service. We are here as democrats and republicans to serve veterans and that is what the committee does. The program,n in our weekly spotlight on magazine segments. We are going to talk to the National Review about a reason peace taking a look at how technology is going to affect the working class. Next 45 minutes we want to continue this conversation we are having across the United States and we want to ask you, how would you rate the care that you received . Let us know for calling the lines. 488000 and 2027 488001. We will take those calls when washington journal continues. Review the list of search results and click on the program you would like to watch or refine your search with our many search tools. If youre looking for our most current programs, our homepage has many current programs ready for your immediate viewing such as todays washington journal or the events we covered that day. Cspan. Org is a Public Service of your cable or satellite provider. Washington journal continues. For our next 45 minutes, care atd you rate your the Veterans Administration . 2027488000 for the eastern and central time zones. This, as far as veterans care, we will talk about in the next 45 minutes. Uninsured is a topic of a story in the wall street journal. The number of uninsured people in the u. S. Remained at historic lows in early 2016. 8. 6 withoutd that health coverage. That translates to 28. 7 3 million people. Ae cdcs Interview Survey had Previous Survey covering the whole of 2015 that put the figure at 9. 1 or 1. 3 million more people. The data shows the law has had an impact in lowering the number of people without coverage. It says skeptics argue the results are lackluster compared with the cost of the Affordable Care act. , earl,lls on v. A. Care from las vegas, nevada, starting a soft today. How would you rate the care . I live in the las vegas area. The care i get here is perfect. Quick, if you cant an appointment, you have a Choice Program. That works out really well. The only thing that is a downside is the personnel that have sometimes they particular agendas, i would think. It is just the attitudes that they have. As far as the health care goes it is fantastic. Host when you say agendas, what do you mean . When you walk into a hospital, you like to walk into a hospital or a clinic and be treated with respect and also the people that are helping you, sometimes you go in and a person that might be dressed in a particular type of religious outfit and sometimes you know, it bothers a whole lot of vets. But i would think that the v. A. Is on the right path. I think that as time goes on, it will catch up. Host skip is next, dolly springs california. Caller thanks for taking my call. I wish i could have talked to mr. Wrote earlier but this will do. Issituation with the v. A. Very mixed. Areas, i am on the west coast. I guess im on the wrong lines. Host what would you rate is a horrible experience at the v. A. . Caller i live close to sacramento, 45 minutes away but i am actually assigned to the v. A. Center and it is 120 miles for me to go there. That is kind of weird. Anyway, they did a fairly good job. I was treated very well, especially with any kind of preventative health. Lets go to don in samson, virginia. Good morning. Caller thanks for taking my call. I am a proud veteran of the United States air force. Virginia, imond, received excellent care. Had a brain operation that took five hours and they were fantastic. ,he doctors operating on me they were actually from vcu medical hospital and they rotate from there to the v. A. And they are highly professional. Medicallycomplaints as far as the v. A. Administration goes. Only than that my complaints would be i am a nonserviceconnected veterans with ptsd and yet the military has been fighting me. They wont award me Service Connections and there should be Service Connections. That is a horse of another color. Also, one day, the director of the physical Therapy Department gave me a hard time because i was sitting down in that appointment and all i was doing was punching a hole in my bill. I couldnt believe he gave me a hard time over putting a hole in the belt. How we are asking veterans you would rate the experience you get when it comes to health care. 2027488001 for the mountain and pacific time zones. The stories in the papers deal with the collapse of itt tech. Politico follows up that story about the cost to taxpayers. This is Michael Stratford and kimberly health lang writing, with the collapse of itt tech, a forprofit education company, comes 12 days after president obamas Education Department posted new stringent regulatory restrictions on the college chain. It goes on to say that the actions against itt by the Obama Administration signals a new willingness to take on large forprofit colleges regardless of the millions it could cost. In itts case it could cost taxpayers 500 million. Federal coffers will likely be softened by the more than 94 million the Education Department had already ordered the company to set aside. Lets hear from eric from carrollton, kentucky. Surgery inad a louisville, kentucky, and the doctors were excellent surgeons. The backup care nearly killed me twice. Brittle diabetic. My blood sugar was dropping as my son happened to be there and i told the nurses that i was dropping. Latert back 10 minutes and that sugar was really getting low. The nurse went to lunch. Operation. Time, same the doctor had told me to walk ,very day to prevent pneumonia so it is all i can do. In the hallway, this big fellow grabbed a hold of my arm and yelled, what are you doing . My doctor told me to walk and he