commitment to finding out what works and ask congress for its implementation? >> i want to make sure everybody understands the question here. a lot of doctors have argued, and in some cases they are justified, that their costs for medical malpractice insurance, the threat of a lawsuit if something goes wrong with a patient even if it is not their fault, is so high that not only is it increasing their out of pocket costs, but they are also engaging this what is called defensive medicine. that they have to order five tests when one is enough just to make sure they are covered so that if something goes wrong that is not their fault later, they can say look, i did everything possible even if a lot of that isn't required. so the argument is if you cap the pain and suffering or the liability that is awarded as a consequence you being hurt, in the hospital or by a doctor, that that would drive down everybody's costs. . . >> i want to make sure people's pain, suffering, out of pocket expenses -- those are covered. i do want to work with doctors to find ways we can reduce their liabilities when they haven't done anything wrong, where they have performed effectively. i want to see if there are ways that we can reduce the constant threat of lawsuits that doctors and hospitals experience because i think that causes defensive medicine. i want to see ways that we can reduce some of these litigation costs and malpractice rates. one point that i have to dispute. he says he is from texas and that we have caps in texas so we have seen what works. the fact is, there was an article about a town in texas where they had the highest health care costs in the country down by the border. even though they have caps there, they spend about three times as much per person -- they spend about 30% more per person than they do in el paso, texas, which is also operating under caps. the problem of rising costs does not simply have to do with whether or not liabilities are capped, but it really has to do with the incentives that are operating in various communities. there are some places like the mayo clinic that provides outstanding care, some of the best in the world. it turns out, they provide care much more cheaply than a lot of other health systems even though it is better care and part of the reason is they do some things that are common sense but unfortunately we do not do in the health-care system. instead of you going to your primary physician and that referring you to a specialist and then maybe you go to a third specialist, go to the hospital, they recast you, what they do at mayo clinic, when you meet with your primary physician, he calls in all of the specialists at the same time. they evaluate you, do all of the tests there, so you do not duplicate a bunch of stuff. that coordinated care drive down costs tremendously. that is the kind of common-sense approaches that we are going to have to take. one of the things that we have to do is incentivize those smart practices, coordinating care, as opposed to what we do right now -- pay you for the more services you provide, which gives doctors and hospitals a pretty strong incentive to test you five times rather than one time. right now, we are preventing them from coordinating in a smart fashion because of the ways we reimburse. >> how about one more question from our wonderful audience? >> i think it is a girl's turn, isn't it? i think so. this young lady right here. >> hi, mr. president. i am down here in fairfax county working on a change that works. what can i do as a member of the union to help you with your referral -- with your reform bill? >> i appreciate the question. the most important thing i think the american people can do right now is to just be informed. tell your friends, tell your neighbors to get informed about what is happening in the health- care system right now. it is very complicated and i don't expect everybody to be an expert. but i want everybody to be well enough informed that the scare tactics of those who would oppose reform do not work. when you hear of somebody saying, obama is proposing a government takeover of health care. that is an old argument that has been used for years. i just want to be clear. if you have got a health care plan that you get through your employer or some other private plan, i want you to keep it. i actually think reforming the system is the most likely way for you to keep the health care that you got. i don't want to take it over. i think it is great that you can keep the care that you have. all i have said is that i want to make sure that those things that taxpayers are paying for, that we are getting our money's worth. i don't want to provide $177 billion in subsidies to insurance companies. i don't want to reimburse for five tests that the evidence shows that you get in one test will be better for you because that means the taxpayers are saving money and i can use that to help lower your costs or help somebody that does not have health care at all. i do think we should have plan to compete with the private plans. these private insurance companies are always telling me what a great deal they give to the american consumer. if it is such a great deal, why are they worried about competing against the public plan? [applause] they will tell you that we are trying to take over health care. i don't want to take over health care. they tell you that we will try to rationed the system. we don't want to get between you and your doctor. what we do believe is that if there is good evidence out there that shows that the best way to treat your illness is to give you the blue bell, and instead right now you are getting prescribed the red pill costs twice as much, i think you and your doctor, having that information, are probably going to decide to go with the cheaper pill that will do a better job and save you money. that is being sensible. whenever you start hearing these arguments about socialized medicine, government takeover, rationing, canada-style health care, what i need you to do and everybody that is watching to do is actually pay attention to the argument. don't let people scare you out of reforming a system that we know is not working. america -- one of the great things about this country, we have a system that is sometimes hard to change. congress gets kind of bogged down and part of that is because the way the constitution is designed. it has served us well because it keeps us very stable. we don't have cous and all kinds of government collapsing all the time. the disadvantage is is that sometimes it is hard for us to make big, bold steps, but the great thing about the system is that every once in a while when we finally hit a point where things just aren't working at all, we are able to generate the political will to finally get things done. that is how we got social security. after the great depression, nobody had any protection and people started realizing we can't have a country where suddenly older americans are just on the streets. after working hard all their lives, and finally, we got social security. then people said we can't have older americans that do not have health care, and then we got medicare. this is one of those times, so don't be scared about the future. let's embrace the future. let's go after the future. if we do, i am confident we can create a health care system that gives you a choice, allows you to keep your doctor, drives down costs, and make sure every american does not have to worry if they lose or change their jobs. that is our aim, that is our goal. thank you, everybody. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> you can watch this town hall meeting with president obama again later tonight. up next, republican governor on indiana and wisconsin congressman paul ryan debate the future of the gop. >> and number of state governments face budget shortfalls. tomorrow morning, we will talk with jon shure about the impact the economy is having on state budgets. we will also talk with mort zuckerman and martha raddatz of abc news. after that, an update on the automobile industry with edward montgomery. later, a federal communications commission meeting on access to high-speed internet. the sec will also examine the recent transition to an all digital broadcast tv signal. live coverage begins at 11:30 a.m. eastern. >> this holiday weekend, discover and unfamiliar side of our nation's first president as we are live from george washington's mount vernon estate with an historian and author. join our three-hour conversation, sunday on "in depth." >> now, a discussion on the future of conservatism and the republican party. we'll hear from the indiana governor, ranking member paul ryan, and rich lowery of the national review. >> good morning. i am the director of the bradley center of the hudson institute here in washington. we welcome you to the fifth annual bradley symposium. a special welcome to our nationwide c-span audience. the bradley center is a proud grantee in milwaukee. we are grad -- we are glad to have with us today board members, spouses, and staff. my particular things this morning to the bread the vice- president dan schmidt for his critical assistance and advising in directing this symposium. a very young republican hill staffer named paul ryan stopped by the lion house to find out more about our civic renewal efforts in milwaukee and to announce he was going to run for the united states house of representatives in the first congressional district down lake michigan shoreline from milwaukee. that was a noble but hopeless dream of course because the notoriously volatile first district had just fallen into democratic hands and looked tuesday that way for the foreseeable future. congressmen ryan is serving his sixth term from the first district and has emerged as a major national spokesman for market-oriented alternatives to the administration costs government focus proposals. he must be on his way shortly to a meeting of the house budget committee where he is the ranking minority member. before we introduce the rest of our program, we are pleased to welcome congressman paul ryan. [applause] >> thank you, bill. i believe i am the first elected official to be invited to give the opening symposium address. i want you to note your bailout check is in the mail. i am honored to be on the platform today. governor daniels, rich lowery, good friends, it is an honor to be with you today. it is an honor to be a part of this event here today. i want to just note an article in the wall street journal recently. my address this morning in elaborates on some of these ideas. actually, the ideas of many friends in this room contributed to these remarks so you are all to blame. i am not going to spend my time picking over the ashes of the recent elections. republicans lost. conservatives and republicans are not exact -- are not exact equivalence. this is not to say americans have become liberals. more hurdles in on a per norse ship and appliance division of risktakers with a wall of -- hurdles in of entrepreneurship and division of risktakers. president bush himself admitted that when the meltdown began, he departed from capitalism in order to save it. let's just leave it at that for now. americans establish world standing as a people of exceptional character. in the 1830's, [unintelligible] america put heroism in a manner of doing commerce. the french observer said that americans succeeded because of their character, personal energy, energy in action, creative energy. the greatness of the united states, ready for and the kind of enterprise. consider the five sullivan brothers who volunteered to serve our country in the navy and died together on the juneau torpedoed in 1922 with the hundreds of first responders that saved strangers that they did not know and then died when the world trade center's fell on september 11 or the millions of young and all that have offered their sweat, time, and money to the victims of hurricane katrina about four years ago. during a labor union dinner, the nobel laureate assessed the american character this way. the united states has held europe to win the first and second world wars, twice raised europe from postwar destruction for 10, 20, 30 years it has dole -- it has stood as a shield protecting europe. to avoid paying for armaments, thinking how to leave nato, knowing that in any case, america would protect them. the united states has long shown themselves as being the most generous country in the world. wherever there is a flood, an earthquake, a natural disaster, an epidemic, who is the first to help prove the united states. -- the first to help? the united states. what does it mean to be people of character? people that uphold changes of standards in good and practice great or virtues from household, to the economy, to culture, and the political order. conservatism defends the standards and qualities which the fine people of character. the original source of these standards is the western tradition of this civilization, rooted in reason and faith stretching back thousands of years. the tradition as a whole confirms the high dignity, the rights of the individual person. one of the glories of western civilization was to break out of the mythological past which saw only groups and classes rank and organized by collective governments. before the western tradition began, the individual person as a subject of rights was simply unknown. nowhere was the western tradition epitomized more memorably but in our declaration of independence. all of human beings are created equal. not