said if i catch you again, we strap you into your bed. , and i did done that tell the doctor when he came through later what happened, if he had done that i would have gotten pneumonia and died. But i shouldnt have to depend on a son to come visit and save my life after a surgery. Host teresa up next, lancaster, pennsylvania. Good morning. The recordould rate in pennsylvania as very poor. So poor that i have left the v. A. I am 100 serviceconnected since 1980. That i had several issues with the v. A. In pennsylvania. Inhouse andsolve was unable to do that so i filed a complaint with a higher up. Floodwaters broke loose for me. Treated unbelievably, so i left the v. A. And had to buy my and i found that when i went to have a colonoscopy that it just so wasens the doctor said she the next v. A. Dr. And i specifically asked her not to contact the v. A. For any information regarding me and she deliberately went behind my back and contacted the v. A. She had an attitude for the , and ithat i saw her nearly bled to death. I have lost all faith in the medical profession. I will say that for a number of at the mercy va hospital in san antonio and received excellent care. Once you speak up and become thenient whistleblower, you had better beware because they will the hospital will get you. Hear from bob, bob is in pennsylvania, clifton heights. You are next. Caller good morning. I have been a patient that the years and i would rate them a plus all the way. With thism i see problem with people having a problem with the v. A. Is the influx of new people coming in. It is not their fault. It is just that there are so many people coming in in the past four or five years with health care the way it is. It is just overwhelming. I have been a patient for 35 years and i go once a month to i am onlood checked and oxygen now and i had a stroke in 1979 in the brain operation, and i talked to the v. A. And my when 100 , i see people they go there who do nothing but complain that they want it now. You just cant do it that way. That is bob in clifton heights, pennsylvania. The line is 2027488000 for the eastern and central time zones. Two 0274 88001 for the mountain and pacific. A cash payment of 400 million to iran. This is jay solomon and carol lee reporting that the administration followed up with two more such shipments. That brings the total to 1. 3 billion. Payments, made in swiss francs, euros and other currencies settle a decadesold arms deal dispute. It coincided with irans release american prisoners used as leverage to ensure they were flown out of tehran on january 17. The revelations come as Congress Returns with republicans vowing to pursue charges. Jeffrey is up next from North Carolina. Caller yes, sir. Good morning to you. The experience i had with the very, my wifeells had Breast Cancer and she was a veteran and she went over to the v. A. And she loved the place. The folks took care of her up till she was deceased. The cancer had spread to her she had surgery two days later. That night, she said they had passed they said she had passed. She just died in the bed. My other thing was i went over because i was legally blind to get some help. I am six years in the military with the Army Reserves and i got out and they told me i do not qualify and there are a lot of us in this country that went to the reserves only because the recruiters didnt tell us everything and every veteran out there knows that. I found out later i dont even qualify for the v. A. With an honorable discharge. I would like somebody to look into that but my thing is, they are appreciative people but i ride the bus all the time. Other than that, i dont know what else to say. I just hope that the v. A. Over here gets their act together. I see people sleeping under bridges. Ok. lets hear from joseph in georgia. Hello. I am here and i had to stop working because my health ,ot bad in by dr. , our nurse they do an excellent job. They get a lot of benefits and of them know, the secretary got an email and a number. Host that is joseph in georgia. Atald trump was in an event Virginia Beach yesterday. Towas asked what he would do reform and change things at the Veterans Administration. Here is what he had to say. We came out with a 10 point plan on the website and you will see it. It has been praised by the veterans. Ba the v. A. E is the Veterans Administration and you have good doctors but people cant get in to see them because the bureaucratic workings of the Veterans Administration are in total disaster. What i have done and what i have looked at, you know all about the rate of suicide and all of the problems numbers that honestly are not even believable when you hear 22 people a day. These are numbers you wouldnt even think of believable and a lot of it is because of the fact that they cant get better. They have no service whatsoever and it has been really badly handled. We allow, when that weight is so long and so horrible, sometimes a simple thing can make a persons life wonderful, healthwise. But they cant see the doctor and we have a plan where if you wait, you are going to see a doctor, a really good doctor, you are going to get taken care of or you are going to go to a local hospital, public or private, get taken care of and your government is going to pay your bill. Host here is allen, in oregon. Go ahead. I am 100 disabled. We haveem here is excruciatingly long waits to see doctors, even to see primary care doctors. It it is 56 months. Is an extremely long wait. And for me to get to the hospital, it is 150 miles. And to get over there is a nightmare. And i refused to go over there anymore. And they do try to outsource you. The program, but even that, a lot of times it is a 69 months to get into the program to see yours. So, a lot of veterans here are there is abecause lot of veterans in Central Oregon where we dont have any other choices. We have to go to portland. Becauses unfortunate there are so many of us over here. And there is no facility for us anywhere else except portland. Host charlie is in pennsylvania. Caller good morning. How are you . That i lived to say in pittsburgh and i have gone to the va hospital in pittsburgh. The treatment they give me is beyond compare. I am a vietnam vet. Me intoter talked signing up for the v. A. Health administration and it is the best thing i ever did in my life. They treated me for a chronic liver disease. The medication was 180,000 and i paid 50. When they give you an appointment at 10 15, at 10 15, you are seen. One thing i would like to add. If you are a vietnam veteran and you served in country, it doesnt matter what your income is, the v. A. Will cover you. Host lets hear from diana in california. Good morning. Speaking from the perspective of a registered nurse who could no longer afford obamacare, i opted into the v. A. Care over two years ago and have been thoroughly delighted. I cant tell you how impressed i am with the professionalism, kindness and thoughtfulness of all the professionals who work in that facility. I would rate it better than civilian care. Host what do you think makes the difference . Caller i suspect that there is a Great Respect for the veterans that they are treating. They the sense that respect the people they care for. Of i didnt get the sense respectful care from my civilian doctors that i was seeing in the years prior. Host jennifer is up next, from ohio. Caller first of all, i want to mention that i am one of those veterans who attempted to take my life. That i needrst say to take responsibility for that. That was my choice. To do that. And i immediately got help for that. I was immediately taken into the system. I had never tried to get help for that. Try, when i did get taken into the system, i was immediately accepted. There was no wait. So, people need to realize that i think, it depends on where you are at. In the cleveland area, there was no wait for me. I also have multiple sclerosis and so i am seen at the ms clinic and the care i received is just amazing. It is just incredible. Say, i was going to going to ask if you had a sense of improvement because of your experience with the ba . Va . Caller oh my goodness. I told my doctor that i thought i had been healed. And she said well, ok. And i said no, really. [laughter] and she said i have a benign case maybe. I dont know. Ofm on a pill now instead injections, which is terrific for me and the pill i take is about 24,000 a year. Which i would never be able to afford. Host that was jennifer talking about her experience with the v. A. Heard from donald trump earlier talking about what he would do for veterans. Yesterday, the Hillary Clinton campaign released an ad that would go on to question Donald Trumps respect for military veterans. Here is the ad. I know more about isis than the generals. John mccain he is not a war hero. I like people that were not captured, ok . Donald trump compared the sacrifices of disco parents who lost their son to war to his sacrifices. I have had tremendous success. Dean inod morning to walnut creek, california. Caller good morning. I have been with the Veterans Administration since i was in 19961997. I have testified before the National Institute of health and the senate. In desert storm as a result of chemical exposure. And i haveed lesions the diagnosis of ptsd, which i am compensated for. Unfortunately, because of the diagnosis of posttraumatic , a lot of times the physical ailments are touted i attribute ,y exposure of chemical agents they are overlooked or pushed to the side. Because with the emotional , it is a frustration. To that. E is no answer they cant stop the brain lesions from growing. The ms type symptoms come and go. At a greater rate. Which, when somebody is chronically ill, they have depression. , 24yearolds old when i went to desert storm and i came back with headaches, trying to do work work was unable. Host i appreciate the call. Lets go next to leverage in wisconsin. Caller good morning. Here, ithe va hospital have been going for 15 years, and i dont know how anybody could condemn the hospital. This is the finest hospital in the world. And the people are just outstanding. They work with you and try to help you. I dont know how anybody could condemn the va hospitals. Alabama. T we go to caller good morning. Sir, i am a vietnam veteran. I went through the alabama v. A. System and va hospital. I thought that they werent getting around to doing what needed to be doing needed to be done. So i went to nashville. And now i am getting the best k im getting the best pay. I have to get surgery on my knees and they were fantastic. They have excellent doctors there. Va that id by the th for to wait until 2018 video after hearing the other the senatorking, from tennessee, he is outstanding. And our congressmen here in , i dont see them pulling anything for veterans. I dont get very much. An endorsement from a newspaper this morning from Hillary Clinton comes from the dallas morning news, the editors writing that we dont come to this decision easily. In newspaper has not nominated in moresed a democrat than 75 years and nearly 20 elections. On parties overreliance government and regulation to remedy the countrys ills is at odds with our belief in private sector innovation. Our values are more about individual