in height or skills or knowledge or color or other non essentials, but equal in certain unalienable rights, to live, to be free, and to fulfill the best individual potential, including the right to materials. each individual is unique and possesses rights and dignities. there are no group or collective rights in the declaration. nor does basic human equality employ equal result. it means equal opportunity. every person has a right not to be prevented from pursuing happiness, from developing his or her potential. the results should differ from one another. that is what fairness is. the great conservative purpose of government is to secure these natural rights under a popular consent. protecting every person's life, liberty, and pursuit of happiness should be the great and only mission of legitimate government. whenever republicans lose an election, a fraction of dispute arises about economic issues versus moral or social issues. they blame each other, each climbing the republicans would do better. i remember this fight in the 1990's. we all try to keep it altogether. since november 2008, this fight and this argument has been rejoined. why anyone would think that a minority party can grow into a majority by splitting itself in half is a political and mathematical mystery to me. after gerald ford lost the white house, ronald reagan refused to read either group out of the republican party. he wanted 1980 by uniting both groups by a coalition that held into the presidency of george w. bush. ronald reagan fought with the mind of the founding fathers. the founders believed that to a door, freedom and self- government demanded people of all outstanding character. president washington said, "the foundations of our national policy will be laid in the principles of private morality. there is no truth more thoroughly established then that there exist in the economy in course of major in the union between virtue and happiness. the smiles of heaven can never be expected on a nation that disregards the rules of order which have been itself has ordained." vice president john adams replied, "if individuals be not influenced by moral principles, it is in vain to look for public virtue. state constitutions in trying public laws as well." no free government or the blessings of liberty can be preserved by any people by a firm adherence to justice, moderation, temperance, frugality and virtue and by frequent reference to recurrence fundamental principles. the american character was not a private matter. it was a central problem to the common good and it had to be cared for by those that represented the people. how we should do this is the problem. capitalism is a crucial part of the answer. the year 7076 would not only the declaration of independence but it was also the year adam smith's treaty on the nation's came available. smith expand that what he called the system of national liberty or capitalism would vastly increase national wealth. the framers of our constitution knew smith not only as an economic thinker but as a moral philosopher. they were justice-committed to freedom as there were two american moral greatness. hamilton road, "the prosperity of commerce received by all enlightened statesmen to be the most useful in the most productive source of national wealth and has accordingly become a primary object of their political careers." the authors of the constitution surrounded economic freedom with a multitude of guarantees. freedom of contract against government interference. private property rights. standard weights, measures, and monetary values. punishment of counterfeits. enforcement of agreements in law court, uniform bankruptcy laws, and various other protections. they produced resources for strong military defenses and to keep america free of dependency on other nations. they also expected commercial like to encourage certain moral qualities. say, create businesses, hire employees, pay off debts, kern and rewards, moderate appetites, self discipline, industriousness, timeliness, plus trust and confidence in other persons. the hope to succeed, grow wealthier, and leave a better life for your children is a very powerful incentive to work for and a free and open economy is a stimulus for that incentive. to transform that hope into reality, the habits that help make success possible must be practiced and honored. a free market will fail if people lack basic moral character. at some level, people notice. in the current financial crisis, we hear complaints about widespread greed, dishonesty, fraud, and cheating. whether the charges are true or not, they show americans see that peril in prosperity and equality. please don suppose that i or the founders advocate that the federal government should make men and moral. washington cannot do this even if it wanted to. the authentic source of moral education is mediating institutions of a free society. thriving mediating institutions that create the moral predispositions for economic markets and choice. a conservative should insist on a free-market economy to supply needs for families, schools, and churches. in a nutshell, the notion of separating the social from economic issues is a false choice because they stem from the same route. since america's first principles established a high but limited mission of securing national rights of all persons, conservatives should expect government to fulfil that entire mission by enforcing every human beings natural right to life. the first clause of the social compact that formed america -- the declaration of independence. it will also to seek legal status of marriage. the traditional marriage should be protected for developing the moral qualities of a free people. it a credible conservatism will resist the purging of faith from the public square and make public space for the practice of faith because believe is a central pillar of a free and prosperous society. nor can government welfare programs substitute for the faith-based law that unites citizens. a credible conservatism will also be attended to the education of future generations of across a spectrum of our nation's schools and higher institutions of learning. the success of self government requires citizens having knowledge of truth and the prosperity of our economy depends on the advances of unbiased research and college libraries and university labs. a credible conservatism will recognize that the very culture of capitalism today is under assault. we must fight the new capitalism not because it won't work but because it destroys the moral foundation of human achievement. our nation's interest and perhaps our survival is at risk. a credible conservatism will offer a viable alternative to each of these economic issues.

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