liberty, free markets and a Strong National defense. We have been critical of clintons handling of certain issues in the past. Trump, hillaryld has Actual Experience in governance. We go to california. Eddie. Caller i am a veteran of the vietnam war. I came down with prostate cancer. My complaint with the the a is not on the medical side. It is the administration side. It seems like it takes them forever to get them to review your records. To see the claim that you make come down. They know it is difficult for you to prove your claims. Also, the reimbursement for travel if you provide your own transportation to get to and from the hospital or clinic, they are supposed to reimburse you to do that but it takes months or maybe even years to get reimbursed. If these the a is not taking va is not if the the going to take care of its if they went through what we went through, it may be it would be Better Health care. From mississippi, here is george. Caller hi, this is george. Host you are on, go ahead. Caller yes, i go to the the a va in mississippi. Once i went and i had pneumonia. And they took me to the emergency room. And i sat in a room with a gown on for two hours. Saw tobut and nobody come and see if i went to a different hospital. , its not so much the v. A. Is the people they hire. They dont have a clue. And most of them have credentials on the wall but they dont have the love in their heart to be working in Public Service. And i feel as though if you dont want to work and deal with person,nd be a people you need to find somewhere else to go. Because it only adds to the frustrations for those like myself, who have depression and anxiety. And things like that arent helpful. Host james is the last call for veterans who want to talk about how they would rate their v. A. Care. He is calling from colorado. Caller good morning. I just wanted to say that, first of all, im thankful that we who have medical care. Here in colorado, i dont have any problems. Ive been treated and received good care. The only problems i have is with medical centers that are being built here in denver. They are from private contractors. Host ok. Caller i dont know if you have heard about this, but there is a new hospital being built and when it first started, it was probably 400,000 or, i should say a Million Dollars and now it is a quarter of 1 billion or more. And it is just a situation where civilians are doubting the government and the taxpayer has two foot the bill. I am more frustrated about that. Colorado was the last caller on that topic. We are switching topics to talk technologympact of on the working class. Will join us. Ord the conversation continues after this. For campaign 2016, cspan continues on the road to the white house. Clinton i will be a president for democrats, republicans and independents. We are going to win. Coverage of the president ial and Vice President ial debates. Cspan mobile app, cspan radio and cspan. Org. September 26 is the first debate at hofstra university. 4, the vicer president ial debate at Longwood University in virginia. 9, Washington University in st. Louis is the second debate, leading up to the third and final debate between Hillary Clinton and donald trump. It will take place in nevada on october 19. Live coverage of the president ial and vice. Residential debates on cspan watch live or anytime ondemand at cspan. Org. Cspan. Americas Cable Television companies and brought to you as a Public Service by your satellite divider. Washington journal continues. Weekly spotlight on magazine segments continues. And joining us from new york, writing for the National Review on the topic of technology and how it impacts the working class is Andrew Stuttaford. Good morning to you. What prompted you to write about this impact . Really, it was the thought that there has been a lot of talk in recent years about what technology is meaning to the working force. But my interest is actually more about what is unexplored, what will it mean for politics. And in particular, but i was interested in is what it would mean for politics because of the way what i think it is going to happen automation is going to impact not only the traditional bluecollar jobs but also those on the upper employment scale. Host when you talk about robots, to find you mean in this case . Meaning in automation, basically the of humans by machines. Host one of the things you talk about and reference is the working class but you use the term elite and how technology will affect them. Guest it is a somewhat lazy term but if you look at jobs, it really means higher paid jobs. Lawyers, doctors, financial people those sorts of jobs. People who have traditionally seen themselves as really immune from the effects of automation been a. , or i. T. Has help and not a threat. What we are not talking about so much is the effect of automation on manufacturing jobs. Theme,o stick with your give us an example of how technology is replacing these before that had to be done by man. Guest i will give you one example in the legal profession. Which is discovery. I examine i expect you are familiar with the process. One of the things that has to happen is that if you are suing or people are suing each other, both sides have to show documents that are relevant to the lawsuit. Is thet that involves lawyers from each side looking at their own paperwork and saying well, i dont have to hand over that bit of paper because it is privileged and it was a conversation between the client and lawyer. Or because it is irrelevant. Now you have technologies which mean that the sifting process can be done by machines. Top, justawyer at the signing off and doing a double check. So what was once a has nowtensive process become essentially automated. Fact, you nown havea discovery you factories where you have lawyers sorted through papers filed for them by machines and then they come to a judgment. The point is, this is industrialization of what was once a personal process. And those lawyers working in , what sort of progression are they having . What are they learning about . Not that much. All they are doing is supervising the automated process. Host we are talking about the impact of technology on the fields of law, medicine and other fields. If you want to ask some questions about his thoughts on his story and his thinking on it, 202 7488000 for democrats. 202 7488001, republicans. 202 7488002, independent line. The companies that are replacing humans that were doing these jobs, are they based in the u. S. Or are they being offshore and, so to speak . Well, i think the basic technology is very often provided in the u. S. , we lead on that. But you ask a good question , because iforing you break down the elements of what was once the job of the man in an oak paneled room, you say, if this part of the job can be done by a machine and this part can be done by another machine or a piece of technology, there is no reason why somebody sitting in china or india could not do that work. We have very Good Communications these days. So we do have the technological , that a machine can do what a lawyer did before in the machined perhaps the can be interpreted by a lawyer undercuttingdia, the lawyer in america. A double whammy. Host one of the things you do to introduce your piece is to 2012. E example back to can you relate that to what you are talking about now . Guest absolutely. Developed a theory of what he called elite overproduction. Simply, thet very point is the same. He said that if you produce a lot of educated people and there isnt work or good work for them to do, they are quite likely to cause trouble. Now, the arab springs was an extreme cause of that, because these are operating in countries and this has occurred in countries where there was no democratic way of expressing themselves. So people had to take to the streets. But the principle is the same. You have large numbers of educated people with not a lot to do. And educated people with not a lot to do or who think they are have ating their due tendency to push back quite hard. WroteAndrew Stuttaford this piece for the National Review and is joining us to talk about this. We go to connecticut. Go ahead. Caller thank you for having me. This point, about all i can do is echo everything the guest has said. It is very true. I have seen it in manufacturing. People realize how inexpensive it is to update and it is moving into the professions like wall street. I have an attorney who talks about how much is being done on the computers. You know. Are not coming back because the machine is doing them. Whathe real question is, do we do with the people who are being displaced . That is what we need to focus on. I think that is a very good question. And i dont know whether you have read my article, but at the end of it, i say unhelpfully, well, i dont know. I have no answer to this. But i think to take a step back from that, firstly, we have all these people and what are they going to do . Many of them are welleducated. And they will not be very happy. One of the things that i think will happen is that a will attempt to reshape the political agenda in order to find themselves a role. And what i think they will do is, one way or another, there will be a pressure for redistribution. And that may take the form of introducing a universal basic income, or do we put higher onedo we tax capital , ifhe things that this does you create the machinery of redistribution, who operates the machinery . The dispossessed lawyers or accounts of the past. There is self interest there. Host from miami, florida. Mandolin, hello. There is an argument that Hillary Clinton is trying to kill jobs. I was wondering if the guest could outline the impact of , and if it is significantly changing the work within the industry. And should we look to options of creating jobs . Because a lot of jobs are going. And that is because of the availability of technology. Guest well, i cant speak much about the coal industry. There, we have the threat from environmental regulations as well. Undoubtedly, i am assuming but common sense tells me that it is the case that technology and or mislead technology enormously impacted the mining business. But if you look at the manufacturing business, it is slightly different. But again, high paid, bluecollar jobs, it has hollowed out American Manufacturing production it is growing pretty fast now but American Manufacturing employment is falling. And has been falling consistently for quite some time. The is not a function of ups and downs in the economy. And then you asked the good question so what happens to these people . And the answer is, we really dont know. If we look at where jobs are created, they are created in the service sector. But i think there is an enormous a wellnce between being unionized bluecollar worker at General Motors 30 years ago or 50 years ago, where you had a pretty secure future, and working now as a barista in starbucks. The jobs are coming on but they are not the quality that the working class needs. Host from colorado, andrew is next. Caller i love your show, thank you for having me. I want to talk real quick. My job is literally to make sure that people get the medication and my facility has recently how we figure out who needs what medicine. So our server completely went and we called tech support who said, my shift is about to end, can you make it until 8 00 a. M. . The time the server went down medicinea. M. And i had to pack. Im just commenting in that technology is good in certain it raises thebut point, what are people like me, who have no other options, supposed to do . Again, a good question. What one should understand is that technology is not going to replace all jobs. And interestingly, the pharmacy area, if i can use that in a broad sense, is an area where ofhnology is making a lot interest. But you will see humans there. Initiallyies will not not put enough humans there to provide the backup that you need. But at the and of the day, if the machines are doing most of the work and the humans are sitting there for the times when human,s a glitch, that who perhaps 20 years ago had a well paying job, because he was dispensing and he knew what he had to dispense now, what he , he is like a maytag repair man. Waiting for something to go wrong. And he wont be paid so well. Host robert up next from indianapolis. Caller yes, i would like to comment on how i think the ,oters are being misled particularly by the republican nominee, that these jobs, the manufacturing jobs are somehow coming back when those jobs arent coming back. Because our workers are not being trained for those jobs. And the biggest reason why they are overseas, in china they are being trained to do those manufacturing jobs. We dont have the training here and we are not getting the training to do those jobs. And people are being misled. By saying, we will bring these jobs back, they will come back but that is just not going to happen. The workforce is not being trained for those jobs in manufacturing. It used to be it took a thousand people in a plant but now they can get it done with 100 people. And those jobs just arent coming back. Host thank you. Guest you have touched on various issues. The st one is that when people look at what has happened to manufacturing jobs colbert, iftry, the you like, for who is to blame is globalization. That is certainly something that donald trump talks about. That, as youty is highlight, that the factories actually can come back and are coming back but the problem is that you dont need many people to operate them. And there is a phenomenon known as reshoring. And it is imagining that factories will come back from china and employ 20,000 people but that is simply not going to happen. What people will do is bring ,heir factories back from china like you have seen with the Sporting Goods manufacturer thats, they have just done factories can respond quickly to the consumer and they are operated by very few people. You also asked about training. Receives a great answer halfwe have given for the a century you can train people as much as you want but if there is no job for them to go to, then they are better trained unemployed. Host Andrew Stuttaford talking. Out his story, robot envy at one time we were a farming industry and we have moved, doesnt that to just that we eventually adapt to changes . Guest thats true. That is what it suggests. The magic word is eventually. And two things need to be said about this. One is, if you look at farming, it is true that the defenders of people who used to work on a farm have found jobs in the great industrial nation during the 20th century. Well ands didnt do so the awkward fact is that now we before, weng replaced brawn and now, we are essentially replacing brain. We are the horses of tomorrow. If you look at my home company my home country, britain. You saw the beginning of the industrial revolution, and we all know in the end that it worked out pretty well. But again, even truly. There was a time which economists and historians e pause, in the po which wages actually fell. And during that time, there was an increasing total disorder and a fellow went on to write the communist manifesto. Or coright the communist manifesto. The point of my argument is that yes, history suggests that in end, this will resolve itself. Host we go to maryland, go ahead. Caller i work in the food truck industry. And i food truck manager make 16 an hour and there are over 400 trucks. I dont how a robot can do my job and drive so i am safe for a few more years. But i hear from my colleagues is itndividual really necessary for me to go back to school . If i plan on starting mail business or running my own food truck, i could do quite well for myself. You for my call. I appreciate being on. Guest that is a good question. The pollen statistic is that if jobsook at jobs to be the that are out there and the jobs that are being taken up, there are now basically more graduates doing jobs for which they are overqualified. There are not enough jobs out level thateople of a require a degree. So given the amount of debt that people go into that people have to pay for their degree, it does raise that awkward question. Now it does vary from degree to degree, but we go back to this educationhe idea that was massively the answer is not as straightforward as it used to be. And with the truck, i would say you are in the safest area. Driving around the city but what will happen to the trucking sector . Driverlessted or trucking happens . Again, there is a great area of bluecollar or selfemployment and we may see in 25 years that it will go. Host we go to florida with kathleen. Caller thank you for taking my call. I have a big student debt. School for to medical drafting and i graduated in 2012 and i havent been able to find a job because it is outsourced to india. My question is, with this technology, does that move us closer to a socialist country . Because if there is no job for us to do, how are we supposed to make a living . Thank you. Guest indeed. And this is what is driving the question of a universal, a sick income. Basic income. Youhear it on the left, as may expect, but also from people on the right. Someone, and you have a lot of people, who have done all of the right things, not educated, but there is a massive change in the nature of the employment going on. There simply are not jobs to go around. So what do you do . And the argument i think one has to think about this. Maybe the most straightforward to give people a universal basic income. Basically what the welfare system has to offer. But if you do that, you then create a mechanism for a very powerful thing indeed. Because somebody has to decide what exactly that income is and somebody has to decide who will pay for it. And that puts immense power into those hands. Our guest is Andrew Stuttaford, and editor for the National Review. That ise, robot envy our gues what were talking about. Fred, from illinois, good morning. Caller thank you for what you do. I would like to approach this from a different angle. Much of the social injustice of worker beingrom a forced to give paycheck to the greater good, infrastructure, schools for children. And as to the architecture we could develop in the future with we wouldical process, pay taxes, somehow to contribute to a general welfare . That is my comment. Enough, that has been suggested. I have not studied this in great detail. If you google this, im sure you can find it. In the european parliament, of all places, that there should be some sort of tax on robots, which in essence would be part of the tax on the wealth that they generate. The question of the where the money comes from for the bridges and the tunnels, i guess one of the arguments is that we move to a star trek economy. And the immense productivity that these machines could generate would ensure that everything gets built. The question is, how do you pay for it . And how do you pay for the people who are no longer having a job to do . Would education or Computer Science technology be good for people entering the workforce . Considering if technology will be replacing all these things . Guest you would think it. Outhe new york fed came with an interesting report in 2012, and what they found was that the demand of people with it peakeds of skills, at the end of the 1990s, when companies were scrambling to. Djust to the new world since then, there has been a fall in demand for people with these sorts of skills. The fact of the matter is that the i. T. Guy you needed sitting in the office to help with your computer problems is now in the cloud, somewhere. And one Software Program in the cloud is made up of large numbers of machines. Before, that they would have been made up of individuals. Nevertheless, if i was going to guess where the job of the future is going to be, it will be those that can work well and creatively with machines. The question is, how many jobs of those kind will there be . Host two florida, tom, good morning. Caller thank you for cspan. ,f we have a universal income the comment i have is about the low income people our country no cost ofm living allowance. That could be helping. And they wanted to change Social Security which means that if you thenating lean hamburger the president maybe wants you to eat hamburger out of Something Else due to the cost of living allowance and the next year, hotdogs. Basically, he doesnt want to give us a cost of living allowance at all. And then minimum wage has , buted up to 15 an hour with a 2 increase in Social Security, the buying power will not be anything at all. Another not sure how that can support the democratic party. Host thank you. Back to the idea of the universal basic income. I dont necessarily endorse it but it needs more of a look then it has had. Nish are doing a small experiment about it. A basic of life and allowance, how much is it . Does it take into account the inflation . There is a low headline figure of inflation at 1 or 2 but then we look at the medical bills and see what they look like. So the power to determine what the basic income will be will be an important power indeed. In theory, this is meant to replace the current Welfare Benefits that people get. That dont know quite how relates to Social Security. But the idea is that it would universalize it. Tomeans it would be meant culminate all. But that would be an enormous centralization of power. And it would be for an increasingly large prop percent large percent of the population. To talk to Andrew Stuttaford, marian. Caller good morning. Had a taste of this already, twice in my life. , we worked florida 61 individuals per shift. Then technology came in and it pushed it down to eight people. That was in 1990. My first paycheck ever was 1982. So technology came out and replaced guys in my department. The came out with diagnostic, handheld mechanisms. It tells you where the area of default is and it helps. It eliminated going through blueprints. Is, what will a person be doing . Because that is what i see. That is where we are headed. If the robots will be taxed, to take care of us all . Guest i think what will happen and remember, we should be careful and i should say this that we dont know that all of this is going to happen. And it may take far longer to happen to the extent that i fear. But you have seen in your own experience how this works. You have had a taste of that with the introduction of container shipping and those jobs never came back. As for the tax, maybe you get the tax on the robots but when i think you will get is higher taxes on capital. He will get higher Capital Gains taxes. You may get wells taxes. Because for a large percentage of the population, if they have nothing to do, they will seek and it will go to those possessing capital. Host you have talked a little bit about a revolt among the elite, what does that look like in your mind . Guest well, what you are already seeing is that we have talked a lot in this election season about inequality. And it is interesting to note at the toplity is end and the bottom end. , ithe upper middleclass dont shed many tears for them, but they are lagging behind the rich. Lagging behind the super rich. There are a lot of increasingly irritating people. And i think what they will do is that these are guys and people who are used to having their way. And they will try to rework the system so that it benefits them. Think, you can see traces of it here and there already in the calls for higher taxation. I would argue that it is in the occupy movement where you had a fairly educated group of people, 1020 yearsing in time, and say, what am i going to be doing . I want to be part of the 1 or the 5 . And this is where i think the political extremes will come out of this process. Host we go to stare at in washington state. Good morning. On the issue of technology, i retired in technology some time ago. Since then, i have been busier than i ever was while i was working. I am in the northwest. And i have been able to decipher a number of things going on in politics simply from my experience in technology. Aen i began i was taught matter of programming codes and i went on during the years and learned it and used it and continue to grow in my career. With several employers. Three. I was sent out to the Pacific Northwest by a growing company and i am grateful to them anduse i continued to learn i have always loved puzzles. Card will help us repair and rebuild and build a that this the bridges country has been needing for a very long time. Mr. Trump has the answers. I am going to volunteer, if i have to. Guest well, lets see. To i would say that you went the right place in the Pacific Northwest. And the people who are able to enjoy the public aspect of it are the people who are putting together the pieces of the puzzle. You obviously have a good grasp of working with computers and that is where the jobs will be. Host is the impact that you are seeing on the other fields affecting Technology Companies like google and apple . Guest oh, yes. I go back to my point about revolutions leading themselves. Google is obviously an extremely good place to work. About 50,000res people worldwide. Which is roughly the same as General Motors used to hire, used to employ, around the michigan area at the peak, to put that in perspective. Team, ife in a winning you like, a google or apple, im sure that their rate of Business Growth will find room for everyone who is a board that particular ship. But a lot of i. T. Companies, it is not necessarily the case. They will apply technology to their own processes and even those who are tech savvy may find that their jobs are being automated. Host we have paul from indianapolis. Caller good morning. Two quick points. Id used to be an auditor for the department of defense. One of the things we did was look at the computer systems. A lot of them are 5060 years old. They dont run very well. A lot of major systems and corporations, including those ones on robots, i think we will employ a lot of people repairing old computer systems. We are going to need a lot of programmers. Think you have to take a look at the work done by a fellow named lauren computers are extremely limited by their binary thinking. And the Opening Statement of a paper written was that to design a computer that could read jane and describe it to the known universe. That was 20 years ago at computers have got more powerful but i think you get the idea. Computers are extremely limited in what they can do. And even small manufacturing jobs cannot be done by a computer. Because it takes more skill than what a computer can bring to it. Guest yes. We should note that computers are already composing music. Im not sure that i would be a big fan but i have listened to it and you can find it online. A computer already writes news stories. Welding, welding a bentley is a way off but it is on they remarkable now thought of manufacturing and assembling and handling cars, that robots can do that. And on the question of complexity, and going back to i would say what is to keep an eye on artificial intelligence. I think that is developing exponentially. On repairing computers, yes, that will be tough. There is machinery out there that will go as the years go by but machines mending machines is already a thing and we will see a lot more of it. , on twitter,sh up the question is as a machine becomes more complex, does it become like the terminator . Guest [laughter] with a bit of luck, we get to be like the jetsons. Not that i think skynet is going to strike, i dont think we have to go through too much chaos before we get there. Host Andrew Stuttaford, he can be found in the pages of the National Review. I do now, we take you to the house of representatives. The chair lays before the house a communication from the speaker. The clerk the speakers rooms. Washington, d. C. , september 7, 2016. I hereby appoint the honorable david g. Valadao to act as speaker pro tempore on this day. Signed, paul d. Ryan, speaker of the house of representatives. The speaker pro tempore pursuant to the order of the house of january 5,